US Federal Register - CMS Rules

CLIA: Virtual Access, Gynecologic Cytology Proficiency Testing, Personnel Qualifications, and Other Changes — Proposed Rule

Proposed amendments to CLIA regulations to permit virtual access for laboratory testing data, digital images for cytology proficiency testing, and updated personnel and reporting requirements.

Medicare and Medicaid Programs; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage, Medicaid, CHIP, and Qualified Health Plans

Proposed requirements for electronic prior authorization for drugs and extended interoperability standards across Medicare Advantage, Medicaid, CHIP, and QHP issuers.

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and Long-Term Care Hospital Prospective Payment System and Policy Changes; FY 2027 Rates; Quality Programs; Health Information Technology Standards

CMS revises IPPS and LTCH payment rates for FY 2027, updates quality program requirements, and ONC adopts updated health IT standards.

Global Benchmark for Efficient Drug Pricing (GLOBE) Model

CMS implements mandatory Medicare payment model testing alternative drug inflation rebate calculation for Part B drugs to reduce costs.

Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction

Correction of technical errors in the final rule establishing FY 2027 hospice wage index, payment rates and quality reporting requirements.

Request for Information: Medicare Part D Reasonable and Relevant Pharmacy Contracting Standards

CMS solicits input on standards for reasonable and relevant pharmacy contract terms under Medicare Part D, effective plan year 2029.

Request for Information on Clinical Laboratory Improvement Amendments (CLIA) Regulations

CMS and CDC seek public input on updating CLIA regulations covering breath testing, laboratory processes, emergency preparedness, biosafety, biosecurity, and cybersecurity.

Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children

Federal Medicaid and CHIP funding prohibited for sex-rejecting procedures in individuals under 18 (Medicaid) and 19 (CHIP); existing hormone therapy may continue for 6 months.

Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements

Updates hospice wage index, payment rates, aggregate cap, and quality reporting requirements for fiscal year 2027.

Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program

Final rule updates IRF prospective payment rates for FY 2027, completes rural adjustment phaseout, and establishes therapy and team-meeting timing requirements.

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027

Final rule updates SNF prospective payment rates, quality reporting requirements, and value-based purchasing program for FY 2027.

Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update

CMS updates IPF prospective payment rates, wage index, outlier thresholds, and implements standardized patient assessment for FY 2027.

Medicare Program: Updates to Master List of Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements

CMS updates HCPCS codes on the Master List and the Required Face-to-Face Encounter and Written Order Prior to Delivery and Prior Authorization Lists.

Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes

Proposed rule revising indirect hold harmless thresholds for health care-related taxes, effective October 1, 2026 and 2027, implementing the Working Families Tax Cut legislation.

CY 2027 Medicare Payment Policies: Physician Fee Schedule, Part B Payment, Shared Savings Program, and Prescription Drug Inflation Rebate Program

CMS proposes updates to physician fee schedule, Part B payment policies, Medicare Shared Savings Program, Quality Payment Program, and Promoting Interoperability Program for calendar year 2027.

Medicare Program; Contract Year 2027 and Certain Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program

Final rule revises Medicare Advantage, Prescription Drug Benefit, and cost plan regulations for Star Ratings, marketing, drug coverage, and enrollment.

Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DMEPOS Policies

CMS proposes updates to Medicare home health payment rates, case-mix weights, quality reporting requirements, and DME enrollment and benefit policies for calendar year 2027.

Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program

Final rule sets 2027 payment parameters, user fee rates for health plan issuers, risk adjustment provisions, and QHP certification standards including provider access and essential health benefit requirements.

Medicare Program; CY 2027 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Acute Kidney Injury Dialysis (AKI) Payment, and ESRD Quality Incentive Program

Proposed updates to ESRD prospective payment rates, AKI dialysis payment, and ESRD Quality Incentive Program requirements for calendar year 2027.

Medicare Program; Strengthening Oversight of Accrediting Organizations and Preventing AO Conflicts of Interest

Final rule strengthens oversight of Medicare accrediting organizations, addresses conflicts of interest, establishes consistent standards, and revises survey processes.

