{"description":"Documents matching 'Mental Health Care Internet Software & Services'","count":1037,"total_pages":50,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=Mental+Health+Care+Internet+Software+%26+Services&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":"notifications for value-based <span class=\"match\">care</span> and <span class=\"match\">care</span> coordination, <span class=\"match\">health</span> <span class=\"match\">care</span> resiliency and securing <span class=\"match\">health</span> <span class=\"match\">care</span> operations in a modern <span class=\"match\">health</span> <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 <span class=\"match\">health</span> <span class=\"match\">care</span> environment, and we are seeking"},{"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":"The term “group <span class=\"match\">health</span> plan” includes both insured and self-insured group <span class=\"match\">health</span> plans. \n \n In the upcoming sections, we summarize sections of the PHS Act, \n \n Affordable <span class=\"match\">Care</span> Act, and WFTC legislation that are relevant to this final rule.\n \n Section 1301(a)(1)(B) of the Affordable <span class=\"match\">Care</span> Act directs all issuers of qualified <span class=\"match\">health</span> plans (QHPs) to cover the Essential <span class=\"match\">Health</span> Benefit (EHB) package described in section 1302(a) of the Affordable <span class=\"match\">Care</span> Act, including coverage of the <span class=\"match\">services</span> described in section 1302(b) of the Affordable <span class=\"match\">Care</span> Act, adherence"},{"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":"The term “group <span class=\"match\">health</span> plan” includes both insured and self-insured group <span class=\"match\">health</span> plans. \n In the upcoming sections, we summarize sections of the PHS Act, Affordable <span class=\"match\">Care</span> Act, and WFTC legislation that are relevant to this proposed rule. \n \n Section 1301(a)(1)(B) of the Affordable <span class=\"match\">Care</span> Act directs all issuers of qualified <span class=\"match\">health</span> plans (QHPs) to cover the Essential <span class=\"match\">Health</span> Benefit (EHB) package described in section 1302(a) of the Affordable <span class=\"match\">Care</span> Act, including coverage of the <span class=\"match\">services</span> described in section 1302(b) of the Affordable <span class=\"match\">Care</span> Act, adherence"},{"title":"Privacy Act of 1974; System of Records","type":"Notice","abstract":"Pursuant to the Privacy Act of 1974, notice is hereby given that VA is modifying the system of records titled, \"National Patient Databases-VA\" (121VA10). VA provides health care services to many Veterans through VHA. During the course of providing health care, VHA collects medical and health information about Veterans under their care. This system is used for planning, distribution, and utilization of resources; monitoring the performance of VHA programs and Veteran population health; and statistical analysis of clinical and administrative support provided within VHA.","document_number":"2025-15587","html_url":"https://www.federalregister.gov/documents/2025/08/15/2025-15587/privacy-act-of-1974-system-of-records","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-08-15/pdf/2025-15587.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-15587.pdf?1755175532","publication_date":"2025-08-15","agencies":[{"raw_name":"DEPARTMENT OF VETERANS AFFAIRS","name":"Veterans Affairs Department","id":520,"url":"https://www.federalregister.gov/agencies/veterans-affairs-department","json_url":"https://www.federalregister.gov/api/v1/agencies/520","parent_id":null,"slug":"veterans-affairs-department"}],"excerpts":"Support <span class=\"match\">Services</span> caregivers. \n The Routine Uses of Records Maintained in the System, including Categories of Users and the Purposes of such Uses is amended to add two Routine Uses. Routine Use number 32 is added to state, “To Federal <span class=\"match\">health</span> <span class=\"match\">care</span> providers, such as DoD, for the purpose of performing quality improvement activities or other <span class=\"match\">health</span> <span class=\"match\">care</span> operations of the recipient Federal <span class=\"match\">health</span> <span class=\"match\">care</span> provider.” \n Routine Use number 33 is added to state, “To non-VA entities for the purpose of performing outreach to Veterans regarding VA <span class=\"match\">health</span> <span class=\"match\">care</span> benefits"},{"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":"following address ONLY: Centers for Medicare &amp; Medicaid <span class=\"match\">Services</span>, Department of <span class=\"match\">Health</span> and Human <span class=\"match\">Services</span>, Attention: CMS-1849-P, P.O. Box 8013, Baltimore, MD 21244-8013.