{"description":"Documents matching 'Mental Health Care compliance'","count":5030,"total_pages":50,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=Mental+Health+Care+compliance&format=json&page=2","results":[{"title":"School-Based Mental Health Grant Program","type":"Notice","abstract":"The Department of Education (Department) announces final priorities, requirements, and definitions under the School-Based Mental Health Services (SBMH) Program, Assistance Listing Number (ALN) 84.184H. We may use one or more of these priorities, requirements, and definitions for competitions in fiscal year (FY) 2025 and later years. These final priorities, requirements, and definitions are designed to target activities with the purpose of increasing the number of credentialed school-based mental health services providers, specifically school psychologists, in high-need local educational agencies (LEAs) available to provide mental health services to students. These priorities, requirements, and definitions replace the Notice of Final Priorities, Requirements, and Definitions published in the Federal Register on October 4, 2022 (87 FR 60092). However, those priorities, requirements, and definitions remain in effect for previous grant competitions in which the notices inviting applications (NIAs) were published before the Department finalized the proposed priorities, requirements, and definitions in this notice.","document_number":"2025-18900","html_url":"https://www.federalregister.gov/documents/2025/09/29/2025-18900/school-based-mental-health-grant-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-09-29/pdf/2025-18900.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-18900.pdf?1758890722","publication_date":"2025-09-29","agencies":[{"raw_name":"DEPARTMENT OF EDUCATION","name":"Education Department","id":126,"url":"https://www.federalregister.gov/agencies/education-department","json_url":"https://www.federalregister.gov/api/v1/agencies/126","parent_id":null,"slug":"education-department"}],"excerpts":"The Department recognizes the complex intersection of substance use and <span class=\"match\">mental</span> <span class=\"match\">health</span>. School psychologists trained and hired to provide early intervention and intensive \n \n <span class=\"match\">mental</span> <span class=\"match\">health</span> services under this program can address these needs as part of their provision of <span class=\"match\">mental</span> <span class=\"match\">health</span> services to the extent they impact the student's engagement in school. However, funds cannot be used for other substance use treatment services apart from early intervention or intensive <span class=\"match\">mental</span> <span class=\"match\">health</span> services.\n \n \n Changes: \n None.\n \n \n Comments: \n Several commenters suggested"},{"title":"Health Care Professionals Practicing Via Telehealth","type":"Rule","abstract":"The Department of Veterans Affairs (VA) adopts as final, with changes, a proposed rule to amend its medical regulations that govern VA's health care professionals who practice health care via telehealth. This final rule implements the authorities of the VA MISSION Act of 2018 and the William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021. This final rule enables VA to maximize health care resource utilization and provide safe and convenient national health care to veterans using telehealth. It also strengthens VA's role in supporting national and State responses to war, terrorism, national emergencies and natural disasters.","document_number":"2025-19324","html_url":"https://www.federalregister.gov/documents/2025/10/02/2025-19324/health-care-professionals-practicing-via-telehealth","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-10-02/pdf/2025-19324.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-19324.pdf?1759322726","publication_date":"2025-10-02","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":"postgraduate <span class=\"match\">health</span> <span class=\"match\">care</span> employees, <span class=\"match\">health</span> professional trainees, and those providing clinical supervision, as long as they meet the definition of <span class=\"match\">health</span> <span class=\"match\">care</span> professional in 38 CFR 17.417(a)(2). We note that such defense does not extend to situations where a State Board may be taking appropriate disciplinary action against a VA <span class=\"match\">health</span> <span class=\"match\">care</span> professional when their behavior or clinical practice substantially fails to meet generally accepted standards of clinical practice as to raise reasonable concern for the safety of patients or if the VA <span class=\"match\">health</span> <span class=\"match\">care</span> professional"},{"title":"School-Based Mental Health Services Grant Program","type":"Proposed Rule","abstract":"The Department of Education (Department) proposes priorities, requirements, and definitions under the School-Based Mental Health Services Grant (SBMH) Program, Assistance Listing Number (ALN) 84.184H. The Department may use these priorities, requirements, and definitions for competitions in fiscal year (FY) 2025 and later years. The proposed priorities, requirements, and definitions are designed to better target