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CMS announces proposed rules for hospital payments in 2026

CMS announces proposed rules for hospital payments in 2026

The Centers for Medicare and Medicaid Services issued the 2026 hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule. This proposal introduces 'a series of patient-focused reforms that would modernize payments, expand access to care, and enhance hospital accountability,' the agency said in a statement. CMS says the proposed changes are designed to: Reduce out-of-pocket costs for Medicare beneficiaries; Expand choices in where patients can receive care; Increase hospital accountability and transparency; and Safeguard the Medicare Trust Fund from waste and abuse. 'CMS seeks to equalize payments for certain services delivered in hospitals and off-campus facilities, helping ensure beneficiaries aren't penalized with additional copays simply based on where they receive care. The rule also proposes phasing out the inpatient-only list, which would give physicians greater flexibility to determine the most clinically appropriate setting for care and allow more patients to choose outpatient surgical options,' it added. Publicly traded companies in the hospitals space include Community Health (CYH), HCA Healthcare (HCA), Tenet Healthcare (THC) and Universal Health (UHS).
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Gary Harm Reduction works with local agencies to provide services
Gary Harm Reduction works with local agencies to provide services

Chicago Tribune

timea day ago

  • Chicago Tribune

Gary Harm Reduction works with local agencies to provide services

Although federal funding changes are challenging Gary Harm Reduction, the local grassroots organization does what it can to help those affected by addiction in Northwest Indiana. The local organization hosted Regional Health Systems' medical van from 1 to 3 p.m. Wednesday, doing community outreach for those with nowhere else to go. 'We can't do what we do without other systems and the same with them,' said Executive Director Kristen Martin. 'My approach is all hands on deck, all fighting, all inclusive. … We don't want to further stigmatize or harm anybody, so we're just making sure people's values align.' The organization was founded in 2020, according to its website, and it provides the opioid antidote naloxone, known by its brand name Narcan, advocacy for substance users and people in recovery. The group is entirely volunteer and has distributed more than 5,000 Narcan kits, according to its website. Indiana's overdose death rate is 41 per 100,000 individuals, according to the Centers for Disease Control and Prevention. Lake County has the second-highest overdose rate in the state, according to Post-Tribune archives. For the local unhoused population, Gary Harm Reduction provides items like fresh clothes, blankets, ponchos and other items, Martin said. Gary Harm Reduction works with the medical van every first and third Wednesday of the month, Martin said. Regional Health Systems provides medical and dental services through its van, said Practice Manager Douglas Van Ramshorst, and it can assist with harm and overdose reduction. 'This looks pretty much like any other family doctor's office,' Van Ramshorst said. 'We can see kids, elderly folks, adults, do sick visits, primary care visits, physicals, pretty much anything.' The medical van helps ensure that Regional Health Systems is providing care to all areas that need it, Van Ramshorst said. Regional Health Systems' medical van isn't a free clinic, Van Ramshorst said, but they bill patients later and don't accept payment on-site. Most patients have Medicaid or Medicare, and Regional Health Systems accepts 'almost every private insurance.' The agency charges based on a sliding scale, which allows people to pay based on their income. For example, if someone is homeless and has no income, the organization waives all fees. 'We're a fairly qualified health center, which means that we don't turn anyone away due to their inability to pay,' Van Ramshorst said. 'We always tell people, 'If you're going to have an issue, going to us is better than going to urgent care or the emergency room'.' Since the beginning of 2025, Gary Harm Reduction has seen its federal and state grants decrease from about $500,000 to about $50,000, Executive Board Member Robert Bailey previously told the Post-Tribune. Federal cuts went to diversity, equity and inclusion, LGBTQ+ and HIV grants, Bailey previously said. The city of Gary has multiple Narcan vending machines, including one at Gary Harm Reduction's 5610 W. Ridge Road location. Martin said. The city's Narcan machines were funded through the Opioid Settlement Fund, which is a state program. Gary hasn't had to pivot plans for Narcan due to changes in federal funding, city spokesperson Erika Blackwell said in an email. In addition to Narcan, the machines also have socks, hand sanitizer, wipes and other sanitary items. Gary Behavioral Health Manager Chakara Gunn helps at Gary Harm Reduction, and in addition to the Narcan machine, she serves as a resource connection. 'People call and they're like, 'Hey, this is what I'm looking for',' Gunn said, 'and I can connect them from the health department to Kristen and the services she can offer.' For Martin, it's important to have connections like the Gary Health Department to reach more residents who need assistance. Gary Harm Reduction is also participating in community events that help raise awareness for their work, Martin said. On Saturday, the organization participated in the city's Neighborhood Wellness Block Party with other Gary health agencies. The organization also hosts an annual Region Recovery Riot, which will be Sept. 6 at the Gary Aquatorium. The Region Recovery Riot helps connect the community with prevention resources. Through the various provided resources, Martin hopes people become more comfortable asking for help when needed. 'There's no court orders saying they have to come here,' she said. 'It's all just love and wanting to help. … We're trying to get rid of the stigma.'

