{"description":"Documents matching 'fraud abuse proposed patient protection'","count":1388,"total_pages":50,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=fraud+abuse+proposed+patient+protection&format=json&page=2","results":[{"title":"Solicitation of Proposals for New and Modified Safe Harbors and Special Fraud Alerts","type":"Proposed Rule","abstract":"In accordance with section 205 of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), this annual notification solicits proposals and recommendations for developing new, or modifying existing, safe harbor provisions under section 1128B(b) of the Social Security Act (the Act), the Federal anti-kickback statute, as well as developing new OIG Special Fraud Alerts.","document_number":"2025-22327","html_url":"https://www.federalregister.gov/documents/2025/12/09/2025-22327/solicitation-of-proposals-for-new-and-modified-safe-harbors-and-special-fraud-alerts","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-09/pdf/2025-22327.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-22327.pdf?1765201522","publication_date":"2025-12-09","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":"CFR part 1001.\n \n \n \n 1 \n  \n See, e.g., \n Medicare and State Health Care Programs: <span class=\"match\">Fraud</span> and <span class=\"match\">Abuse</span>; Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements, 85 FR 77684 (Dec. 2, 2020).\n \n \n \n \n 2 \n  Medicare and State Health Care Programs: <span class=\"match\">Fraud</span> and <span class=\"match\">Abuse</span>; OIG Anti-Kickback Provisions, 56 FR 35952, 35958 (July 29, 1991).\n \n \n B. OIG Special <span class=\"match\">Fraud</span> Alerts \n \n OIG periodically issues Special <span class=\"match\">Fraud</span> Alerts to give continuing guidance to health care industry stakeholders about practices"},{"title":"Solicitation of Proposals for New and Modified Safe Harbors and Special Fraud Alerts","type":"Proposed Rule","abstract":"In accordance with section 205 of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), this annual notification solicits proposals and recommendations for developing new, or modifying existing, safe harbor provisions under section 1128B(b) of the Social Security Act (the Act), the Federal anti-kickback statute, as well as developing new OIG Special Fraud Alerts.","document_number":"2024-27710","html_url":"https://www.federalregister.gov/documents/2024/11/27/2024-27710/solicitation-of-proposals-for-new-and-modified-safe-harbors-and-special-fraud-alerts","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-27710.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-27710.pdf?1732628717","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":"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":"CFR part 1001.\n \n \n \n 1 \n  \n See, e.g., \n Medicare and State Health Care Programs: <span class=\"match\">Fraud</span> and <span class=\"match\">Abuse</span>; Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements, 85 FR 77684 (Dec. 2, 2020).\n \n \n \n \n 2 \n  Medicare and State Health Care Programs: <span class=\"match\">Fraud</span> and <span class=\"match\">Abuse</span>; OIG Anti-Kickback Provisions, 56 FR 35952, 35958 (July 29, 1991).\n \n \n B. OIG Special <span class=\"match\">Fraud</span> Alerts \n \n OIG periodically issues Special <span class=\"match\">Fraud</span> Alerts to give continuing guidance to health care industry stakeholders about practices"},{"title":"Performance Standards for Medicaid Fraud Control Units","type":"Rule","abstract":"This document sets forth OIG guidance regarding standards OIG will apply in assessing the performance of Medicaid Fraud Control Units (MFCUs or Units). Based on its experience in overseeing MFCUs, and after consultation with key stakeholders, OIG is revising the standards. These standards replace and supersede standards published on June 1, 2012.","document_number":"2024-20416","html_url":"https://www.federalregister.gov/documents/2024/09/18/2024-20416/performance-standards-for-medicaid-fraud-control-units","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-18/pdf/2024-20416.