{"description":"Documents matching 'Care Coordination Healthcare Software'","count":990,"total_pages":50,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=Care+Coordination+Healthcare+Software&format=json&page=2","results":[{"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":"Portability and Accountability Act of 1996 (HIPAA), and the Patient Protection and Affordable <span class=\"match\">Care</span> Act, as amended by the Health <span class=\"match\">Care</span> and Education Reconciliation Act of 2010, enacted on March 30, 2010—collectively, the Affordable <span class=\"match\">Care</span> Act. Specifically, this final rule adopts standards for health <span class=\"match\">care</span> claims attachments transactions, which will support health <span class=\"match\">care</span> claims transactions, and a standard for electronic signatures to be used in conjunction with health <span class=\"match\">care</span> claims attachments transactions. \n \n \n DATES: \n \n \n Effective Date: \n This final rule"},{"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":"and governance, in <span class=\"match\">coordination</span> with the CIO as required under statutory responsibilities. \n • Advances patient experience, innovation, and responsible use of emerging technologies, including artificial intelligence, to improve service delivery, program integrity, and health outcomes. \n • Advises the CMS Administrator and senior leadership on <span class=\"match\">healthcare</span> technology, digital transformation, product delivery, and innovation strategies. \n • Supports CIO-led governance, category management, and acquisition oversight for <span class=\"match\">healthcare</span> technology and digital"},{"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":"notifications for value-based <span class=\"match\">care</span> and <span class=\"match\">care</span> <span class=\"match\">coordination</span>, health <span class=\"match\">care</span> resiliency and securing health <span class=\"match\">care</span> operations in a modern health <span class=\"match\">care</span> ecosystem, improving the implementation of payer API technology through testing and \n \n certification, using technology to manage step therapy, and prior authorization requirements for laboratory tests and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items.\n \n Electronic event notifications are valuable tools for coordinating <span class=\"match\">care</span> in the modern health <span class=\"match\">care</span> environment, and we are seeking"},{"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":"for spending and quality of <span class=\"match\">care</span> during an inpatient stay or hospital outpatient procedure and for the 90 days following hospital discharge. If finalized, the CJR-X Model would be mandatory for acute <span class=\"match\">care</span> hospitals, except for those participating in TEAM, and acute <span class=\"match\">care</span> hospitals located in Maryland. CJR-X would include some modifications to the CJR Model. Some quality measures and payment methodology policies have been updated in response to CJR Model evaluation results, stakeholder feedback, and changes to national <span class=\"match\">care</span> delivery patterns among both"},{"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":"services only from a managed <span class=\"match\">care</span> plan's network of providers or primary <span class=\"match\">care</span> provider, including through PCCMs and PCCM entities.\n \n B. Relevant Medicaid Managed <span class=\"match\">Care</span> Rules \n \n In the May 6, 2016 \n Federal Register \n (81 FR 27498), we published the “Medicaid and Children's Health Insurance Program (CHIP) Programs; Medicaid Managed <span class=\"match\">Care</span>, CHIP Delivered in Managed <span class=\"match\">Care</span>, and Revisions Related to Third Party Liability” final rule (hereinafter referred to as “the 2016 final rule”) that modernized the Medicaid and CHIP managed <span class=\"match\">care</span> regulations to reflect changes"},{"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":"Comptroller's website at \n https://comptroller.defense.gov/Financial-Management/Reports/rates2023/. \n Funds collected through the <span class=\"match\">healthcare</span> cost recovery programs are used to enhance <span class=\"match\">healthcare</span> delivery at MTFs.\n \n In carrying out the DoD's <span class=\"match\">healthcare</span> cost recovery programs, charges and fees for <span class=\"match\">care</span> provided are assessed, as applicable, to civilian non-beneficiary patients who receive treatment at MTFs. When medical <span class=\"match\">care</span> is provided, such individuals become indebted to the United States. The DoD has authority under the Debt Collection Improvement"},{"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":"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":" (ii) \n Dental health <span class=\"match\">care</span> claims. \n The ASC X12 Standards for Electronic Data Interchange Technical Report Type 3—Health <span class=\"match\">Care</span> Claim: Dental (837), May 2006, ASC X12N/005010X224, and Type 1 Errata to Health <span class=\"match\">Care</span> Claim: Dental (837) ASC X12 Standards for Electronic Data Interchange Technical Report Type 3, October 2007, ASC X12N/005010X224A1 (both incorporated by reference in § 162.920).