Medicaid Monitor
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Medicaid Monitor
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Federal Policy·14d ago

CMS Re-Establishes Data Matching Program With Department of War for ACA Coverage Verification

CMS is re-establishing a Privacy Act matching program with the Department of War to verify minimum essential coverage under the Affordable Care Act through War Department health benefit plans. The matching program allows CMS to cross-reference enrollment data to confirm ACA coverage requirements are met. The notice was published August 5, 2026, under Privacy Act requirements. This routine administrative action maintains existing data-sharing arrangements between federal agencies for coverage verification purposes.

Federal Policy·15d ago

CMS Announces Healthcare Advisory Committee Virtual Meetings for FY 2026-2027

CMS has announced virtual public meetings of the Healthcare Advisory Committee (HAC) for fiscal year 2026-2027. The Committee advises the HHS Secretary and CMS Administrator on healthcare system improvements consistent with the Executive Order establishing the President's Make American Healthy Again Commission. The meetings are open to public participation. The announcement provides stakeholders advance notice of opportunities to observe federal healthcare policy deliberations.

Federal Policy·15d ago

CMS Issues FY 2027 IPPS Final Rule With GME, LTCH, and Quality Reporting Changes

CMS published its final rule updating Medicare inpatient prospective payment systems for acute care hospitals and long-term care hospitals for fiscal year 2027, effective October 1, 2026. The rule revises operating and capital payment rates, modifies graduate medical education policies for teaching hospitals, updates LTCH PPS rates, and changes requirements for hospital quality reporting programs. HHS also adopts updated health IT standards. While this is a Medicare rule, Medicaid managed care organizations and state agencies should monitor GME policy changes and quality measure updates that often influence Medicaid hospital payment methodologies and managed care contract requirements.

Federal Policy·21d ago

CMS Re-Establishes Data Match With OPM for Marketplace and Medicaid Eligibility Verification

CMS has re-established a Privacy Act matching program with the Office of Personnel Management to verify minimum essential coverage through OPM health benefit plans. The data match enables CMS and State Administering Entities to determine eligibility for qualified health plans through exchanges and insurance affordability programs, including Medicaid and CHIP. The match supports initial eligibility determinations, renewals, redeterminations, and appeals. Effective July 29, 2026, this routine data exchange ensures states can verify coverage status when individuals apply for Medicaid or marketplace subsidies.

Federal Policy·22d ago

CMS Publishes Q2 2026 Quarterly Listing of Medicare and Medicaid Program Issuances

CMS published its quarterly compilation of manual instructions, regulations, and Federal Register notices issued between April and June 2026 for Medicare, Medicaid, and other CMS-administered programs. This is a routine administrative notice that compiles previously issued guidance and rulemakings from the quarter into a single reference document. The listing provides a consolidated index of policy issuances for stakeholders tracking program changes. This quarterly publication serves as an administrative record and reference tool rather than announcing new policy.

Federal Policy·27d ago

CMS Announces Public Data Release Under OPEN Government Data Act

CMS will release new public data assets in machine-readable formats under the OPEN Government Data Act, part of the Foundations for Evidence-Based Policymaking Act of 2018. The data release aims to support fraud, waste, and abuse identification while promoting transparency and accountability. CMS states it has balanced transparency objectives with protection of sensitive information. The notice does not specify which datasets will be released or when they will become available.

Federal Policy·29d ago

HHS Corrects Technical Errors in 2027 ACA Payment Parameters Final Rule

The Department of Health and Human Services published a correction to the 2027 Notice of Benefit and Payment Parameters final rule, originally issued May 20, 2026. The correction addresses typographical errors in the rule governing qualified health plan standards, risk adjustment, and the Basic Health Program. These are technical corrections only and do not change the substantive policy or operational requirements established in the May rule. The corrections are effective immediately upon publication.

