Rural Health & Human Services News by Topic: Health insurance - Rural Health Information Hub

CMS: Medicare and Medicaid Programs; Application From The Joint Commission for Continued CMS Approval of Its Home Health Agency (HHA) Accreditation Program

Fri, 10 Jul 2026 00:00:00 -0500

The Centers for Medicare & Medicaid Services (CMS) announces the approval of The Joint Commission for continued recognition as a national accrediting organization for home health agencies that wish to participate in Medicare or Medicaid programs. This approval is effective March 31, 2026, through June March 31, 2032.

CMS: Medicare Program; Announcement of the Advisory Panel on Hospital Outpatient Payment Meeting-August 24, 2026

Wed, 08 Jul 2026 00:00:00 -0500

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.

CMS: Privacy Act of 1974; Matching Program

Tue, 07 Jul 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the re-establishment of a matching program between CMS and the Department of Veterans Affairs (VA) titled "Verification of Eligibility for Minimum Essential Coverage Under the Patient Protection and Affordable Care Act." CMS will share data with the VA to verify if an applicant is enrolled in Minimum Essential Coverage in a Veterans Health Administration Health Care Program. This information from the VA will be used to assist CMS in determining if an individual is eligible for Insurance Affordability Programs. Comments are due by August 6, 2026.

CMS: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots

Tue, 07 Jul 2026 00:00:00 -0500

Notice of a proposed 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 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 also proposes updates related to the requirements for the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Reporting Program; requests information regarding potential approaches to improve comparability and standardization of the HPT information reported in machine-readable files and consumer-friendly displays, particularly for complex contracting methodologies; and announces notices of closure of teaching hospitals and opportunities to apply for available slots. Comments are due by August 31, 2026.

CMS: Privacy Act of 1974; Matching Program

Mon, 06 Jul 2026 00:00:00 -0500

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) titled "Verification of Eligibility for Insurance Affordability Programs Under the Patient Protection and Affordable Care Act." This matching program will provide CMS with information for determining individuals' eligibility for Insurance Affordability Programs (IAPs). Comments are due by August 5, 2026.

DOD: TRICARE Demonstration Project for TRICARE Ambulance Add-On Reimbursement for Pre-Hospital Blood Transfusion

Mon, 06 Jul 2026 00:00:00 -0500

Notice from the U.S. Department of Defense announcing a new demonstration project titled "TRICARE Demonstration Project for Pre-Hospital Blood Transfusion Ambulance Add-On Reimbursement," also called the "TRICARE PHBT Demonstration" or "PHBTD." This five-year demonstration will test the effectiveness of providing separate, unbundled add-on reimbursement to the TRICARE ambulance fee schedule for the cost of medically necessary blood products and professional services administered by authorized ambulance providers in a pre-hospital setting. The PHBTD will be effective January 1, 2027, and will conclude on December 31, 2031.

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request

Mon, 06 Jul 2026 00:00:00 -0500

The Centers for Medicare & Medicaid Services (CMS) is seeking comments on the following information collections: 1) Rural Health Transformation Program Reporting and 2) Medicare Part C and Part D Program Audit and Industry-Wide Part C Timeliness Monitoring Project (TMP) Protocols. Comments are due by August 5, 2026.

CMS: Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies

Mon, 06 Jul 2026 00:00:00 -0500

Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) updating the home health payment rates for calendar year (CY) 2027. This rule also proposes changes to the Home Health Quality Reporting Program (HH QRP) and summarizes potential initiatives to improve alignment between the HH QRP and the expanded Health Value-Based Purchasing (HHVBP) Model requirements. Among other things, this proposed rule discusses the provision of home health palliative care services and includes a request for information (RFI) on a home health specific wage index. Comments are due by August 31, 2026.

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request

Thu, 02 Jul 2026 00:00:00 -0500

The Centers for Medicare & Medicaid Services (CMS) is seeking comments on the following information collections: 1) Submissions of Acute Hospital Care at Home (AHCAH) Waiver Submission and Data Collection; 2) Clinical Laboratory Improvement Amendments (CLIA) Regulations; and 3) Granting and Withdrawal of Deeming Authority to Private Nonprofit Accreditation Organizations and CLIA Exemption Under State Laboratory Programs. Comments are due by August 3, 2026.