activities designed to increase the number of credentialed school-based mental health services providers, specifically school psychologists, in high-need local educational agencies (LEAs) available to provide mental health services to students. These priorities, requirements, and definitions are intended to replace the Notice of Final Priorities, Requirements, and Definitions published in the Federal Register on October 4, 2022 (87 FR 60092). However, those priorities, requirements, and definitions remain in effect for previous grant competitions in which the notices inviting applications (NIAs) were published before the Department finalizes the proposed priorities, requirements, and definitions in this notice.","document_number":"2025-13384","html_url":"https://www.federalregister.gov/documents/2025/07/17/2025-13384/school-based-mental-health-services-grant-program","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-07-17/pdf/2025-13384.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-13384.pdf?1752669910","publication_date":"2025-07-17","agencies":[{"raw_name":"DEPARTMENT OF EDUCATION","name":"Education Department","id":126,"url":"https://www.federalregister.gov/agencies/education-department","json_url":"https://www.federalregister.gov/api/v1/agencies/126","parent_id":null,"slug":"education-department"}],"excerpts":"school psychologists delivering early intervention and intensive <span class=\"match\">mental</span> <span class=\"match\">health</span> services in high-need LEAs. \n \n To meet this priority, applicants must propose to increase the number of credentialed school psychologists who will engage in the following: \n (a) Providing intensive <span class=\"match\">mental</span> <span class=\"match\">health</span> services and supports to individual students most in need of those services, \n (b) Providing early intervention <span class=\"match\">mental</span> <span class=\"match\">health</span> services to address acute concerns and determine if intensive <span class=\"match\">mental</span> <span class=\"match\">health</span> services are needed, and \n (c) Building necessary capacity and"},{"title":"Intent To Request Extension From OMB of One Current Public Collection of Information: Law Enforcement/Federal Air Marshal Service Physical and Mental Health Certification","type":"Notice","abstract":"The Transportation Security Administration (TSA) invites public comment on one currently approved Information Collection Request (ICR), Office of Management and Budget (OMB) control number 1652-0043, abstracted below, that we will submit to OMB for an extension in compliance with the Paperwork Reduction Act (PRA). The ICR describes the nature of the information collection and its expected burden. The collection involves forms that applicants to and incumbents in the position of Federal Air Marshal (FAM) are required to complete regarding their physical and mental health history.","document_number":"2026-08578","html_url":"https://www.federalregister.gov/documents/2026/05/04/2026-08578/intent-to-request-extension-from-omb-of-one-current-public-collection-of-information-law","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-04/pdf/2026-08578.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-08578.pdf?1777639509","publication_date":"2026-05-04","agencies":[{"raw_name":"DEPARTMENT OF HOMELAND SECURITY","name":"Homeland Security Department","id":227,"url":"https://www.federalregister.gov/agencies/homeland-security-department","json_url":"https://www.federalregister.gov/api/v1/agencies/227","parent_id":null,"slug":"homeland-security-department"},{"raw_name":"Transportation Security Administration","name":"Transportation Security Administration","id":494,"url":"https://www.federalregister.gov/agencies/transportation-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/494","parent_id":227,"slug":"transportation-security-administration"}],"excerpts":"determine if the FAM is medically qualified. \n TSA uses a <span class=\"match\">Mental</span> <span class=\"match\">Health</span> Certification (MHC) form to facilitate the determination of applicants' ability to meet established <span class=\"match\">mental</span> <span class=\"match\">health</span> standards and safely and effectively perform the essential functions of the public safety law enforcement position. As part of the psychological assessment, applicants are required to complete the MHC form related to their <span class=\"match\">mental</span> <span class=\"match\">health</span> history. Applicants are asked questions that may be indicative of <span class=\"match\">mental</span> <span class=\"match\">health</span> conditions that may impact the ability to safely and"},{"title":"State Home Care Agreements for State Home Medical Model Adult Day Health Care","type":"Proposed Rule","abstract":"The Department of Veterans Affairs (VA) proposes to amend two of its State Veterans Home (State home) regulations. One amendment would define medical model adult day health care (MMADHC). The other would codify into regulation VA's ability to enter into State Home Care Agreements (SHCA) for MMADHC and pay for services rendered. Additionally, this rulemaking proposes the methodology for the payment rate.","document_number":"2026-03427","html_url":"https://www.federalregister.gov/documents/2026/02/20/2026-03427/state-home-care-agreements-for-state-home-medical-model-adult-day-health-care","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-20/pdf/2026-03427.