{"description":"Documents matching 'Care Coordination Healthcare Plans'","count":2166,"total_pages":50,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=Care+Coordination+Healthcare+Plans&format=json&page=2","results":[{"title":"Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges","type":"Proposed Rule","abstract":"These proposals are intended to improve the electronic exchange of health care data and streamline processes related to prior authorization by increasing the interoperability of systems used across the health care industry. We are proposing 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 Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs), including issuers that offer small group market QHPs on the Federally-facilitated Small Business Health Options Program (FF- SHOP) Exchanges (hereinafter referred to as \"small group market QHP issuers on the FF-SHOPs\") (collectively \"impacted payers\"), to make available electronic prior authorization for drugs. We are also proposing to extend many existing interoperability requirements for the prior authorization of non-drug items and services to include prior authorizations for drugs to further reduce patient and provider burden. We are also proposing to require impacted payers to report their application programming interfaces (API) endpoints and related information for the Patient Access, Provider Directory, Provider Access, Payer-to-Payer, and Prior Authorization APIs to CMS. To help assess the impact of our policies, we are proposing to collect API usage metrics. In addition, we are proposing to apply the existing interoperability requirements to small group market QHP issuers on the FF-SHOPs as impacted payers. To improve impacted payers' ability to exchange health information while continuing CMS's drive toward interoperability, we are proposing to require certain Health Level Seven (HL7[supreg]) Fast Healthcare Interoperability Resources (FHIR[supreg]) implementation guides (IGs) that are currently recommended. In addition, HHS is proposing to adopt the HL7 FHIR base standard and certain associated specifications and IGs as the Health Insurance Portability and Accountability Act of 1996 (hereinafter referred to as \"HIPAA\") (Pub. L. 104-191, enacted Aug. 21, 1996) standards for dental, professional, and institutional \"referral certification and authorization\" transactions and \"eligibility for a health plan\" transactions associated with prior authorization. We are proposing to add a definition for \"failure to report,\" which would allow CMS to impose a civil monetary penalty (CMP) on applicable manufacturers or applicable group purchasing organizations (GPOs) if those entities fail to grant CMS timely access to documents for the purposes of an audit. Finally, ONC is using this rulemaking to propose to adopt updated versions of certain health information technology (health IT) standards and specifications for HHS use, such as CMS's interoperability requirements, to support a more robust health IT infrastructure.","document_number":"2026-07205","html_url":"https://www.federalregister.gov/documents/2026/04/14/2026-07205/medicare-and-medicaid-programs-patient-protection-and-affordable-care-act-interoperability-standards","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-14/pdf/2026-07205.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-07205.pdf?1775852111","publication_date":"2026-04-14","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"managed <span class=\"match\">care</span> <span class=\"match\">plans</span>, cross reference to 42 CFR 438.242 in 42 CFR 457.1233(d) for CHIP managed <span class=\"match\">care</span> entities, and 45 CFR 156.221(b) for individual market QHP issuers on the FFEs.\n \n \n \n The “Medicare and Medicaid Programs; Patient Protection and Affordable <span class=\"match\">Care</span> Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed <span class=\"match\">Care</span> <span class=\"match\">Plans</span>, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed <span class=\"match\">Care</span> Entities, Issuers of Qualified Health <span class=\"match\">Plans</span> on the"},{"title":"Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures","type":"Rule","abstract":"This final rule 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, as amended by the Health Care and Education Reconciliation Act of 2010, enacted on March 30, 2010--collectively, the Affordable Care Act. Specifically, this final rule adopts standards for health care claims attachments transactions, which will support health care claims transactions, and a standard for electronic signatures to be used in conjunction with health care claims attachments transactions.","document_number":"2026-05676","html_url":"https://www.federalregister.gov/documents/2026/03/24/2026-05676/administrative-simplification-adoption-of-standards-for-health-care-claims-attachments-transactions","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-03-24/pdf/2026-05676.