\n \n Please allow sufficient time for mailed comments to be received before the close of the comment period. \n \n 3. \n By express or overnight mail. \n You may send written comments via express or overnight mail to the following address ONLY: Centers for Medicare &amp; Medicaid <span class=\"match\">Services</span>, Department of <span class=\"match\">Health</span> and Human <span class=\"match\">Services</span>, Attention: CMS-1849-P, Mail Stop C4-26-05, 7500 Security"},{"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":"date range used for episode attribution; (12) removing <span class=\"match\">health</span> equity plans and <span class=\"match\">health</span> related social needs data reporting; (13) broadening the Skilled Nursing Facility (SNF) 3-day rule waiver; (14) modifying the referral to primary <span class=\"match\">care</span> <span class=\"match\">services</span> requirement; and (15) removing the Decarbonization and Resilience Initiative (DRI). \n k. ONC <span class=\"match\">Health</span> IT Certification Program Updates \n \n In the <span class=\"match\">Health</span> Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public <span class=\"match\">Health</span> Interoperability proposed rule (HTI-2 Proposed Rule) (89"},{"title":"Enhancing Coverage of Preventive Services Under the Affordable Care Act","type":"Proposed Rule","abstract":"This document sets forth proposed rules that would amend the regulations regarding coverage of certain preventive services under the Public Health Service Act. Specifically, this document proposes rules that would provide that medical management techniques used by non- grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage with respect to such preventive services would not be considered reasonable unless the plan or issuer provides an easily accessible, transparent, and sufficiently expedient exceptions process that would allow an individual to receive coverage without cost sharing for the preventive service that is medically necessary with respect to the individual, as determined by the individual's attending provider, even if such service is not generally covered under the plan or coverage. These proposed rules also contain separate requirements that would apply to coverage of contraceptive items that are preventive services under the Public Health Service Act. Specifically, these proposed rules would require plans and issuers to cover certain recommended over-the-counter contraceptive items without requiring a prescription and without imposing cost-sharing requirements. In addition, the proposed rules would require plans and issuers to cover certain recommended contraceptive items that are drugs and drug-led combination products without imposing cost-sharing requirements, unless a therapeutic equivalent of the drug or drug-led combination product is covered without cost sharing. Finally, this document proposes to require a disclosure pertaining to coverage and cost-sharing requirements for over-the-counter contraceptive items in plans' and issuers' Transparency in Coverage internet-based self-service tools or, if requested by the individual, on paper. These proposed rules would not modify Federal conscience protections related to contraceptive coverage for employers, plans and issuers.","document_number":"2024-24675","html_url":"https://www.federalregister.gov/documents/2024/10/28/2024-24675/enhancing-coverage-of-preventive-services-under-the-affordable-care-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-10-28/pdf/2024-24675.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-24675.pdf?1729714518","publication_date":"2024-10-28","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":"Coverage of Preventive <span class=\"match\">Services</span> Under the Affordable <span class=\"match\">Care</span> Act and Implementing Regulations \n \n The Patient Protection and Affordable <span class=\"match\">Care</span> Act (Pub. L. 111-148) was enacted on March 23, 2010. The <span class=\"match\">Health</span> <span class=\"match\">Care</span> and Education Reconciliation Act of 2010 (Pub. L. 111-152) was enacted on March \n \n 30, 2010. These statutes are collectively known as the Affordable <span class=\"match\">Care</span> Act (ACA). The ACA reorganized, amended, and added to the provisions of part A of title XXVII of the Public <span class=\"match\">Health</span> <span class=\"match\">Service</span> Act (PHS Act) relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers"},{"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":"to high-quality and effective <span class=\"match\">health</span> <span class=\"match\">care</span> by establishing standards for the security of ePHI. The standards, when implemented appropriately by regulated entities, protect the confidentiality, integrity, and availability of individuals' <span class=\"match\">health</span> information. Such protections promote the electronic transmission of PHI through a national <span class=\"match\">health</span> information system. To ensure access to high-quality <span class=\"match\">health</span> <span class=\"match\">care</span> <span class=\"match\">services</span>, regulated entities must assure their customers (\n e.g., \n individuals, <span class=\"match\">health</span> <span class=\"match\">care</span> providers, and <span class=\"match\">health</span> plans) of the security of the"},{"title":"Medicaid Program; Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality","type":"Rule","abstract":"This final rule will advance CMS's efforts to improve access to care, quality and health outcomes, and better address health equity issues for Medicaid and Children's Health Insurance