Billy Wynne

Panel Explores Benefits and Risks of AI in Medicaid Prior Authorization The Medicaid and CHIP Payment and Access Commission (MACPAC) held a panel session focused on the use of automation and artificial intelligence (AI) in the Medicaid prior authorization process. The discussion explored how these technologies are currently being implemented, their potential to improve efficiency,…

Commissioners Discuss the Value of MA Supplemental Benefits; Emphasize Data Limitations and Consider Modifications The Medicare Payment Advisory Committee (MedPAC) convened a session to assess the utilization and delivery of supplemental benefits in Medicare Advantage (MA). This meeting followed a session in October focused on the background and plan financing of supplemental benefits (Impact summary). The staff presentation…

Commission Continues Work on Long-Stay Nursing with Review of Quality Policies Today, the Medicare Payment Advisory Committee (MedPAC) convened its third session this cycle about the long-stay nursing home population. The Commission previously reviewed its workplan for the topic in October (Impact summary) and discussed Institutional Special Needs Plans (I-SNPs) in March (Impact summary). Today’s…

Commissioners Review Draft Chapter on the Program of All-Inclusive Care for the Elderly (PACE) and Discuss Potential Areas for Work The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session to review a draft chapter for the June 2025 Report to Congress on the Program of All-Inclusive Care for the Elderly (PACE) –…

Agency Issues Press Release Detailing Dr. Oz’s Vision After Recent Town Hall CMS issued a press release describing the new Administrator for the Center for Medicare & Medicaid’s vision and his role in the “Make America Healthy Again” agenda. The release describes a focus on modernizing Medicare, the Marketplaces, and Medicaid, including empowering Americans with personalized health…

GAO Recommends Greater Coordination Within HHS to Address Ongoing Drug Shortages The Government Accountability Office (GAO) released a study addressing ongoing drug shortages in the United States, which have been significantly exacerbated by the COVID-19 pandemic. Although the types of drugs in shortage remain consistent with pre-pandemic patterns, the report underscores how the pandemic deepened…

Health Subcommittee Examines Biosimilar Market; PBMs and Part B Payment Considered Potential Barriers to Biosimilar Uptake The House Ways and Means (W&M) Health Subcommittee convened a hearing on the health of the biosimilar market and how increased access to such products can lower prescription drug costs for patients. The following witnesses spoke to the market…

CY 2026 MA and Part D Rate Announcement to Increase Payments to MA Plans by 5.06 Percent the Centers for Medicare and Medicaid Services (CMS) announced the Calendar Year (CY) 2026 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Rate Announcement) (press release and fact sheet) and the Final CY…

CY 2026 MA and Part D Policy and Technical Changes Final Rule Released, CMS Does not Finalize Coverage of Anti-Obesity Medications, AI Guardrails, Pharmacy Network Transparency, or Beneficiary Protections The Centers for Medicare and Medicaid Services (CMS) released the Contract Year (CY) 2026 Policy and Technical Changes to the Medicare Advantage (MA) program and Medicare…

USDA Cracks Down on SNAP Application Processing Times The US Department of Agriculture (USDA) announced a set of steps that it will take to bring states into compliance with timeliness requirements for Supplemental Nutrition Assistance Program (SNAP) application processing. USDA issued a letter to state agencies demanding that they take immediate action to address delays in processing applications…