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-05676.pdf?1774037709","publication_date":"2026-03-24","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Office of the Secretary"}],"excerpts":"162—Health <span class=\"match\">Care</span> Attachments (87 FR 78446). In Subpart T, in § 162.2001, we proposed to define the “health <span class=\"match\">care</span> attachments transaction” for health <span class=\"match\">care</span> claims transactions and prior authorization transactions. Specifically, we proposed that any of the following different types of transmissions would constitute a “health <span class=\"match\">care</span> attachments transaction”: (1) the transmission of attachment information from a health <span class=\"match\">care</span> provider to a health <span class=\"match\">plan</span> in support of a referral certification and authorization transaction or in support of a health <span class=\"match\">care</span> claims or"},{"title":"Medical Billing for Healthcare Services Provided by Department of Defense Military Medical Treatment Facilities to Civilian Non-Beneficiaries","type":"Rule","abstract":"As required by the James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 (NDAA-23), this rule reduces financial harm to civilians who are not covered beneficiaries of the Military Health System (MHS), and who receive healthcare services at DoD military medical treatment facilities (MTF). The rulemaking implements the MHS Modified Payment and Waiver Program (MPWP) through which the DoD applies a sliding fee scale and/or a catastrophic fee waiver to medical invoices of certain non-beneficiaries and accepts payments from health insurers of non-beneficiaries as full payment except for copays, coinsurance, deductibles, nominal fees and non- covered services.","document_number":"2026-02437","html_url":"https://www.federalregister.gov/documents/2026/02/06/2026-02437/medical-billing-for-healthcare-services-provided-by-department-of-defense-military-medical-treatment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-06/pdf/2026-02437.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-02437.pdf?1770299125","publication_date":"2026-02-06","agencies":[{"raw_name":"DEPARTMENT OF DEFENSE","name":"Defense Department","id":103,"url":"https://www.federalregister.gov/agencies/defense-department","json_url":"https://www.federalregister.gov/api/v1/agencies/103","parent_id":null,"slug":"defense-department"},{"raw_name":"Office of the Secretary"}],"excerpts":"health insurance <span class=\"match\">plan</span> provides coverage for the geographic area where the <span class=\"match\">care</span> was delivered; \n (iii) The <span class=\"match\">care</span> provided to the patient is an item or service covered by the terms of the insurance <span class=\"match\">plan</span>, and; \n (iv) The health insurance <span class=\"match\">plan</span> provides coverage for <span class=\"match\">care</span> rendered in a U.S. Government/DoD facility; \n (v) The insurer agrees to pay the facility directly; \n (vi) The insurer agrees to provide the facility with an Explanation of Benefits (EOB) that details how the insurer processed the claims according to the insurance <span class=\"match\">plan</span>; and \n (vii) The"},{"title":"Statement of Organization, Functions, and Delegations of Authority","type":"Notice","abstract":"The Centers for Medicare and Medicaid Services (CMS), Office of Health Technology and Products (OHTP), has been established. This new organizational component will provide enterprise leadership and oversight for CMS healthcare technology modernization, digital products, and transformation of platforms and services supporting Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and other CMS-administered programs, in close coordination with the CMS Chief Information Officer (CIO) and subject to CIO-led enterprise information technology (IT) governance, cybersecurity, enterprise architecture, and capital planning and investment control responsibilities, as well as CIO-led digital service delivery, customer experience, and public digital experience responsibilities under applicable law.","document_number":"2026-11743","html_url":"https://www.federalregister.gov/documents/2026/06/11/2026-11743/statement-of-organization-functions-and-delegations-of-authority","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-11/pdf/2026-11743.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-11743.pdf?1781095520","publication_date":"2026-06-11","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"component will provide enterprise leadership and oversight for CMS <span class=\"match\">healthcare</span> technology modernization, digital products, and transformation of platforms and services supporting Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and other CMS-administered programs, in close <span class=\"match\">coordination</span> with the CMS Chief Information Officer (CIO) and subject to CIO-led enterprise information technology (IT) governance, cybersecurity, enterprise architecture, and capital <span class=\"match\">planning</span> and investment control responsibilities, as well as CIO-led digital"},{"title":"Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments","type":"Proposed Rule","abstract":"This proposed rule describes alternatives to modify the limit on the total payment rate and other requirements for State directed payments in Medicaid managed