The latest CMS changes aim to improve patient care while simplifying administrative procedures, including a nationwide push to remove ineligible Medicaid enrollees, new requirements for dual eligible special needs plans (D-SNPs) by 2027 to integrate member IDs and health risk assessments, the finalization of a prior authorization rule to enhance health data exchange, and the extension of certain telehealth flexibilities through September 30, 2025. Additionally, CMS is working to address administrative burden through efforts like the prior authorization rule and a request for information on reducing administrative resources. 

You qualify for hospice care if you have Medicare Part A (Hospital Insurance) and meet all of these conditions:

Condition Code 44 and W2 are Medicare billing codes for hospitals to reclassify medically unnecessary inpatient stays to outpatient claims, but CC44 is for changes made before a patient is discharged, while CCW2 applies to post-discharge status changes, with different documentation and approval requirements for each scenario. 

In April of 2025, CMS the 2026 Medicare Advantage final rule. 

Yes. Medicare Advantage plans must provide coverage and pay for an inpatient admission when, based on consideration of complex medical factors (e.g., history and comorbidities, the severity of signs and symptoms, current medical needs, the risk of an adverse event occurring during hospitalization) documented in the medical record, the admitting physician expects the patient to require hospital care that crosses two midnights.1 Medicare Advantage Plans may still use prior authorization or concurrent case management review to determine if the complex medical factors are sufficiently documented in the medical record to support medical necessity of the inpatient admission.2