Unified Agenda
Centers for Medicare & Medicaid Services: 2026 Regulatory Agenda
Every rulemaking the CMS has on its regulatory agenda in the 2026 Unified Agenda. Proposed rules, final rules, and long-term actions, each with the agency's own summary and its latest status.
Source: the 2026 Regulatory Plan and Unified Agenda, published by OIRA on July 3, 2026 (reginfo.gov). The CMS lists 52 active actions plus 19 completed this cycle. Refreshed as the agenda changes.
Regulatory Plan marks the agency’s most significant planned actions, singled out by OIRA in the Regulatory Plan that accompanies this edition.
What changed since the Spring 2025 agenda
Between editions, the CMS added 33 new rules, changed the stage on 23, and dropped 13 from the agenda. The official agenda only shows you today’s snapshot. We keep the history, so you can see what actually moved.
- New this edition. Alternative Payment Model (CMS-5548) (entered the Proposed Rule stage)
- Moved. Administrative Simplification: Adoption of Standards for Health Care Attachment Transactions and Electronic Signatures (CMS-0053) (Final Rule to Completed)
- Moved. Administrative Simplification: Modifications of Operating Rules for Eligibility for a Health Plan, Health Care Claim Status and Health Care EFT and ERA Transactions (CMS-0060) (Final Rule to Completed)
and 66 more changes this edition, including 13 rules that dropped off the agenda entirely.
Track the CMS agenda freeSignificant, priority, and finalized rules are shown in full below. Routine actions are condensed to a line, with full summaries for every rule on the dashboard.
Slated for a final rule. Several have already published in the Federal Register, which we mark on each; the rest are still pending.
CY 2027 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts (CMS-8092)
This annual notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 2027 under Medicare's Hospital Insurance program (Medicare Part A). The Medicare statute specifies the formula used to determine these amounts.
Agenda status: Notice (planned)
Establishing State Community Engagement Requirements for Certain Individuals Under Section 1902(xx) of the Social Security Act (CMS-2454)
Section 71119 (Requirement for States to Establish Medicaid Community Engagement Requirements for Certain Individuals) of Public Law 119-21 amended section 1902 of the Social Security Act (the Act) to add subsection (xx). Section 1902(xx) of the Act requires states and the District of Columbia to ensure that applicable individuals demonstrate, as a condition of their Medicaid eligibility, a minimum number of community engagement hours (generally, that they work, are enrolled in an educational program, complete community service, participate in a work program, or any combination thereof) for a minimum period of time preceding their application and during their enrollment. The requirements of section 1902(xx) of the Act are effective beginning January 1, 2027, unless a state opts to implement the requirements sooner. Section 71119 also requires the agency to promulgate an interim final rule to implement 1902(xx) of the Act no later than June 1, 2026.
Status: Final rule published in the Federal Register on June 29, 2026
Independent Dispute Resolution Operations (CMS-9897)
This document finalizes rules related to certain provisions of the No Surprises Act regarding the Federal independent dispute resolution (IDR) process, which was established as part of the Consolidated Appropriations Act, 2021 (CAA). This rule sets forth new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act. This rule also requires plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice to an entity that does not have a contractual relationship with the plan or issuer. This document also amends certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review, and the payment and collection of administrative fees and certified IDR entity fees. This document also defines bundled payment arrangements, amends requirements related to batched items and services, and amends the rules for extensions of timeframes due to extenuating circumstances. Additionally, this document requires plans and issuers to register in the Federal IDR portal.
Status: Final rule published in the Federal Register on June 4, 2026
Transparency in Coverage (CMS-9882)
This rule amends the Transparency in Coverage final rule published November 12, 2020, (85 FR 72158) to improve the quality, accessibility, usability, and transparency of healthcare price data.
Status: Proposed rule published on February 25, 2026
Strengthening Oversight of Accrediting Organizations (AO), Burden Reduction, and Related Provisions (CMS-3367)
This final rule sets forth a number of provisions to strengthen the oversight of accrediting organizations (AO) by addressing conflicts of interest, establishing consistent standards, processes and definitions, and updating the validation and performance standards systems.
Status: Final rule published in the Federal Register on June 16, 2026
Other actions in this stage
Rules open for, or headed toward, public comment.
Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes (CMS-2452)
Section 71115 of One Big Beautiful Bill Act of 2025 (OBBBA) amended the indirect hold harmless threshold, effective October 1, 2026. This provision of OBBBA sets the indirect hold harmless threshold equal to the level of revenue for taxes enacted and imposed as of July 4, 2025. This rule will revise regulations to reflect the new indirect hold harmless limit and establish requirements that will allow CMS to implement this change accurately and effectively.
Agenda status: NPRM (planned)
Amendments to Excepted Benefits (CMS-9879)
This proposed rule would amend the limited excepted benefit regulations to permit employers to cover certain fertility benefits as excepted benefits consistent with Executive Order 14216, Expanding Access to In Vitro Fertilization.
Status: Proposed rule published on May 13, 2026
Contract Year 2027 Policy and Technical Changes to Medicare Advantage, Medicare Prescription Drug Benefit, Medicare Cost Plan, and Programs of All-Inclusive Care for the Elderly Programs (CMS-4212)
This rule finalizes changes to strengthen and improve the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE). This rule also codifies Part D provisions of the Inflation Reduction Act of 2022 (IRA). Additionally, this rule finalizes provisions included in the Contract Year 2026 proposed rule implementing changes to supplemental benefits and making a technical clarification related to Star Ratings.
Status: Final rule published in the Federal Register on April 6, 2026
Contract Year 2028 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and PACE (CMS-4214)
This rule would propose changes to strengthen and improve the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) programs for Contract Year 2028.
Agenda status: NPRM (planned)
Cutting Administrative Requirements for Excellence in Patient Care (CMS-3484)
This proposed rule would enhance direct patient care by modernizing the Conditions of Participation, Conditions for Coverage, and Requirements for Medicare- and Medicaid-participating providers and suppliers, reducing burden and increasing flexibility to deliver high quality care. CMS identified obsolete, outdated, and excessively burdensome regulations that can be eliminated or reformed to enhance the effectiveness of facility operations and services and free up resources that health care providers could otherwise use to improve patient health and safety.
Agenda status: NPRM (planned)
CY 2027 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System and Quality Incentive Program (CMS-1846)
This annual proposed rule would update the bundled payment system for ESRD facilities by January 1, 2027. The rule would also update the quality incentives in the ESRD program.
Status: Proposed rule published on June 26, 2026
CY 2027 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Payment Update (CMS-1844)
This annual proposed rule would update the national, standardized 30-day period payment rate, national per-visit rates used to calculate low utilization payment adjustments (LUPAs) and outlier payments under the Medicare prospective payment system for home health agencies based on the applicable home health payment update percentage. Additionally, this proposed rule would update payment rates for home infusion therapy services and home intravenous immune globulin (IVIG) services. These changes would apply to services furnished on or after January 1, 2027.
Status: Proposed rule published on July 6, 2026
CY 2027 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates (CMS-1850)
This annual proposed rule would revise the Medicare hospital outpatient prospective payment system to implement statutory requirements and changes arising from our continuing experience with this system. The proposed rule describes changes to the amounts and factors used to determine payment rates for services. In addition, the rule proposes changes to the ambulatory surgical center payment system list of services and rates, including implementing the second year of the three-year phase-out of the inpatient only list requirement. This proposed rule would also update and refine the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program.
Status: Proposed rule published on July 7, 2026
CY 2027 Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Medicare Part B (CMS-1848)
This annual proposed rule would revise payment polices under the Medicare physician fee schedule, and make other policy changes to payment under Medicare Part B, including for telehealth and primary care, to promote rural health and support deregulation. These changes would apply to services furnished beginning January 1, 2027. Additionally, this rule proposes updates to the Quality Payment Program.
