Rural Healthcare Payment and Reimbursement – News

CMS: Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction Federal Register

Nov 28, 2025 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical corrections to the November 5, 2025, final rule. This correction is effective January 1, 2026.

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CMS: Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program Federal Register

Nov 28, 2025 - Notice of a proposed rule from the Centers of Medicare & Medicaid Services (CMS) that would revise the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), and Medicare cost plan regulations. Proposed revisions would implement changes related to Star Ratings, marketing and communications, drug coverage, enrollment processes, special needs plans, and other programmatic areas for contract year 2027. Among other things, this proposed rule also includes a request for information regarding changes to the Medicare Advantage (MA) that would modernize and improve the MA program and could be implemented through either programmatic changes or through a CMS Innovation Center (CMMI) model. Comments are due by January 26, 2026.

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CMS: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices Model Federal Register

Nov 24, 2025 - Notice of final 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 2026 and updating 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 updates requirements for the ESRD Quality Incentive Program and modifying and terminating requirements for the ESRD Treatment Choices Model. These regulations are effective January 1, 2026.

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CMS: Medicare Program; Public Meeting for New Revisions to the Healthcare Common Procedure Coding System (HCPCS) Coding-December 17, 2025, With an Overflow Date of December 18, 2025 Federal Register

Nov 19, 2025 - The Centers for Medicare & Medicaid Services (CMS) will hold a virtual public meeting on December 17, 2025 from 9:00 a.m. until 5:00 p.m. Eastern to discuss CMS preliminary coding, Medicare benefit category, and Medicare payment determinations, if applicable, for new revisions to the HCPCS Level II code set for non-drug and non-biological items and services. If all of the agenda items are not addressed on December 17, 2025, a subsequent virtual session will be held on December 18, 2025 at 9:00 a.m. Eastern. All individuals who plan to speak must register by December 3, 2025.

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CMS: Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program Federal Register

Nov 5, 2025 - 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) the Ambulatory Specialty Model; 4) updates to the Medicare Diabetes Prevention Program expanded 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, 2023 provisions; and 11) updates to the Medicare Promoting Interoperability Program. These regulations are effective January 1, 2026.

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