Centers for Medicare & Medicaid Services

Medicare, Medicaid Regulations Logjam Should Soon End

The shutdown of the federal government brought the usual flow of Medicare and Medicaid regulations to an almost complete halt. Now that the shutdown has ended, the logjam should end fairly quickly – and with a sense of urgency. Currently, a number of major Medicare and Medicaid regulations remain with the Office of Management and Budget for review. Even though the shutdown has now ended, it is not yet clear when they will be addressed. By statute, the following regulations must be implemented by January 1. CY 2026 Hospital Outpatient Prospective Payment System Policy Changes and Payment Rates and Ambulatory [...]

joe2025-11-13T17:00:30-05:00November 18, 2025|Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for November 13

The following is the latest health policy news from the federal government for November 7-13. Some of the language used below is taken directly from government documents. Please note that during the federal government shutdown, most HHS and other health care-related agencies, with limited exceptions, engaged in little public activity such as announcements, the publication of new regulations, and updating their web sites. Now that the shutdown has ended, normal activity can be expected to resume shortly. The End of the Federal Government Shutdown On Wednesday night the House passed the Senate-amended version of the continuing resolution (CR) in a [...]

joe2025-11-13T15:20:05-05:00November 13, 2025|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare reimbursement policy, Telehealth|

Applications Highlight Rural Health Targets

Chronic disease prevention. Greater access to mobile health services. Rural clinician recruitment. Improved emergency medical services. Technological advancements. These are among the priorities articulated by rural states in their applications for federal Rural Health Transformation Program funds according to a Stateline analysis of the materials submitted by ten states with large rural populations. All 50 states submitted applications for a piece of the $50 billion pool that was part of the “One Big Beautiful Bill Act” to help offset some of the massive Medicaid cuts that were a major part of that legislation. Applicants for the Rural Transformation Program money [...]

joe2025-11-12T11:42:39-05:00November 12, 2025|Centers for Medicare & Medicaid Services, Medicaid|

Federal Health Policy Update for November 6

The following is the latest health policy news from the federal government for October 31 – November 6. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown; some are engaging in limited exceptions. Congress and the Shutdown Senate Majority Leader John Thune (R-SD) today told his caucus that he plans to bring the House-passed CR to yet another vote in the Senate on [...]

joe2025-11-06T21:35:12-05:00November 6, 2025|340b, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

New Methodology Helps Facilitate Medicaid Renewals

When the end of the COVID-19 pandemic led to the end of the moratorium on Medicaid disenrollments, states faced a daunting challenge: how to redetermine eligibility for 90 million people on their Medicaid rolls. The challenge grew even greater when it appeared that significant numbers of people were losing their Medicaid eligibility not because they no longer met the program’s eligibility criteria but for procedural reasons such as inability to gather the information needed to demonstrate eligibility, incomplete applications, or missing application deadlines. To address this problem, the Centers for Medicare & Medicaid Services tried a different approach, working with [...]

joe2025-11-04T16:35:21-05:00November 5, 2025|Centers for Medicare & Medicaid Services, COVID-19, Medicaid|

Federal Health Policy Update for October 30

The following is the latest health policy news from the federal government for October 24-30. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown The federal government remains shut down and the Senate expects to leave Washington today without another vote on the House-passed continuing resolution (CR), ensuring that the shutdown will continue into next week. Republican leaders believe [...]

joe2025-10-31T12:15:23-04:00October 30, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicare|

CMS Employees Return to Work

The Centers for Medicare & Medicaid Services has recalled 3000 employees – 47 percent of its workforce – furloughed earlier this month when the federal government shutdown began. In a published report, a CMS spokesperson explained that “In order to best serve the American people amid the Medicare and Marketplace open enrollment seasons, CMS is temporarily calling back all furloughed employees on Monday, October 27.” In addition to working on Medicare and Marketplace open enrollment, some of the employees returning to work also will participate in the review of applications for Rural Health Transformation Program funding. The deadline for states [...]

joe2025-10-29T11:35:05-04:00October 30, 2025|Centers for Medicare & Medicaid Services, Medicare|

Federal Health Policy Update for October 23

The following is the latest health policy news from the federal government for October 17 - 23. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown The Senate postponed its 13th vote on the House-passed continuing resolution (CR), scheduled for today; without bipartisan negotiations on Affordable Care Act enhanced premium subsidies, the measure – whenever the next vote is [...]

joe2025-10-23T15:32:04-04:00October 23, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare|

Federal Health Policy Update for October 9

The following is the latest health policy news from the federal government for October 3-9. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown Today the Senate voted on separate Democratic- and Republican-led continuing resolutions (CRs) for the seventh time but again was unable to reach the 60-vote majority needed to pass a measure. Once again, only three Democratic senators [...]

joe2025-10-09T15:13:15-04:00October 9, 2025|Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicaid managed care, Medicare|

Dispute Resolution Continues Despite Shutdown

The No Surprises Act’s Independent Dispute Resolution process continues during the federal government shutdown. The Centers for Medicare & Medicaid Services has issued a notice advising disputing parties to continue submitting disputes for resolutions but warns that a prolonged shutdown could affect the timeliness of the resolution of those disputes. Learn more from this CMS notice.

joe2025-10-07T11:52:54-04:00October 7, 2025|Centers for Medicare & Medicaid Services|