Federal Policy·33d ago

CMS Proposes CY 2027 Physician Fee Schedule with Part B Payment and Quality Program Updates

CMS published a proposed rule updating the physician fee schedule for calendar year 2027, along with changes to Medicare Part B payment policies, Quality Payment Program requirements, and Medicare Shared Savings Program rules. The proposal also codifies the Medicare Prescription Drug Inflation Rebate Program established under the Inflation Reduction Act of 2022 and updates policies for rural health clinics, federally qualified health centers, ambulance services, and clinical laboratory fee schedules. While primarily Medicare-focused, the rule affects providers participating in both Medicare and Medicaid managed care networks, potentially impacting provider contracting, rate negotiations, and network adequacy for dual-eligible populations. Comments are due 60 days after Federal Register publication.

Federal Policy·34d ago

CMS Seeks Comment on Generic Medicaid and CHIP Information Collection Activities

The Centers for Medicare & Medicaid Services is requesting public comment on proposed generic information collection activities under control number 0938-1148 (CMS-10398). The generic clearance process covers low-burden, voluntary collections related to Medicaid and CHIP state plan amendments, waivers, demonstrations, and reporting. Comments are due 60 days after publication in the Federal Register on July 16, 2026. The umbrella approval allows CMS to expedite certain data requests without full Paperwork Reduction Act review when collections do not raise substantive policy issues.

Federal Policy·40d ago

CMS Approves Joint Commission for Continued HHA Accreditation Through 2026

CMS has approved The Joint Commission for continued recognition as a national accrediting organization for home health agencies seeking Medicare or Medicaid participation. The approval is effective July 10, 2026. Joint Commission-accredited HHAs are deemed to meet Medicare Conditions of Participation and Medicaid provider standards. This decision maintains the existing accreditation pathway for home health agencies providing services under managed care contracts and fee-for-service arrangements.

Federal Policy·43d ago

CMS Re-Establishes Data Match With VA to Verify Minimum Essential Coverage for Marketplace Eligibility

CMS has re-established a data matching program with the Department of Veterans Affairs to verify whether Marketplace applicants are enrolled in VA health care programs that constitute minimum essential coverage. The match allows CMS to determine eligibility for Insurance Affordability Programs by checking VA enrollment status. The program takes effect July 7, 2026, under Privacy Act requirements. This represents continuation of an existing verification process used in Marketplace eligibility determinations.

Federal Policy·47d ago

CMS and VA Launch Data Match to Verify Marketplace Subsidy Eligibility

CMS is establishing a new Privacy Act computer matching program with the Department of Veterans Affairs to verify eligibility for insurance affordability programs under the Affordable Care Act. The data match will allow CMS to cross-check applicant information against VA records to confirm subsidy eligibility for Marketplace coverage. The matching program follows standard Privacy Act protocols requiring advance notice before implementation. This affects how eligibility is determined for individuals who may qualify for both VA benefits and Marketplace subsidies, though it does not directly alter Medicaid managed care operations.

Federal Policy·62d ago

CMS Seeks Input on PBM Compensation Restrictions and Data Reporting for 2028 Implementation

CMS issued a request for information on pharmacy benefit manager compensation structures and business practices to inform implementation of new legislative requirements. The RFI focuses on two mandates taking effect in 2028: restrictions on remuneration PBMs and affiliates may receive for services related to Part D drug utilization, and new data reporting requirements. CMS is seeking technical input on PBM service arrangements, affiliate relationships, and compensation models. Comments will shape how CMS defines permissible PBM compensation and structures data collection requirements for Medicare Part D plans.

Federal Policy·64d ago

CMS Proposes Rule to Codify Medicare Drug Price Negotiation Program

CMS has issued a proposed rule to codify the Medicare Drug Price Negotiation Program and establish new policies for both the Negotiation Program and the Medicare Prescription Drug Benefit Program as required by the Inflation Reduction Act of 2022. The rule also proposes modifications to the fixed combination drug policy. The Negotiation Program allows Medicare to negotiate prices for certain high-cost drugs, which could affect formulary dynamics and pricing strategies for Medicare Advantage plans that include prescription drug coverage. The proposed rule sets the framework for how negotiated prices will be implemented and administered.

