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Laboratory services face cuts of up to 15% in Medicare payments for approximately 775 tests under the proposed 2027 fee schedule. Quest Diagnostics and Labcorp are pushing for passage of the RESULTS Act to change how pricing data are collected, while analysts believe Congress will postpone the cuts again.
The Centers for Medicare and Medicaid Services is expanding the ACCESS program to include heart failure, chronic obstructive pulmonary disease, substance use disorders, and smoking cessation, while extending support for certain musculoskeletal conditions. The program combines outcome-linked payments with a regulatory pathway for collecting real-world data on certain digital health technologies.
A report by the Office of Inspector General concluded that Medicare Advantage plans do not sufficiently vet medical equipment suppliers, particularly out-of-network suppliers and those not enrolled in Medicare. The report called on plans and CMS to strengthen screening and use fraud-prevention tools regularly.
The Centers for Medicare and Medicaid Services approved coverage for transcatheter aortic valve replacement for patients with severe aortic stenosis even without symptoms. Analysts expect Edwards Lifesciences to benefit particularly, while evidence continues to be collected on this patient group.