AtlantiCare President and CEO Michael Charlton Hosts Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz for One of His First Integrated Health System Visits in the Nation
AtlantiCare President and CEO Michael Charlton Hosts Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz for One of His First Integrated Health System Visits in the Nation

Associated Press

time2 days ago

  • Associated Press

AtlantiCare President and CEO Michael Charlton Hosts Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz for One of His First Integrated Health System Visits in the Nation

In Atlantic City, New Jersey, Dr. Oz meets with cross-sector of national leaders to discuss Medicare, Medicaid, and the future of care delivery EGG HARBOR TOWNSHIP, N.J., July 18, 2025 /PRNewswire/ -- Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), visited AtlantiCare this week for one of his first integrated health system visits since assuming the role. The visit brought national focus to southeastern New Jersey through critical conversations, elevating the role of health systems in advancing care and evaluating policy efficacy on the ground. Hosted by AtlantiCare President and CEO Michael Charlton, Dr. Oz's visit included a tour of Atlantic City, with stops at AtlantiCare's medical facilities, regional educational institutions, and community outreach sites. The tour showcased ongoing efforts to position Atlantic City as a destination for healthcare, education, and innovation—sectors that are proven drivers of economic revitalization and long-term regional growth. Following the tour, Dr. Oz joined a private roundtable with leaders from healthcare, government, education, and technology to discuss how national programs like Medicare and Medicaid remain vital to the communities served by regional health systems. The conversation centered on how evolving federal policy intersects with the day-to-day delivery of care—and the need for reforms that improve access, reduce complexity, and strengthen equity. Leaders shared insights on the administrative and clinical impacts of prior authorization, raising concerns about care delays and provider burden. They also discussed technology opportunities and regulatory relief, referencing recommendations from the American Hospital Association to streamline operations and ease administrative strain. Their input helped advance constructive dialogue about aligning federal policy with the practical realities facing health systems nationwide. 'We were honored to welcome Dr. Oz to AtlantiCare today. As a health system serving southern New Jersey — including Atlantic City, a community marked by both extraordinary need and untapped potential — we were proud to host this important conversation,' said Michael Charlton, president and CEO of AtlantiCare. 'AtlantiCare is small enough to be nimble in our transformation efforts, yet big enough to matter and make a real difference. That's what allows us to move fast, build partnerships that matter, and create real outcomes. Today's discussion made clear how important it is for national policy to stay grounded in what's actually happening on the front lines.' Dr. Oz noted the value of hearing directly from leaders about their concerns, 'I was pleased to join leaders from healthcare, education, government, and technology at AtlantiCare for a thoughtful and solutions-driven conversation,' said Oz. 'AtlantiCare's vision is transformative for the city of Atlantic City and an approach that other health systems could model.' AtlantiCare is the largest non-casino employer in southeastern New Jersey, serving more than one million residents across five counties. Based in Atlantic County, the organization anchors a region where access to care, workforce shortages, and economic instability remain ongoing challenges. Vision 2030, AtlantiCare's six-year strategic plan to redefine how healthcare is delivered and experienced, is driving transformation through community investment, workforce development, clinical innovation, and operational growth. The strategy is increasingly informing national dialogue on how regional health systems can lead meaningful, scalable change. About AtlantiCare AtlantiCare is an award-winning integrated healthcare system based in Egg Harbor Township, New Jersey, whose team of more than 6,500 serves the community in over 110 locations in Atlantic, Burlington, Camden, Cape May, and Ocean counties of southern New Jersey. Committed to an innovative approach to providing the best care in the industry, AtlantiCare has a vision of building healthy communities that drives its mission of making a difference in health and healing, one person at a time. Learn more at or call 1-888-569-1000. *B-roll footage and high-resolution images from the visit are available. Interviews with AtlantiCare leadership can be arranged upon request. To access assets or coordinate interviews, please contact: [email protected] View original content to download multimedia: SOURCE AtlantiCare Health Network

UChicago Medicine to discontinue all gender-affirming pediatric care
UChicago Medicine to discontinue all gender-affirming pediatric care

Chicago Tribune

time2 days ago

  • Chicago Tribune

UChicago Medicine to discontinue all gender-affirming pediatric care

Bowing to federal pressure under the Trump administration, UChicago Medicine has become the latest Illinois hospital to end gender-affirming pediatric care. The decision, announced Friday, leaves no room for ongoing transitional care, and an unknown number of patients in limbo. 'UChicago Medicine has reached the difficult decision that, in response to continued federal actions, it will discontinue all gender-affirming pediatric care effective immediately,' the hospital said in a statement. 'We understand that this news will have a significant impact on our patients.' The announcement by UChicago Medicine, the esteemed century-old academic medical health system based at the University of Chicago, follows a similar decision by Rush University System for Health, which 'paused' hormonal care to new patients under the age of 18 beginning July 1. Rush is continuing to offer mental and behavioral support, but referring gender care patients that need additional treatment to other providers. UChicago Medicine will no longer be on that shrinking list of hospitals providing gender-affirming pediatric care, which can include counseling, medications to delay puberty and surgery. In January, President Donald Trump issued an executive order ostensibly protecting children under 19 from 'chemical and surgical mutilation' that threatened to withhold federal research grants as well as Medicaid and Medicare reimbursement for institutions that provide such pediatric gender care services. 'We reached this conclusion in light of emerging federal actions, which would place at risk our ability to care for all Medicare or Medicaid patients,' UChicago Medicine said in its statement. 'These patients make up the majority of those we serve. As the largest Medicaid provider in Illinois, this step is necessary to ensure UChicago Medicine can continue serving our broader community and delivering on our mission.' Federal pressure to end gender-affirming pediatric care has caused several Chicago-area hospitals to curtail such services. In February, Lurie Children's Hospital paused gender-affirming surgeries for patients younger than 19, a policy which remains in place, the hospital said earlier this week. Meanwhile, UI Health allegedly canceled an Illinois teenager's gender-affirming chest surgery, according to a February federal court filing. Reached earlier this week, UI Health would not say if it was still providing gender-affirming care to minors. As for UChicago Medicine, all gender-affirming pediatric care ends Friday. 'Our focus right now is working with affected patients to discuss options going forward,' the hospital said in its statement. rchannick@

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