(Oct. 2, 2026) – CMS Cancels 315,000 Unauthorized Marketplace Enrollments
The Centers for Medicare & Medicaid Services announced an effort to reduce fraud, waste and abuse in the federal Health Insurance Marketplace. Through the CMS Federally Facilitated Exchange anti-fraud coordination group, CMS is canceling about 315,000 unauthorized enrollments, affecting more than 760,000 individuals. By eliminating these unauthorized enrollments, CMS estimates it will recover roughly $2.2 billion in taxpayer-funded subsidies. CMS also is strengthening marketplace program integrity by:
- Requiring all existing agents and brokers to verify their identity through Login.gov or ID.me;
- Requiring applications involving an agent or a broker to include Social Security numbers or immigration document numbers;
- Updating the system to prevent agents and brokers from being added to applications that consumers should be completing; and
- Requiring electronic consumer authorization before an agent or broker can act on a consumer’s application or enrollment.
CMS Issues Preliminary CY 2027 Medicare Clinical Laboratory Fee Schedule Payment Rates
As directed by the Protecting Access to Medicare Act of 2014, the Centers for Medicare & Medicaid Services must collect private payer rates from applicable laboratories to establish a market-based methodology for calculating Medicare clinical laboratory fee schedule rates. CMS released information ahead of final rates, which are expected to be shared in November, indicating that the new methodology would save Medicare $1 billion annually. CMS also projects that hospital-based and freestanding labs should prepare for 15 percent rate decreases on hundreds of tests.