Status: Proposed rule published on July 16, 2026
Exchange Pre-Enrollment Eligibility Verification (CMS-9873)
Public Law 119-21, known as the Working Families Tax Cut (WFTC) Legislation, amended the Internal Revenue Code (26 U.S. Code 36B) to establish new requirements for Federal and State-based Exchanges regarding eligibility verification for the premium tax credit (PTC). As a result, all Exchanges must verify certain eligibility criteria for individuals seeking coverage through a qualified health plan (QHP) with the advance premium tax credit (APTC) before an individual is eligible for APTC. This new policy changes existing policy established by Affordable Care Act Section 1411(e)(4)(B)(i) that allowed the Exchange to provide APTC for a set period of time to individuals who needed to submit documentation to verify their eligibility. Beginning with plan year 2028, individuals will not receive APTC until they have successfully verified their eligibility through a documentation submission process. Given that the Open Enrollment Period for plan year 2028 begins November 1, 2027, these requirements must be implemented before this date. Public Law 119-21 also establishes an additional requirement beginning August 1, 2027, for all Exchanges to provide a pre-enrollment verification process no later than August 1st of the year preceding the plan year. At a minimum, this process must allow individuals to verify their income and eligibility for a QHP for the upcoming plan year. If an Exchange fails to provide this process, no individual enrolled through that exchange will be eligible for PTC. This proposed rule would outline how Exchanges will implement these new statutory requirements.
Agenda status: NPRM (planned)
FY 2027 Hospice Wage Index, Payment Rate Update, and Quality Reporting Requirements (CMS-1851)
This annual proposed rule would update the hospice payment rates and the wage index for fiscal year 2027. The rule also proposes changes to the Hospice Quality Reporting program.
Status: Proposed rule published on April 6, 2026
FY 2027 Inpatient Rehabilitation Facility (IRF) Prospective Payment System Rate Update and Quality Reporting Program (CMS-1845)
This annual proposed rule would update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for fiscal year 2027. The rule also proposes changes to the IRF quality reporting program (QRP).
Status: Proposed rule published on April 6, 2026
FY 2027 Skilled Nursing Facility (SNFs) Prospective Payment System and Consolidated Billing and Updates to the Value-Based Purchasing and Quality Reporting Programs (CMS-1843)
This annual proposed rule would update the payment rates used under the prospective payment system for SNFs for fiscal year 2027. The rule also includes proposals for the SNF Quality Reporting Program (QRP) and for the Skilled Nursing Facility Value-Based Purchasing (VBP) Program that will affect Medicare payment to SNFs.
Status: Proposed rule published on April 7, 2026
Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; the Long-Term Care Hospital Prospective Payment System; and FY 2027 Rates (CMS-1849)
This annual proposed rule would revise the Medicare hospital inpatient and long-term care hospital prospective payment systems for operating and capital-related costs. The rule would update the geographic payment adjustment for rural hospitals and contain deregulatory proposals for Graduate Medical Education that impede competition. This proposed rule would implement changes arising from our continuing experience with these systems. In addition, the rule proposes to establish new requirements or revise existing requirements for quality reporting by specific Medicare providers.
Status: Proposed rule published on May 22, 2026
Interoperability Standards and Prior Authorization for Drugs (CMS-0062)
This rule would propose new requirements for Medicare Advantage (MA) organizations, state Medicaid fee-for service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plans (QHPs) offered on the Federally-facilitated Exchanges (FFEs) to streamline processes for the prior authorization for certain drugs. We are developing this rule, in part, based on the significant number of public commenters who responded to the CMS Interoperability and Prior Authorization proposed rule (87 FR 76238) urging CMS to expand the proposed prior authorization policies to include drugs. This rule would also propose a modified standard for prior authorization-related transactions under the Administrative Simplification provisions of HIPAA. In addition, as part of this rule, ASTP/ONC would propose to adopt updated versions of certain standards referenced in the proposed updated technical requirements for payer APIs, including standards supporting electronic prior authorization transactions. Finally, we are proposing to update the definition of "failure to report" under the Open Payments program.
Status: Proposed rule published on April 14, 2026
Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments (CMS-2449)
This rule would propose to modify the limit on the total payment rate and other requirements for state directed payments in Medicaid Managed Care. CMS would propose these changes to comply with Section 71116 of the One Big Beautiful Bill Act, known as the Working Families Tax Cut (WFTC) legislation, as well as the Presidential Memorandum, "Eliminating Waste, Fraud, and Abuse in Medicaid" issued June 6, 2025. This rule also proposes to set a limit for certain targeted Medicaid practitioner payments in Medicaid fee-for-service.
Status: Proposed rule published on May 22, 2026
Medicare Drug Price Negotiation Program (CMS-4215)
This proposed rule would codify the Medicare Drug Price Negotiation Program established in the Inflation Reduction Act. These changes would apply to the Negotiation Program effective initial price applicability year 2029.