\n \n \n (iii) \n Professional health <span class=\"match\">care</span> claims. \n The ASC X12 Standards for Electronic Data Interchange Technical Report Type 3—Health <span class=\"match\">Care</span> Claim: Professional (837)"},{"title":"Medicare and Medicaid Programs and the Children's Health Insurance 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 2025 Rates; Quality Programs Requirements; and Other Policy Changes","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); and makes other policy- related changes.","document_number":"2024-17021","html_url":"https://www.federalregister.gov/documents/2024/08/28/2024-17021/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-28/pdf/2024-17021.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-17021.pdf?1722960072","publication_date":"2024-08-28","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":"of an episode of <span class=\"match\">care</span>. Because providers and suppliers are paid for each individual item or service delivered, providers may not be incentivized to invest in quality improvement and <span class=\"match\">care</span> <span class=\"match\">coordination</span> \n \n activities. As a result, <span class=\"match\">care</span> may be fragmented, unnecessary, or duplicative. By holding hospitals accountable for all items and services provided during an episode, providers would be better incentivized to coordinate patient <span class=\"match\">care</span>, avoid duplicative or unnecessary services, and improve the beneficiary <span class=\"match\">care</span> experience during <span class=\"match\">care</span> transitions.\n \n"},{"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":"Protection and Affordable <span class=\"match\">Care</span> Act (Pub. L. 111-148) was enacted on March 23, 2010. The <span class=\"match\">Healthcare</span> and Education Reconciliation Act of 2010 (Pub. L. 111-152), which amended and revised several provisions of the Patient Protection and Affordable <span class=\"match\">Care</span> Act, was enacted on March 30, 2010. In this rulemaking, the two statutes are referred to collectively as the “Patient Protection and Affordable <span class=\"match\">Care</span> Act” or “Affordable <span class=\"match\">Care</span> Act.”\n \n \n \n \n 2 \n  \n See \n sections 1301, 1302, 1311, 1312, 1313, 1321, 1331, and 1343 of the Affordable <span class=\"match\">Care</span> Act and section 2792"},{"title":"21st Century Cures Act: Establishment of Disincentives for Health Care Providers That Have Committed Information Blocking","type":"Rule","abstract":"This final rule implements the provision of the 21st Century Cures Act specifying that a health care provider determined by the HHS Inspector General to have committed information blocking shall be referred to the appropriate agency to be subject to appropriate disincentives set forth through notice and comment rulemaking. This rulemaking establishes, for certain health care providers, a set of appropriate disincentives using authorities under applicable Federal law.","document_number":"2024-13793","html_url":"https://www.federalregister.gov/documents/2024/07/01/2024-13793/21st-century-cures-act-establishment-of-disincentives-for-health-care-providers-that-have-committed","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-07-01/pdf/2024-13793.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-13793.pdf?1719432919","publication_date":"2024-07-01","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":"all health <span class=\"match\">care</span> providers that fall within the definition of health <span class=\"match\">care</span> provider at 45 CFR 171.102. While effective deterrence of information blocking can benefit patients by reducing the degree to which health <span class=\"match\">care</span> providers engage in this practice, fewer patients will benefit from these deterrent effects if disincentives have not been established for all health <span class=\"match\">care</span> providers within the definition of health <span class=\"match\">care</span> provider at 45 CFR 171.102. In section IV of the 21st Century Cures Act: Establishment of Disincentives for Health <span class=\"match\">Care</span> Providers That"},{"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":"Protection and Affordable <span class=\"match\">Care</span> Act (Pub. L. 111-148) was enacted on March 23, 2010. The <span class=\"match\">Healthcare</span> and Education Reconciliation Act of 2010 (Pub. L. 111-152), which amended and revised several provisions of the Patient Protection and Affordable <span class=\"match\">Care</span> Act, was enacted on March 30, 2010. In this rulemaking, the two statutes are referred to collectively as the “Patient Protection and Affordable <span class=\"match\">Care</span> Act” or “Affordable <span class=\"match\">Care</span> Act.”