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The Centers for Medicare & Medicaid Services (CMS) said late Thursday that the estimated improper payment rate in traditional Medicare was 6.55%, or $28.83 billion, in 2025. That's down from $31.7 billion, or a 7.66% rate, the year prior. The CMS said in a fact sheet that this marks the ninth year in a row in which this figure has been below the 10% threshold required by statute.
The American Hospital Association is advocating for value-based care as the House of Representatives seeks input on modernizing the Medicare Access and CHIP Reauthorization Act of 2015, a Jan. 16 letter said. The organization stressed the importance of alternative payment models, but it said member hospitals sometimes struggled to implement Center for Medicare & Medicaid Innovation initiatives.
During a Jan. 6 virtual conversation hosted by the Leonard Davis Institute of Health Economics at the University of Pennsylvania, experts discussed how well the initial funding announcements from the $50 billion Rural Health Transformation Program (RHTP) align with the healthcare needs of rural communities.
Telehealth, hospital-at-home set to receive multi-year extensions in recent funding proposal
Medicare telehealth flexibilities and the Acute Hospital Care at Home (AHCaH) program are teed up to receive multi-year extensions from Congress in its recently released funding package for the Department of Health and Human Services. The extensions would provide more certainty for the industry than it’s had since the end of 2022, when Congress extended Medicare telehealth and hospital-at-home for two years.
Healthcare False Claims settlements reached record $5.7B in 2025
The False Claims Act imposes penalties on those who defraud U.S. government programs. Healthcare has historically made up a majority of settlements in the FCA as federal health spending grows. Still, settlements were outsized in 2025 and totaled over $5.7 billion; the highest amount ever and more than triple last year’s total.
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