Federal Policy·69d ago

CMS Establishes Office of Health Technology and Products to Oversee Technology Modernization

CMS has created the Office of Health Technology and Products (OHTP) to lead enterprise-wide healthcare technology modernization and digital transformation across Medicare, Medicaid, CHIP, and other CMS programs. The office will oversee digital products and platforms in coordination with the CMS Chief Information Officer, who retains governance authority over IT infrastructure, cybersecurity, and enterprise architecture. The organizational change takes effect immediately through this statement of delegations. The new structure may affect how states and managed care organizations interact with CMS technology systems and digital service delivery initiatives.

Legal·78d ago

Court Vacates Gender Identity Protections in Section 1557 Nondiscrimination Rule

On October 22, 2025, the U.S. District Court for the Southern District of Mississippi vacated provisions of HHS's May 2024 Section 1557 final rule that expanded Title IX's sex discrimination definition to include gender identity discrimination. The vacated provisions are legally void. All other provisions of the Section 1557 nondiscrimination rule remain in effect. The ruling affects how Medicaid managed care organizations must handle gender identity-related coverage determinations, prior authorization policies, and grievance procedures under federal nondiscrimination requirements.

Legal·78d ago

Court Vacates Gender Identity Provisions in Section 1557 Nondiscrimination Rule

On October 22, 2025, the U.S. District Court for the Southern District of Mississippi vacated portions of CMS's May 2024 Section 1557 nondiscrimination rule that expanded Title IX's definition of sex discrimination to include gender identity discrimination. The vacated provisions are legally void nationwide. All other provisions of the Section 1557 final rule remain in effect. This decision affects how Medicaid managed care plans must comply with federal nondiscrimination requirements related to gender identity in coverage decisions, utilization management, and member communications.

Federal Policy·83d ago

CMS Recharters Medicare Lab Test Advisory Panel, Announces July 2026 Meeting

CMS has rechartered the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests and appointed five new members. The panel will meet July 14-15, 2026, to advise HHS and CMS on clinical diagnostic laboratory test issues under Medicare. While focused on Medicare, decisions on laboratory test coverage and payment often influence Medicaid managed care plan policies for diagnostic services, particularly for dual-eligible populations and carve-in lab benefits. State Medicaid programs frequently align lab fee schedules and coverage criteria with Medicare determinations.

Federal Policy·83d ago

CMS Recharters Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests

The Centers for Medicare & Medicaid Services announced the rechartering of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests and appointed five new members. The panel will meet July 14-15, 2026, to advise the HHS Secretary and CMS Administrator on clinical diagnostic laboratory test policy. The panel provides recommendations on laboratory benefit coverage, coding, and payment policy under Medicare Part B.

Federal Policy·84d ago

CMS Finalizes 2027 Exchange Payment Parameters, Expands Hardship Exemptions, Revises QHP Standards

CMS issued final 2027 benefit and payment parameters for federally-facilitated exchanges, modifying risk adjustment methodology, HHS-RADV processes, and user fee rates for QHP issuers. The rule codifies expanded hardship exemption eligibility, establishes new provider access and essential community provider standards for QHP certification, prohibits routine non-pediatric dental services as essential health benefits, and allows catastrophic plans with up to 10-year terms. Changes take effect for plan year 2027. While focused on individual and small group exchange markets, provisions affecting network adequacy standards, civil money penalties, and broker oversight may inform state Medicaid managed care oversight frameworks.