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-03427.pdf?1771508721","publication_date":"2026-02-20","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":"Assistance Listing \n The Assistance Listing number and title for the program affected by this document is 64.015, Veterans State Nursing Home <span class=\"match\">Care</span>. \n \n List of Subjects in 38 CFR Part 51 \n Administrative practice and procedure; Claims; Day <span class=\"match\">care</span>; Dental <span class=\"match\">health</span>; Government contracts; Grant programs—<span class=\"match\">health</span>; Grant programs—veterans; <span class=\"match\">Health</span> <span class=\"match\">care</span>; <span class=\"match\">Health</span> facilities; <span class=\"match\">Health</span> professions; <span class=\"match\">Health</span> records; <span class=\"match\">Mental</span> <span class=\"match\">health</span> programs; Nursing homes; Reporting and recordkeeping requirements; Travel and transportation expenses; Veterans. \n \n Signing Authority \n Douglas"},{"title":"Revising Definitions of “Adjudicated as a Mental Defective” and “Committed to a Mental Institution”","type":"Proposed Rule","abstract":"The Bureau of Alcohol, Tobacco, Firearms, and Explosives (\"ATF\") proposes amending Department of Justice (\"Department\") regulations to update the definitions of \"adjudicated as a mental defective\" and \"committed to a mental institution.\"","document_number":"2026-09156","html_url":"https://www.federalregister.gov/documents/2026/05/08/2026-09156/revising-definitions-of-adjudicated-as-a-mental-defective-and-committed-to-a-mental-institution","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-08/pdf/2026-09156.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-09156.pdf?1778157914","publication_date":"2026-05-08","agencies":[{"raw_name":"DEPARTMENT OF JUSTICE","name":"Justice Department","id":268,"url":"https://www.federalregister.gov/agencies/justice-department","json_url":"https://www.federalregister.gov/api/v1/agencies/268","parent_id":null,"slug":"justice-department"},{"raw_name":"Bureau of Alcohol, Tobacco, Firearms, and Explosives","name":"Alcohol, Tobacco, Firearms, and Explosives Bureau","id":19,"url":"https://www.federalregister.gov/agencies/alcohol-tobacco-firearms-and-explosives-bureau","json_url":"https://www.federalregister.gov/api/v1/agencies/19","parent_id":268,"slug":"alcohol-tobacco-firearms-and-explosives-bureau"}],"excerpts":"Consolidate and Amend the Law Relating to the <span class=\"match\">Care</span> \n \n and Control of <span class=\"match\">Mentally</span> Defective Persons.” \n 26 \n \n That act defined “<span class=\"match\">mentally</span> defective person” as:\n \n \n \n 26 \n  <span class=\"match\">Mental</span> Defectives Act 1911, 2 Geo. V No. 6 (N.Z.), \n https://www.nzlii.org/nz/legis/hist_act/mda19112gv1911n6240.pdf. \n \n \n a person who, owning to his <span class=\"match\">mental</span> condition, requires oversight, <span class=\"match\">care</span>, or control for his own good or in the public interest, and who according to the nature of his <span class=\"match\">mental</span> defect and to the degree of oversight, <span class=\"match\">care</span>, or control deemed to be necessary is included"},{"title":"Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole","type":"Rule","abstract":"This final rule addresses a loophole in a regulatory statistical test applied to State proposals for Medicaid tax waivers. The test is designed to ensure, as required by statute, that non- uniform or non-broad-based health care-related taxes, authorized under a waiver, are generally redistributive. The inadvertent loophole currently allows some health care-related taxes, especially taxes on managed care organizations, to be imposed at higher tax rates on Medicaid taxable units than non-Medicaid taxable units, contrary to statutory and regulatory intent for health care-related taxes to be generally redistributive. The final rule closes the loophole by finalizing the policies in the proposed rule to add additional safeguards to ensure that tax waivers that exploit the loophole because they pass the current statistical test, but are not generally redistributive, are not approvable. By adding these safeguards, the final rule is also implementing recently added statutory requirements for a tax to be considered generally redistributive.","document_number":"2026-02040","html_url":"https://www.federalregister.gov/documents/2026/02/02/2026-02040/medicaid-program-preserving-medicaid-funding-for-vulnerable-populations-closing-a-health","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-02/pdf/2026-02040.