CMS Publishes Quarterly Roundup of Medicare and Medicaid Program Changes

2026-07205 — Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges

This new rule will help Medicare, Medicaid, CHIP, and health plan companies share patient info more easily and speed up drug approval requests. It affects Medicare Advantage, Medicaid, CHIP, and health plans on federal exchanges, aiming to make care smoother and faster. These changes will start soon and could save time and money by cutting red tape.

2026-04797 — 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

This document fixes some typos and technical mistakes in the Medicare and Medicaid payment rules for 2026. It affects doctors, healthcare providers, and anyone using Medicare Part B by clarifying payment policies and program requirements starting January 1, 2026. These corrections help make sure payments and coverage rules are clear and accurate, so everyone gets paid right and on time.

2026-04467 — Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction

This correction fixes some missing labels in important tables from the 2027 health insurance rules under the Affordable Care Act. It mainly affects insurance companies and people using marketplace plans by clarifying how risk and payments are calculated. These fixes take effect right away on March 6, 2026, ensuring everyone has clear info before the 2027 plan year starts.

2025-23081 — Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program; Correction

This correction fixes some math and typo mistakes in the Medicare payment rules for inpatient rehab facilities starting October 1, 2025. It mainly affects rehab centers by updating their payment rates and quality reporting details to be fair and accurate. These changes ensure providers get the right money and info for the 2026 fiscal year.

2025-22543 — Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model

Medicare is updating its payment plans to help more people get organ transplants through the Increasing Organ Transplant Access (IOTA) Model starting in Performance Year 2. These changes affect hospitals and doctors who work with Medicare patients needing transplants, aiming to improve care and save lives. Comments on the proposed rule are open until February 9, 2026, so stakeholders can share their thoughts before it’s finalized.

2025-21767 — Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies

Starting in 2026, Medicare is updating how it pays for home health care and durable medical equipment, making sure payments match patient needs better. Home health providers will see new rules for quality reporting and value-based programs, while suppliers must meet updated accreditation and enrollment standards. These changes affect patients, providers, and suppliers, with payment updates and new deadlines kicking in early next year.

Previous: 2026-09629 — Agency Information Collection Activities; Turtle Distribution Database

The U.S. Geological Survey wants to keep collecting info for its Turtle Distribution Database and is asking for your thoughts by July 13, 2026. This affects anyone who shares turtle data or uses it to help protect these shelled friends. No big costs or changes, just a chance to make sure the data collection stays useful and easy for everyone.

Next: 2026-09631 — Notice of OFAC Sanctions Action

The U.S. Treasury’s OFAC just added new people to its blacklist, meaning their money and property in the U.S. are frozen. Americans can’t do business with these folks anymore, starting May 7, 2026. This move aims to stop bad actors from using the U.S. financial system and sends a clear message: shady dealings won’t be tolerated!