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Advisory
Member

CMS Issues Proposed Notice of Benefit and Payment Parameters for 2027

Advisory
The Centers for Medicare & Medicaid Services (CMS) Feb. 9 released its 2027 proposed standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees.
Health Insurance, Marketplace Issues/Stability, Cost Management, Making Healthcare More Affordable, Program Integrity, Enroll in Health Insurance
Advisory
Member

HHS Proposes Actions Regarding ‘Sex-rejecting Procedures’ on Children

Advisory
The Department of Health and Human Services (HHS) Dec. 18 proposed a series of regulatory actions intended to end the practice of “sex-rejecting procedures” (SRPs) on children.
Medicaid, CHIP, Advocacy & Public Policy, Medicare, Reimbursement, Access to Behavioral Health
Advisory
Member

CMS Issues Hospital Outpatient, Ambulatory Surgical Center Final Rule for CY 2026

Advisory
The Centers for Medicare & Medicaid Services (CMS) Nov. 21 released its calendar year (CY) 2026 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) final rule.
Ambulatory and Outpatient Care, Post-Acute Care, Advocacy & Public Policy, Medicare, Access to Behavioral Health, Reimbursement
Advisory
Member

Update: Congress Passes Health Care Funding, Extends Key Health Care Provisions

Advisory
Congress has passed the Consolidated Appropriations Act of 2026 (H.R.7148), which consists of a short-term continuing resolution for the Department of Homeland Security (DHS) appropriations bill and a package of five full-year appropriations bills, containing conferenced legislation for the Departments of Defense, Labor, Health and Human Services, Education,
Legislation and Legislative Advocacy, Medicaid, Medicare, Medicare Sequestration Payment Reductions, Cybersecurity, Rural issues, Workforce, Child and Adolescent Health, Maternal Health, Medical Education and Research, Access to Behavioral Health, Substance Use Disorder, Disaster Preparedness, 340B Drug Pricing Program
Advisory
Member

Implications for Hospitals and Health Systems as Partial Government Shutdown Looms

Advisory
Specific government agency funding, including programs within the Department of Health and Human Services, is set to expire at midnight Jan. 30.
Advocacy & Public Policy, Legislation and Legislative Advocacy, Conditions of Participation, Medicare, Disaster Preparedness, Access to Behavioral Health, Substance Use Disorder
Advisory
Member

Home Health Prospective Payment System Final Rule for CY 2026

Advisory
The Centers for Medicare & Medicaid Services (CMS) Nov. 28 issued its final rule for the calendar year (CY) 2026 home health (HH) prospective payment system (PPS).
Home Health PPS, Home Health, Long-term Care, Post-Acute Care
Advisory
Member

CMS Issues Hospital Outpatient, Ambulatory Surgical Center Final Rule for CY 2026

Advisory
The Centers for Medicare & Medicaid Services Nov. 21 released its calendar year 2026 outpatient prospective payment system and ambulatory surgical center final rule. The rule increases OPPS rates by a net 2.6% in CY 2026 compared to CY 2025.
Outpatient Prospective Payment Systems (OPPS), Ambulatory Surgical Center (ASC)
Advisory
Member

CMS Issues Proposed Rule for CY 2027 Medicare Advantage, Prescription Drug Plans

Advisory
The Centers for Medicare & Medicaid Services (CMS) Nov. 28 released its proposed Policy and Technical Changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly for Contract Year (CY) 2027.
Medicare Advantage, Drug Prices, Prescription Drugs
Advisory
Member

CMS Releases CY 2026 Home Health PPS Final Rule

Advisory
The home health prospective payment system final rule for calendar year 2026 will reduce payments by 1.3%, or $220 million relative to CY 2025, according to the Centers for Medicare & Medicaid Services.
Home Health PPS, Long-term Care, Post-Acute Care
Advisory
Member

Aetna Delays, Issues Additional Details on ‘Level of Severity Inpatient Payment’ Policy

Advisory
The Centers for Medicare & Medicaid Services (CMS) Oct. 31 issued a final rule that updates physician fee schedule (PFS) payments for calendar year (CY) 2026.
Inpatient Prospective Payment Systems (IPPS)