Program (CHIP) managed care enrollees. The final rule addresses standards for timely access to care and States' monitoring and enforcement efforts, reduces State burdens for implementing some State directed payments (SDPs) and certain quality reporting requirements, adds new standards that will apply when States use in lieu of services and settings (ILOSs) to promote effective utilization and that specify the scope and nature of ILOSs, specifies medical loss ratio (MLR) requirements, and establishes a quality rating system for Medicaid and CHIP managed care plans.","document_number":"2024-08085","html_url":"https://www.federalregister.gov/documents/2024/05/10/2024-08085/medicaid-program-medicaid-and-childrens-health-insurance-program-chip-managed-care-access-finance","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-10/pdf/2024-08085.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08085.pdf?1713816918","publication_date":"2024-05-10","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":"promote consistent access to <span class=\"match\">health</span> <span class=\"match\">care</span> for all beneficiaries across all types of <span class=\"match\">care</span> delivery systems in accordance with statutory requirements, access regulations need to be multi-factorial. Strategies to enhance access to <span class=\"match\">health</span> <span class=\"match\">care</span> <span class=\"match\">services</span> should reflect how people move through and interact with the <span class=\"match\">health</span> <span class=\"match\">care</span> system. We view the continuum of <span class=\"match\">health</span> <span class=\"match\">care</span> access across three dimensions of a person-centered framework: (1) enrollment in coverage; (2) maintenance of coverage; and (3) access to high-quality <span class=\"match\">services</span> and supports. Within each of"},{"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":"following address ONLY: Centers for Medicare &amp; Medicaid <span class=\"match\">Services</span>, Department of <span class=\"match\">Health</span> and Human <span class=\"match\">Services</span>, Attention: CMS-1833-P, P.O. Box 8013, Baltimore, MD 21244-8013.\n \n Please allow sufficient time for mailed comments to be received before the close of the comment period. \n \n 3. \n By express or overnight mail. \n You may send written comments via express or overnight mail to the following address ONLY: Centers for Medicare &amp; Medicaid <span class=\"match\">Services</span>, Department of <span class=\"match\">Health</span> and Human <span class=\"match\">Services</span>, Attention: CMS-1833-P, Mail Stop C4-26-05, 7500 Security"},{"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":"for all <span class=\"match\">health</span> <span class=\"match\">care</span> providers that fall within the definition of <span class=\"match\">health</span> <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 <span class=\"match\">health</span> <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 <span class=\"match\">health</span> <span class=\"match\">care</span> providers within the definition of <span class=\"match\">health</span> <span class=\"match\">care</span> provider at 45 CFR 171.102. In section IV of the 21st Century Cures Act: Establishment of Disincentives for <span class=\"match\">Health</span> <span class=\"match\">Care</span> Providers"},{"title":"Request for Information: Administration for Children and Families Development of Interoperability Standards for Human Service Programs","type":"Notice","abstract":"The Administration for Children and Families (ACF), in the U.S. Department of Health and Human Services (HHS), invites public comments to inform the use or adoption of interoperability standards for human services programs. ACF and state, local, and tribal governments all provide a number of health and human services programs for children, youth, families, communities, and individuals. ACF seeks public comment on the most effective approaches, technical standards, and technological tools that currently or could promote interoperability between health and human services programs. ACF collaborates with the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ ONC) as a critical steward and advisor for human services interoperability with responsibility for leading the development and harmonization of interoperability standards between health and human services in line with the HHS Data Strategy. The potential of interoperability across the full spectrum of health and human services is immense--it can enable efficient delivery of government services, enhance access to critical non-profit programs, and most importantly, improve overall individual and community outcomes. ACF has authority under the Title IV of the Social Security Act to designate use of interoperable data standards for several of its programs (e.g., Temporary Assistance for Needy Families (TANF), child support, child welfare, and foster care). The purpose of this RFI is to understand how ACF, in collaboration with ASTP/ONC, can better support interoperability between human services within and across states and local community resources, between states, and ACF.","document_number":"2024-24924","html_url":"https://www.federalregister.gov/documents/2024/10/28/2024-24924/request-for-information-administration-for-children-and-families-development-of-interoperability","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-10-28/pdf/2024-24924.