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CMS Releases CY 2027 Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule

CMS adopts performance-based standards for CRC biomarker tests

CMS established a new national framework setting performance thresholds to qualify noninvasive, biomarker-based colorectal cancer screening options — including FDA-approved stool-...

CMS tightens oversight of accreditation facilities, limits fee-based consulting

A final rule updates performance reviews, codifies existing requirements and brings new conflict-of-interest protections for the nine organizations that regularly survey and accred...

CMS Issues Proposed Rule on Mandatory Provider-Based Attestation Requirements for Off-Campus Outpatient Departments

Morning Headlines 7/7/26

CMS ACCESS Model launches in July: What doctors should know ...

Mandatory Provider-Based Attestations Are Taking Shape: CMS Releases Proposed Implementation Framework

Earlier this year, Congress enacted Section 6225 of the Consolidated Appropriations Act, 2026 (“CAA”), establishing a new Medicare condition of payment for off-campus hospital outp...

CMS implements work requirements for Medicaid

CMS has issued an interim final rule that implements new work requirements for adults on Medicaid.The new statutory requirement will apply to adults who are aged 19 to 64, not preg...

Serco Inc. to Support CERT Program Under $109M CMS Contract

CMS awarded Serco a $109 million contract to review a randomized sample of claims for the agency’s Comprehensive Error Rate Testing program The seven-year contract will be performe...

CMS creates new health tech office to lead interoperability efforts, digital products

The Centers for Medicare and Medicaid Services (CMS) aims to play a bigger role in health tech modernization efforts, including leading interoperability initiatives.

Health Provider News

National 7 CMS rules and policy updates to know in 2026 Agencies issue proposed rule codifying Medicare Drug Price Negotiation Program AHA calls for improvements to FY 2027 payment...

<![CDATA[CMS ACCESS Model: Changing the Landscape of Disease Management]]>

CMS finalizes sweeping ACA marketplace overhaul for 2027

Lower user fees, tighter eligibility checks and more state control

HealthEdge, Peraton Secure $2B in CMS ClaimsCore Modernization Contracts

CMS has awarded nearly $2 billion in contracts for Medicare claims modernization effort HealthEdge and Peraton were selected to help replace legacy fee-for-service processing syste...

CMS Seeks Guidance on Medicare Part D PBM Reform under the CAA 2026

CMS Awards 17 Companies Positions on RMADA 3 BPA

CMS has launched the third RMADA contract vehicle with a $3.5 billion ceiling over five years Seventeen companies secured spots after a competition that drew 34 offers The contract...

CMS rule reforming prior authorization still needs work, ACR says

A new CMS proposed rule would reduce the burden of prior authorizations by further shortening payer decision timeframes and increasing transparency, but still does not go far enoug...

EPtalk by Dr. Jayne 7/9/26

The Centers for Medicare & Medicaid Services has added language ...

CMS Recalculates Star Ratings — Again

CMS is recalculating some 2026 Medicare Advantage Star Ratings after a court ruled it improperly calculated Clover Health’s rating, a decision that could boost payments for a small...

Crushing and Flexing: CMS Proposes to Expand Its Discretion to Deny and Revoke Medicare Enrollment

Clover Health Decision Raises Significant Questions for CMS Star Ratings Framework