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-20416.pdf?1726577114","publication_date":"2024-09-18","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":"volume of case referrals and workload for both Medicaid <span class=\"match\">fraud</span> and <span class=\"match\">abuse</span> or neglect of <span class=\"match\">patients</span> or residents. \n B. The Unit employs an appropriate mix and number of attorneys, auditors, investigators, and other professional staff that is commensurate with the State's total Medicaid program expenditures and that allows the Unit to effectively investigate and prosecute (or refer for prosecution) an appropriate volume of case referrals and workload for both Medicaid <span class=\"match\">fraud</span> and <span class=\"match\">abuse</span> or neglect of <span class=\"match\">patients</span> or residents. \n C. The Unit, when warranted for the"},{"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":"ACTION: \n <span class=\"match\">Proposed</span> rule. \n \n \n SUMMARY: \n This <span class=\"match\">proposed</span> rule contains provisions to improve implementation of the <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> 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 <span class=\"match\">proposed</span> rule also includes provisions related to civil"},{"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":"regulatory burden on interested parties, and improve affordability.\n \n \n \n 1 \n  The <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act (Pub. L. 111-148) was enacted on March 23, 2010. The Healthcare and Education Reconciliation Act of 2010 (Pub. L. 111-152), which amended and revised several provisions of the <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act, was enacted on March 30, 2010. In this rulemaking, the two statutes are referred to collectively as the “<span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act” or “Affordable Care Act.”\n \n \n \n \n 2 \n  \n See \n sections"},{"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":"whether such circumstances were related to <span class=\"match\">patient</span> <span class=\"match\">abuse</span> or neglect. In addition, we <span class=\"match\">propose</span> to modify this section to require that, in the case of a license revocation or suspension for reasons related to <span class=\"match\">patient</span> <span class=\"match\">abuse</span> or neglect, OIG will not consider a request for early reinstatement until the individual or entity has been excluded for at least 5 years for parity with those excluded for the statutory minimum period of 5 years for a conviction related to the neglect or <span class=\"match\">abuse</span> of a <span class=\"match\">patient</span>.\n \n We also <span class=\"match\">propose</span> several clarifying changes throughout § 1001"},{"title":"Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH)","type":"Proposed Rule","abstract":"This request for information (RFI) solicits stakeholder feedback on potential regulatory changes that might be included in a potential upcoming CRUSH proposed rule, as well as other programmatic changes that could be implemented to make CMS more effective in crushing fraud to protect taxpayer dollars and the Americans we serve.","document_number":"2026-03968","html_url":"https://www.federalregister.gov/documents/2026/02/27/2026-03968/request-for-information-rfi-related-to-comprehensive-regulations-to-uncover-suspicious-healthcare","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-27/pdf/2026-03968.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-03968.pdf?1772054108","publication_date":"2026-02-27","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":"Department of Justice have issued multiple reports \n 4 \n \n and <span class=\"match\">fraud</span> alerts,\n 5 \n \n and have engaged in multiple enforcement actions \n 6 \n \n related to <span class=\"match\">fraud</span> in lab tests, particularly genetic tests, including molecular diagnostic tests. CMS is concerned about <span class=\"match\">fraud</span>, waste, and <span class=\"match\">abuse</span> related to lab tests and has targeted this as a focus area through its <span class=\"match\">Fraud</span> Defense Operations Center (FDOC), which is a high-tech unit formed in 2025 that utilizes cross-functional teams to target <span class=\"match\">fraud</span> in real time and has expedited the issuance of payment suspensions"},{"title":"Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability","type":"Rule","abstract":"This final rule revises standards relating to denial of coverage for failure to pay past-due premium; excludes Deferred Action for Childhood Arrivals recipients from the definition of \"lawfully present;\" establishes the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; revises the Exchange automatic reenrollment hierarchy; revises standards related to the annual open enrollment period and special enrollment periods; revises standards relating to failure to file and reconcile, income eligibility verifications for premium tax credits and cost-sharing reductions, annual eligibility redeterminations, de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements, and income-based cost-sharing reduction plan variations. This final rule also revises the premium adjustment percentage methodology and prohibits issuers of coverage subject to EHB requirements from providing coverage for specified sex-trait modification procedures as an EHB.","document_number":"2025-11606","html_url":"https://www.federalregister.gov/documents/2025/06/25/2025-11606/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-06-25/pdf/2025-11606.