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News by Topic: Health insurance

Apr 16, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical corrections to the April 14, 2026, proposed rule. Comments on the proposed rule are due by June 9, 2026.
Source: Federal Register
Apr 14, 2026 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) proposing to improve the electronic exchange of healthcare data and streamline processes related to prior authorization by increasing the interoperability of systems used across the healthcare industry. Among other things, this rule proposes new requirements for Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to make electronic prior authorization for drugs available; to report their application programming interfaces (API) endpoints and related information for the Patient Access, Provider Directory, Provider Access, Payer-to-Payer, and Prior Authorization APIs to CMS; and extend many existing interoperability requirements for the prior authorization of non-drug items and services to include prior authorizations for drugs. In addition, ONC proposes adopting updated versions of certain health information technology (health IT) standards and specifications for HHS use. Comments are due by June 15, 2026.
Source: Federal Register
Apr 14, 2026 - Notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) regarding changes to the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2027. Contains details of proposed changes related to Medicare graduate medical education (GME) for teaching hospitals; payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals; and certain quality programs, among other things. Comments are due by April 10, 2026.
Source: Federal Register
Apr 14, 2026 - Notice from the Centers for Medicare and Medicaid Services (CMS) of a hybrid public meeting on June 1-2, 2026, to discuss the preliminary coding, Medicare benefit category, and Medicare payment determinations for new revisions to the Healthcare Common Procedure Coding System (HCPCS) Level II code set. The agenda and information on how to join the meeting will be posted on the CMS website. Registration is required for in-person attendees.
Source: Federal Register
Apr 9, 2026 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of receipt of an application from DNV Healthcare Inc. for continued recognition as a national accrediting organization for hospitals that wish to participate in the Medicare or Medicaid programs. Comments are due by May 11, 2026.
Source: Federal Register
Apr 7, 2026 - Notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) that would update the skilled nursing facility (SNF) prospective payment system (PPS) payment rates for fiscal year 2027. Among other things, this rule includes proposals to update the requirements for the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program. Comments are due by June 1, 2026.
Source: Federal Register
Apr 7, 2026 - Notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) updating the FY 2027 prospective payment rates, outlier threshold, and wage index for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF), including psychiatric hospitals and excluded psychiatric units of an acute care hospital or Critical Access Hospital. Among other things, this rule proposes refinement of the IPF PPS outlier policy, implementation of a standardized IPF patient assessment, and the removal of two measures used in the IPF Quality Reporting Program. Comments are due by June 1, 2026.
Source: Federal Register
Apr 6, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the extension of an information collection titled "Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instruction." The physician certification and recertification are intended to ensure that the beneficiary's need for services has been established and then reviewed and updated at appropriate intervals and are conditions for Medicare Part A payment for post-hospital skilled nursing facility (SNF) care. Comments are due by June 5, 2026.
Source: Federal Register
Apr 6, 2026 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) revising the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan regulations. Among other things, this rule finalizes revisions related to Star Ratings, marketing and communications, drug coverage, enrollment processes, special needs plans, and other programmatic areas for contract year 2027. These regulations are effective June 1, 2026, and are applicable to coverage beginning January 1, 2027.
Source: Federal Register
Apr 6, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing a delay in the implementation of two services from the list of Wasteful and Inappropriate Services Reduction (WISeR) model items and services. The two services for which the prior authorization or pre-payment review process are delayed are 1) Deep Brain Stimulation for Essential Tremor and Parkinson's Disease (NCD 160.24) and 2) Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13). This notice is effective April 6, 2026.
Source: Federal Register