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-02040.pdf?1769721310","publication_date":"2026-02-02","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":"constructed, the baseline assumption is that all <span class=\"match\">health</span> <span class=\"match\">care</span>-related taxes are impermissible with limited exceptions for <span class=\"match\">health</span> <span class=\"match\">care</span>-related taxes that satisfy the parameters specified by the statute. \n <span class=\"match\">Health</span> <span class=\"match\">care</span>-related taxes may only be imposed permissibly on certain groups of <span class=\"match\">health</span> <span class=\"match\">care</span> items or services known as permissible classes, which are outlined in section 1903(w)(7) of the Act and expanded upon in § 433.56. In general, and as discussed in the introduction to this section, such <span class=\"match\">health</span> <span class=\"match\">care</span>-related taxes must be broad-based or apply to"},{"title":"Submission for OMB Review; 30-Day Comment Request; Regular Clearance for Autism Spectrum Disorder (ASD) Research Portfolio Analysis (National Institute of Mental Health)","type":"Notice","abstract":"In compliance with the Paperwork Reduction Act of 1995, the National Institutes of Health (NIH) has submitted to the Office of Management and Budget (OMB) a request for review and approval of the information collection listed below.","document_number":"2026-02440","html_url":"https://www.federalregister.gov/documents/2026/02/06/2026-02440/submission-for-omb-review-30-day-comment-request-regular-clearance-for-autism-spectrum-disorder-asd","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-06/pdf/2026-02440.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-02440.pdf?1770299125","publication_date":"2026-02-06","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":"National Institutes of Health","name":"National Institutes of Health","id":353,"url":"https://www.federalregister.gov/agencies/national-institutes-of-health","json_url":"https://www.federalregister.gov/api/v1/agencies/353","parent_id":221,"slug":"national-institutes-of-health"}],"excerpts":"an additional 30 days for public comment.\n \n The National Institute of <span class=\"match\">Mental</span> <span class=\"match\">Health</span> (NIMH), National Institutes of <span class=\"match\">Health</span>, may not conduct or sponsor, and the respondent is not required to respond to, an information collection that has been extended, revised, or implemented on or after October 1, 1995, unless it displays a currently valid OMB control number. \n In <span class=\"match\">compliance</span> with Section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the National Institutes of <span class=\"match\">Health</span> (NIH) has submitted to the Office of Management and Budget (OMB) a request"},{"title":"Requirements Related to the Mental Health Parity and Addiction Equity Act","type":"Rule","abstract":"This document sets forth final rules amending regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and adding new regulations implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021). Specifically, these final rules amend the existing NQTL standard to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from using NQTLs that place greater restrictions on access to mental health and substance use disorder benefits as compared to medical/surgical benefits. As part of these changes, these final rules require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on relevant outcomes related to access to mental health and substance use disorder benefits and medical/surgical benefits and to take reasonable action, as necessary, to address material differences in access to mental health or substance use disorder benefits as compared to medical/surgical benefits. These final rules also amend existing examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the requirements of MHPAEA. Additionally, these final rules set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Department of the Treasury (Treasury), the Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, the Departments), as well as to an applicable State authority, and to participants, beneficiaries, and enrollees. Finally, HHS finalizes regulatory amendments to implement the sunset provision for self-funded non-Federal governmental plan elections to opt out of compliance with MHPAEA, as adopted in the Consolidated Appropriations Act, 2023 (CAA, 2023).","document_number":"2024-20612","html_url":"https://www.federalregister.gov/documents/2024/09/23/2024-20612/requirements-related-to-the-mental-health-parity-and-addiction-equity-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-23/pdf/2024-20612.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-20612.pdf?1726258517","publication_date":"2024-09-23","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":"Around <span class=\"match\">Mental</span> <span class=\"match\">Health</span> Need, McKinsey &amp; Company, \n https://www.mckinsey.com/industries/healthcare/our-insights/national-surveys-reveal-disconnect-between-employees-and-employers-around-<span class=\"match\">mental</span>-<span class=\"match\">health</span>-need. \n \n \n \n \n 10 \n  America's <span class=\"match\">Health</span> Insurance Plans (AHIP), <span class=\"match\">Health</span> Insurance Providers Facilitate Broad Access to <span class=\"match\">Mental</span> <span class=\"match\">Health</span> Support (Aug. 2022), \n https://ahiporg-production.s3.amazonaws.com/documents/<span class=\"match\">Mental</span>-<span class=\"match\">Health</span>-Survey-July-2022-FINAL.pdf. \n \n \n \n \n 11 \n  Consistent with the