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Rural Health Information Hub
Rural Health Information Hub

Rural Health
News by Topic: Health insurance

Oct 30, 2026 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) making changes related to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2027 and updating the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). This rule also updates the requirements for the ESRD Quality Incentive Program. These regulations are effective January 1, 2027.
Source: Federal Register
Oct 29, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing the re-establishment of a matching program between CMS and State-Based Administering Entities (AEs), titled "Determining Eligibility for Enrollment in Applicable State Health Subsidy Programs Under the Patient Protection and Affordable Care Act." The matching program will enable CMS to provide information to AEs to assist in verifying applicant information to determine applicants' eligibility for enrollment in applicable state health subsidy programs under the Patient Protection and Affordable Care Act of 2010. Comments are due by November 30, 2026.
Source: Federal Register
Oct 27, 2026 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) regarding requirements outlined in the Working Families Tax Cut (WFTC) legislation related to health insurance exchange eligibility and verification. This proposed rule also includes updates to provisions affecting inconsistency periods, inconsistency verification procedures, and annual eligibility redeterminations and eligibility redeterminations during the plan year. This rule also proposes expanding enrollment methods during the verification process and establishing new coverage effective dates. Comments are due November 27, 2026.
Source: Federal Register
Oct 26, 2026 - Describes the application of a direct primary care (DPC) model of care in an agricultural Oklahoma community. Discusses how the model works, why a provider may want to use the model, and the geographic distribution of DPC practices.
Source: Farm Press
Oct 21, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on a new matching program between CMS and the Department of Veterans Affairs (VA) that would identify beneficiaries enrolled in both Medicare and Veterans Health Administration (VHA) healthcare. The matching program will be used to identify and recover duplicate payments; improve payment accuracy; and identify potential fraud, waste, and abuse. Comments are due by November 20, 2026.
Source: Federal Register
Oct 20, 2026 - Notice of a proposed rule that would implement the following sections of the Consolidated Appropriations Act, 2026: 1) section 6219, "Adjustments to Medicare Part D Cost-Sharing Reductions for Low-Income Individuals;" 2) section 6220, "Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act;" and 3) section 6224, "Modernizing and Ensuring Pharmacy Benefit Manager Accountability." The implementation of Section 6219 would reduce the generic drug copayment from $1 to $0 for full-benefit dual eligible individuals at or below 100% of the Federal Poverty Level, effective for plan years starting January 1, 2028. The implementation of Section 6220, the REAL Health Providers Act, would establish new provider directory accuracy and accountability requirements for Medicare Advantage (MA) organizations beginning in contract year 2028. In addition, CMS has several proposals to implement section 6224, which established requirements related to pharmacy benefit managers (PBMs) and their affiliates specific to the Medicare Part D program. Comments are due by December 15, 2026.
Source: Federal Register
Oct 16, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the following information collections: 1) Annual State Report on CMS Value Based Purchasing Arrangements (VBP) Supplemental Rebate Agreements; and 2) Generic Clearance for Improving Customer Experience (OMB Circular A-11, Section 280 Implementation). Comments are due by December 15, 2026.
Source: Federal Register
Oct 7, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the following information collections: 1) Transformed-Medicaid Statistical Information System (T-MSIS) and 2) Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery. Comments are due by November 6, 2026.
Source: Federal Register
Oct 6, 2026 - Notice of final rule from the Internal Revenue Service (IRS), Department of the Treasury, Employee Benefits Security Administration (EBSA), Department of Labor (DOL), Centers for Medicare & Medicaid Services (CMS), and Department of Health and Human Services (HHS) amending regulations under the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code regarding price transparency reporting requirements for non-grandfathered group health plans and health insurance issuers offering non-grandfathered group and individual health insurance coverage. These final rules aim to improve the standardization, accuracy, and accessibility of public pricing disclosures in line with the goals of Executive Order 14221. These regulations are effective December 7, 2026.
Source: Federal Register
Oct 5, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the proposed revision of an information collection titled "Medicare Health Outcomes Survey." The Medicare Health Outcomes Survey is a longitudinal patient-reported outcome measure that assesses self-reported beneficiary quality of life and daily functioning and allows CMS to assess the health of the Medicare Advantage population. Comments are due by December 4, 2026.
Source: Federal Register