The Regulator

Medicare’s newest chronic care model just tripled the ground it covers, and about three in four people on Medicare now qualify for at least one track. The Centers for Medicare and Medicaid Services (CMS) announced September 15, 2026 that it is expanding its ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Innovation Center model, adding new tracks for heart failure, chronic obstructive pulmonary disease (COPD), substance use disorder, tobacco cessation, and extended support for chronic musculoskeletal pain, on top of the diabetes, high blood pressure, depression, and anxiety tracks the 10 year model launched with in July 2026. The new tracks open to patients April 1, 2027, and organizations already in the model do not need to reapply to offer them. ACCESS pays participating organizations through Outcome-Aligned Payments, recurring payments for managing a patient’s qualifying chronic condition, with the full amount earned only when the patient hits measurable health targets rather than for delivering individual services; a CMS-published directory lists 39 organizations currently approved to offer it. Confidence: High. This run reviewed CMS’s own ACCESS model page directly, corroborated by STAT’s September 15 report on the expansion. Sources: ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, Centers for Medicare and Medicaid Services, Medicare to expand pilot that pays for technology to manage chronic diseases, STAT.

Mississippi just handed out $104 million of its federal rural health windfall to 167 local providers in a single announcement. Governor Tate Reeves announced September 14, 2026 that the state has awarded $104,115,146 across 167 grants to hospitals, clinics, mental health practitioners and other rural providers under three programs, technology upgrades, capital projects to close care gaps, and telehealth hub connectivity, funded through the federal Rural Health Transformation Program Congress created in this year’s reconciliation law. The awards are the first disbursement from Mississippi’s $205.9 million first year implementation budget, part of a five year, nearly $206 million total CMS has committed to the state; the money reimburses providers for approved projects rather than arriving as a lump sum. Confidence: High. This run reviewed the Governor’s own press release directly. Sources: Governor Reeves Announces 167 Rural Health Transformation Program Awards Totaling More Than $104 Million, Office of Governor Tate Reeves.

A federal watchdog just opened two new investigations into who profits from Medicare’s drug spending: GLP-1 dispensing under the pharmacy benefit, and Medicare Advantage’s gatekeeping of physician-administered drugs. The Department of Health and Human Services (HHS) Office of Inspector General (OIG) added two projects to its public Work Plan on September 15, 2026: one examining overdispensing of GLP-1 weight loss and diabetes drugs under Medicare Part D, and a second examining how Medicare Advantage organizations use prior authorization to control access to Part B drugs, the physician-administered medications billed under Medicare’s medical benefit rather than its pharmacy benefit. Both are newly announced audits, not completed reports, so OIG has not yet published findings or dollar figures; the additions come as GLP-1 drugs have become one of Medicare’s fastest growing and most expensive drug categories and follow prior OIG findings that Medicare Advantage plans overturn the large majority of prior authorization denials that patients appeal. Confidence: Medium. This run reviewed OIG’s own Work Plan listings directly; the underlying audits have not been completed, so this account describes OIG’s stated scope rather than findings. Sources: GLP-1 Overdispensing in Part D, HHS Office of Inspector General, MAOs’ Use of Prior Authorization for Part B Drugs, HHS Office of Inspector General.

The House Budget Committee votes today on a bill that would change how Congress scores the cost of preventing disease, a technical fix that could reshape which health bills get funded for years. The House Committee on the Budget holds a markup Wednesday, September 16, 2026 on H.R. 4464, the Preventive Health Savings Act from Rep. Jay Obernolte, which would require the Congressional Budget Office (CBO), on request, to estimate whether a bill’s use of preventive health care would reduce federal spending beyond CBO’s standard 10 year budget window and to detail those savings separately. The same markup takes up H.R. 6470, the Increasing Baseline Updates Act from Rep. Blake Moore, requiring CBO to issue at least two baseline spending updates a year instead of one. Neither bill changes Medicare or Medicaid payment rules directly, but by changing how CBO scores prevention, the Preventive Health Savings Act could make it easier to pass future legislation funding screening, vaccination or chronic disease prevention whose savings currently fall outside CBO’s scoring window. Confidence: High. This run reviewed the House Budget Committee’s own markup notice directly. Sources: Markup Notice, House Committee on the Budget, H.R. 4464, Preventive Health Savings Act, Congress.gov.

The federal committee that recommends new Medicare payment models to HHS spent two days this week road testing a roadmap for value based care, without voting on a single new model. The Physician-Focused Payment Model Technical Advisory Committee (PTAC), the statutory body that reviews and recommends physician-focused alternative payment models to the HHS Secretary, held its third of four scheduled 2026 public meetings September 14 and 15, taking expert testimony across sessions on total cost of care models, value-based payment design, rural implementation, and technology-enabled and artificial intelligence applications. Rather than voting on a specific submitted payment model, PTAC used the sessions to gather stakeholder feedback on a draft white paper, “Transforming Health Care Delivery Through Value-Based Payment Models and Care: A Roadmap,” that will help shape which kinds of proposals the committee prioritizes recommending to the Secretary, a recommendation pipeline that has previously fed into Medicare payment models worth billions of dollars. PTAC’s next scheduled meeting is December 8 and 9, 2026. Confidence: Medium-High. This run reviewed ASPE’s own PTAC meetings page directly; the draft white paper itself was not independently reviewed in full. Sources: PTAC Meetings, HHS Assistant Secretary for Planning and Evaluation.