CMS proposes CY2027 rule raising ACO shared-savings rate, delaying 2025 reconciliation to November
Plus: House E&C Committee to markup 29 bills including price transparency and prior-auth reform. The day's rules, money, and enforcement, sourced and tiered below.
Plus: House E&C Committee to markup 29 bills including price transparency and prior-auth reform. The day's rules, money, and enforcement, sourced and tiered below.
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American Health Intel
Rules · Money · Medicine · Decoded daily
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| The Regulator |
Sunday, July 19, 2026 |
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CMS proposes CY2027 rule raising ACO shared-savings rate, delaying 2025 reconciliation to November
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Plus: House E&C Committee to markup 29 bills including price transparency and prior-auth reform. The day's rules, money, and enforcement, sourced and tiered below.
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Rule Confidence: High
CMS just proposed a rule for Medicare's accountable care organizations, the physician groups paid extra for controlling costs, that raises their bonus rate while delaying last year's payments to them until November.
The proposed CY2027 rule raises the Medicare Shared Savings Program's Level E shared-savings rate from 50% to 60%, but a new retroactive spending guardrail pushes 2025 reconciliation payments to November 2026. Comments due Sept 14.
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Why it matters
This reshapes how Medicare's largest accountable care program splits savings, and if finalized it could delay payments many physician organizations were expecting this year.
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Deadline Confidence: High
A House committee, the panel that writes the rules for hospitals, insurers, and drugmakers, votes Monday on 29 bills covering price transparency, Medicare Advantage prior authorization, and faster generic biosimilar access.
The House Energy and Commerce Committee's markup is 5pm ET July 20 in Rayburn 2123, open to the public and livestreamed. Bills include the Lower Costs, More Transparency Act and the Prior Authorization Accountability Act.
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Why it matters
This is a legislative step, not law yet; watch which of the 29 bills clear committee since that signals what Congress may act on next.
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