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-24924.pdf?1729860315","publication_date":"2024-10-28","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":"Administration for Children and Families","name":"Children and Families Administration","id":49,"url":"https://www.federalregister.gov/agencies/children-and-families-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/49","parent_id":221,"slug":"children-and-families-administration"}],"excerpts":"interoperable data standard like Fast Healthcare Interoperability Resources (FHIR)? \n 3. <span class=\"match\">Care</span> coordination: ACF seeks comments on current <span class=\"match\">care</span> coordination activities and data standards to support the interoperable data exchange for <span class=\"match\">service</span> delivery, operations, and reporting. \n 3.1 How do you currently use interoperable data to support <span class=\"match\">care</span> coordination across human <span class=\"match\">services</span>, both between human <span class=\"match\">services</span> programs and between human <span class=\"match\">services</span> and <span class=\"match\">health</span> <span class=\"match\">services</span>? For example, are you able to collect medical data for children who have medical issues"},{"title":"Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, Including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Formerly in Custody of Penal Authorities; Revision to Medicare Special Enrollment Period for Formerly Incarcerated Individuals; and All-Inclusive Rate Add-On Payment for High-Cost Drugs Provided by Indian Health Service and Tribal Facilities","type":"Rule","abstract":"This final rule with comment period revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2025 based on our continuing experience with these systems. We describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. Also, this final rule updates the requirements for the Hospital Outpatient Quality Reporting Program, Rural Emergency Hospital Quality Reporting Program, Ambulatory Surgical Center Quality Reporting Program, and Hospital Inpatient Quality Reporting Program. We also summarize information received in response to a Request for Information on potential modifications to the Safety of Care measure group in the Overall Hospital Quality Star Rating methodology. In this final rule, we are also finalizing our proposal to narrow the description of \"custody\" in the Medicare payment exclusion rule and to revise the special enrollment period criteria for formerly incarcerated individuals. We are also finalizing our Medicaid and Children's Health Insurance Program (CHIP) continuous eligibility provisions. We are also finalizing the proposal to reduce the review timeframe for standard prior authorization requests for certain covered outpatient department services paid under the OPPS from 10-business days to 7-calendar days. Further, this rule finalizes updates to the Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs) in an effort to advance the health and safety of pregnant, birthing, and postpartum women. This rule also finalizes our proposed policy to separately pay Indian Health Service (IHS) and Tribal hospitals for high-cost drugs furnished in hospital outpatient departments through an add-on payment in addition to the all-inclusive rate (AIR) under the authorities used to calculate the AIR starting January 1, 2025. Finally, we are finalizing exceptions to the Medicaid clinic services four walls requirement for IHS and Tribal clinics, and, at state option, for behavioral health clinics and clinics located in rural areas.","document_number":"2024-25521","html_url":"https://www.federalregister.gov/documents/2024/11/27/2024-25521/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-25521.pdf?1730492130","publication_date":"2024-11-27","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 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":"comprehensive <span class=\"match\">service</span> (78 FR 74865 and 79 FR 66799). Payments for adjunctive <span class=\"match\">services</span> are packaged into the payments for the primary <span class=\"match\">services</span>. This results in a single prospective payment for each of the primary, comprehensive <span class=\"match\">services</span> based on the costs of all reported <span class=\"match\">services</span> at the claim level. One example of a primary <span class=\"match\">service</span> would be a partial mastectomy and an example of a secondary <span class=\"match\">service</span> packaged into that primary <span class=\"match\">service</span> would be a radiation therapy procedure. \n \n <span class=\"match\">Services</span> excluded from the C-APC policy under the OPPS include <span class=\"match\">services</span> that are"},{"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":"items and <span class=\"match\">services</span> furnished to a beneficiary over the course of an episode of <span class=\"match\">care</span>. Because providers and suppliers are paid for each individual item or <span class=\"match\">service</span> delivered, providers may not be incentivized to invest