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States Regulate Healthcare Amid Federal Void

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Summary

Arnall Golden Gregory LLP's April 2026 Healthcare Authority Newsletter summarizes recent healthcare regulatory developments, including CMS proposals on drug prior authorization timeframes, rumors of a national hospice enrollment moratorium, hospital M&A reaching $14.5B in Q1, hospitals' legal challenge over Medicare DSH payments, and FBI findings identifying healthcare as the most ransomware-targeted critical infrastructure sector.

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The April 2026 Healthcare Authority Newsletter from Arnall Golden Gregory LLP provides a regulatory news summary covering multiple healthcare sector developments, including CMS's proposed rule on electronic prior authorization for prescription drugs, unconfirmed reports of a potential national hospice enrollment moratorium, hospital merger and acquisition activity reaching $14.5B in the first quarter, over 130 hospitals' litigation challenging HHS disproportionate share hospital payment calculations, and FBI data identifying healthcare as the most targeted critical infrastructure sector for ransomware attacks.

Healthcare providers, health systems, and physician practices should monitor these developments for compliance implications. The CMS prior authorization proposal, if finalized, would impose new electronic standards and shortened decision timeframes on payers. Organizations facing regulatory burden concerns and those serving Medicaid populations should track the DSH payment litigation and potential hospice enrollment restrictions for operational impact.

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Apr 21, 2026

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April 21, 2026

Healthcare Authority Newsletter - April 2026 #3

W. Jerad Rissler Arnall Golden Gregory LLP + Follow Contact LinkedIn Facebook X ;) Embed News Briefs

States Step in to Oversee, Regulate Healthcare

They say that nature abhors a vacuum, and, apparently, U.S. healthcare doesn't care for one much, either. Because in the absence of federal legislation and regulation, many states are stepping in to fill the void.

(Source: Managed Healthcare Executive, 2026-04-08)

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CMS Proposes Requiring Payers to Speed Drug Prior Authorizations

Health insurers face a prior authorization prescription drug mandate similar to the rule imposed on claims, under a proposal released Friday by the Centers for Medicare & Medicaid Services. CMS is proposing to require payers to support electronic prior authorization and to make decisions on requests within a shorter timeframe, in the 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule.

(Source: Healthcare Finance News, 2026-04-13)

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Hospices Concerned About Possible National Enrollment Moratorium

Rumors have circulated that the U.S. Centers for Medicare & Medicaid Services is mulling a national moratorium on hospice provider enrollment in Medicare, stirring some debate in the provider community. To date, CMS has not made any public statements about a moratorium, but sources in Washington relayed rumors to Hospice News that such an action is under consideration, which the agency has not confirmed.

(Source: Hospice News, 2026-04-13)

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Hospital Dealmaking Hits Six-Year High, Reaching Record $14.5B

Hospital and health systems announced 22 mergers and acquisitions in the first quarter this year, the highest first-quarter amount in six years, according to a report from consultancy Kaufman Hall. Several mega-mergers, or deals in which the smaller party's annual revenue is more than $1 billion, boosted the total transacted revenue in the quarter to $14.5 billion, the highest amount the consultancy said it's seen in recent years.

(Source: Healthcare Dive, 2026-04-10)

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Report Says 450 Hospitals at Risk of Closing or Cutting Services

A new report from Public Citizen paints a concerning picture of the future of American healthcare. The Nonprofit Consumer Advocacy Organization claims nearly 450 hospitals, including several in Ohio, are at risk of closing or cutting services because of Medicaid cuts made in HR 1.

(Source: Spectrum News 1, 2026-04-08)

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Over 130 Hospitals Sue HHS Over Disproportionate Share Payments

More than 130 hospitals across 16 states have filed suit against the Department of Health and Human Services, challenging a 2023 final rule that alters how Medicare calculates disproportionate share hospital payments. Providers argue the rule retroactively changes longstanding policy and results in significant underpayments to hospitals serving low-income populations.

(Source: HealthLeaders Media, 2026-04-09)

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FBI Report Says Healthcare Sector Most Targeted with Ransomware

The FBI's Internet Crime Complaint Center, or IC3, tracked 278 healthcare ransomware attacks in 2025, making it the most targeted critical infrastructure sector. In addition to the ransomware complaints, the IC3 tracked 182 healthcare data breaches, according to its annual internet crime report.

(Source: TechTarget, 2026-04-08)

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Physician Practices Reporting Rise in Regulatory Burdens

Prior authorization, Medicare Advantage requirements, and quality reporting are among the leading drivers of practices' administrative woes, which respondents to an annual survey on regulatory burden said have worsened over recent years. Ninety-five percent of respondents said their practice's regulatory burden had increased over the past three years, and that burden was also cited as the top contributor to physician burnout.

(Source: FierceHealthcare, 2026-04-09)

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Medicare Unveils Health Tech Ecosystem to Upload Medical Records

Medicare enrollees will soon be able to export their medical records to their doctor or hospital under a program launched by CMS. The Health Tech Ecosystem allows patients to use an app on their phone that creates a QR code which allows them to share their medical records straight to the provider, "and it goes straight into their electronic health record," said Amy Gleason, acting administrator of the Department of Government Efficiency and a senior advisor at HHS.

(Source: MedPage Today, 2026-04-10)

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Study Finds More Urban Hospitals Using Dual Classification

A recent study published in Health Affairs found that the incidents of dual classification have exploded over the past decade, increasing the money dual-classified hospitals get to run their operations, while rural hospitals continue to struggle. According to the study, the number of geographically urban hospitals that are dual-classified rose from three in 2017 to 425 in 2023.

(Source: Daily Yonder, 2026-04-13)

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As Patient Cost Sharing Shifts, Hospitals Face Financial Threat

Shifts in patient cost sharing pose a financial threat to hospitals, and the implications are especially meaningful for rural providers. A new Health Affairs study revealed that patients are responsible for a growing share of hospital revenue, with the gap between rural and metropolitan hospitals’ share of allowed amounts per encounter widening over time.

(Source: HealthLeaders Media, 2026-04-09)

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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Last updated

Classification

Agency
JD Supra
Published
April 21st, 2026
Instrument
Notice
Branch
Executive
Legal weight
Non-binding
Stage
Final
Change scope
Minor

Who this affects

Applies to
Healthcare providers Patients Government agencies
Industry sector
6211 Healthcare Providers
Activity scope
Healthcare regulation monitoring Healthcare mergers and acquisitions Healthcare data security
Geographic scope
United States US

Taxonomy

Primary area
Healthcare
Operational domain
Compliance
Topics
Public Health Cybersecurity

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