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Rural Health Information Hub
Rural Health Information Hub

Rural Health
News by Topic: Reimbursement and payment models

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
Nov 2, 2026 - Discusses non-emergency medical transportation, including both the benefits of the service and the health impacts on patients who lack transportation. Highlights ongoing research investigating the service in Minnesota, including the impact on hospital finances, reimbursement issues, and certifying drivers.
Source: The Daily Yonder
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 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 21, 2026 - Describes challenges with emergency medical services (EMS) provision in rural Vermont, discussing patients using EMS for primary care and low reimbursement rates. Notes possible policy measures to address EMS challenges.
Source: VTDigger
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 9, 2026 - A Maine health center has avoided bankruptcy after receiving funds from Maine's Rural Health Transformation Program. The funding will allow the facility to use a new medical records system and alternative payment models.
Source: Maine Public