care. We propose these changes based on our authority to interpret and implement section 1902(a)(4) of the Social Security Act (the Act) with respect to prepaid inpatient health plans and prepaid ambulatory health plans, and section 1903(m)(2)(A)(iii) of the Act, which require that contracts between States and managed care organizations to provide payments under a risk- based contract for services and associated administrative costs that are actuarially sound. This rule also proposes to set a limit for certain targeted Medicaid payments in Medicaid fee-for-service. We propose this change based on our authority to interpret and implement section 1902(a)(30)(A) of the Act with respect to certain targeted Medicaid payments which require that payments be consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.","document_number":"2026-10292","html_url":"https://www.federalregister.gov/documents/2026/05/22/2026-10292/medicaid-program-medicaid-managed-care-state-directed-payments-and-medicaid-fee-for-service-targeted","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-22/pdf/2026-10292.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-10292.pdf?1779308109","publication_date":"2026-05-22","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"risk-based managed <span class=\"match\">care</span> arrangements with States, Medicaid managed <span class=\"match\">care</span> <span class=\"match\">plans</span> have the responsibility to negotiate payment rates with providers. Subject to certain exceptions, States are not permitted to direct the expenditures of a Medicaid managed <span class=\"match\">care</span> <span class=\"match\">plan</span> under the contract between the State and the <span class=\"match\">plan</span> or to make direct payments to providers for services covered under the contract between the State and the <span class=\"match\">plan</span> (§§ 438.6 and 438.60, respectively). However, there are circumstances under which requiring managed <span class=\"match\">care</span> <span class=\"match\">plans</span> to make specified payments"},{"title":"Proposed Data Collection Submitted for Public Comment and Recommendations","type":"Notice","abstract":"The Centers for Disease Control and Prevention (CDC), as part of its continuing effort to reduce public burden and maximize the utility of government information, invites the general public and other federal agencies the opportunity to comment on a proposed information collection, as required by the Paperwork Reduction Act of 1995. This notice invites comment on a proposed information collection project titled Occupational exposures to waste anesthetic gases in healthcare professionals. The purpose of the proposed data collection is to assess occupational exposures to waste anesthetic gases (WAGs) in healthcare and veterinary workers in postanesthetic care units (PACUs) and veterinary hospitals, examine associated adverse acute health effects of WAGs and recommend control measures to reduce WAG exposures for healthcare and veterinary workers in PACUs and veterinary hospitals.","document_number":"2025-10866","html_url":"https://www.federalregister.gov/documents/2025/06/16/2025-10866/proposed-data-collection-submitted-for-public-comment-and-recommendations","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-06-16/pdf/2025-10866.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-10866.pdf?1749818712","publication_date":"2025-06-16","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Disease Control and Prevention","name":"Centers for Disease Control and Prevention","id":44,"url":"https://www.federalregister.gov/agencies/centers-for-disease-control-and-prevention","json_url":"https://www.federalregister.gov/api/v1/agencies/44","parent_id":221,"slug":"centers-for-disease-control-and-prevention"}],"excerpts":"proposed information collection project titled Occupational exposures to waste anesthetic gases in <span class=\"match\">healthcare</span> professionals. The purpose of the proposed data collection is to assess occupational exposures to waste anesthetic gases (WAGs) in <span class=\"match\">healthcare</span> and veterinary workers in postanesthetic <span class=\"match\">care</span> units (PACUs) and veterinary hospitals, examine associated adverse acute health effects of WAGs and recommend control measures to reduce WAG exposures for <span class=\"match\">healthcare</span> and veterinary workers in PACUs and veterinary hospitals. \n \n \n DATES: \n CDC must receive written"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital- related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals; update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); update and make changes to requirements for certain quality programs; and make other policy-related changes.","document_number":"2026-07203","html_url":"https://www.federalregister.gov/documents/2026/04/14/2026-07203/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-ipps-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-14/pdf/2026-07203.