Federal Policy·84d ago

CMS Corrects Technical Errors in FY 2027 IPPS Proposed Rule

CMS issued a correction notice for technical and typographical errors in the FY 2027 Hospital Inpatient Prospective Payment System proposed rule published April 14, 2026. The correction addresses errors in the original proposed rule covering Medicare payment rates for acute care hospitals and long-term care hospitals, along with quality program requirements. Stakeholders reviewing the proposed rule for comment should incorporate these corrections when preparing submissions. While this is a Medicare-focused rule, Medicaid managed care organizations with dual-eligible populations or Medicare Advantage Special Needs Plans should monitor for cross-program policy implications affecting hospital contracting and quality metrics.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Information Collection Request

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing a proposed information collection activity under the Paperwork Reduction Act of 1995. The agency is soliciting public comments on burden estimates, necessity and utility of the proposed collection, accuracy of burden estimates, and ways to enhance data quality or reduce reporting burden through automation. Comments are due 60 days from publication. This matters for MCOs because information collection requirements often translate to new reporting obligations, quality measure submissions, or encounter data specifications that affect plan operations and compliance costs.

Federal Policy·84d ago

CMS Seeks Comment on Medicaid and CHIP Generic Paperwork Clearance Process

The Centers for Medicare & Medicaid Services is requesting public comment on information collection activities under its generic Paperwork Reduction Act clearance process (control number 0938-1148). The umbrella approval, last renewed in April 2021, covers voluntary, low-burden data collection related to Medicaid and CHIP state plan amendments, waivers, demonstrations, and reporting. CMS is inviting stakeholders to comment on burden estimates, necessity of proposed collections, and opportunities to reduce administrative requirements. Comments are particularly relevant for states and managed care organizations that submit routine program updates and compliance documentation to CMS.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Paperwork Reduction Act Information Collection

CMS announced a Federal Register notice seeking public comment on a proposed information collection under the Paperwork Reduction Act. The agency is soliciting feedback on burden estimates, necessity of the collection, and ways to streamline reporting requirements. Comments are due 60 days from publication. This notice matters to Medicaid managed care organizations because PRA collections often involve reporting requirements for health plans, including quality measures, encounter data, or network adequacy documentation that affect operational compliance costs.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Proposed Information Collection Requirements

The Centers for Medicare & Medicaid Services is soliciting public comment on a proposed information collection under the Paperwork Reduction Act. The 60-day comment period allows stakeholders to weigh in on burden estimates, necessity of the collection, and potential use of automation to reduce reporting burden. CMS has not specified which programs or reporting requirements are affected in this notice. Managed care organizations should monitor the Federal Register for details on whether MCO reporting, quality measures, or network adequacy documentation are subject to this collection.

Federal Policy·84d ago

CMS Imposes 6-Month Nationwide Moratorium on New Hospice Enrollment

CMS has announced a 6-month nationwide moratorium on enrollment of new hospice providers in Medicare, Medicaid, and CHIP. The temporary suspension prevents new hospice agencies from enrolling or re-enrolling during the moratorium period. Existing hospice providers can continue operations and current Medicaid managed care networks are unaffected. The action reflects CMS efforts to address fraud, waste, and abuse in hospice services, which may impact managed care organizations' ability to contract with new hospice providers during this period.

Federal Policy·84d ago

CMS Imposes 6-Month Nationwide Moratorium on Home Health Agency Medicare Enrollment

CMS has announced a 6-month nationwide moratorium on the enrollment of new home health agencies in the Medicare program. The moratorium applies to HHA enrollment applications and prevents new agencies from billing Medicare during the suspension period. This action follows established regulatory authority to impose temporary enrollment moratoria when fraud, waste, or abuse concerns exist. The moratorium affects providers seeking Medicare participation but does not directly impact Medicaid managed care plans, though dual-eligible care coordination and LTSS network adequacy planning may be indirectly affected in markets with limited HHA capacity.

Federal Policy·84d ago

CMS Publishes Q1 2026 Quarterly Listing of Medicare and Medicaid Program Issuances

CMS has released its quarterly compilation of manual instructions, regulations, and Federal Register notices published from January through March 2026 affecting Medicare, Medicaid, and other CMS-administered programs. This index provides a consolidated reference for all policy guidance issued during the quarter, helping managed care organizations and state agencies track regulatory changes across multiple program areas. The listing includes substantive and interpretive regulations that may affect MCO operations, compliance requirements, and state plan administration. Compliance officers should review the index to identify any guidance affecting their contracts or service areas that may have been issued during the first quarter.

