Articles and Blogs

The Centers for Medicare & Medicaid Services (“CMS”) has released the Calendar Year 2026 Hospital Outpatient Prospective Payment System Final Rule, which includes another round of substantial updates to the Hospital Price Transparency (“HPT”) regulations. The new policies aim to further standardize the data disclosed by hospitals, enhance the utility of the machine-readable files... READ MORE

On November 14, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued a letter, which it describes as “preliminary guidance,” concerning two significant restrictions on Medicaid provider taxes set forth in H.R. 1, including: (i) a change in the indirect hold harmless threshold for provider taxes—which, in effect, prohibits states from increasing the... READ MORE

On October 31, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued its calendar year (“CY”) 2026 Medicare Physician Fee Schedule (“MPFS”) final rule (“Final Rule”), announcing finalized policy changes for Medicare payments under the MPFS and other Medicare Part B (“Part B”) issues, effective on or after January 1, 2026. The Final... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) finalized several important updates to graduate medical education (“GME”) and nursing and allied health educational programs (“NAH Programs”) policies in the FY 2026 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”), and proposed a notable limitation on virtual supervision for teaching physicians in the 2026... READ MORE

On July 15, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued the CY 2026 Hospital Outpatient Prospective Payment System (“OPPS”) and Ambulatory Surgical Center (“ASC”) Payment System proposed rule. The rule, as drafted, proposes updating the payment rates of both OPPS hospital rates and ASC rates by 2.4%, calculated via the respective... READ MORE

On July 17, 2025, the Centers for Medicare & Medicaid Services (“CMS”) extended the due date to complete and submit the new Form CMS-855A SNF Disclosures Attachment for every Skilled Nursing Facility (“SNF”).  In its Medicare Learning Network, 2025-07-17-MLNC, CMS formally announced that enrolled SNFs should collect data on ownership, managerial and related party information and... READ MORE

On November 27, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) updating the Medicare Conditions of Participation (“CoPs”) for hospitals subject to 42 CFR Part 482 and critical access hospitals (“CAHs”) subject to 42 CFR Part 485. These updates establish a progressive rollout of nationwide standards for both... READ MORE

On May 21, 2025, the Centers for Medicare & Medicaid Services (“CMS”) announced a substantial expansion of its Risk Adjustment Data Validation (“RADV”) audit program for all Medicare Advantage (“MA”) plans. Effective immediately, CMS will audit all eligible MA plans annually and aims to complete outstanding audits for prior payment years (“PY”) 2018-2024 by... READ MORE

On April 30, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released the FFY 2026 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”) to update IPPS payment rates, change DSH payments, increase uncompensated care payments and request input on ways to streamline Medicare regulations and reduce provider burden. Increase to Payment Rates... READ MORE

On April 17, 2025, the Centers for Medicare & Medicaid Services (“CMS”) extended the due date to complete and submit the new Form CMS-855A SNF Disclosures Attachment for every Skilled Nursing Facility (“SNF”). In its Medicare Learning Network, 2025-04-17-MLNC, CMS formally announced that enrolled skilled nursing facilities should collect data on ownership, managerial and related party... READ MORE