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-07203.pdf?1775852113","publication_date":"2026-04-14","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"rule, we are proposing to adopt two new measures: (1) Advance <span class=\"match\">Care</span> <span class=\"match\">Planning</span> eCQM beginning with the FY 2030 program year; and (2) Malnutrition <span class=\"match\">Care</span> Score eCQM beginning with the FY 2030 program year. We are also proposing to remove the COVID-19 Vaccination Coverage Among <span class=\"match\">Healthcare</span> Personnel (HCP COVID-19 Vaccination) measure beginning with the FY 2028 program year. In addition, we propose establishing reporting and submission requirements for eCQMs in this program. \n g. Long-Term <span class=\"match\">Care</span> Hospital Quality Reporting Program (LTCH QRP) \n In the LTCH QRP"},{"title":"Occupational Exposure to COVID-19 in Healthcare Settings","type":"Proposed Rule","abstract":"OSHA is proposing to remove OSHA's COVID-19 Emergency Temporary Standard and its associated recordkeeping and reporting provisions from the Code of Federal Regulations.","document_number":"2025-11625","html_url":"https://www.federalregister.gov/documents/2025/07/01/2025-11625/occupational-exposure-to-covid-19-in-healthcare-settings","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-07-01/pdf/2025-11625.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-11625.pdf?1751287514","publication_date":"2025-07-01","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Occupational Safety and Health Administration","name":"Occupational Safety and Health Administration","id":386,"url":"https://www.federalregister.gov/agencies/occupational-safety-and-health-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/386","parent_id":271,"slug":"occupational-safety-and-health-administration"}],"excerpts":"and Emergency Centers \n First Aid and Emergency <span class=\"match\">Care</span> \n 114.03 \n 43.50 \n \n \n 621498 \n All Other Outpatient <span class=\"match\">Care</span> Centers \n Other Patient <span class=\"match\">Care</span> \n 114.03 \n 43.50 \n \n \n 621610 \n Home Health <span class=\"match\">Care</span> Services \n Home Health <span class=\"match\">Care</span> and Temp Labor \n 114.03 \n 43.50 \n \n \n 621910 \n Ambulance Services \n First Aid and Emergency <span class=\"match\">Care</span> \n 114.03 \n 43.50 \n \n \n 621991 \n Blood and Organ Banks \n Other Patient <span class=\"match\">Care</span> \n 114.03 \n 43.50 \n \n \n 621999 \n All Other Miscellaneous Ambulatory Health <span class=\"match\">Care</span> Services \n First Aid and Emergency <span class=\"match\">Care</span> \n 114.03 \n 43.50 \n \n \n 622110 \n General Medical"},{"title":"Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly","type":"Rule","abstract":"This final rule revises the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to prescription drug coverage, the Medicare Prescription Payment Plan, dual eligible special needs plans (D-SNPs), Part C and D Star Ratings, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This final rule also codifies existing sub-regulatory guidance in the Part C and Part D programs.","document_number":"2025-06008","html_url":"https://www.federalregister.gov/documents/2025/04/15/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-04-15/pdf/2025-06008.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-06008.pdf?1743797708","publication_date":"2025-04-15","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"provision applies to all Part D <span class=\"match\">plan</span> sponsors, including both stand-alone PDPs and MA-PD <span class=\"match\">plans</span>, as well as Employer Group Waiver <span class=\"match\">Plans</span> (EGWPs), cost <span class=\"match\">plans</span>, and demonstration <span class=\"match\">plans</span>. CMS further stated that for the reasons articulated in the final part two guidance, we do not expect <span class=\"match\">plans</span> that exclusively charge $0 cost sharing for covered Part D drugs to offer enrollees the option to pay their OOP costs through monthly payments over the course of the <span class=\"match\">plan</span> year or otherwise comply with the Medicare Prescription Payment <span class=\"match\">Plan</span> requirements set forth in the"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program","type":"Rule","abstract":"This final rule contains provisions to improve implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This final rule also includes provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; standards governing agents, brokers, and web-brokers; the expansion and codification of hardship exemption eligibility; implementation of the State Exchange Improper Payment Measurement (SEIPM); provider access standards and essential community provider standards for QHP certification; QHP certification of non-network plans; a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); requirements related to defrayal for the cost of any State-required benefits in addition to the EHB; cost- sharing flexibilities for catastrophic and individual market bronze plans; establishment of catastrophic plans with plan terms of up to 10 consecutive plan years; QHP issuer quality improvement strategies (QISs); and revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States. This final rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation.","document_number":"2026-10050","html_url":"https://www.federalregister.gov/documents/2026/05/20/2026-10050/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2027-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-20/pdf/2026-10050.