Federal Policy·84d ago

CMS Announces First Healthcare Advisory Committee Meeting for May 2026

The Centers for Medicare & Medicaid Services has announced the inaugural meeting of the Healthcare Advisory Committee (HAC) scheduled for May 18, 2026. The Committee will advise the HHS Secretary and CMS Administrator on healthcare system improvements pursuant to an Executive Order establishing the President's Make American Healthy Again Commission. The virtual meeting is open to the public. While the Committee's scope appears broad, its recommendations could influence future Medicaid managed care policy directions including quality measures, value-based payment models, and program integrity standards.

Federal Policy·84d ago

CMS Opens Public Comment on Medicaid Information Collection Requirements

The Centers for Medicare & Medicaid Services is soliciting public comments on proposed information collection activities under the Paperwork Reduction Act. This notice provides a second opportunity for stakeholders to comment on reporting burden estimates, data collection utility, and potential automation of collection processes. Comments are being accepted for submission to the Office of Management and Budget. Managed care organizations should review whether any proposed collections affect their existing reporting obligations or create new compliance requirements.

Federal Policy·84d ago

CMS Reopens Comment Period on Medicaid Eligibility Template After Posting Error

CMS is reopening the comment period for 12 days on a previously published information collection notice after discovering an error in posting the S89 citizenship and noncitizen eligibility template under Medicaid State Plan Eligibility. The original notice published April 22, 2026, with a 14-day comment period. This affects state Medicaid agencies and managed care organizations that rely on these standardized templates for eligibility determinations and enrollment processes. The reopening provides stakeholders additional time to review the corrected template and submit comments on its operational impact.

Federal Policy·84d ago

CMS Opens OMB Comment Period on Paperwork Reduction Act Information Collection

CMS has published a Federal Register notice announcing a second public comment opportunity for proposed information collection activities under the Paperwork Reduction Act of 1995. The notice invites stakeholders to comment on burden estimates, necessity and utility of the proposed collections, and ways to reduce reporting requirements through automation or other means. Comments must be submitted to OMB during the specified comment period. This routine procedural notice affects Medicaid managed care organizations only if the specific information collection relates to MCO reporting, quality measurement, or compliance documentation.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Paperwork Reduction Act Information Collection

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing a proposed information collection activity under the Paperwork Reduction Act of 1995. The agency is seeking public comment on burden estimates, necessity and utility of the collection, and ways to enhance data quality or reduce reporting burden through technology. The 60-day comment period is now open. This procedural notice affects any entities subject to CMS reporting requirements, though the specific collection instrument and affected programs are not identified in this excerpt.

Federal Policy·84d ago

CMS Opens Public Comment on Information Collection Activities Under Paperwork Reduction Act

CMS announced a Federal Register notice seeking public comment on proposed information collection activities under the Paperwork Reduction Act of 1995. The notice covers proposed extensions or reinstatements of existing data collection requirements and invites feedback on burden estimates, necessity of the collections, and ways to reduce reporting burden through automation or other means. Comments are being solicited during the OMB review period. This is a routine procedural notice that may affect MCO reporting requirements if specific collections relate to managed care data submissions.

Federal Policy·84d ago

CMS Schedules September 2026 Medicare Lab Fee Panel Meeting

CMS announced a public meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests for September 15-16, 2026. The panel will review and recommend payment methodologies (crosswalking or gapfilling) for laboratory tests that lacked applicable pricing data during the May-July 2026 reporting period under the Clinical Laboratory Fee Schedule. Public stakeholders may present payment recommendations and supporting data before the panel advises CMS on Medicare reimbursement rates. While this concerns Medicare fee-for-service laboratory payments, Medicaid managed care organizations should monitor these rate-setting discussions as Medicare pricing often serves as a benchmark for Medicaid supplemental payments and influences lab contract negotiations.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Information Collection Under Paperwork Reduction Act

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing a proposed information collection activity under the Paperwork Reduction Act of 1995. CMS is seeking public comment on burden estimates, necessity and utility of the data collection, and methods to minimize reporting burden. The 60-day comment period is now open for stakeholders to submit feedback on the proposed collection, extension, or reinstatement. Managed care organizations should review the specific collection requirements to assess potential reporting obligations.