in quality improvement and <span class=\"match\">care</span> coordination \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 <span class=\"match\">services</span> provided during an episode, providers would be better incentivized to coordinate patient <span class=\"match\">care</span>, avoid duplicative or unnecessary <span class=\"match\">services</span>, and improve"},{"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":"Raja P, Rose S, Mehrotra A. Disruptions in <span class=\"match\">Care</span> for Medicare Beneficiaries with Severe <span class=\"match\">Mental</span> Illness During the COVID-19 Pandemic. JAMA Netw Open. 2022 Jan 4;5(1):e2145677. doi: 10.1001/jamanetworkopen.2021.45677. PMID: 35089352; PMCID: PMC8800078. Retrieved from: \n https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800078/. \n \n \n We propose to require MA and Cost Plans' in-network cost sharing for categories of <span class=\"match\">mental</span> <span class=\"match\">health</span> and substance use disorder <span class=\"match\">services</span> (collectively called “behavioral <span class=\"match\">health</span> <span class=\"match\">services</span>”) be no greater than that in Traditional Medicare"},{"title":"Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies","type":"Rule","abstract":"This final rule will set forth routine updates to the Medicare home health payment rates; the payment rate for the disposable negative pressure wound therapy (dNPWT) devices; and the intravenous immune globulin (IVIG) items and services payment rate for CY 2025 in accordance with existing statutory and regulatory requirements. In addition, it finalizes changes to the Home Health Quality Reporting Program (HH QRP) requirements and provides an update on potential approaches for integrating health equity in the Expanded Health Value Based Purchasing (HHVBP) Model. It also finalizes a new standard for an acceptance-to-service policy in the HH conditions of participation (CoPs). Lastly, it updates provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses.","document_number":"2024-25441","html_url":"https://www.federalregister.gov/documents/2024/11/07/2024-25441/medicare-program-calendar-year-cy-2025-home-health-prospective-payment-system-hh-pps-rate-update-hh","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-07/pdf/2024-25441.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-25441.pdf?1730492128","publication_date":"2024-11-07","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":"commonly used by home <span class=\"match\">health</span> agencies to bill <span class=\"match\">services</span> under a home <span class=\"match\">health</span> plan of <span class=\"match\">care</span>. \n 2. Current System for Payment of Home <span class=\"match\">Health</span> <span class=\"match\">Services</span> \n For home <span class=\"match\">health</span> periods of <span class=\"match\">care</span> beginning on or after January 1, 2020, Medicare makes payment under the HH PPS on the basis of a national, standardized 30-day period payment rate that is adjusted for case-mix and area wage differences in accordance with section 51001(a)(1)(B) of the BBA of 2018. The national, standardized 30-day period payment rate includes payment for the six home <span class=\"match\">health</span> disciplines (skilled"},{"title":"Nondiscrimination in Health Programs and Activities","type":"Rule","abstract":"The Department of Health and Human Services (HHS or the Department) is issuing this final rule regarding section 1557 of the Affordable Care Act (ACA) (section 1557). Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Section 1557(c) of the ACA authorizes the Secretary of the Department to promulgate regulations to implement the nondiscrimination requirements of section 1557. The Department is also revising its interpretation regarding whether Medicare Part B constitutes Federal financial assistance for purposes of civil rights enforcement. Additionally, the Department is revising provisions prohibiting discrimination on the basis of sex in regulations issued by the Centers for Medicare & Medicaid Services (CMS) governing Medicaid and the Children's Health Insurance Program (CHIP); Programs of All-Inclusive Care for the Elderly (PACE); health insurance issuers and their officials, employees, agents, and representatives; States and the Exchanges carrying out Exchange requirements; agents, brokers, or web-brokers that assist with or facilitate enrollment of qualified individuals, qualified employers, or qualified employees; issuers providing essential health benefits (EHB); and qualified health plan issuers.","document_number":"2024-08711","html_url":"https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-06/pdf/2024-08711.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08711.pdf?1714162519","publication_date":"2024-05-06","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":"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":"the term “group <span class=\"match\">health</span> plan coverage” to refer to the underlying <span class=\"match\">health</span> coverage or benefits provided by the group <span class=\"match\">health</span> plan.