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-10050.pdf?1779135308","publication_date":"2026-05-20","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"Affordable <span class=\"match\">Care</span> Act requires the Exchange to implement procedures for the certification, recertification, and decertification of health <span class=\"match\">plans</span> as QHPs, consistent with guidelines developed by the Secretary under section 1311(c) of the Affordable <span class=\"match\">Care</span> Act. Section 1311(e)(1) of the Affordable <span class=\"match\">Care</span> Act grants the Exchange the authority to certify a health <span class=\"match\">plan</span> as a QHP if the health <span class=\"match\">plan</span> meets the Secretary's requirements for certification issued under section 1311(c) of the Affordable <span class=\"match\">Care</span> Act, and the Exchange determines that making the <span class=\"match\">plan</span> available"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program","type":"Proposed Rule","abstract":"This proposed rule contains provisions to improve implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This proposed rule also includes provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; standards governing agents, brokers, and web-brokers; the expansion and codification of hardship exemption eligibility; implementation of the State Exchange Improper Payment Measurement (SEIPM); provider access standards and essential community provider standards for QHP certification; QHP certification of non-network plans; a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); cost-sharing flexibilities for catastrophic and individual market bronze plans; establishment of catastrophic plans with plan terms of up to 10 consecutive years; QHP issuer quality improvement strategies (QISs); revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States; and seeks comment on potential adjustments to other Federal standards, including the Federal medical loss ratio (MLR) standard in the individual market. This proposed rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation.","document_number":"2026-02769","html_url":"https://www.federalregister.gov/documents/2026/02/11/2026-02769/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2027-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-11/pdf/2026-02769.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-02769.pdf?1770671709","publication_date":"2026-02-11","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"State-specific <span class=\"match\">plans</span>, we apply the CSR adjustment factors that correspond to each <span class=\"match\">plan's</span> AV. See, \n e.g., \n the 2025 Payment Notice, 89 FR at 26252-26253. However, a different approach is taken for States whose State-specific <span class=\"match\">plans</span> take the form of Medicaid expansion <span class=\"match\">plans</span> offered on the Exchange (for example, Arkansas), because these Medicaid-expansion <span class=\"match\">plans</span> are identical in all their parameters, including AV and degree of <span class=\"match\">plan</span> liability, to other <span class=\"match\">plans</span> offered on the Exchange in those States and are differentiated from their comparable <span class=\"match\">plans</span> only in"},{"title":"Administrative Simplification: Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard","type":"Rule","abstract":"This final rule adopts updated versions of the retail pharmacy standards for electronic transactions adopted under the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These updated versions are modifications to the currently adopted standards for the following retail pharmacy transactions: health care claims or equivalent encounter information; eligibility for a health plan; referral certification and authorization; and coordination of benefits. This final rule also adopts a modification to the standard for the Medicaid pharmacy subrogation transaction.","document_number":"2024-29138","html_url":"https://www.federalregister.gov/documents/2024/12/13/2024-29138/administrative-simplification-modifications-of-health-insurance-portability-and-accountability-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-13/pdf/2024-29138.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-29138.pdf?1734011124","publication_date":"2024-12-13","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Office of the Secretary"}],"excerpts":"adopt standards for the following transactions: health claims or equivalent encounter information; health claims attachments; enrollment and disenrollment in a health <span class=\"match\">plan</span>; eligibility for a health <span class=\"match\">plan</span>; health <span class=\"match\">care</span> payment and remittance advice; health <span class=\"match\">plan</span> premium payments; first report of injury; health claim status; and referral certification and authorization. The Affordable <span class=\"match\">Care</span> Act additionally required the Secretary to adopt standards for electronic funds transfers transactions. Section 1173(a)(1)(B) of the Act requires the Secretary to adopt"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital- related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals; update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); update and make changes to requirements for certain quality programs; and make other policy-related changes.","document_number":"2025-06271","html_url":"https://www.federalregister.gov/documents/2025/04/30/2025-06271/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-04-30/pdf/2025-06271.