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Rural Health
News by Topic: Reimbursement and payment models

Nov 5, 2026 - Pre-publication notice of final rule from the Centers for Medicare & Medicaid Services (CMS) updating the home health payment rates for calendar year (CY) 2027. This rule also finalizes changes to the Home Health Quality Reporting Program (HH QRP) and summarizes potential initiatives to improve alignment between the HH QRP and the expanded Home Health Value-Based Purchasing (HHVBP) Model. Among other things, this rule finalizes permanent and temporary behavior adjustments and recalibrates the case-mix weights and updates the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2027; and summarizes and responds to comments received on the July 6, 2026, proposed rule regarding the provision of home health palliative care services and a home health specific wage index. The home health prospective payment system and HH QRP provisions of this rule and the regulatory changes at 42 CFR 484.245 are effective January 1, 2027. The remaining regulations are effective 60 days after the date of filing for public inspection. Publication is scheduled for November 9, 2026.
Source: Federal Register
Nov 5, 2026 - Pre-publication notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) addressing: 1) changes to the Physician Fee Schedule and Medicare Part B payment policies; 2) policies for the Medicare Prescription Drug Inflation Rebate Program under the Inflation Reduction Act of 2022; 3) limiting Medicare coverage of certain individuals; 4) the Ambulatory Specialty Model; 5) updates to drugs and biological products paid under Part B; 6) Medicare Shared Savings Program requirements; 7) updates to the Quality Payment Program; 8) updates to policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); 9) updates to the Ambulance Fee Schedule regulations; 10) codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2026 provisions; 11) updates to Clinical Laboratory Fee Schedule regulations; and 12) updates to the Medicare Promoting Interoperability Program. These regulations are effective January 1, 2027.
Source: Federal Register
Nov 5, 2026 - Pre-publication notice of a final rule with comment period from the Centers for Medicare & Medicaid Services (CMS) making changes to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2027, including changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment systems. Among other things, this rule updates and refines requirements for the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Reporting Program; finalizes the implementation of provisions of the Consolidated Appropriations Act, 2026, regarding off-campus outpatient departments of a provider; and announces notices of closure of teaching hospitals and opportunities to apply for available slots. Comments are due by January 4, 2027. This rule is effective January 1, 2027.
Source: Federal Register
Nov 4, 2026 - Notice from the Centers for Medicare & Medicaid Services making corrections to the November 2, 2026, notice regarding an information collection titled "Pre-Claim Review Demonstration for Home Health Services."
Source: Federal Register
Nov 2, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the reinstatement of an information collection titled "Inpatient Psychiatric Unit Criteria Work Sheet." Information collected is used by inpatient psychiatric units (IPUs) to prove that they meet the requirements to be exempt from receiving payment from Medicare under the lower paying hospital inpatient prospective payment system (IPPS). Comments are due by January 4, 2027.
Source: Federal Register
Nov 2, 2026 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on revisions to an information collection titled "Pre-Claim Review Demonstration For Home Health Services." The approval of this data collection process is essential to ensure that the Review Choice Demonstration for Home Health Services is expanded to California within the specified timeframe. Comments are due by November 16, 2026.
Source: Federal Register
Nov 2, 2026 - Discusses non-emergency medical transportation, including both the benefits of the service and the health impacts on patients who lack transportation. Highlights ongoing research investigating the service in Minnesota, including the impact on hospital finances, reimbursement issues, and certifying drivers.
Source: The Daily Yonder
Oct 30, 2026 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) making changes related to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2027 and updating the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). This rule also updates the requirements for the ESRD Quality Incentive Program. These regulations are effective January 1, 2027.
Source: Federal Register
Oct 26, 2026 - Describes the application of a direct primary care (DPC) model of care in an agricultural Oklahoma community. Discusses how the model works, why a provider may want to use the model, and the geographic distribution of DPC practices.
Source: Farm Press
Oct 21, 2026 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on a new matching program between CMS and the Department of Veterans Affairs (VA) that would identify beneficiaries enrolled in both Medicare and Veterans Health Administration (VHA) healthcare. The matching program will be used to identify and recover duplicate payments; improve payment accuracy; and identify potential fraud, waste, and abuse. Comments are due by November 20, 2026.
Source: Federal Register