medicare
Every record this desk has filed under medicare, newest first, each with the number of sources it can still show you.
CMS organ procurement rule revises service-area competition and quality requirements while keeping performance tiers
A CMS final rule scheduled for November 3 revises how organ procurement organizations can serve and compete for donation service areas and how they handle appeals and quality problems. CMS says the donor and transplant outcome measures and three-tier accountability structure stay in place. The rule's 60-days-after-publication effective date is bracketed in the public-inspection copy, so no fixed effective date has yet been printed there.
Also filed undercmsorgan-donationtransplantationfederal-register
TelevisitMD owner receives 20-year sentence; DOJ reports $46.2 million in fraudulent Medicare claims
Christopher Harwood, who owned the telemedicine company TelevisitMD, was sentenced October 23 to 20 years in prison after pleading guilty in March to a health care fraud and wire fraud conspiracy, according to the Justice Department. DOJ says he caused $46.2 million in fraudulent Medicare claims, of which Medicare paid $17.9 million. The court ordered restitution and forfeiture; the announcement does not establish amounts already recovered.
Also filed underhealth-care-fraudtelemedicinesentencingrestitution
CMS proposes a Medicare rule that would eliminate some generic-drug copays, require Medicare Advantage provider-directory accuracy, and limit PBM pay, starting in 2028
The Centers for Medicare & Medicaid Services has proposed a rule, scheduled to be published in the Federal Register on October 20, 2026, to carry out three sections of the Consolidated Appropriations Act, 2026. It would zero out the generic-drug copay for about 6 million low-income enrollees, make Medicare Advantage plans verify their provider directories and charge only the lower cost sharing when an enrollee relied on a wrong listing, and limit pharmacy benefit manager pay to flat service fees, mostly from 2028. Comments are due at 5 p.m. Eastern Standard Time on December 15, 2026.
Also filed undermedicare-advantageprescription-drugspharmacy-benefit-managersfederal-register
Medicare's annual open enrollment begins October 15, with plan changes due by December 7
Medicare's annual October 15–December 7 window opens today for changes to Medicare Advantage and prescription drug coverage. Medicare says coverage starts January 1 when the plan receives an enrollment request by December 7. This is a plan-choice window, with separate considerations for drug coverage and Medigap when returning to Original Medicare.
Also filed underenrollmenthealth-coverageprescription-drugsconsumer-information
AEP is here, and I finally have more time for clients
Medicare's annual enrollment period starts today. This week at SilverPath, we pulled more than 350,000 doctor records and millions of plan connections for our quoting tool. Most of my routine work is now automated. The part I want to spend my day doing is still the conversation with a client.
Also filed underaepsilverpathautomationclient-service
Medical equipment company owner sentenced to 14 years after scheme submitted over $30 million in false claims
DOJ says Oklahoma medical-equipment company owner Mark Loftis was sentenced October 8 to 14 years after a July jury conviction. The scheme submitted over $30 million in false claims to Medicare, TRICARE and CHAMPVA and received over $8 million. The court also ordered over $8 million in restitution and over $560,000 forfeited. Those amounts describe different parts of the case; claims submitted are not payments received.
Also filed underjustice-departmenthealth-care-fraudtricaremedical-equipmentsentencing
GAO reports CMS awarded $10 billion in rural health funding to all 50 states while much of the oversight GAO reviewed is still a plan
A GAO report dated October 6 finds the Centers for Medicare & Medicaid Services awarded $10 billion in rural health funding to all 50 states at the end of 2025, ranging from $147 million for New Jersey to $281 million for Texas. Much of the monitoring GAO reviewed was still planned as of July 2026: CMS officials said they had begun bimonthly state meetings and completed 21 site visits, but no state report had yet come due for review, and audits are planned for 2027. GAO made no recommendations.
Also filed underhealthmedicaidrural-healthgaooversight
CMS proposes letting lab staff review most test data remotely, but not cytology, and to drop a COVID-era reporting rule
CMS and the CDC proposed a rule October 8 that would let laboratory personnel review most digital test data and images from off-site under their lab's existing certificate, with cytology excluded. It would also allow digital images of slides for gynecologic cytology proficiency testing, ease some personnel qualification rules, and rescind SARS-CoV-2 reporting requirements left on the books since the public health emergency ended. Comments must be received by December 7, 2026.
