CMS told stakeholders in a March 16 email it will shift the Federal independent dispute resolution process to a new IDR Gateway in the second half of 2026. The agency plans to replace single-use web forms with a secure, centralized platform to initiate disputes, follow up, and track status. This is operational plumbing for No Surprises Act arbitration, where dispute inventory and cycle time affect payment timing. Expect workflow updates and possible changes in open IDR volume that can move payables and reserves.

Prime Healthcare and Blue Cross and Blue Shield of Illinois are facing a June 1 deadline to finalize a new network contract, Fierce Healthcare reported. Prime, new to Illinois, told patients it is working to avoid its hospitals and physicians being dropped from network. If talks fail, Prime risks an immediate volume hit while BCBSIL leans on steerage and disruption to reset unit costs. Actuaries should scenario OON leakage, continuity-of-care exceptions, and member abrasion through summer renewals.

CMS on Jan. 27, 2026 selected 15 Part D and Part B drugs for the third IRA negotiation cycle, with prices effective Jan. 1, 2028. CMS said the drugs totaled about $27B in Part B and D spending from Nov 2024-Oct 2025, used by roughly 1.8M beneficiaries. Negotiated prices for the first 10 Part D drugs took effect Jan. 1, 2026, and the next 15 Part D drugs are slated for 2027. For PDP and MA-PD actuaries, the 2028 list is a rebate-reset: lower net costs should flow into bids, but utilization can eat savings.

A March 16, 2026 STAT op-ed is lobbying Congress to move H.R. 5343, a Medicare breakthrough-device coverage bill advanced in committee 37-3. H.R. 5343 would cover CMS-designated "breakthrough devices" for a 4-year transitional period, unless CMS cites undue risk or use outside FDA-approved labeling. It also requires CMS to finish a national coverage determination before the 4-year window ends, and funds implementation at $10M per year in FY2025-2030. Economically, this shifts Medicare spend forward, and leaves MA and providers less room to slow-walk adoption while evidence and pricing catch up.

On March 12, 2026, ASTP/ONC said it is issuing notices of nonconformity to certified health IT developers accused of information blocking. If violations are sustained and corrective plans ignored, ONC can pull certification, and CMS would withhold incentive payments tied to certified tech use. Keane told HIMSS26 attendees this is the first enforcement step in nearly a decade since Congress banned information blocking. HHS OIG can also assess civil monetary penalties up to $1 million per violation, so interoperability disputes become a real reserve and vendor-risk line item.