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-06271.pdf?1744402510","publication_date":"2025-04-30","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"multiple different comorbid conditions. \n • Reflects systemic impact. \n • Post-operative/post-procedure condition/complication impacting recovery. \n • Typically requires higher level of <span class=\"match\">care</span> (that is, intensive monitoring, greater number of caregivers, additional testing, intensive <span class=\"match\">care</span> unit <span class=\"match\">care</span>, extended length of stay). \n • Impedes patient cooperation or management of <span class=\"match\">care</span> or both. \n • Recent (last 10 years) change in best practice, or in practice guidelines and review of the extent to which these changes have led to concomitant changes in expected"},{"title":"Medical Billing for Healthcare Services Provided by Department of Defense Military Medical Treatment Facilities to Civilian Non-Beneficiaries","type":"Proposed Rule","abstract":"As required by the James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 (NDAA-23), this document proposes to reduce financial harm to civilians who are not covered beneficiaries of the Military Health System (MHS), and who receive healthcare services at DoD military medical treatment facilities (MTF). The rulemaking, once finalized, will implement the MHS Modified Payment and Waiver Program (MPWP) through which the DoD will apply a sliding fee scale and/or a catastrophic fee waiver to medical invoices of certain non-beneficiaries and will accept payments from health insurers of non-beneficiaries as full payment except for copays, coinsurance, deductibles, nominal fees and non-covered services.","document_number":"2024-22584","html_url":"https://www.federalregister.gov/documents/2024/10/01/2024-22584/medical-billing-for-healthcare-services-provided-by-department-of-defense-military-medical-treatment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-10-01/pdf/2024-22584.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-22584.pdf?1727700348","publication_date":"2024-10-01","agencies":[{"raw_name":"DEPARTMENT OF DEFENSE","name":"Defense Department","id":103,"url":"https://www.federalregister.gov/agencies/defense-department","json_url":"https://www.federalregister.gov/api/v1/agencies/103","parent_id":null,"slug":"defense-department"},{"raw_name":"Office of the Secretary"}],"excerpts":"health insurance <span class=\"match\">plan</span> provides coverage for the geographic area where the <span class=\"match\">care</span> was delivered; \n (iii) The <span class=\"match\">care</span> provided to the patient is an item or service covered by the terms of the insurance <span class=\"match\">plan</span>, and; \n \n (iv) The health insurance <span class=\"match\">plan</span> provides coverage for <span class=\"match\">care</span> rendered in a U.S. Government/DoD facility;\n \n \n (v) The insurer agrees to pay the facility directly; \n (vi) The insurer agrees to provide the facility with an Explanation of Benefits (EOB) that details how the insurer processed the claims according to the insurance <span class=\"match\">plan</span>; and \n (vii) The"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2026 Rates; Changes to the FY 2025 IPPS Rates Due to Court Decision; Requirements for Quality Programs; and Other Policy Changes; Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization","type":"Rule","abstract":"This final rule revises the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; makes changes relating to Medicare graduate medical education (GME) for teaching hospitals; updates the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); updates and makes changes to requirements for certain quality programs; and makes other policy- related changes. We are also finalizing the provisions of the interim final action with comment period regarding the changes to the FY 2025 IPPS rates due to the court decision in Bridgeport Hosp. v. Becerra. Lastly, it finalizes certain updates to the ONC Health Information Technology (IT) Certification Program.","document_number":"2025-14681","html_url":"https://www.federalregister.gov/documents/2025/08/04/2025-14681/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-ipps-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-08-04/pdf/2025-14681.