Also filed underhealthregulationlaboratoriesfederal-register
CMS projects the national average Medicare Advantage premium will fall to $12.00 a month in 2027 from $14.37; Open Enrollment runs October 15 to December 7
CMS's September 28 release projects a lower national average Medicare Advantage premium for 2027, $12.00 a month against $14.37, and the average stand-alone drug-plan premium up less than $1. Its Arizona sheet gives that state's average MA premium as $4.47 for 2026 and $2.81 for 2027. An average is not any one plan's premium. Open Enrollment runs October 15 to December 7; Medicare.gov advises reviewing the plan's Annual Notice of Change.
Also filed undermedicare-advantagepart-dopen-enrollmentcmsarizona
Medicare's open enrollment starts October 15, and the numbers that matter this fall are not the averages
CMS projects the average Medicare Advantage premium will fall to $12 a month in 2027, and says about eight in ten enrollees can keep their plan at the same or a lower premium. Those are averages. What decides one person's year is the plan's change letter, the drug benefit's new limits, and two blanks an agent who sells for more than one company must fill in before talking about benefits. Open enrollment runs October 15 to December 7.
Also filed underhealth-insuranceopen-enrollmentprescription-drugsconsumer-protection
CMS's final GLOBE rule, scheduled to publish October 2, adds rebates on certain Part B drugs tied to other countries' prices and can cut some patients' coinsurance from April 2027.
CMS's final rule creating the GLOBE Model is on public inspection and scheduled to publish October 2; it takes effect November 30, 2026. Makers of certain Medicare Part B drugs must take part and may owe rebates measured against other countries' prices. From April 1, 2027, people in Original Medicare in randomly chosen ZIP codes can pay less coinsurance on covered drugs. CMS says patients do not have to enroll or take any action.
Also filed underprescription-drugspart-bcmsfederal-registerdrug-pricing
Fiscal 2027 starts Thursday: the SNAP maximum for a family of four rises to $1,023 in the 48 states and D.C. but falls to $1,655 in Hawaii, most immigration court filing fees rise for filings from October 1, domestic package postage rises 6.0 percent on average from October 4, and the 2027 Social Security raise is not an October 1 change at all.
Fiscal year 2027 begins Thursday, October 1, and a set of federal numbers resets with it. Under the Agriculture Department's August 21 memo to states, SNAP's maximum monthly benefit for a family of four becomes $1,023 in the 48 states and D.C., up from this year's $994, and also rises in Alaska, Guam and the Virgin Islands, but falls in Hawaii, to $1,655 from $1,689. The memo gives no reason. The separate fee Congress added to a green card application filed in immigration court rises from $1,540 to $1,590 for filings on or after October 1, and the annual asylum fee from $102 to $105. Postal Service prices for Priority Mail, Priority Mail Express, Ground Advantage and Parcel Select rise 6.0 percent on average from October 4 until January 17, 2027. The FBI's fee for a fingerprint check for a job or license rises from $12 to $15. Medicare Advantage plans may start marketing 2027 coverage October 1. Not out yet: the 2027 Social Security raise, which waits on price data due October 14, and, on the CMS pages read September 28, the 2027 plan premiums CMS said it would release in September.
Also filed undersnapimmigration-courtpostal-servicesocial-securityfiscal-2027federal-register
August 6: case desk — six enforcement records, three files, and five lanes that stayed quiet.
While the week's louder records arrived, the enforcement lanes kept producing dated paper — a $14.1 million Medicare Advantage settlement, a $95 million wound-care indictment, a federal complaint over adulterated dental products, a $5.15 million customs-duty settlement, and two SEC crypto judgments. Each is filed to its case file at the weight the document actually carries — settlements resolve allegations, indictments are accusations, and this desk says which is which. Five lanes were checked and had nothing, which is also a finding.
Also filed undercase-filesdojsecfalse-claims-actcustomscryptoenforcementconsumer-protectionevidence-postureprimary-source
A record appears here because it carries medicare in its own tags. If a record you expected is missing, it was filed under a different subject — the full list is on the topics index.