Join host Chad Mulvany as he shares the latest healthcare policy and legislative updates for the week of April 15, 2026. First, he shares updates from the latest round of CMS rulemaking, including proposed rules for skilled nursing facility (SNF), inpatient rehabilitation facility (IRF), and inpatient psychiatric facility (IPF) payments in fiscal year 2027. Then, he explores the finalized Medicare Advantage (MA) rates for 2027, a lawsuit related to the 340B program, and insights from new data on insurance exchange enrollment, claim denials, and rural hospital financial performance. Learn more about the show at forvismazars.us/AchievingHealthPodcast. Subscribe to Healthcare FORsights™ to receive tailored insights on the healthcare sector directly to your inbox. Related content: Managed Care Denials: Trends &amp; Steps to Mitigate Navigating Denial Management: Strategies for Financial Resilience Navigating 340B: Operational Strategies to Manage Regulatory Change Download our Healthcare Market Point of View: Achieving Health. Download our Mindsets 2026 Healthcare Executive Leadership Report. Questions? Contact us. Connect on LinkedIn: Healthcare Practice at Forvis Mazars Chad Mulvany

Washington Watch: 2027 CMS Facility Rules, MA Rates

Achieving Health

# Full Transcript

**Podcast:** Achieving Health

## Participants

- **Chad Mulvaney** (Forvis Mazars)

## Transcript

On today's episode of Achieving Health, I've got the latest policy and legislative updates from Washington, D.C. for the week of April 15th, 2026. Stay tuned. This is Achieving Health, a podcast from Forvis Mazars, where we delve into the topics that matter most to healthcare organizations across the continuum of care. Our goal is to help you navigate the dynamic healthcare landscape and achieve health at your organization. Here's your host, Chad Mulvaney.

Welcome to Achieving Health. I'm Chad Mulvaney, Director in the Healthcare Practice at Forvis Mazars. Thank you for joining me. In case you missed it, on last week's episode we had a great conversation with Craig Thompson, CEO of Golden Valley Memorial Healthcare. He shared how his team approaches strategic planning and execution in an uncertain regulatory and economic environment. Hope you'll give it a listen. If you haven't already, it was a great discussion. With that, let's get started with today's Washington Watch.

The updates reflect information as of 1030 a.m. Eastern Time on Friday, April 10th, 2026. My comments on these discussions are based on what's being reported by the D.C. Trade Press at the time of the conversation, mixed with a lot of judgment about where things may go based on my experience in D.C. So today's remarks reflect information as of this moment and will change.

As far as our agenda is concerned, we obviously saw the week of April 2nd, CMS issue proposed rules for inpatient rehab psych and SNF PPS. For FY 2027, CMS proposes updating SNF PPS rates by a net 2.4%, psych PPS rates by a net 2.3% and IRF rates by a net 2.4%. We'll dive into some of the other key changes in this episode as well.

We also got on April 6th, the 2027 Medicare Advantage final rate announcement. The rates are projected to result in an increase of 2.48% or $13 billion more than in 2026 for Medicare Advantage plans. This is an increase over the projected 0.09% from the advance notice that was provided in January.

Also, CMS provided a March exchange enrollment snapshot, and so CMS's most recently posted 2026 open enrollment report shows how consumers adjusted their coverage choices following the loss of enhanced ACA tax credits, highlighting shifts towards lower cost plans and overall a modest enrollment decline.

With exchange enrollment shifting towards high deductible and lower value coverage and a projected rise in the uninsured, hospitals should expect sustained growth in uncompensated care and bad debt unless they act decisively at the front end of the revenue cycle. We also saw data recently that ACA plans denied 19% of in-network claims in 2024, and this is a report from Modern Healthcare.

Insurers selling plans on the federal exchanges denied 19% of claims in 2024, matching the highest rate since ACA Marketplace is launched in 2015, and this is based on analysis by the ...

Washington Watch: 2027 CMS Facility Rules, MA Rates

Transcript

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Washington Watch: 2027 CMS Facility Rules, MA Rates

Transcript

Built for investment professionals

Every day you wait, your competitors are findingedge in conversations you're not hearing.

Every day you wait, your competitors are finding
edge in conversations you're not hearing.