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-14681.pdf?1753992911","publication_date":"2025-08-04","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"multiple different comorbid conditions. \n • Reflects systemic impact. \n • Post-operative/post-procedure condition/complication impacting recovery. \n • Typically requires higher level of <span class=\"match\">care</span> (that is, intensive monitoring, greater number of caregivers, additional testing, intensive <span class=\"match\">care</span> unit <span class=\"match\">care</span>, extended length of stay). \n • Impedes patient cooperation or management of <span class=\"match\">care</span> or both. \n • Recent (last 10 years) change in best practice, or in practice guidelines and review of the extent to which these changes have led to concomitant changes in expected"},{"title":"Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicaid, Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to Star Ratings, marketing and communications, agent/broker compensation, health equity, drug coverage, dual eligible special needs plans (D-SNPs), utilization management, network adequacy, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This proposed rule also includes proposals to codify existing subregulatory guidance in the Part C and Part D programs.","document_number":"2024-27939","html_url":"https://www.federalregister.gov/documents/2024/12/10/2024-27939/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-10/pdf/2024-27939.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-27939.pdf?1732656194","publication_date":"2024-12-10","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"as Employer Group Waiver <span class=\"match\">Plans</span> (EGWPs), cost <span class=\"match\">plans</span>, and demonstration <span class=\"match\">plans</span>. \n \n In the final part two guidance, CMS stated that while the Medicare Prescription Payment <span class=\"match\">Plan</span> is applicable to all Part D <span class=\"match\">plans</span>, it has no practical \n \n application for PACE participants or enrollees in <span class=\"match\">plans</span> that exclusively charge $0 cost sharing for Part D covered drugs. As such, CMS does not expect Part D <span class=\"match\">plans</span> that exclusively charge $0 cost sharing for covered Part D drugs to all <span class=\"match\">plan</span> enrollees to offer enrollees the option to pay their OOP costs through monthly"},{"title":"Proposed Data Collection Submitted for Public Comment and Recommendations","type":"Notice","abstract":"The Centers for Disease Control and Prevention (CDC), as part of its continuing effort to reduce public burden and maximize the utility of government information, invites the general public and other Federal agencies the opportunity to comment on a proposed information collection, as required by the Paperwork Reduction Act of 1995. This notice invites comments on a proposed information collection project titled Survey to Promote Resources and Opportunities for aUtistic Teens and young adults (SPROUT). This follow-up survey will allow CDC to collect longitudinal data on prior participants in the Study to Explore Early Development (SEED) and family members in order to better understand the healthcare utilization, service and support needs, and impact of co-occurring conditions on autistic adolescents and young adults and their families, as well as the educational, social, and/or vocational needs and experiences of autistic adolescents and young adults.","document_number":"2026-01617","html_url":"https://www.federalregister.gov/documents/2026/01/27/2026-01617/proposed-data-collection-submitted-for-public-comment-and-recommendations","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-01-27/pdf/2026-01617.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-01617.pdf?1769435127","publication_date":"2026-01-27","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Disease Control and Prevention","name":"Centers for Disease Control and Prevention","id":44,"url":"https://www.federalregister.gov/agencies/centers-for-disease-control-and-prevention","json_url":"https://www.federalregister.gov/api/v1/agencies/44","parent_id":221,"slug":"centers-for-disease-control-and-prevention"}],"excerpts":"thereby addressing the priorities established in the Autism <span class=\"match\">CARES</span> Act of 2024 and draft 2024 IACC Strategic <span class=\"match\">Plan</span>. Given the size of the original SEED birth cohorts and the wealth of baseline and follow-up information collected, additional surveys of participants can help address critical information gaps. Specifically, the information collected from the Survey to Promote Resources and Opportunities for aUtistic Teens and young adults (SPROUT) will allow us to better understand: (1) the <span class=\"match\">healthcare</span> utilization of, service and support needs of, and impact"},{"title":"Statement of Organization, Functions, and Delegations of Authority","type":"Notice","abstract":"The Agency for Healthcare Research and Quality has modified its organizational structure.","document_number":"2024-23316","html_url":"https://www.federalregister.gov/documents/2024/10/09/2024-23316/statement-of-organization-functions-and-delegations-of-authority","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-10-09/pdf/2024-23316.