proposed rules, these final rules apply directly to group <span class=\"match\">health</span> plans"},{"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":"Removal of Regulations for the Shelter Plus Care and the Supportive Housing Programs","type":"Rule","abstract":"This rule removes HUD's Shelter Plus Care program and Supportive Housing Program regulations from title 24 of the Code of Federal Regulations. HUD is removing these regulations and references to these regulations because the Shelter Plus Care and Supportive Housing Programs were consolidated into and replaced by the Continuum of Care (CoC) Program following the enactment of the Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH Act).","document_number":"2026-07633","html_url":"https://www.federalregister.gov/documents/2026/04/20/2026-07633/removal-of-regulations-for-the-shelter-plus-care-and-the-supportive-housing-programs","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-20/pdf/2026-07633.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-07633.pdf?1776429915","publication_date":"2026-04-20","agencies":[{"raw_name":"DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT","name":"Housing and Urban Development Department","id":228,"url":"https://www.federalregister.gov/agencies/housing-and-urban-development-department","json_url":"https://www.federalregister.gov/api/v1/agencies/228","parent_id":null,"slug":"housing-and-urban-development-department"}],"excerpts":"disabilities, <span class=\"match\">Mental</span> <span class=\"match\">health</span> programs, Nonprofit organizations, Rent subsidies, Reporting and recordkeeping requirements. \n \n Civil rights, Community facilities, Employment, Grant programs—housing and community development, Grant programs—social programs, Homeless, Indians, Individuals with disabilities, <span class=\"match\">Mental</span> <span class=\"match\">health</span> programs, Nonprofit organizations, Reporting and recordkeeping requirements, Technical assistance. \n Accordingly, for the reasons discussed in the preamble, HUD amends 24 CFR chapter V as follows: \n \n \n PART 578—CONTINUUM OF <span class=\"match\">CARE</span> PROGRAM"},{"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 services 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 services described in section 1302(b) of the Affordable <span class=\"match\">Care</span> Act, adherence"},{"title":"HHS Request for Comment on Chronic Disease of Addiction","type":"Notice","abstract":"Thanks to President Trump's leadership, since 2017, the country has made significant progress in addressing mental health and substance use. However, President Trump and HHS Secretary Kennedy realize that the Department and country have more work to do. To facilitate this effort, HHS invites public comment in response to this RFI on the research, development, programs, and policies that have been most successful in improving availability of and access to effective prevention, treatment, and recovery interventions for addiction, mental illness, and co-occurring substance use and mental disorders. The purpose of this RFI is to identify research, programs, and policies that have been successful and recommend novel policy ideas and gaps in research that could be addressed and implemented to further the Great American Recovery using existing funding.","document_number":"2026-11602","html_url":"https://www.federalregister.gov/documents/2026/06/10/2026-11602/hhs-request-for-comment-on-chronic-disease-of-addiction","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-10/pdf/2026-11602.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-11602.pdf?1780931706","publication_date":"2026-06-10","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"}],"excerpts":"html. \n \n \n 2. <span class=\"match\">Health</span> Technology \n \n As part of a $20 million Behavioral <span class=\"match\">Health</span> IT (BHIT) initiative, the Assistant Secretary for Technology Policy/Office of the National Coordinator for <span class=\"match\">Health</span> Information Technology and SAMHSA are awarding $5 million to test a standardized set of behavioral <span class=\"match\">health</span> data elements to ensure interoperability and exchange of information across providers, states, and federal programs and help further the use of <span class=\"match\">health</span> technology to advance chronic disease of addiction and <span class=\"match\">mental</span> <span class=\"match\">health</span> <span class=\"match\">care</span> treatment, <span class=\"match\">care</span> coordination"},{"title":"Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity","type":"Notice","abstract":"VA is announcing the availability of funds for suicide prevention grants under the Staff Sergeant Fox Suicide Prevention Grant Program (SSG Fox SPGP). The SSG Fox SPGP directs efforts to reduce Veteran suicide by awarding grants to community-based organizations to provide or coordinate the provision of primarily non-clinical suicide prevention services, including outreach and linkage to VA and community resources, to eligible individuals and their families. The SSG Fox SPGP furthers VA's public health approach to suicide prevention by combining community-based efforts with linkage to clinical care to prevent Veteran suicide for those inside and outside of VA health care. The goal of these grants is to reduce Veteran suicide risk by improving mental health status, well-being, financial stability, and social support for eligible individuals and their families.","document_number":"2025-08537","html_url":"https://www.federalregister.gov/documents/2025/05/15/2025-08537/staff-sergeant-fox-suicide-prevention-grant-program-funding-opportunity","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-05-15/pdf/2025-08537.