Federal Policy·84d ago

CMS Opens Comment Period on Information Collection Requirements Under PRA

CMS is seeking public comment on proposed information collection activities under the Paperwork Reduction Act of 1995. The notice provides stakeholders an opportunity to comment on burden estimates, necessity of data collection, and potential ways to streamline reporting requirements. Comments may address accuracy of estimated burden, methods to enhance data quality, and use of automated collection techniques. This affects any entities required to submit data to CMS, including managed care organizations subject to reporting requirements.

Federal Policy·84d ago

CMS Proposes 2028 HCBS Quality Measure Set With New Stratification Requirements

CMS released a notice seeking comment on the 2028 Home and Community-Based Services Quality Measure Set, proposing mandatory and voluntary quality measures for state Medicaid HCBS programs. The proposal includes new requirements for states to report stratified data by rural/urban status and other factors, along with specific reporting schedules and calculation methodologies. States and managed care organizations operating HCBS programs must review which measures become mandatory, what populations require reporting, and how stratification requirements affect current data collection systems. Comments are due on the proposed measure set, data collection methods, stratification factors, and reporting timelines.

Federal Policy·84d ago

CMS Proposes 2028 HCBS Quality Measure Set With New Mandatory Reporting Requirements

CMS published a notice with comment period proposing the 2028 Home and Community-Based Services Quality Measure Set, which establishes nationally standardized quality measures for Medicaid-funded HCBS programs. The proposal includes mandatory and voluntary measures, specifies data collection and reporting requirements, and requires stratified reporting by factors including rural/urban status for certain measures. CMS seeks comment on which measures should be mandatory versus voluntary, how states should collect and calculate measure data, which populations should be included in reporting, and the proposed reporting schedule. The measure set aims to enable cross-state quality comparisons and drive improvement in HCBS care and outcomes.

Federal Policy·84d ago

CMS Opens Second Comment Period on Information Collection Request Under Paperwork Reduction Act

CMS is soliciting public comment on a proposed information collection under the Paperwork Reduction Act of 1995. This notice provides a second opportunity for stakeholders to comment on burden estimates, necessity and utility of the proposed collection, and ways to reduce reporting burden through automation or other means. The notice does not specify which data collection is under review, when comments are due, or which CMS programs are affected. Managed care organizations should monitor the Federal Register for details on the specific collection instrument and program area.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Paperwork Reduction Act Information Collection

CMS announced a 60-day public comment period under the Paperwork Reduction Act for a proposed information collection activity. The agency is seeking feedback on burden estimates, necessity and utility of the collection, accuracy of estimated burden, and ways to improve data quality and reduce reporting burden through technology. Comments are due 60 days from Federal Register publication. The notice does not specify which CMS programs or forms are affected by the proposed collection.

Federal Policy·84d ago

CMS Schedules Medicare Clinical Diagnostic Lab Test Advisory Panel for September 2026

CMS will convene the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests on September 15-16, 2026, to establish payment rates for laboratory tests lacking sufficient data from the May-July 2026 reporting period. The public may present crosswalking or gapfilling recommendations during the meeting. The Panel will then advise the Secretary and CMS Administrator on appropriate payment amounts for these tests under the Clinical Laboratory Fee Schedule.

Federal Policy·84d ago

CMS Opens Public Comment on Information Collection Activities Under Paperwork Reduction Act

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing an opportunity for public comment on proposed information collection activities under the Paperwork Reduction Act of 1995. The notice covers proposed extensions or reinstatements of existing data collection requirements and invites comments on burden estimates, necessity and utility of the collections, accuracy of burden estimates, and ways to enhance data quality or reduce collection burden through automation. Comments are being solicited as part of CMS's statutory obligation to provide a second public comment period before submitting information collection requests to the Office of Management and Budget for approval. This is a routine administrative notice; specific collections subject to comment are not detailed in the provided text.

