CMS-2449-P Medicaid state-directed-payments rule hits its comment deadline
Plus: NeoGenomics pays $9.8M after self-disclosing kickback-style referral arrangement. The day's rules, money, and enforcement, sourced and tiered below.
Plus: NeoGenomics pays $9.8M after self-disclosing kickback-style referral arrangement. 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 |
Tuesday, July 21, 2026 |
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CMS-2449-P Medicaid state-directed-payments rule hits its comment deadline
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Plus: NeoGenomics pays $9.8M after self-disclosing kickback-style referral arrangement. The day's rules, money, and enforcement, sourced and tiered below.
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Rule Confidence: High
A federal rule capping what states can pay hospitals and insurers above Medicare rates through Medicaid, the health coverage program for low-income Americans, hit its public comment deadline today.
CMS-2449-P would cap Medicaid state-directed payments at 100% to 110% of Medicare rates and phase down existing above-cap payments starting 2028. CMS projects $774.8B in savings over 10 years, $510.1B of it federal.
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Why it matters
This rule could reshape how much money flows to hospitals and insurers through Medicaid, one of the country's largest health programs; watch for a final rule and whether the caps survive as proposed.
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Enforcement Confidence: Low
A national medical lab that reads biopsies and runs genetic tests, NeoGenomics, will pay $9.8 million after turning itself in for giving doctors' offices cut-rate perks and commissions in exchange for sending it business.
The government alleged NeoGenomics gave providers below-market consulting deals and paid referral-based commissions for lab-testing referrals, an anti-kickback and physician self-referral concern. Self-disclosed to HHS in 2021.
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Why it matters
A national lab company is paying millions after admitting it gave doctors' offices financial perks tied to referrals, a reminder that even self-reported violations carry real settlement costs.
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191 Records | $16.0B Enforcement | 7 Deadlines | 69 Rules |
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