What Are the Top Threats Rural Hospitals Face for Survival?

Tue, 30 Jun 2026 00:00:00 -0500

Highlights common rural hospital healthcare delivery challenges as identified by Wisconsin hospital CEOs. Discusses nursing workforce shortages, employee burnout, reimbursement rates, cybersecurity, artificial intelligence, home health, Medicare Advantage, and maintaining inpatient care access.

CMS: Medicaid Program; Community Engagement Requirement for Certain Individuals

Mon, 29 Jun 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) making corrections to the June 3, 2026, interim final rule titled "Medicaid Program; Community Engagement Requirement for Certain Individuals."

CMS: Medicare Program; CY 2027 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Acute Kidney Injury Dialysis (AKI) Payment, and ESRD Quality Incentive Program

Fri, 26 Jun 2026 00:00:00 -0500

Notice of proposed 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 2027 and proposing updates to 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 proposes updated requirements for the ESRD Quality Incentive Program and includes requests for information (RFI) to inform future policies related to increasing home dialysis uptake, improving palliative dialysis, and supporting alternative dialysis schedules. Comments are due by August 24, 2026.

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request

Thu, 18 Jun 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on revisions to an information collection titled "Submission of 1135 Waiver Request Automated Process." CMS aims to better support emergency response by capturing the emergency date, simplifying ongoing status updates for stakeholders, and providing a more comprehensive view of cybersecurity incidents through expanded reporting on patient and operational impacts. The Acute Hospital Care at Home (AHCAH) initiative was codified in the Consolidate Appropriations Act, 2025, and is no longer part of the 1135 waiver information collection request. Comments are due by July 20, 2026.

CMS: Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard

Mon, 15 Jun 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) seeking public input regarding its comprehensive review of the Essential Health Benefits (EHB) framework and the requirement that the scope of EHB be equal to the scope of benefits provided under a typical employer plan. Among other things, CMS seeks comments on current interpretations of EHB, state approaches to selecting and updating EHB-benchmark plans, methodologies used to determine the scope of benefits included as EHB, and how these approaches relate to access and market stability under the Patient Protection and Affordable Care Act. Comments are due by July 15, 2026.

CMS Takes Bold New Approach to Stewarding Medicaid Demonstration Project Spending

Thu, 11 Jun 2026 00:00:00 -0500

Describes a planned notice of proposed rulemaking regarding budget neutrality standards for Medicaid section 1115 demonstrations. The new standard is expected to be in effect on or after January 1, 2027. States with demonstrations up for renewal in 2027 may be required to take additional steps in the renewal process. More information will be released in future rulemaking.

CMS: Statement of Organization, Functions, and Delegations of Authority

Thu, 11 Jun 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) establishing the CMS Office of Health Technology and Products (OHTP). OHTP will provide enterprise leadership and oversight for CMS healthcare technology modernization, digital products, and transformation of platforms and services supporting Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and other CMS-administered programs. This organizational change was effective June 9, 2026.

CMS: Announcement of the Approval of COLA as an Accreditation Organization for the Specialty of Histocompatibility Under the Clinical Laboratory Improvement Amendments of 1988

Wed, 10 Jun 2026 00:00:00 -0500

Announcement from the Centers for Medicare & Medicaid Services (CMS) of the approval of the Commission on Laboratory Accreditation (COLA) as an accreditation organization for clinical laboratories under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) program for the specialty of histocompatibility. This approval is applicable from July 10, 2026, to June 10, 2031.

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request

Wed, 10 Jun 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the extension of an information collection titled "Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instruction." The physician certification and recertification is intended to ensure that the beneficiary's need for services has been established and then reviewed and updated at appropriate intervals and is a condition for Medicare Part A payment for post-hospital skilled nursing facility (SNF) care. Comments are due by July 10, 2026.

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request

Wed, 10 Jun 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the reinstatement with change of an information collection titled "Generic Clearance for the Collection of Qualitative Feedback." Information collected will be used to ensure that CMS customers and stakeholders have effective, efficient, and satisfying experiences with CMS's programs. Comments are due by August 10, 2026.

