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News by Topic: Legislation and regulations

Nov 6, 2026 - Notice of a final rule with comment period 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 2027, 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 updates and refines requirements for the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Reporting Program; finalizes the implementation of provisions of the Consolidated Appropriations Act, 2026, regarding off-campus outpatient departments of a provider; and announces notices of closure of teaching hospitals and opportunities to apply for available slots. Comments are due by January 4, 2027. This rule is effective January 1, 2027.
Source: Federal Register
Nov 6, 2026 - Pre-publication notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) proposing to modify, remove, or streamline Medicare and Medicaid regulations deemed obsolete or excessively burdensome on healthcare providers and suppliers. These changes aim to reduce costs, enhance flexibility in delivering innovative care, and streamline existing regulations. Outlines proposed revisions for hospitals, long-term care facilities, intermediate care facilities for individuals with intellectual disabilities, Rural Emergency Hospitals, and Critical Access Hospitals (CAHs). Among other things, this proposed rule includes requests for information on potential changes to regulations regarding transplant programs, supervision of anesthesia services, and hospital and CAH respiratory illness and infectious disease data reporting. Comments are due 60 days after the publication of this notice, which is scheduled for November 10, 2026.
Source: Federal Register
Nov 6, 2026 - Pre-publication notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) that codifies the Medicare Drug Price Negotiation Program, establishes certain new policies for the Negotiation Program and the Medicare Prescription Drug Benefit Program as required by the Inflation Reduction Act of 2022, and finalizes a proposed modification to the fixed combination drug policy. These regulations are effective December 5, 2026, and are applicable to the Negotiation Program with respect to initial price applicability year 2029 and to Part D Program coverage beginning January 1, 2029.
Source: Federal Register
Nov 5, 2026 - Describes a proposed rule from the Centers for Medicare & Medicaid Services offering regulatory revisions to Conditions of Participation, Conditions for Coverage, and Requirements for Participation for Medicare- and Medicaid-participating providers and suppliers. Impacted facilities include Critical Access Hospitals and Rural Emergency Hospitals, among others. Also requests comments regarding other policies such as long-term care facility discharge; data reporting requirements; physician supervision of certified registered nurse anesthetists, physician assistants, and nurse practitioners; transplant program certification; and other policies addressing Medicaid institutional workforce.
Source: Centers for Medicare & Medicaid Services Newsroom
Nov 5, 2026 - Pre-publication notice of final rule from the Centers for Medicare & Medicaid Services (CMS) updating the home health payment rates for calendar year (CY) 2027. This rule also finalizes changes to the Home Health Quality Reporting Program (HH QRP) and summarizes potential initiatives to improve alignment between the HH QRP and the expanded Home Health Value-Based Purchasing (HHVBP) Model. Among other things, this rule finalizes permanent and temporary behavior adjustments and recalibrates the case-mix weights and updates the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2027; and summarizes and responds to comments received on the July 6, 2026, proposed rule regarding the provision of home health palliative care services and a home health specific wage index. The home health prospective payment system and HH QRP provisions of this rule and the regulatory changes at 42 CFR 484.245 are effective January 1, 2027. The remaining regulations are effective 60 days after the date of filing for public inspection. Publication is scheduled for November 9, 2026.
Source: Federal Register
Nov 5, 2026 - Pre-publication notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) addressing: 1) changes to the Physician Fee Schedule and Medicare Part B payment policies; 2) policies for the Medicare Prescription Drug Inflation Rebate Program under the Inflation Reduction Act of 2022; 3) limiting Medicare coverage of certain individuals; 4) the Ambulatory Specialty Model; 5) updates to drugs and biological products paid under Part B; 6) Medicare Shared Savings Program requirements; 7) updates to the Quality Payment Program; 8) updates to policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); 9) updates to the Ambulance Fee Schedule regulations; 10) codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2026 provisions; 11) updates to Clinical Laboratory Fee Schedule regulations; and 12) updates to the Medicare Promoting Interoperability Program. These regulations are effective January 1, 2027.
Source: Federal Register
Nov 4, 2026 - Notice from the Centers for Medicare & Medicaid Services making corrections to the November 2, 2026, notice regarding an information collection titled "Pre-Claim Review Demonstration for Home Health Services."
Source: Federal Register
Nov 3, 2026 - Notice of final rule from the U.S. Department of Health and Human Services (HHS) finalizing revisions to 45 CFR 84.4(g) in the regulation implementing section 504 of the Rehabilitation Act of 1973 as it applies to recipients of HHS funding to exclude gender dysphoria from the definition of "disability" and "individual with a disability." This rule is effective January 4, 2027.
Source: Federal Register
Nov 2, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the reinstatement of an information collection titled "Inpatient Psychiatric Unit Criteria Work Sheet." Information collected is used by inpatient psychiatric units (IPUs) to prove that they meet the requirements to be exempt from receiving payment from Medicare under the lower paying hospital inpatient prospective payment system (IPPS). Comments are due by January 4, 2027.
Source: Federal Register
Nov 2, 2026 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on revisions to an information collection titled "Pre-Claim Review Demonstration For Home Health Services." The approval of this data collection process is essential to ensure that the Review Choice Demonstration for Home Health Services is expanded to California within the specified timeframe. Comments are due by November 16, 2026.
Source: Federal Register