Federal Policy·84d ago

CMS Seeks Comment on Proposed Information Collection Under Paperwork Reduction Act

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing a proposed information collection and requesting public comment under the Paperwork Reduction Act of 1995. The notice opens a 60-day comment period for the public to weigh in on burden estimates, necessity and utility of the proposed collection, accuracy of estimated burden, and ways to enhance data quality or reduce collection burden through automation. The notice does not specify which programs or collection activities are subject to this comment period.

Federal Policy·84d ago

CMS Opens Second Comment Period on Paperwork Reduction Act Information Collection Request

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing a second public comment period on a proposed information collection under the Paperwork Reduction Act of 1995. The notice invites stakeholders to comment on burden estimates, necessity and utility of the proposed data collection, accuracy of burden estimates, and methods to reduce reporting burden through automation or other means. Comments may address how the information collection affects agency operations and whether alternative collection methods could reduce administrative burden. This is a standard procedural notice required before OMB can approve federal data collection activities.

Federal Policy·84d ago

CMS Reopens Comment Period for Medicaid CHIP Generic Information Collection Activities

CMS is reopening the comment period for 12 days on its Medicaid and CHIP Generic Information Collection Activities notice, originally published April 22, 2026. The reopening addresses an inadvertent issue with posting the revised S89 template for Citizenship and Noncitizen Eligibility under Medicaid State Plan Eligibility. The original notice provided a 14-day comment period, and CMS is adding 12 days to account for the period when the template was incorrectly posted. This affects states and managed care organizations that rely on standardized eligibility templates for enrollment and compliance documentation.

Federal Policy·84d ago

CMS Opens Second Comment Period for Information Collection Under Paperwork Reduction Act

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing a second public comment opportunity for a proposed information collection activity under the Paperwork Reduction Act of 1995. The notice invites stakeholders to comment on burden estimates, necessity and utility of the collection, accuracy of burden calculations, and ways to improve data quality and reduce reporting burden through automation or other means. This represents the standard OMB review phase following initial Federal Register publication. The specific collection instrument and deadline are detailed in the full Federal Register notice.

Federal Policy·84d ago

CMS Announces First Healthcare Advisory Committee Meeting for May 2026

The Centers for Medicare & Medicaid Services announced the inaugural meeting of the Healthcare Advisory Committee (HAC) scheduled for May 18, 2026. The committee will advise the HHS Secretary and CMS Administrator on healthcare system improvements consistent with a presidential executive order. The virtual meeting is open to the public. This represents a new federal advisory structure that may influence future Medicaid policy direction and program reforms.

Federal Policy·84d ago

CMS Publishes Q1 2026 Quarterly Listing of Medicare and Medicaid Program Issuances

CMS released its quarterly compilation of manual instructions, regulations, and Federal Register notices published between January and March 2026 affecting Medicare, Medicaid, and other CMS-administered programs. This reference document consolidates all policy guidance, regulatory updates, and program instructions issued during the quarter in a single indexed listing. The compilation serves as an administrative record of policy activity but does not introduce new requirements. Managed care organizations should review the listing to identify any Q1 issuances affecting their contracts, compliance obligations, or operational requirements that may have been issued outside of major rulemaking.

Federal Policy·84d ago

CMS Imposes 6-Month Nationwide Moratorium on Home Health Agency Enrollment

CMS has announced a 6-month nationwide moratorium on the enrollment of new home health agencies in Medicare. The moratorium applies to Medicare enrollment only and does not directly affect existing Medicaid managed care network contracts with currently enrolled HHAs. The action is typically taken to address fraud and abuse concerns in the home health sector. Medicaid MCOs should monitor whether states implement parallel enrollment restrictions and assess potential network adequacy implications if the moratorium affects HHA availability in their service areas.