Status: Proposed rule published on June 16, 2026
Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883)
This annual final rule sets forth payment parameters and provisions related to the risk adjustment programs; cost-sharing parameters; and user fees for issuers offering plans on Federally-facilitated Exchanges and State-based Exchanges using the Federal platform. It also provides additional standards for several other Affordable Care Act programs.
Status: Final rule published in the Federal Register on May 20, 2026
Requirements Related to Advanced Explanation of Benefits and Other Provisions Under the Consolidated Appropriations Act 2021 (CMS-9900)
This proposed rule would implement section 9816 of the Internal Revenue Code of 1986 (Code), section 716 of the Employee Retirement Income Security Act of 1974 (ERISA), and section 2799A1 of the Public Health Service (PHS Act), as directed by section 111 of the No Surprises Act (NSA); and may include other provisions under the Consolidated Appropriations Act, 2021.
Status: Proposed rule published on September 16, 2022
Short-Term, Limited-Duration Insurance (CMS-9881)
This proposed rule would amend the definition of short-term, limited-duration insurance (STLDI) for purposes of exclusion from the definition of individual health insurance coverage under section 2791(b)(5) of the Public Health Service Act. The Departments continue to receive feedback from stakeholders expressing concerns that the current regulatory framework has created barriers to affordable coverage options for consumers who do not qualify for premium tax credits. While individuals who qualify for premium tax credits are largely insulated from significant premium increases, individuals who are not eligible for subsidies face financial challenges due to increased premiums in the individual market and few more affordable alternative coverage options. This rule would increase insurance options for consumers and provide greater flexibility in meeting their healthcare coverage needs.
Agenda status: NPRM (planned)
Strengthening the Integrity of Medicaid and CHIP Managed Care, Financing, and Access to Care (CMS-2450)
This proposed rule would update regulations to strengthen the integrity of state enrollment processes, state directed payments and other payment and access requirements.
Agenda status: NPRM (planned)
Strengthening the Integrity of Section 1115 Demonstrations (CMS-2412)
This rule would propose new requirements related to section 1115 demonstration budget neutrality codified in statute under section 71118 of the Working Families Tax Cut (WTFC) Legislation (Pub. L. 119-21), which added subsection (g) under section 1115 of the Social Security Act.
Agenda status: NPRM (planned)
Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model (CMS-5544)
This final rule updates and revises the Increasing Organ Transplant Access (IOTA) Model for Performance Year (PY) 2.
Status: Final rule published in the Federal Register on June 1, 2026
Other actions in this stage
Early-stage actions: reviews and advance notices that come before a formal proposal.
On the agenda, but not expected to move within the next 12 months.
Contract Year 2026 Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, and Medicare Cost Plan Programs, and PACE (CMS-4208)
The final rule implements changes to strengthen and improve the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE). This rule also codifies Part D provisions of the Inflation Reduction Act of 2022 (IRA). Changes included in this rule are based on feedback and public consultations with Medicare Advantage Organizations (MAOs), Part D sponsors, health care provider organizations, pharmaceutical manufacturers, pharmacy organizations, and beneficiary advocates, including regular listening sessions and other engagements to assist in the implementation of IRA provisions, gain input, identify areas that can be improved, and address vulnerabilities in the Part C and D programs. The 2nd final rule implements Medicare Advantage disclosure requirement changes.
Status: Final rule published in the Federal Register on April 6, 2026
Cost Sharing Under the Affordable Care Act (CMS-9885)
The proposed rule would amend regulations implementing the Affordable Care Act's provisions related to cost sharing protections. This proposed rule would address the applicability of drug manufacturer support to the annual limitation on cost sharing for group and individual coverage.
Agenda status: NPRM (planned)
Global Benchmark for Efficient Drug Pricing (GLOBE) Model (CMS-5545)
This rule implements the GLOBE Model, a new Medicare payment model under section 1115A of the Social Security Act (the Act). The GLOBE Model tests whether a payment model that uses an alternative method for calculating inflation rebates for certain separately payable Part B drugs and biologicals reduces costs for Medicare fee-for-service (FFS) beneficiaries and the Medicare program while preserving quality of care.
