Rural Healthcare Payment and Reimbursement – News
News stories from the past 60 days.
IHS: Reimbursement Rates for Calendar Year 2026
Federal Register
Jan 22, 2026 - Notice from the Indian Health Service (IHS) announcing the calendar year 2026 reimbursement rates for inpatient and outpatient medical care provided by IHS facilities to Medicare, Medicaid, and other federal program beneficiaries. The updated rates apply to all qualifying services provided on or after January 1, 2026.
Source: Federal Register
Jan 9, 2026 - The Government Accountability Office (GAO) is accepting nominations for appointment to the Medicare Payment Advisory Commission (MedPAC) by February 6, 2026. Appointments are effective May 2026.
Source: Federal Register
Jan 7, 2026 - The Quality Payment Program is seeking feedback from the general public on the Merit-based Incentive Payment System (MIPS) Value Pathway (MVP) candidates for 2027. Feedback will be reviewed by the Centers for Medicare & Medicaid Services (CMS) for consideration in future rulemaking. Comments are due February 6, 2026.
Source: Quality Payment Program, Centers for Medicare & Medicaid Services
CMS: Global Benchmark for Efficient Drug Pricing (GLOBE) Model
Federal Register
Dec 23, 2025 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on a proposed rule implementing the Global Benchmark for Efficient Drug Pricing Model ("GLOBE Model"), a new Medicare payment model under section 1115A of the Social Security Act. The GLOBE Model would test whether a payment model that uses an alternative method for calculating Part B inflation rebate amounts for certain separately payable Part B drugs and biological products reduces costs for Medicare fee-for service (FFS) beneficiaries and the Medicare program while preserving quality of care. Comments are due by February 23, 2026.
Source: Federal Register
CMS: Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model
Federal Register
Dec 23, 2025 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on a proposed rule implementing the Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model to test a new Medicare payment model under section 1115A of the Social Security Act. The model proposes a test of an alternative payment method for calculating inflation rebates for certain Part D drugs and biological products. The proposed GUARD Model would test whether changing the calculation of the Part D inflation rebate would reduce costs for the Medicare program while preserving or enhancing quality of care for Part D enrollees. Comments are due by February 23, 2026.
Source: Federal Register
CMS: Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model
Federal Register
Dec 11, 2025 - Notice of a proposed 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, which will begin on July 1, 2026. 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. Comments are due by February 9, 2026.
Source: 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.
Source: 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.
Source: 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.
Source: Federal Register
Last Updated: 1/22/2026

