CMS & CMMI Updates
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CMS Intelligence Summary
Key Actions:
CMS activity over the last 30 days centered on claims-system updates, FY 2027 payment operations, rural access investments, emergency flexibilities, Medicaid/CHIP coverage limits, and program-integrity enforcement.
Key Actions:
CMS activity over the last 30 days centered on claims-system updates, FY 2027 payment operations, rural access investments, emergency flexibilities, Medicaid/CHIP coverage limits, and program-integrity enforcement.
CMS issued multiple Medicare transmittals with October 5, 2026 implementation dates: R13924CP / CR 14557 updated the FY 2027 hospice payment rates, hospice cap, wage index, and Hospice Pricer (R13924CP); R13812CP / CR 14519 updated FY 2027 IPPS MS-DRG rules for replaced devices offered without cost or with credit (R13812CP); R13884CP / CR 14569 updated the October 2026 CLFS/CLIA HCPCS files (R13884CP); R13910OTN / CR 14464 implemented October 2026 ICD-10 and NCD coding revisions (R13910OTN); and R13934OTN / CR 14429 updated HIPAA EDI front-end processing for October 2026 (R13934OTN). CMS also reissued/updated SNF Consolidated Billing HCPCS enforcement guidance under R13943CP / CR 14561 after an earlier R13881CP version (R13943CP, R13881CP).
For January 2027, CMS released R13923OTN / CR 14570 on ICD-10 and NCD coding revisions (R13923OTN), R13933OTN / CR 14454 to allow FISS/ECPS to process more than 10 medical policy reason codes (R13933OTN), and R13932OTN / CR 14553 for A/B MAC Part A and FISS processing of certain Medicare Secondary Payer claims (R13932OTN).
CMS revised ESRD survey guidance via R246SOMA, updating State Operations Manual Appendix H effective August 17, 2026 (R246SOMA). It also announced it had prevented $1.6 billion in fraudulent Medicare laboratory payments (CMS lab fraud release) and ended federal Medicaid and CHIP funding for sex-rejecting procedures for children and youth (CMS Medicaid/CHIP release). CMS issued public health emergency flexibilities for Washington (Washington PHE alert).
The Trump Administration also announced targeted rural and access investments: $160 million for Alaska technology, drone prescription delivery, and surgical robotics (Alaska); $149.3 million for rural Arkansas telehealth and specialty/preventive access (Arkansas); $144 million for Alabama mental health, substance use, emergency, maternal care, and workforce (Alabama); $122 million for Virginia access, workforce, and innovation (Virginia); $93.3 million for Georgia telehealth, surgical robotics, and rural access (Georgia); $90 million for South
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Recent Publications
- R13943CPCMS Transmittals· Sep 1, 2026
- Trump Administration Announces $58 million to Deliver New Ambulances and Upgrade Emergency Communications Systems Across HawaiiCMS Newsroom (direct)· Sep 1, 2026
- Trump Administration Announces $149.3 Million to Expand Telehealth and Increase Access to Specialty Care and Preventive Screenings in Rural ArkansasCMS Newsroom (direct)· Aug 31, 2026
- CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory PaymentsCMS Newsroom (direct)· Aug 28, 2026
- Trump Administration Announces $122 Million to Expand Healthcare Access, Workforce and Innovation Across VirginiaCMS Newsroom (direct)· Aug 28, 2026
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