\n \n \n \n \n 2 \n  \n See \n sections 1301, 1302, 1311, 1312, 1313, 1321, 1331, and 1343 of the Affordable <span class=\"match\">Care</span> Act and section 2792"},{"title":"Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability","type":"Proposed Rule","abstract":"This proposed rule seeks to advance interoperability, improve transparency, and support the access, exchange, and use of electronic health information through proposals for: standards adoption; adoption of certification criteria to advance public health data exchange; expanded uses of certified application programming interfaces, such as for electronic prior authorization, patient access, care management, and care coordination; and information sharing under the information blocking regulations. It proposes to establish a new baseline version of the United States Core Data for Interoperability. The proposed rule would update the ONC Health IT Certification Program to enhance interoperability and optimize certification processes to reduce burden and costs. The proposed rule would also implement certain provisions related to the Trusted Exchange Framework and Common Agreement (TEFCA), which would support the reliability, privacy, security, and trust within TEFCA.","document_number":"2024-14975","html_url":"https://www.federalregister.gov/documents/2024/08/05/2024-14975/health-data-technology-and-interoperability-patient-engagement-information-sharing-and-public-health","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-05/pdf/2024-14975.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-14975.pdf?1721825115","publication_date":"2024-08-05","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":"and Intolerances, <span class=\"match\">Care</span> Team Members, Goals and Preferences, Immunizations, Laboratory, Medications, Medical Devices, Patient Summary and Plan, and Problems. Across these nine data classes, the USCDI v4 includes the following: \n • The data elements in the Allergies and Intolerances data class include Substance (Medication), Substance (Drug Class), Substance (Non-Medication) and Reaction. \n • The data elements in the <span class=\"match\">Care</span> Team Member(s) data class include <span class=\"match\">Care</span> Team Member Name, <span class=\"match\">Care</span> Team Member Identifier, <span class=\"match\">Care</span> Team Member Role, <span class=\"match\">Care</span> Team Member Location"},{"title":"Medicare and Medicaid Programs and the Children's Health Insurance 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 2025 Rates; Quality Programs Requirements; 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); and make other policy-related changes.","document_number":"2024-07567","html_url":"https://www.federalregister.gov/documents/2024/05/02/2024-07567/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-02/pdf/2024-07567.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-07567.pdf?1712780118","publication_date":"2024-05-02","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":"course of an episode of <span class=\"match\">care</span>. Because providers and suppliers are paid for each individual item or service delivered, providers may not be incentivized to invest in quality improvement and <span class=\"match\">care</span> <span class=\"match\">coordination</span> activities. As a result, <span class=\"match\">care</span> may be fragmented, unnecessary, or duplicative. By holding hospitals accountable for all items and services provided during an episode, providers would be better incentivized to coordinate patient <span class=\"match\">care</span>, avoid duplicative or unnecessary services, and improve the beneficiary <span class=\"match\">care</span> experience during <span class=\"match\">care</span> transitions. \n Under"},{"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":"aware that there are multiple types of payment arrangements between long-term <span class=\"match\">care</span> pharmacies and long-term <span class=\"match\">care</span> facilities and/or Part D enrollees. In some situations, long-term <span class=\"match\">care</span> pharmacies do not collect Part D cost sharing from the enrollee but instead bill the long-term <span class=\"match\">care</span> facility for the final patient OOP responsibility. When such an arrangement is in place between a long-term <span class=\"match\">care</span> pharmacy and a long-term <span class=\"match\">care</span> facility, and an enrollee in a long-term <span class=\"match\">care</span> facility is participating in the Medicare Prescription Payment Plan, billing the"},{"title":"Agency Information Collection Activities: Submission for OMB Review; Comment Request","type":"Notice","abstract":"The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the burden estimate or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.","document_number":"2025-16789","html_url":"https://www.federalregister.gov/documents/2025/09/02/2025-16789/agency-information-collection-activities-submission-for-omb-review-comment-request","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-09-02/pdf/2025-16789.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-16789.pdf?1756471534","publication_date":"2025-09-02","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":"providing explicit statutory authority for the <span class=\"match\">Healthcare</span> Fraud Prevention Partnership including the potential expansion of the public-private partnership analyses.