Patients Rising

For a patient waiting on treatment, prior authorization is rarely just paperwork. It’s the days or weeks between a doctor’s decision and the care that decision was supposed to deliver—time a serious illness doesn’t always give back.

That’s why we submitted a public comment on the 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS-0062-P) —the federal government’s most significant attempt yet to fix how prior authorization works for medications.

Take a look at what we had to say right here:

What Patients Rising Told CMS About Prior Authorization (2026) In its 2026 comment to CMS, Patients Rising urged faster prior authorization decisions, plain-language denials, and an end to timing-based lab-test denials.

The Lowering Costs for Caregivers Act — http://H.R. 138 Led by Rep. Vern Buchanan (R-FL) with Rep. Mike Thompson (D-CA), and co-sponsored by Rep. Paul Tonko (D-NY), would let family caregivers use tax-free HSA and FSA dollars toward the qualified medical expenses of a parent or parent-in-law — creating meaningful financial relief for the millions of Americans caring for an aging loved one.

We invite you to join Patients Rising on Tuesday at 2 p.m. ET for our online workshop, Alzheimer's & Caregiving: What's Moving in Congress to discuss this piece of legislation and ask questions. Register here: https://hubs.ly/Q04k-_w00

An earlier diagnosis. A little financial breathing room.

For Alzheimer's patients and the families who care for them, both are within reach — if Congress acts.

On June 16, Patients Rising sits down with staff from the congressional offices leading two bipartisan bills built for patients and caregivers: the Alzheimer's Screening and Prevention (ASAP) Act and the Lowering Costs for Caregivers Act. We'll walk through what each bill does, where it stands, and what it would mean for the people living these diagnoses every day.

Have your questions ready, and register here: https://hubs.ly/Q04k_h940

The American Hospital Association's September 2025 community benefit report, the source of the often-cited "$100 billion" figure, is based on IRS Form 990 Schedule H data submitted by 340B hospitals themselves.

Hospitals report the data. The AHA collects it. The AHA, which represents and advocates for hospitals, then publishes a report highlighting the community benefits those hospitals say they provide.

What is often overlooked is that the underlying numbers are not independently verified. There is no federal auditor reviewing how each hospital categorized its spending, and there is no consistent enforcement mechanism to ensure expenses are classified the same way from one hospital to the next. Hospitals report the information, and the AHA reports what hospitals reported.

There is also no single federal definition of "community benefit" that requires uniform reporting. Two hospitals serving similar patients can, and often do, categorize similar expenses differently. The IRS provides guidance on what hospitals may report, but it does not require every hospital to classify expenses the same way.

As a result, the AHA's $100 billion figure is an aggregate of self-reported data that may be categorized differently from hospital to hospital. The number reflects what hospitals reported, not a standardized accounting of community benefit spending.

Patients Rising reviewed 130 bankruptcy filings across Louisiana and found a pattern that is difficult to ignore. More than one-third of the cases involved medical debt owed to nonprofit hospitals participating in the federal 340B drug discount program, with nearly $1 million in verified debt identified. Two major health systems alone accounted for 84% of the total, and among the filings was a family surviving on just $1,800 per month while carrying more than $386,000 in hospital debt, the largest single hospital balance uncovered in Patients Rising's six-state investigation.

Read more about our investigation here:

What 130 Louisiana Bankruptcy Filings Reveal | 340B Hospital Debt A $386,758 hospital balance on a single Plain Dealing schedule. A review of 130 Louisiana bankruptcy filings and $954,000 in debt to 340B hospitals.