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Rural Health
News by Topic: Reimbursement and payment models

Aug 4, 2026 - Notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) revising the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2027. This rule also makes changes 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 requirements for certain quality programs, among other things. The Office of the National Coordinator for Health Information Technology (ONC) also adopts certain health information technology (health IT) standards and specifications on behalf of HHS. These regulations are effective October 1, 2026.
Source: Federal Register
Aug 3, 2026 - Notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) updating the prospective payment system (PPS) rates for inpatient rehabilitation facilities (IRFs) for fiscal year 2027. Among other things, this rule includes classification and weighting factors for the IRF prospective payment system's case-mix groups, finalizes the third and final year of the 3-year phase-out of the rural adjustments, and updates the IRF Quality Reporting Program and changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. This rule also summarizes comments received in response to requests for information regarding alternative data sources for the IRF PPS wage index and potential future IRF PPS payment reform. These regulations are effective October 1, 2026.
Source: Federal Register
Aug 3, 2026 - Notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) updating the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. Among other things, this rule finalizes conforming regulation text changes to discharge from hospice care regulations and the face-to-face encounter regulations. This rule also summarizes comments received in response to requests for information regarding community-based palliative care; the construction of a hospice-specific wage index; and the overlap between hospice and medical aid in dying laws. These regulations are effective October 1, 2026.
Source: Federal Register
Aug 3, 2026 - Notice from the Health Resources and Services Administration (HRSA) announcing the availability of a revised 340B Rebate Model Pilot Program (Pilot). The Pilot provides a rebate mechanism through which qualifying drug manufacturers may effectuate the 340B ceiling price for certain drugs sold to covered entities. Eligible manufacturers seeking to participate in the 340B Rebate Model Pilot Program must submit plans to 340BPricing@hrsa.gov by August 24, 2026, for an effective date of January 1, 2027.
Source: Federal Register
Jul 31, 2026 - Notice of final 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 also refines the IPF PPS outlier policy, implements a standardized IPF patient assessment, and removes two measures used in the IPF Quality Reporting Program. These regulations are effective October 1, 2026.
Source: Federal Register
Jul 31, 2026 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) updating the skilled nursing facility (SNF) prospective payment system (PPS) payment rates for fiscal year 2027. This rule also updates the requirements for the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program. These regulations are effective October 1, 2026.
Source: Federal Register
Jul 31, 2026 - Announces the revised 340B Rebate Model Pilot Program to use a claims-based rebate approach. Eligible manufacturers must submit rebate plans by August 24, 2026 for pricing periods effective January 1, 2027.
Source: Health Resources & Services Administration
Jul 16, 2026 - Notice of a proposed 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) the Ambulatory Specialty Model; 4) updates to drugs and biological products paid under Part B; 5) Medicare Shared Savings Program requirements; 6) updates to the Quality Payment Program; 7) updates to policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); 8) updates to the Ambulance Fee Schedule regulations; 9) codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2026 provisions; 10) updates to Clinical Laboratory Fee Schedule regulations; and 11) updates to the Medicare Promoting Interoperability Program. Comments are due on September 14, 2026.
Source: Federal Register
Jul 9, 2026 - Describes an air medical response nonprofit program in Montana that aims to bring emergency medical care to residents in remote parts of the state. Discusses how the group manages Montana's geographic and weather challenges, costs associated with equipment and training, and its membership model.
Source: NBC Montana
Jul 8, 2026 - The Centers for Medicare & Medicaid Services (CMS) will hold a virtual meeting of the Advisory Panel on Hospital Outpatient Payment on August 24, 2026. The purpose of the Panel is to advise the Secretary on the clinical integrity of the Ambulatory Payment Classification groups and their associated weights, which are major elements of the Medicare Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center payment system, and supervision of hospital outpatient therapeutic services. The agenda and information on how to join the meeting will be posted on the Panel's website. Presentations and comment letters are due by July 31, 2026.
Source: Federal Register