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-23316.pdf?1728391527","publication_date":"2024-10-09","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Agency for Healthcare Research and Quality","name":"Agency for Healthcare Research and Quality","id":5,"url":"https://www.federalregister.gov/agencies/agency-for-healthcare-research-and-quality","json_url":"https://www.federalregister.gov/api/v1/agencies/5","parent_id":221,"slug":"agency-for-healthcare-research-and-quality"}],"excerpts":"Conducts and supports research on health <span class=\"match\">care</span> delivery and practice improvement across the continuum of <span class=\"match\">care</span> from prevention to chronic <span class=\"match\">care</span> management to end-of-life <span class=\"match\">care</span>. Specifically: (1) Synthesizes evidence and translates science for multiple stakeholders; (2) advances decision and communication sciences to facilitate informed treatment and <span class=\"match\">healthcare</span> decision-making by patients and their <span class=\"match\">healthcare</span> providers; (3) explores how digital <span class=\"match\">healthcare</span> research can improve clinical decision-making and health <span class=\"match\">care</span> quality; (4) catalyzes and promotes sustainability"},{"title":"Excepted Fertility Benefits","type":"Proposed Rule","abstract":"This document contains proposed rules that would amend the regulations regarding excepted benefits under the Employee Retirement Income Security Act of 1974, the Internal Revenue Code, and the Public Health Service Act to establish certain fertility benefits as a new category of limited excepted benefits. Excepted benefits are generally exempt from the market requirements that were added to those laws by the Health Insurance Portability and Accountability Act, the Patient Protection and Affordable Care Act, the No Surprises Act, and certain other Federal laws specifically related to group health plans and group and individual health insurance coverage.","document_number":"2026-09479","html_url":"https://www.federalregister.gov/documents/2026/05/13/2026-09479/excepted-fertility-benefits","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-13/pdf/2026-09479.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-09479.pdf?1778589913","publication_date":"2026-05-13","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"term <span class=\"match\">care</span>, nursing <span class=\"match\">care</span>, and home <span class=\"match\">care</span> and community-based <span class=\"match\">care</span>, this proposed excepted fertility benefit is for targeted, limited benefits that are not typically covered under an employer's major medical <span class=\"match\">plan</span> and are often administered under a separate contract. The definition of limited-scope dental and vision benefits under 26 CFR 54.9831-1(c)(3)(iii), 29 CFR 2590.732(c)(3)(iii), and 45 CFR 146.145(b)(3)(iii) allows for coverage of \n \n a range of services from preventive <span class=\"match\">care</span> visits through more intensive <span class=\"match\">care</span> such as major restorative <span class=\"match\">care</span>, orthodontics"},{"title":"Agency Information Collection Activities: Proposed Collection; Comment Request","type":"Notice","abstract":"In compliance with the Paperwork Reduction Act of 1995, this notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the reinstatement without change of the information collection project Evaluating the Implementation of PCOR to Increase Referral, Enrollment, and Retention through Automatic Referral to Cardiac Rehabilitation (CR) with Care Coordinator OMB No. 0935-0252 for which approval has expired. The reinstatement of this previously approved PRA collection for which approval has expired is required in order to discontinue this collection.","document_number":"2024-21564","html_url":"https://www.federalregister.gov/documents/2024/09/20/2024-21564/agency-information-collection-activities-proposed-collection-comment-request","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-20/pdf/2024-21564.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-21564.pdf?1726749948","publication_date":"2024-09-20","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Agency for Healthcare Research and Quality","name":"Agency for Healthcare Research and Quality","id":5,"url":"https://www.federalregister.gov/agencies/agency-for-healthcare-research-and-quality","json_url":"https://www.federalregister.gov/api/v1/agencies/5","parent_id":221,"slug":"agency-for-healthcare-research-and-quality"}],"excerpts":"dissemination and implementation efforts \n • the uptake and usage of Automatic Referral with <span class=\"match\">Care</span> <span class=\"match\">Coordination</span> and \n • levels of referral to CR at the end of the intervention. \n Evaluation results were used to improve the intervention and to provide guidance for future AHRQ dissemination and implementation projects. Two cohorts of “Partner Hospitals,” up to 125 hospitals in total, engaged in efforts to implement Automatic Referral with <span class=\"match\">Care</span> <span class=\"match\">Coordination</span> over twelve-month periods. The evaluation ascertained the diversity of hospitals engaged in the"}]}