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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant

Avoiding the Telemedicine Cliff: Why the DEA Extended Prescribing Rules Through 2026

by Fred Pennic 01/02/2026 Leave a Comment

HHS Launches EHR Innovations for Improving Hypertension Challenge_HHS Funded Health Care Innovation Award Projects to Watch

What You Should Know:  - In a significant move for the "tele-prescribing" landscape, the U.S. Department of Health and Human Services (HHS) and the Drug Enforcement Administration (DEA) have announced a fourth temporary extension of telemedicine flexibilities.  - This extension allows practitioners to prescribe controlled medications—including Schedule II–V drugs—via audio-video encounters without a prior in-person medical evaluation through December 31, 2026. A Transitional
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The MAHA Paradox: How Medical Device Tariffs Undermine “Make America Healthy Again

by Kinsey Fabrizio, President, Consumer Technology Association 12/31/2025 Leave a Comment

The MAHA Paradox: How Medical Device Tariffs Undermine "Make America Healthy Again

The Trump Administration’s Make America Healthy Again agenda recognizes a simple truth: the best way to improve our health is to empower people to understand and help manage their own care. Affordable medical devices make that possible. Every day, Americans use this technology to check their blood pressure, track sleep, monitor heart rhythms, manage hearing loss, and more. These devices bring care into our homes, extend the reach of doctors, and help millions of people stay healthy
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CMS Launches $50B in Awards to Strengthen Rural Health in All 50 States

by Fred Pennic 12/29/2025 Leave a Comment

CMS Launches New Oversight Initiative to Verify Medicaid and CHIP Eligibility

What You Should Know:  - The Centers for Medicare & Medicaid Services (CMS) is deploying a massive $50 billion investment across all 50 states to overhaul the nation's rural healthcare infrastructure starting in 2026.  - Under the guidance of HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz, the program prioritizes not just workforce expansion, but a significant technological shift toward AI adoption, cybersecurity resilience, and "food-as-medicine"
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CMS Launches WISeR Model: New Medicare Prior Authorization Rules Start Jan. 1

by Gregg Killoren, General Counsel at Xsolis 12/23/2025 Leave a Comment

CMS Launches WISeR Model: New Medicare Prior Authorization Rules Start Jan. 1

Earlier this year the Centers for Medicare and Medicaid Services introduced the "Wasteful and Inappropriate Service Reduction" model, a series of prior authorization requirements designed to ensure timely and appropriate Medicare payment for select items and services in six states (New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington) that take effect Jan. 1.  As part of the “WISeR” requirements, CMS selected tech vendors to implement enhanced technological models to
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Cornell Survey: Experts Warn HSA Conversion and Small Premiums Threaten ACA Affordability

by Fred Pennic 12/23/2025 Leave a Comment

Cornell Survey: Experts Warn HSA Conversion and Small Premiums Threaten ACA Affordability

What You Should Know:  - A new survey from the Cornell Health Policy Center reveals that 70% of health policy scholars believe converting ACA subsidies into Health Savings Accounts (HSAs) would worsen affordability for enrollees. - Additionally, 81% of experts agree that ending automatic renewals—a policy slated for 2028 under the "One Big Beautiful Bill Act"—will substantially reduce Marketplace enrollment. These findings come as policymakers scramble to find alternatives to enhanced
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Why Rural Health Transformation Must Include Maternal Health

by Anish Sebastian, CEO and co-founder of Babyscripts 12/22/2025 Leave a Comment

ACOG Declares Telehealth an “Ethical Imperative” for Obstetric Care

Congress’ most recent budget reconciliation bill included controversial cuts to Medicaid spending. The legislation slashed hundreds of billions of dollars from the program over the next decade, a move that is likely to disproportionately affect rural hospitals and safety-net providers. To offset the cuts, lawmakers introduced the $50 billion Rural Health Transformation Program (RHTP), a five-year initiative (2026-30) meant to
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The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags

by Fred Pennic 12/12/2025 Leave a Comment

The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags

What You Should Know:  - A new report from Sage Growth Partners reveals a striking disconnect in the healthcare industry: while only 20% of C-suite leaders believe progress has been made in value-based care (VBC) recently, 77% plan to increase their participation in these models over the next two years.  - The "plot twist" indicates that despite operational hurdles and low revenue exposure today, hospital executives view VBC as essential for long-term financial survival. The data
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The $4,000 Deductible Era: Why Employer-Sponsored Insurance is Breaking the American Worker

by Fred Pennic 12/10/2025 Leave a Comment

The $4,000 Deductible Era: Why Employer-Sponsored Insurance is Breaking the American Worker

What You Should Know:  - A new 50-state analysis reveals that over half (51.7%) of U.S. private-sector workers are now enrolled in high-deductible health plans (HDHPs) as employers struggle to manage rising costs. The report shows that annual family premiums jumped to $24,540 in 2024, outpacing inflation, while average family deductibles surpassed $4,000 for the first time.  - The trend exposes millions of Americans to greater financial risk in medical emergencies, signaling a
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Beyond Stereotypes: 3 Ways Empathetic Outreach Can Drive Medicaid Member Engagement and Retention Post-OBBA

by Rhonda Aubrey, MHI, Co-Founder and Vice President of Programs at Beheld 12/05/2025 Leave a Comment

Beyond Stereotypes: 3 Ways Empathetic Outreach Can Drive Medicaid Member Engagement and Retention Post-OBBA

Connecting with Medicaid members has never been so challenging—or so crucial—as the system faces great uncertainty in light of the recently passed One Big Beautiful Bill Act.  Finding inroads that resonate with members can be difficult as this diverse segment faces plenty of barriers to care that also inhibit meaningful connections. Non-medical social drivers of health, such as lack of transportation, food and housing insecurities, and even basic health literacy can get in the way of
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ACOs Must Lead on Specialty Care to Control Costs

by Theresa Hush, CEO and Co-founder of Roji Health Intelligence 11/17/2025 Leave a Comment

ACOs Must Lead on Specialty Care to Control Costs

Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central goal has shifted to cost control, ACOs will need to broaden scope to optimize specialty care. TEAM (Transforming Episode
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