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Rural Health Information Hub
Rural Health Information Hub

Rural Health
News by Topic: Health insurance

Nov 25, 2025 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) making changes to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2026, including changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment systems. Among other things, this rule also updates the requirements for the Hospital Outpatient Quality Reporting Program, Rural Emergency Hospital Quality Reporting Program, Ambulatory Surgical Center Quality Reporting Program, Overall Hospital Quality Star Rating, and hospitals to make public their standard charge information and enforcement of hospital price transparency. This rule also announces the closure of a teaching hospital and the opportunity to apply for available slots. This rule is effective January 1, 2026. Applications for available resident spots are due by February 19, 2026.
Source: Federal Register
Nov 25, 2025 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing that CMS will share certain information with the U.S. Department of Homeland Security (DHS), and its component agency, U.S. Immigration and Customs Enforcement (ICE) upon request. The information shared may include Medicaid information or data shared with CMS by states. This notice is applicable immediately.
Source: Federal Register
Nov 24, 2025 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) making changes related to End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2026 and updating the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). Among other things, this rule also updates requirements for the ESRD Quality Incentive Program and modifying and terminating requirements for the ESRD Treatment Choices Model. These regulations are effective January 1, 2026.
Source: Federal Register
Nov 24, 2025 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) 13th SOW Quality Innovation Network—Quality Improvement Organization (QIN-QIO) and American Indian Alaskan Native (AIAN) Measure Data Collection; 2) Provider Directory Data for Medicare Plan Finder; and 3) CMS Electronic Data Interchange (EDI) Enrollment Registration, CMS EDI Enrollment Form, and CMS EDI Enrollment Attestation Form. Comments are due by January 23, 2026.
Source: Federal Register
Nov 21, 2025 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on the following information collections: 1) Advance Beneficiary Notice of Non-coverage; 2) Medicare Current Beneficiary Survey; 3) Information Collection Requirements in HSQ-110, Acquisition, Protection and Disclosure of Peer review Organization Information and Supporting Regulations; and 4) Information Collection Requirements in 42 CFR 478.18, 478.34, 478.36, 478.42, QIO Reconsiderations and Appeals. Comments are due December 22, 2025.
Source: Federal Register
Nov 20, 2025 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on the following information collections: 1) Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP); 2) Data Request and Attestation for PDP Sponsors; 3) Cooperative Agreement to Support Navigators in Federally-facilitated Exchanges and State Partnership Exchanges; 4) Data Collection to Support Eligibility Determinations for Small Businesses in the Small Business Health Options Program; and 5) State-based Exchange Annual Reporting Tool (SMART). Comments are due by January 20, 2026.
Source: Federal Register
Nov 20, 2025 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on the following information collections: 1) Hospital Wage Index Occupational Mix Survey; 2) Medicare Enrollment Application—Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers; 3) Recognition of Pass-Through Payment for Additional (New) Categories of Devices under the Outpatient Prospective Payment System and Supporting Regulations; and 4) Registration, Attestation, Dispute Resolution and Correction, Assumptions Document and Data Retention Requirements for Open Payments. Comments are due December 22, 2025.
Source: Federal Register
Nov 20, 2025 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on an information collection titled "Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges" which reinstates a previously approved information collection expanding the role of agents/brokers by permitting them to enroll qualified individuals or small employers/employees in qualified health plans through the Exchanges, and assist individuals in applying for Advance Premium Tax Credits and Cost Sharing Reductions. To participate as facilitators to enrollment, agents/brokers must register with the federally-facilitated exchanges, complete a training course covering eligibility and enrollment criteria for assisting in enrollment, and sign agreements that formalize their understanding and commitment to adhere to the rules of the program. Comments are due December 22, 2025.
Source: Federal Register
Nov 19, 2025 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on an information collection titled "Methods for Assuring Access to Covered Medicaid Services Under 42 CFR 447.203 and 447.204." CMS will use the information to monitor ongoing compliance with section 1902(a)(30)(A) of the Social Security Act, and to make informed approval decisions on State plan amendments that propose to make Medicaid rate reductions or restructure payment rates. Beneficiaries, providers, and other affected stakeholders may use the information to raise access issues to state Medicaid agencies and work with agencies to address those issues. Comments are due by January 20, 2026.
Source: Federal Register
Nov 19, 2025 - The Centers for Medicare & Medicaid Services (CMS) will hold a virtual public meeting on December 17, 2025 from 9:00 a.m. until 5:00 p.m. Eastern to discuss CMS preliminary coding, Medicare benefit category, and Medicare payment determinations, if applicable, for new revisions to the HCPCS Level II code set for non-drug and non-biological items and services. If all of the agenda items are not addressed on December 17, 2025, a subsequent virtual session will be held on December 18, 2025 at 9:00 a.m. Eastern. All individuals who plan to speak must register by December 3, 2025.
Source: Federal Register