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-08537.pdf?1747226710","publication_date":"2025-05-15","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":"\n Public benefits and assistance that grantees may provide participants referrals to include: <span class=\"match\">health</span> <span class=\"match\">care</span> services, which include (1) <span class=\"match\">health</span> insurance and (2) referrals to a governmental entity or grantee that provides (i) hospital <span class=\"match\">care</span>, nursing home <span class=\"match\">care</span>, outpatient <span class=\"match\">care</span>, <span class=\"match\">mental</span> <span class=\"match\">health</span> <span class=\"match\">care</span>, preventive <span class=\"match\">care</span>, habilitative and rehabilitative <span class=\"match\">care</span>, case management, respite <span class=\"match\">care</span>, home <span class=\"match\">care</span>, (ii) the training of any eligible individual's family in the <span class=\"match\">care</span> of any eligible individual, and (iii) the provision of pharmaceuticals, supplies, equipment, devices"},{"title":"Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity","type":"Notice","abstract":"VA is announcing the availability of funds for suicide prevention grants under the Staff Sergeant Fox Suicide Prevention Grant Program (SSG Fox SPGP). The SSG Fox SPGP directs efforts to reduce Veteran suicide by awarding grants to community-based organizations to provide or coordinate the provision of primarily non-clinical suicide prevention services, including outreach and linkage to VA and community resources, to eligible individuals and their families. The SSG Fox SPGP furthers VA's public health approach to suicide prevention by combining community-based efforts with linkage to clinical care to prevent Veteran suicide for those inside and outside of VA health care. The goal of these grants is to reduce Veteran suicide risk by improving mental health status, well-being, financial stability, and social support for eligible individuals and their families.","document_number":"2025-07975","html_url":"https://www.federalregister.gov/documents/2025/05/08/2025-07975/staff-sergeant-fox-suicide-prevention-grant-program-funding-opportunity","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-05-08/pdf/2025-07975.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-07975.pdf?1746621917","publication_date":"2025-05-08","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":"\n Public benefits and assistance that grantees may provide participants referrals to include: <span class=\"match\">health</span> <span class=\"match\">care</span> services, which include (1) <span class=\"match\">health</span> insurance and (2) referrals to a governmental entity or grantee that provides (i) hospital <span class=\"match\">care</span>, nursing home <span class=\"match\">care</span>, outpatient <span class=\"match\">care</span>, <span class=\"match\">mental</span> <span class=\"match\">health</span> <span class=\"match\">care</span>, preventive <span class=\"match\">care</span>, habilitative and rehabilitative <span class=\"match\">care</span>, case management, respite <span class=\"match\">care</span>, home <span class=\"match\">care</span>, (ii) the training of any eligible individual's family in the <span class=\"match\">care</span> of any eligible individual, and (iii) the provision of pharmaceuticals, supplies, equipment, devices"},{"title":"Health Data, Technology, and Interoperability: Protecting Care Access","type":"Rule","abstract":"This final rule has finalized certain proposals from the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability Proposed Rule (HTI-2 Proposed Rule) and in doing so supports the access, exchange, and use of electronic health information. Specifically, this final rule amends the information blocking regulations to revise two existing information blocking exceptions and establish an additional reasonable and necessary activity that does not constitute information blocking referred to as the Protecting Care Access Exception.","document_number":"2024-29683","html_url":"https://www.federalregister.gov/documents/2024/12/17/2024-29683/health-data-technology-and-interoperability-protecting-care-access","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-17/pdf/2024-29683.