\n \n \n Data sharing within the HFPP primarily focuses on conducting studies for the purpose of combatting fraud, waste, and abuse. These studies are intended to target specific vulnerabilities within the payment systems in both the public and private <span class=\"match\">healthcare</span> sectors. The HFPP and its committees design and develop studies in <span class=\"match\">coordination</span> with the TTP. The core function of the TTP is to"},{"title":"HIPAA Security Rule To Strengthen the Cybersecurity of Electronic Protected Health Information","type":"Proposed Rule","abstract":"The Department of Health and Human Services (HHS or \"Department\") is issuing this notice of proposed rulemaking (NPRM) to solicit comment on its proposal to modify the Security Standards for the Protection of Electronic Protected Health Information (\"Security Rule\") under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act). The proposed modifications would revise existing standards to better protect the confidentiality, integrity, and availability of electronic protected health information (ePHI). The proposals in this NPRM would increase the cybersecurity for ePHI by revising the Security Rule to address: changes in the environment in which health care is provided; significant increases in breaches and cyberattacks; common deficiencies the Office for Civil Rights has observed in investigations into Security Rule compliance by covered entities and their business associates (collectively, \"regulated entities\"); other cybersecurity guidelines, best practices, methodologies, procedures, and processes; and court decisions that affect enforcement of the Security Rule.","document_number":"2024-30983","html_url":"https://www.federalregister.gov/documents/2025/01/06/2024-30983/hipaa-security-rule-to-strengthen-the-cybersecurity-of-electronic-protected-health-information","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-06/pdf/2024-30983.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-30983.pdf?1735334119","publication_date":"2025-01-06","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":"of docs have lost revenue amid disruptions from Change <span class=\"match\">Healthcare</span> cyberattack,” Fierce <span class=\"match\">Healthcare</span> (Apr. 10, 2024), \n https://www.fiercehealthcare.com/practices/ama-80-docs-have-lost-revenue-amid-disruptions-change-<span class=\"match\">healthcare</span>-cyberattack; \n “AHA survey: Change <span class=\"match\">Healthcare</span> cyberattack having significant disruptions on patient <span class=\"match\">care</span>, hospitals' finances” (Mar. 15, 2024), \n https://www.aha.org/news/news/2024-03-15-aha-survey-change-<span class=\"match\">healthcare</span>-cyberattack-having-significant-disruptions-patient-<span class=\"match\">care</span>-hospitals-finances; see also \n Sean Lyngaas, “ `We're hemorrhaging"},{"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":"aware that there are multiple types of payment arrangements between long-term <span class=\"match\">care</span> pharmacies and long-term <span class=\"match\">care</span> facilities and/or Part D enrollees. In some situations, long-term <span class=\"match\">care</span> pharmacies do not collect Part D cost sharing from the enrollee but instead bill the long-term <span class=\"match\">care</span> facility for the final patient OOP responsibility. When such an arrangement is in place between a long-term <span class=\"match\">care</span> pharmacy and a long-term <span class=\"match\">care</span> facility, and an enrollee in a long-term <span class=\"match\">care</span> facility is participating in the Medicare Prescription Payment Plan, billing the"},{"title":"Request for Information; Health Technology Ecosystem","type":"Notice","abstract":"Effective and responsible adoption of technology can empower patients to make better decisions for their health and well-being. This request for information (RFI) seeks input from the public regarding the market of digital health products for Medicare beneficiaries as well as the state of data interoperability and broader health technology infrastructure. Responses to this RFI may be used to inform CMS and ASTP/ONC efforts to lead infrastructure progress to cultivate this market, increasing beneficiary access to effective digital capabilities needed to make informed health decisions, and increasing data availability for all stakeholders contributing to health outcomes.","document_number":"2025-08701","html_url":"https://www.federalregister.gov/documents/2025/05/16/2025-08701/request-for-information-health-technology-ecosystem","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-05-16/pdf/2025-08701.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-08701.pdf?1747149309","publication_date":"2025-05-16","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 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":"would further motivate solution development? \n F. Value-Based <span class=\"match\">Care</span> Organizations \n This section is intended for all stakeholders to provide input on questions as they relate to use cases and workflows that involve value-based <span class=\"match\">care</span> organizations. While we certainly want value-based <span class=\"match\">care</span> organizations to answer questions in this section (and in other sections) from the value-based <span class=\"match\">care</span> provider point of view, we also invite all stakeholders to provide their viewpoints on the value-based <span class=\"match\">care</span> workflows as appropriate. \n 1. Digital Health Adoption \n VB-1"}]}