\n \n \n \n Response: \n OCR is cognizant that <span class=\"match\">health</span> insurance issuers and group <span class=\"match\">health</span> plans develop their <span class=\"match\">health</span> insurance coverage and other <span class=\"match\">health</span>-related coverage benefit designs in advance of the plan year that the coverage is offered. Accordingly, we are including a delayed applicability date to the extent that the final rule's provisions require changes to <span class=\"match\">health</span> insurance coverage or other <span class=\"match\">health</span>-related coverage, including"},{"title":"Medicaid Program; Ensuring Access to Medicaid Services","type":"Rule","abstract":"This final rule takes a comprehensive approach to improving access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee-for-service (FFS), managed care delivery systems, and in home and community-based services (HCBS) programs. These improvements increase transparency and accountability, standardize data and monitoring, and create opportunities for States to promote active beneficiary engagement in their Medicaid programs, with the goal of improving access to care.","document_number":"2024-08363","html_url":"https://www.federalregister.gov/documents/2024/05/10/2024-08363/medicaid-program-ensuring-access-to-medicaid-services","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-10/pdf/2024-08363.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08363.pdf?1714143731","publication_date":"2024-05-10","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":"availability of <span class=\"match\">care</span> more generally or population <span class=\"match\">health</span> outcomes (which may be indicative of the population's ability to access <span class=\"match\">care</span>). Moreover, the AMRP processes are largely procedural in nature and not targeted to specific <span class=\"match\">services</span> for which access may be of particular concern, requiring States to engage in triennial reviews of access to <span class=\"match\">care</span> for certain broad categories of Medicaid <span class=\"match\">services</span>—primary <span class=\"match\">care</span> <span class=\"match\">services</span>, physician specialist <span class=\"match\">services</span>, behavioral <span class=\"match\">health</span> <span class=\"match\">services</span>, pre- and post-natal obstetric <span class=\"match\">services</span>, and home <span class=\"match\">health</span> <span class=\"match\">services</span>. Although the"},{"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":"Mostashari, and Paul B. Ginsberg, Making <span class=\"match\">Health</span> <span class=\"match\">Care</span> Markets Work: Competition Policy for <span class=\"match\">Health</span> <span class=\"match\">Care</span>, 16-17 (Apr. 2017), available at \n http://heinz.cmu.edu/news/news-detail/index.aspx?nid=3930 \n .\n \n \n \n Lastly, in support of E.O. 14058, Transforming Federal Customer Experience and <span class=\"match\">Service</span> Delivery to Rebuild Trust in Government, issued on December 16, 2021, we are committed to advancing the equitable and effective delivery of <span class=\"match\">services</span> with a focus on the experience of individuals, <span class=\"match\">health</span> IT developers, and <span class=\"match\">health</span> <span class=\"match\">care</span> providers.\n 9 \n \n The proposed rule"},{"title":"HHS Acquisition Regulation: Acquisition of Information Technology; Standards for Health Information Technology (HHSAR Case 2023-001)","type":"Proposed Rule","abstract":"The Department of Health and Human Services (HHS) is proposing to amend and update its Health and Human Services Acquisition Regulation (HHSAR) to implement requirements to procure health information technology (health IT) that meets standards and implementation specifications (standards) adopted by the Office of the National Coordinator for Health Information Technology (ONC) in the following parts: Acquisition of Information Technology and Solicitation Provisions and Contract Clauses.","document_number":"2024-17096","html_url":"https://www.federalregister.gov/documents/2024/08/09/2024-17096/hhs-acquisition-regulation-acquisition-of-information-technology-standards-for-health-information","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-09/pdf/2024-17096.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-17096.pdf?1723121124","publication_date":"2024-08-09","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"}],"excerpts":"identifiable <span class=\"match\">health</span> information between agencies and with non-Federal entities; or \n (2) By <span class=\"match\">health</span> <span class=\"match\">care</span> providers, <span class=\"match\">health</span> plans, or <span class=\"match\">health</span> insurance issuers. \n 339.7001 Definitions \n As used in this subpart— \n \n <span class=\"match\">Health</span> information technology (<span class=\"match\">health</span> IT) \n means hardware, <span class=\"match\">software</span>, integrated technologies or related licenses, intellectual property, upgrades, or packaged solutions sold as <span class=\"match\">services</span> that are designed for or support the use by <span class=\"match\">health</span> <span class=\"match\">care</span> entities or patients for the electronic creation, maintenance, access, or exchange of <span class=\"match\">health</span> information"}]}