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-29683.pdf?1734356733","publication_date":"2024-12-17","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":"coordination and outcomes to ASTP/ONC's official website, HealthIT.gov. We offer a range of resources for <span class=\"match\">health</span> <span class=\"match\">care</span> providers across a broad array of <span class=\"match\">care</span> settings online, free of charge. (Start at \n https://www.healthit.gov/topic/<span class=\"match\">health</span>-it-<span class=\"match\">health</span>-<span class=\"match\">care</span>-settings/<span class=\"match\">health</span>-it-<span class=\"match\">health</span>-<span class=\"match\">care</span>-settings \n ). For example, we offer an educational module for LTPAC providers \n 13 \n \n and our <span class=\"match\">Health</span> IT Playbook (\n https://www.healthit.gov/playbook/ \n ) has implementation resources for LTPAC providers.\n 14 \n \n From an information-blocking perspective, information"},{"title":"Reproductive Health Services","type":"Rule","abstract":"The Department of Veterans Affairs (VA) adopts as final, without changes, a proposed rule to reinstate the exclusions on abortions and abortion counseling from the medical benefits package, which were removed in 2022. Before 2022, these exclusions had been firmly in place since the medical benefits package was first established in 1999. VA is also adopting as final, without changes, the reinstatement of exclusions on abortion and abortion counseling for the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) that were also removed in 2022. VA takes this action to ensure that VA provides only needed and medically necessary and appropriate care to our nation's heroes and CHAMPVA beneficiaries.","document_number":"2025-24061","html_url":"https://www.federalregister.gov/documents/2025/12/31/2025-24061/reproductive-health-services","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-31/pdf/2025-24061.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-24061.pdf?1767102313","publication_date":"2025-12-31","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":"prohibit VA from providing <span class=\"match\">care</span> to pregnant women in life-threatening circumstances (and thus, such <span class=\"match\">care</span> was covered under the medical benefits package). 90 FR 36416. The Deborah Sampson Act of 2020 created a central office to monitor and encourage the activities of the Veterans <span class=\"match\">Health</span> Administration with respect to the provision, evaluation, and improvement of <span class=\"match\">health</span> <span class=\"match\">care</span> services provided to women veterans by the Department. 38 U.S.C. 7310(b)(1). As part of that Act, Congress defined “<span class=\"match\">health</span> <span class=\"match\">care</span>” as the <span class=\"match\">health</span> <span class=\"match\">care</span> and services included in the"},{"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 <span class=\"match\">Health</span> 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":"Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Exclusion Authorities","type":"Proposed Rule","abstract":"This proposed rule proposes to amend the regulations relating to exclusion authorities under the authority of the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS or the Department). The proposed rule would codify changes made by the Medicaid Services Investment and Accountability Act of 2019 (MSIAA), that added exclusion authorities related to misclassification and false information about outpatient drugs. The proposed rule would also update and clarify OIG's procedures for excluding individuals and entities from participation in the Federal health care programs, including the factors that will be considered in determining the length of exclusions, the provisions governing notices of exclusions, and certain provisions related to reinstatement into the programs.","document_number":"2024-26804","html_url":"https://www.federalregister.gov/documents/2024/12/02/2024-26804/health-care-programs-fraud-and-abuse-revisions-to-the-office-of-inspector-generals-exclusion","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-02/pdf/2024-26804.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-26804.pdf?1732887923","publication_date":"2024-12-02","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":"Office of Inspector General, Department of Health and Human Services","name":"Inspector General Office, Health and Human Services Department","id":245,"url":"https://www.federalregister.gov/agencies/inspector-general-office-health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/245","parent_id":221,"slug":"inspector-general-office-health-and-human-services-department"}],"excerpts":"Federal <span class=\"match\">health</span> <span class=\"match\">care</span> program” to “any Federal <span class=\"match\">health</span> <span class=\"match\">care</span> program” because “Federal <span class=\"match\">health</span> <span class=\"match\">care</span> program” is a statutorily defined term that includes (and is broader than) Medicare and State <span class=\"match\">health</span> <span class=\"match\">care</span> programs. \n See \n 42 U.S.C. 1320a-7b(f). Section 1320a-7b(f) of U.S. Code title 42 and § 1000.10 define “Federal <span class=\"match\">health</span> <span class=\"match\">care</span> program” as \n \n “(1) any plan or program that provides <span class=\"match\">health</span> benefits, whether directly, through insurance, or otherwise, which is funded directly, in whole or in part, by the United States Government (other than the <span class=\"match\">health</span> insurance"}]}