Status: Proposed rule published on December 23, 2025
Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model (CMS-5546)
The GUARD Model tests new rebate formula for Medicare Part D drugs, which includes outpatient prescription drugs typically dispensed at retail, mail order, home infusion, and long-term care pharmacies. The GUARD Model will factor in existing Medicare Part D manufacturer rebates and discounts, and CMS will leverage its authority to test a change in the calculation of inflation rebates in Medicare Part D that accounts for how much certain drugs cost in economically similar countries. The intent of the GUARD Model is to test an innovative payment model that modifies the inflation rebate for GUARD Model drugs using international drug pricing information to identify a benchmark that reflects prices paid in a set of economically comparable countries, which CMS expects will reduce program expenditures for Medicare Part D while preserving or enhancing beneficiaries' quality of care.
Status: Proposed rule published on December 23, 2025
Repeal of Minimum Staffing Standards for Long-Term Care Facilities (CMS-3442)
This rule finalizes the December 3, 2025 interim final rule with comment period that repealed provisions of the final rule titled "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting." This action is taken in view of changes made by the One Big Beautiful Bill Act of 2025, which precludes HHS from implementing, administering, or enforcing certain provisions of the final rule until September 30, 2034.
Status: Final rule published in the Federal Register on December 3, 2025
Other actions in this stage
Actions the agency reports as completed this cycle. The official agenda rule list files these separately from the active pipeline.
Administrative Simplification: Adoption of Standards for Health Care Attachment Transactions and Electronic Signatures (CMS-0053)
This rule finalizes new standards for health plans and providers to support both health care claims transactions, and standards for electronic signatures to be used in conjunction with health care attachments transactions. Additionally, this rule finalizes a regulatory change that implements requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Patient Protection and Affordable Care Act (Pub. L. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), enacted on March 30, 2010, (collectively, the ACA).
Status: Final rule published in the Federal Register on March 24, 2026
CY 2026 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System and Quality Incentive Program (CMS-1830)
This annual final rule updates the bundled payment system for ESRD facilities by January 1, 2026. The rule also updates the quality incentives in the ESRD program.
Status: Final rule published in the Federal Register on November 24, 2025
CY 2026 Home Health Prospective Payment System Rate and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program Updates (CMS-1828)
This annual final rule updates the national, standardized 30-day period payment rate, national per-visit rates used to calculate low utilization payment adjustments (LUPAs) and outlier payments under the Medicare prospective payment system (PPS) for home health agencies based on the applicable home health payment update percentage. This rule also includes changes to the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) to help CMS continue to implement an effective, efficient, and sustainable program by generating savings and reducing fraud, waste, and abuse in the Medicare program. Additionally, CMS is finalizing several changes to the DMEPOS CBP to streamline a few operational processes to decrease the burden on bidders, as well as incorporating previous sub-regulatory guidance into regulation.
Status: Final rule published in the Federal Register on December 2, 2025
CY 2026 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates (CMS-1834)
This annual final rule revises the Medicare hospital outpatient prospective payment system to implement statutory requirements and changes arising from our continuing experience with this system. The rule describes changes to the amounts and factors used to determine payment rates for services. In addition, the rule finalizes changes to the ambulatory surgical center payment system list of services and rates. This rule also updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program.
Status: Final rule published in the Federal Register on February 23, 2026
CY 2026 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts (CMS-8089)
This annual notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 2026 under Medicare's Hospital Insurance program (Medicare Part A). The Medicare statute specifies the formula used to determine these amounts.
Agenda status: Notice Effective (planned)
CY 2026 Part A Premiums for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement (CMS-8090)
This annual notice announces the premiums for CY 2026 under Medicare's Hospital Insurance program (Medicare Part A) for the uninsured aged and for certain disabled individuals who have exhausted other entitlement.
Agenda status: Notice Effective (planned)
CY 2026 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B (CMS-1832)
This annual final rule revises payment polices under the Medicare physician fee schedule, and makes other policy changes to payment under Medicare Part B. These changes apply to services furnished beginning January 1, 2026. Additionally, this rule updates the Quality Payment Program.
Status: Final rule published in the Federal Register on March 12, 2026
FY 2026 Hospice Wage Index, Payment Rate Update, and Quality Reporting Requirements (CMS-1835)
This annual final rule updates the hospice payment rates, the wage index, and the hospice aggregate cap for fiscal year 2026. The rule also finalizes changes to the Hospice Quality Reporting program.
