Policy / Regulatory Changes
Signals classified into this topic vertical.
235 signals
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Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice....
Policy / Regulatory Changes · 67 signals · last 30 days -
Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule (CMS-1851-F)
Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule (CMS-1851-F) On July 30, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1851-F) that would update Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2027 under existing statutory and regulatory requirements.
Policy / Regulatory Changes · 67 signals · last 30 days -
FY 2027 Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) Final Rule (CMS-1845-F)
FY 2027 Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) Final Rule (CMS-1845-F) On July 30, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for inpatient rehabilitation facilities under the Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for fiscal year (FY) 2027. CMS is publishing this final rule consistent with the le...
Policy / Regulatory Changes · 67 signals · last 30 days -
Medicare finalizes hospice, rehab and psych pay hikes
One final rule strengthens a tool meant to detect hospice fraud.
Policy / Regulatory Changes · 67 signals · last 30 days -
CCF Comments on Medicaid Work Reporting Requirements Interim Final Rule
The Georgetown University Center for Children and Families submitted the following comments to the Center for Medicare and Medicaid (CMS) and the U.S. Department of Health and Human Services (DHHS) regarding CMS’s Interim Final Rule (IFR) implementing H.R. 1-mandated Medicaid Work Reporting Requirements (WRRs). Read the Comments.
Policy / Regulatory Changes · 67 signals · last 30 days -
Indiana plans to cover GLP-1s for some Medicaid members under BALANCE model
Indiana Gov. Mike Braun directed the state to partake in CMS’ “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” model for GLP-1 access in Medicaid. According to a July 30 Indiana news release, under the pilot, GLP-1s will cost the state $85.16 per member per month. Through BALANCE’s negotiations with Eli Lilly and Novo […] The post Indiana plans to cover GLP-1s for some Medicaid members under BALANCE model appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS finalizes payment updates and coverage changes for IRFs
The Centers for Medicare & Medicaid Services July 30 released the fiscal year 2027 final rule for inpatient rehabilitation facilities. The rule will increase payments by 2.3% overall, which includes a 3.2% market basket update reduced by a 0.9 percentage point productivity adjustment. In addition, CMS updated the outlier threshold, which it says will increase overall payments by 0.4% in FY 2027.CMS also finalized two changes to the IRF coverage requirements. This includes a requirement that t...
Policy / Regulatory Changes · 67 signals · last 30 days -
Banks, Kim introduce stuttering legislation with backing of former NBA player
Sens. Jim Banks (R-Ind.) and Andy Kim (D-N.J.) on Wednesday introduced legislation that attempts to improve identification and treatment for children who stutter, with an assist from former NBA player Michael Kidd-Gilchrist. The legislation, titled the Kidd’s Stuttering Act, proposes directing the Centers for Medicare and Medicaid Services (CMS) to add stuttering and fluency screening...
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS' proposed 340B reimbursement cut—who wins, and who loses?
Disproportionate share hospitals are expected to see a 5.8% net reduction in OPPS revenue under the proposal, while for-profits are expecting a 7.4% net increase, KFF highlighted in a recent analysis of CMS projections.
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS ending Medicare Part D subsidy program
The Trump administration announced that it will end a subsidy program that aimed to keep premiums low for Medicare Part D beneficiaries.
Policy / Regulatory Changes · 67 signals · last 30 days -
Fiscal Year 2027 Medicare Inpatient Psychiatric Facility Prospective Payment System Final Rule (CMS-1847-F)
Fiscal Year 2027 Medicare Inpatient Psychiatric Facility Prospective Payment System Final Rule (CMS-1847-F) On July 29, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update Medicare payment policies and rates for Inpatient Psychiatric Facilities (IPFs) under the IPF Prospective Payment System (PPS) (CMS-1847-F) for fiscal year (FY) 2027. CMS is publishing this final rule consistent with its statutory authority to update Medicare payment policies for IPFs annu...
Policy / Regulatory Changes · 67 signals · last 30 days -
Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1843-F)
Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1843-F) On July 29, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for updates to Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for fiscal year (FY) 2027. CMS is publishing this final rule consistent with the legal requirements to update Medicare payment policies for SNFs annually. This...
Policy / Regulatory Changes · 67 signals · last 30 days -
Medicare nursing home pay to rise 2.4%
The final rule also moves up nursing home quality reporting deadlines.