Federal Policy·84d ago

CMS Imposes 6-Month Nationwide Moratorium on New Hospice Enrollment

CMS has announced a 6-month nationwide moratorium on new hospice provider enrollment in Medicare, effective immediately. The moratorium applies to all new hospice provider enrollment applications and prevents new hospice providers from entering the Medicare program during this period. The action is taken under CMS authority to impose temporary moratoria when necessary to prevent or combat fraud, waste, or abuse. Medicaid managed care organizations with Medicare-Medicaid dual eligible members may see impacts to hospice network capacity and coordination of care for enrollees requiring end-of-life services.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Proposed Medicaid Information Collection

The Centers for Medicare & Medicaid Services published a Federal Register notice announcing a proposed information collection under the Paperwork Reduction Act. The agency is seeking public comment on burden estimates, necessity and utility of the collection, and ways to minimize reporting requirements. Comments are due 60 days from publication. This standard PRA notice indicates CMS plans to collect data from stakeholders, though specific forms, reporting requirements, or affected programs are not detailed in this announcement.

Federal Policy·84d ago

CMS Seeks Comment on Medicare and Medicaid Information Collection Requirements

The Centers for Medicare & Medicaid Services is soliciting public comment on proposed information collection activities under the Paperwork Reduction Act of 1995. The agency is seeking feedback on burden estimates, necessity and utility of the proposed collections, accuracy of burden calculations, and ways to improve data quality and reduce reporting burden through automation. The public has 60 days to submit comments on the proposed collections, which may affect reporting requirements for Medicare and Medicaid programs. The notice does not specify which particular collections are subject to this comment period.

Federal Policy·84d ago

CMS Opens 60-Day Comment Period on Proposed Information Collection Requirements

The Centers for Medicare & Medicaid Services has published a Federal Register notice announcing a proposed information collection under the Paperwork Reduction Act of 1995. The notice opens a 60-day public comment period for stakeholders to weigh in on burden estimates, necessity, accuracy, and implementation of the proposed collection. CMS is seeking feedback on ways to enhance the quality and utility of the information to be collected and minimize administrative burden through automated collection techniques. The notice does not specify which programs or data elements are subject to the proposed collection.

Federal Policy·84d ago

CMS Corrects Technical Errors in FY 2027 Medicare IPPS Proposed Rule

CMS issued a correction to the FY 2027 Medicare Hospital Inpatient Prospective Payment System (IPPS) proposed rule published April 14, 2026. The correction addresses technical and typographical errors in the original proposed rule, which covers payment rates for acute care hospitals and long-term care hospitals, along with quality program requirements. The correction does not alter substantive policy proposals or comment deadlines. This is a routine administrative correction to ensure accuracy in the proposed regulatory text.

Managed Care·84d ago

CMS Proposes New Limits on State Directed Payments and Targeted FFS Payments

CMS issued a proposed rule modifying limits on state directed payments in Medicaid managed care and establishing new limits on certain targeted payments in fee-for-service Medicaid. The rule invokes actuarial soundness requirements under section 1903(m)(2)(A)(iii) for managed care SDPs and section 1902(a)(30)(A) for FFS targeted payments. The proposed changes would affect how states structure supplemental payments to providers through MCO contracts and direct FFS arrangements. This rule represents CMS's most significant intervention in state payment flexibility since the 2016 managed care rule established the current SDP framework.

Federal Policy·84d ago

CMS Finalizes 2027 ACA Payment Parameters, Expands Hardship Exemptions and Bronze Plan Flexibility

CMS issued its final 2027 Notice of Benefit and Payment Parameters, adjusting risk adjustment methodology, setting user fee rates for Federally-facilitated Exchanges, and codifying expanded hardship exemption eligibility. The rule modifies QHP certification standards, prohibits routine non-pediatric dental services from counting as Essential Health Benefits, allows cost-sharing flexibility for catastrophic and bronze plans, and revises Basic Health Program payment calculations. Changes take effect for plan year 2027. While focused on the ACA individual and small group markets, the rule's risk adjustment and payment methodologies may inform Medicaid managed care rate-setting and actuarial approaches in integrated or dually eligible programs.

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