Status: Final rule published in the Federal Register on September 4, 2025
FY 2026 Inpatient Rehabilitation Facility (IRF) Prospective Payment System Rate Update and Quality Reporting Program (CMS-1829)
This annual final rule updates the prospective payment rates for Inpatient Rehabilitation Facilities (IRFs) for fiscal year 2026. The rule also finalizes changes to the IRF quality reporting program (QRP).
Status: Final rule published in the Federal Register on December 17, 2025
FY 2026 Skilled Nursing Facility (SNFs) Prospective Payment System and Consolidated Billing and Updates to the Value-Based Purchasing and Quality Reporting Programs (CMS-1827)
This annual final rule updates the payment rates used under the prospective payment system for SNFs for fiscal year 2026. The rule also includes updates for the SNF Quality Reporting Program (QRP) and for the Skilled Nursing Facility Value-Based Purchasing (VBP) Program that will affect Medicare payment to SNFs.
Status: Final rule published in the Federal Register on August 4, 2025
Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; the Long-Term Care Hospital Prospective Payment System; and FY 2026 Rates (CMS-1833)
This annual final rule revises the Medicare hospital inpatient and long-term care hospital prospective payment systems for operating and capital-related costs. This rule implements changes arising from our continuing experience with these systems. In addition, the rule establishes new requirements or revises existing requirements for quality reporting by specific Medicare providers.
Status: Proposed rule published on June 5, 2025
Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole (CMS-2448)
This rule updates existing regulations to address a loophole in a regulatory statistical test applied to State proposals for Medicaid tax waivers. The test is designed to ensure, as required by statute, that non-uniform or non-broad based health care-related taxes, authorized under a waiver, are generally redistributive. Some States have exploited this loophole to establish tax schemes that generate significant State budget windfalls from Federal Medicaid funds, often without providing additional Medicaid services, increasing quality of care, or improving health outcomes. Nearly all of these existing loophole taxes are associated with managed care organizations, and have been increasing in recent years. The updates will better implement the statutory requirements and strengthen the fiscal integrity of the Medicaid program by adding additional safeguards to ensure that tax waivers that exploit the loophole are not approvable. These changes will end current tax loophole schemes, resulting in significant savings to the federal government.
Status: Final rule published in the Federal Register on February 2, 2026
Medicare Part B Monthly Actuarial Rates, Premium Rates, and Annual Deductible Beginning January 1, 2026 (CMS-8091)
This notice announces the monthly actuarial rates for aged (age 65 and over) and disabled (under age 65) beneficiaries enrolled in Part B of the Medicare Supplementary Medical Insurance (SMI) program beginning January 1, 2026. In addition, this notice announces the monthly premium for aged and disabled beneficiaries, the deductible for 2026, and the income-related monthly adjustment amounts to be paid by beneficiaries with modified adjusted gross income above certain threshold amounts. It also announces the monthly premium for beneficiaries enrolled in the Part B immunosuppressive drug benefit.
Agenda status: Notice Effective (planned)
Administrative Simplification: Modifications to NCPDP Retail Pharmacy Standards (CMS-0056)
The final rule requires pharmacies and vendors to modify the currently adopted National Council for Prescription Drug Programs (NCPDP) standards to the Telecommunications Standard Implementation Guide Version F6 (F6); Batch Standard Implementation Guide version 15; and Batch Standard Subrogation Implementation Guide version 10.
Status: Final rule published in the Federal Register on August 21, 2025
FY 2026 Inpatient Psychiatric Facilities Prospective Payment System Rate and Quality Reporting Updates (CMS-1831)
This annual final rule updates the prospective payment system for inpatient psychiatric facilities (IPF) with discharges beginning on October 1, 2025. The rule also includes updates to the IPF Quality Reporting Program.
Status: Final rule published in the Federal Register on August 5, 2025
Other actions in this stage
Don’t re-check this page. Let us watch it for you.
Create a free account and get an alert the moment a CMS rule advances, a comment period opens, or a new action lands on the agenda.
Create a free accountCompiled from the 2026 Regulatory Plan and Unified Agenda (reginfo.gov), cross-referenced against Federal Register publications. Regulation Roundup tracks all 71 CMS actions and refreshes as the agenda changes.