OPM, TREAS, DOL, HHS: Federal Independent Dispute Resolution Operations

Thu, 04 Jun 2026 00:00:00 -0500

Notice of final rule from the Office of Personnel Management; Internal Revenue Service (IRS), Department of the Treasury; Employee Benefits Security Administration (EBSA), Department of Labor (DOL); and Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS) related to certain provisions of the No Surprises Act regarding the Federal independent dispute resolution (IDR) process. Among other things, this rule finalizes new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act, amendments to certain requirements related to the open negotiation period preceding the Federal IDR process, and the definition of bundled payment arrangements. These rules are effective August 3, 2026.

CMS: Medicaid Program; Community Engagement Requirement for Certain Individuals

Wed, 03 Jun 2026 00:00:00 -0500

Notice of an interim final rule with comment period from the Centers for Medicare & Medicaid Services (CMS) related to the Medicaid community engagement requirement established by Public Law 119-21. This rule specifies the requirements and expectations for States implementing the community engagement requirement, including the Medicaid applicants and beneficiaries who must demonstrate community engagement as a condition of their eligibility, the types of qualifying activities that satisfy the community engagement requirement, the criteria to meet an exception from the requirement, and the criteria to meet a specified exclusion from the requirement. Among other things, this rule also establishes new state reporting requirements. These regulations are effective July 31, 2026. Comments are due by July 31, 2026.

CMS: Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model

Mon, 01 Jun 2026 00:00:00 -0500

Notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) updating and revising the Increasing Organ Transplant Access Model (IOTA Model) for Performance Year (PY) 2. The IOTA Model tests whether performance-based upside risk payments or downside risk payments paid to or owed by participating kidney transplant hospitals increase access to kidney transplants for patients with end-stage renal disease (ESRD) while preserving or enhancing the quality of care and reducing Medicare expenditures. This rule is effective July 1, 2026.

CMS: Medicare Program: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2027 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction

Fri, 22 May 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services making technical and typographical corrections to the April 14, 2026, proposed rule. Comments on the proposed rule are due by June 9, 2026.

CMS: Medicaid Program: Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments

Fri, 22 May 2026 00:00:00 -0500

Notice of proposed rule from the Centers for Medicare & Medicaid Services describing alternatives to modify the limit on the total payment rate and other requirements for State directed payments in Medicaid managed care. This rule also proposes to set a limit for certain targeted Medicaid payments in Medicaid fee-for-service. Includes rural considerations throughout. Comments are due July 21, 2026.

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request

Wed, 20 May 2026 00:00:00 -0500

The Centers for Medicare & Medicaid Services is seeking comments on the following information collections: 1) Administrative Requirements for Section 6071 of the Deficit Reduction Act; and 2) Medicaid Managed Care Quality Including Supporting Regulations. Comments are due within 60 days of this notice.

CMS: Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request

Wed, 20 May 2026 00:00:00 -0500

The Centers for Medicare & Medicaid Services is seeking comments on the following information collections: 1) CHIPRA Connecting Kids to Coverage Outreach and Enrollment; and 2) Behavioral Health Clinic Quality Data Reporting. Comments are due June 3, 2026.

CMS: Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program

Wed, 20 May 2026 00:00:00 -0500

Notice of final rule from the Centers for Medicare & Medicaid Services containing methods to improve the implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs. Among other things, this rule also contains 2027 user fee rates for qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This rule is effective July 20, 2026.

CMS: Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Nationwide Temporary Moratorium on Enrollment of Hospices

Fri, 15 May 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) announcing a 6-month nationwide moratorium on the Medicare enrollment of hospices. The moratorium takes effect on May 13, 2026.

CMS: Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Nationwide Temporary Moratoria on Enrollment of Home Health Agencies (HHAs)

Fri, 15 May 2026 00:00:00 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) announcing a 6-month nationwide moratorium on the Medicare enrollment of home health agencies. The moratorium takes effect on May 13, 2026.

CMS: Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January through March 2026

Thu, 14 May 2026 00:00:00 -0500

Quarterly listing of Centers for Medicare & Medicaid Services (CMS) manual instructions, substantive and interpretive regulations, and Federal Register notices published from January through March 2026, including contact information for general questions or additional information about specific sections.