CMS Health Policy
Material regulatory developments from Centers for Medicare & Medicaid Services are tracked daily by Cresthaven Analytics. Over the last 90 days, 19 material briefs relevant to professionals operating in the healthcare & life sciences sector have been published below. Each brief is sourced directly from the primary regulatory feed, summarized for institutional readers, and scored for materiality.
Recent material activity
A selection of recent published briefs; this is not a complete archive.
CMS issues RFI to establish mandatory pharmacy contracting standards for Medicare Part D networks beginning 2029
CMS published a Request for Information on September 24, 2026, seeking stakeholder input to develop standards for reasonable and relevant pharmacy contract terms under Medicare Part D. The Consolidated Appropriations Act…
Read the full CMS Health Policy brief →CMS renews DNV Healthcare USA accreditation authority for Medicare and Medicaid hospital participation
CMS published a notice on September 17, 2026 confirming continued recognition of DNV Healthcare USA Inc. as a national accrediting organization for hospitals seeking Medicare or Medicaid participation. DNV-accredited hos…
Read the full CMS Health Policy brief →CMS sets 2027 Medicare appeals AIC thresholds at $200 for ALJ hearings and $2,000 for judicial review
CMS published its annual notice on September 16, 2026, adjusting the amount-in-controversy thresholds for Medicare administrative and judicial appeals. The 2027 thresholds apply to requests for ALJ hearings and judicial …
Read the full CMS Health Policy brief →CMS final rule bars federal Medicaid and CHIP funding for gender-transition procedures in minors effective immediately
On August 13, 2026, the Centers for Medicare and Medicaid Services issued a final rule prohibiting federal financial participation in Medicaid and CHIP payments for sex-transition procedures furnished to individuals unde…
Read the full CMS Health Policy brief →CMS proposes RAPID coverage pathway to accelerate national Medicare coverage for innovative medical devices
On August 11, 2026, CMS published a notice with comment period establishing the proposed Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway. The pathway uses existing Medicare coverage pro…
Read the full CMS Health Policy brief →CMS finalizes FY 2027 IPPS and LTCH payment rates with GME, quality program, and health IT standards updates
CMS issued a final rule on August 4, 2026 revising Medicare inpatient prospective payment rates for acute care hospitals and long-term care hospitals, effective for fiscal year 2027. The rule also updates graduate medica…
Read the full CMS Health Policy brief →CMS finalizes FY 2027 hospice payment rate update with new election statement and quality reporting requirements
On August 3, 2026, CMS issued a final rule updating the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. The rule makes the hospice election statement addendum mandatory for all Medicare …
Read the full CMS Health Policy brief →CMS finalizes IRF payment rates and operational requirements for federal fiscal year 2027 with rural adjustment elimination
CMS issued a final rule on August 3, 2026 updating prospective payment rates for inpatient rehabilitation facilities for federal fiscal year 2027. The rule completes the three-year phaseout of the rural payment adjustmen…
Read the full CMS Health Policy brief →CMS finalizes SNF prospective payment system rates and quality program updates for federal fiscal year 2027
On July 31, 2026, the Centers for Medicare and Medicaid Services issued a final rule updating payment rates and billing policies under the Skilled Nursing Facility Prospective Payment System for federal fiscal year 2027.…
Read the full CMS Health Policy brief →CMS finalizes FY 2027 IPF PPS rate update with new patient assessment instrument effective October 1, 2026
CMS issued a final rule on July 31, 2026 updating prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient psychiatric facility services. The rule also finalizes a standardized IPF pati…
Read the full CMS Health Policy brief →CMS updates Medicare prior authorization and face-to-face encounter lists for durable medical equipment effective 2026
CMS published a final notice on July 30, 2026 updating the HCPCS codes on the Medicare Master List, the Required Face-to-Face Encounter and Written Order Prior to Delivery List, and the Required Prior Authorization List.…
Read the full CMS Health Policy brief →CMS renews NCQA deeming authority for Medicare Advantage HMOs and PPOs for six years
On July 27, 2026, CMS approved NCQA's renewal application for Medicare Advantage deeming authority, covering Health Maintenance Organizations and Preferred Provider Organizations. The six-year term allows NCQA-accredited…
Read the full CMS Health Policy brief →CMS proposes to codify WFTC-mandated Medicaid provider tax thresholds with phased reductions beginning October 2026
CMS published a proposed rule on July 23, 2026 to revise the indirect hold harmless threshold for state health care-related taxes under Medicaid. The proposal implements statutory changes from the One Big Beautiful Bill …
Read the full CMS Health Policy brief →CMS releases draft guidance on manufacturer effectuation of maximum fair prices for 2028 Medicare drug price negotiations
CMS published draft guidance on July 20, 2026 on how drug manufacturers must effectuate maximum fair prices under the Medicare Drug Price Negotiation Program for 2028. The release opens a public comment period on operati…
Read the full CMS Health Policy brief →CMS proposes CY 2027 Physician Fee Schedule rule covering payment rates, drug inflation rebates, and shared savings updates
CMS published a proposed rule on July 16, 2026 addressing calendar year 2027 payment policies under the Physician Fee Schedule, Medicare Part B, the Medicare Shared Savings Program, and the Medicare Prescription Drug Inf…
Read the full CMS Health Policy brief →CMS Health Policy release pending Cresthaven Analytics full analysis: Request for Information; Clinical Laboratory Improvement Amendments of 1988 (CLIA) Regulations
CMS Health Policy published a regulatory release titled 'Request for Information; Clinical Laboratory Improvement Amendments of 1988 (CLIA) Regulations'. Cresthaven Analytics' full intelligence brief is pending re-analys…
Read the full CMS Health Policy brief →CMS opens public comment on The Joint Commission's renewal application for home health agency accreditation authority
CMS published a Federal Register notice on July 10, 2026 soliciting public comments on The Joint Commission's application for continued approval to accredit Medicare- and Medicaid-participating home health agencies. The …
Read the full CMS Health Policy brief →CMS proposes 2027 Medicare outpatient and ASC payment system updates with quality reporting revisions
On July 7, 2026, the Centers for Medicare and Medicaid Services issued a proposed rule updating the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System for calendar year 2027. The…
Read the full CMS Health Policy brief →CMS Health Policy release pending Cresthaven Analytics full analysis: Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasi
CMS Health Policy published a regulatory release titled 'Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based P…
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