Policy / Regulatory Changes · 67 signals · last 30 days -
Medicare Part D 2027 National Average Monthly Bid Amount Information
Medicare Part D 2027 National Average Monthly Bid Amount Information On July 28, 2026, the Centers for Medicare & Medicaid Services (CMS) released preliminary technical Medicare Part D bid information for contract year (CY) 2027 to help Part D plan sponsors finalize their Part D and Medicare Advantage (MA) offerings and prepare for Medicare Open Enrollment.
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS Medicaid Fraud War Room Stops More Than $203 Million in Improper Payments During First 88 Days
CMS Medicaid Fraud War Room Stops More Than $203 Million in Improper Payments During First 88 Days 50 high-risk providers identified through coordinated federal, state enforcement actions
Policy / Regulatory Changes · 67 signals · last 30 days -
Trump administration ending Medicare premium subsidy program
The Trump administration on Tuesday said it would move to end a Biden-era Medicare premium subsidy program, alleging it benefited insurance companies more than enrollees. As a result, Medicare Part D subsidies will expire at the end of the year and no longer be offered in 2027. Medicare Part D is optional prescription drug coverage...
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS to end Medicare Part D stabilization program
CMS will discontinue the Part D premium stabilization program at the end of this year, returning the standalone prescription drug plan market to what the agency called “traditional market conditions.” CMS said July 28 its analysis of 2027 bids indicated insurers had gained sufficient experience under the redesigned Part D benefit to support their assumptions […] The post CMS to end Medicare Part D stabilization program appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 67 signals · last 30 days -
Medicare’s Proposed Cut to 340B Drug Payments Would Hit Safety-Net Hospitals While Benefiting For-Profit Hospitals
This analysis finds that CMS’s proposed cut to Medicare reimbursement for 340B drugs, and accompanying increase for other outpatient services, would reduce revenues among safety-net hospitals while increasing revenues among for-profit hospitals.
Policy / Regulatory Changes · 67 signals · last 30 days -
Weaponizing Fraud Against Medicaid in California and Minnesota: Another Quarter, Another Round of Deferrals
At a July 21 press conference, CMS Administrator Mehmet Oz announced that his agency was deferring payment of $1.1 billion in federal Medicaid matching funds to California and Minnesota “pending review of high-risk claims in crackdown on fraud.” The amount of the California deferral was $867.5 million; the Minnesota deferral, $199.0 million. CMS has previously taken […]
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS’s Decision to End Temporary Subsidies to Medicare’s Stand-Alone Drug Plans Could Mean Larger Premium Increases for Some Beneficiaries Next Year
Without these extra subsidies in place for 2027, some Part D stand-alone drug plan (PDP) enrollees could see a larger premium increase for drug coverage next year than they’ve faced in recent years, though plan-specific premium amounts are not yet known. While some policymakers questioned the rationale for and cost of the premium stabilization demonstration, which totaled $9.8 billion in 2025 and 2026, the extra subsidies worked as intended to stabilize year-over-year PDP premium increases an...
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS to end subsidies for Medicare drug plan premiums
The CMS said the program, which went into effect last year to stabilize Part D premiums and enrollment, isn’t needed anymore. One researcher said some enrollees could see higher premium increases in 2027 as a result.
Policy / Regulatory Changes · 67 signals · last 30 days -
Developments in CBO's Projections for Medicare Part D
CBO provides current information about the budgetary effects of drug provisions in the 2022 Reconciliation Act; the effects of drug price negotiation, inflation rebates, and the Medicare Part D redesign; and ongoing updates to CBO's models.
Policy / Regulatory Changes · 67 signals · last 30 days -
Privacy Act of 1974; Matching Program
In accordance with the Privacy Act of 1974, as amended, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) is providing notice of the re-establishment of a matching program between CMS and the Office of Personnel Management, "Verification of Eligibility for Minimum Essential Coverage Under the Patient Protection and Affordable Care Act through an Office of Personnel Management Health Benefit Plan". The matching program provides CMS and State Admi...
Policy / Regulatory Changes · 67 signals · last 30 days -
Medicare drug plan subsidy to expire
Since 2025, Medicare Part D enrollees have had access to extra subsidies to defray higher premiums.
Policy / Regulatory Changes · 67 signals · last 30 days -
CMS Medicaid fraud unit flags 50 providers, $203M in payments
CMS says its “Medicaid Fraud War Room” has identified 50 high-risk providers tied to more than $203 million in Medicaid payments in its first 88 days. In a July 28 news release, CMS characterized the payments as “potentially improper,” and didn’t name any providers or states involved. The Medicaid unit, which launched in late April, […] The post CMS Medicaid fraud unit flags 50 providers, $203M in payments appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 67 signals · last 30 days