Medicare Drug Price Negotiation Program and Medicare Prescription Drug Benefit Program

Proposed rule to codify the Medicare Drug Price Negotiation Program and establish new policies for drug pricing and the prescription drug benefit under the Inflation Reduction Act.

Medicaid Program; Community Engagement Requirement for Certain Individuals

CMS interim final rule implementing Medicaid community engagement requirement under Social Security Act section 1902(xx), effective January 1, 2027.

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2027 Rates; Requirements for Quality Programs; and Other Policy Changes

Proposed rule revising Medicare IPPS and LTCH PPS payment rates, GME policies, and quality program requirements for FY 2027.

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027

CMS proposes updates to SNF payment rates, quality reporting requirements, and value-based purchasing policies for fiscal year 2027.

Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update

CMS updates prospective payment rates, outlier thresholds, wage index, and quality reporting measures for inpatient psychiatric facilities effective October 1, 2026.

Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements

Proposed updates to hospice wage index, payment rates, aggregate cap, quality reporting requirements, and election statement procedures for FY 2027.

Medicaid Program; Community Engagement Requirement for Certain Individuals

Notice of Vacatur Regarding Certain Provisions of the 2024 Nondiscrimination in Health Programs and Activities Final Rule

US District Court vacated portions of the 2024 Section 1557 Rule expanding Title IX sex discrimination to include gender-identity discrimination.

Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations—Closing a Health Care-Related Tax Loophole

Final rule closes loophole in statistical test for state Medicaid tax waivers to ensure health care-related taxes are generally redistributive.

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Prior Authorization; and Hospital Price Transparency Data Standardization

Proposed rule revising Medicare OPPS and ASC payment rates for 2027, updating quality reporting requirements, expanding prior authorization for Botulinum Toxin services, and requesting information on hospital price transparency standardization.

Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program

Proposed rule on 2027 ACA payment parameters, user fees for qualified health plans, risk adjustment programs, and QHP certification standards.

Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model

Final rule updates the IOTA Model for Performance Year 2 and includes a technical correction to regulatory text.

Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments

Proposed rule to modify limits on state directed payments in Medicaid managed care and targeted payments in fee-for-service.

Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program

Proposed rule updates IRF prospective payment rates for FY 2027, continues rural adjustment phaseout, and solicits comments on wage index data sources and payment reform.

Request for Information on Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH)

CMS solicits stakeholder feedback on potential regulatory changes to strengthen fraud detection and prevention in healthcare programs.

Medicare IPPS and LTCH PPS for FY 2027: Correction to Final Rule

Correction of technical and typographical errors in the August 4, 2026 final rule on hospital inpatient and long-term care prospective payment systems and health IT standards adoption.

Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program; Correction

Correction of technical errors in the August 3, 2026 final rule on IRF prospective payment and quality reporting.

Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update; Correction

Correction of technical errors in the final FY 2027 inpatient psychiatric facilities prospective payment system rate update.

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027; Correction

Correction of technical errors in the July 31, 2026 final rule on skilled nursing facility payment and quality reporting.

Request for Information: Pharmacy Benefit Manager Compensation and Data Collection

CMS solicits input on PBM services and business practices to inform implementation of 2028 legislative restrictions on PBM remuneration and data reporting requirements.

CY 2026 Medicare Physician Fee Schedule Payment Policies: Correction

Correction of typographical and technical errors in the November 5, 2025 final rule on CY 2026 Medicare physician fee schedule and Part B payment policies.

Medicare Program; Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots; Correcti

Technical corrections to the CY 2026 OPPS/ASC final rule with comment period effective January 1, 2026.

Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program — Correction

This document corrects typographical errors in the final rule that appeared in the May 20, 2026, Federal Register titled "Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 20...

Medicare IPPS and Long-Term Care Hospital PPS for FY 2027: Correction to Proposed Rule

Correction of technical and typographical errors in the April 14, 2026 proposed rule on hospital inpatient and long-term care prospective payment systems.

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction

This document corrects a typographical error in the proposed rule that appeared in the April 14, 2026 Federal Register titled "Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals ...

Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program — Correction

This document corrects technical errors in the proposed rule that appeared in the February 11, 2026, Federal Register titled "Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters fo...