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-11606.pdf?1750709712","publication_date":"2025-06-25","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":"health care costs, we are finalizing several regulatory actions aimed at strengthening the integrity of the <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act (ACA) eligibility and enrollment systems to reduce waste, <span class=\"match\">fraud</span>, and <span class=\"match\">abuse</span> that we <span class=\"match\">proposed</span> in the 2025 <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act; Marketplace Integrity and Affordability <span class=\"match\">proposed</span> rule (90 FR 12942) (“2025 Marketplace Integrity and Affordability <span class=\"match\">proposed</span> rule” or “<span class=\"match\">proposed</span> rule”). We expect these actions will provide immediate premium relief to families who do not qualify for Federal"},{"title":"Continuity of Care via Telemedicine for Veterans Affairs Patients","type":"Rule","abstract":"This final rule authorizes Department of Veterans Affairs (VA) practitioners acting within the scope of their VA employment to prescribe controlled substances via telemedicine to a VA patient with whom they have not conducted an in-person medical evaluation. VA practitioners are permitted to prescribe controlled substances to VA patients if another VA practitioner has, at any time, previously conducted an in-person medical evaluation of the VA patient, subject to certain conditions.","document_number":"2025-01044","html_url":"https://www.federalregister.gov/documents/2025/01/17/2025-01044/continuity-of-care-via-telemedicine-for-veterans-affairs-patients","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-17/pdf/2025-01044.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-01044.pdf?1736948756","publication_date":"2025-01-17","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":"Drug Enforcement Administration","name":"Drug Enforcement Administration","id":116,"url":"https://www.federalregister.gov/agencies/drug-enforcement-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/116","parent_id":268,"slug":"drug-enforcement-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":"(transfers to the <span class=\"match\">patient</span>) is $146,644 ($2.22 × 66,056). Subtracting the VA reimbursement amount from the total cost savings, DEA estimates a total <span class=\"match\">patient</span> net cost savings of $2,393,870 ($2,540,514 − $146,644) per year. Table 10 summarizes this calculation. \n \n Table 10—Total Cost/Transfer Savings \n \n   \n \n Total cost\n savings \n ($) \n \n \n VA\n reimbursement \n ($) \n \n \n <span class=\"match\">Patient</span> net\n cost savings \n ($) \n \n \n \n <span class=\"match\">Patient</span> cost savings (per visit) \n 38.46 \n 2.22 \n N/A \n \n \n <span class=\"match\">Patient</span> cost savings \n 2,540,514 \n 146,644 \n 2,393,870 \n \n \n e. <span class=\"match\">Patient</span> Benefit: Increased"},{"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 \"Patient Medical Records-VA\" (24VA10A7). This system is used for ongoing treatment of individuals and patients; documentation of treatment provided; payment; health care operations such as producing various management and patient follow-up reports; responding to patient and other inquiries; for epidemiological research and other health care related studies; statistical analysis, resource allocation, and planning; providing clinical and administrative support to patient medical care; and determining entitlement and eligibility for VA benefits.","document_number":"2026-13454","html_url":"https://www.federalregister.gov/documents/2026/07/02/2026-13454/privacy-act-of-1974-system-of-records","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-07-02/pdf/2026-13454.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-13454.pdf?1782909925","publication_date":"2026-07-02","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":"or Discharge: \n To a third party upon the written request of the <span class=\"match\">patient's</span> next-of-kin in order for a non-judicially declared incompetent <span class=\"match\">patient</span> or, consistent with the best interest of the <span class=\"match\">patient</span>, a member of the <span class=\"match\">patient's</span> family to receive a benefit to which the <span class=\"match\">patient</span> or family member is entitled or to arrange for the <span class=\"match\">patient's</span> discharge from a VA medical facility. Sufficient data to make an informed determination will be made available to such next-of-kin. If the <span class=\"match\">patient's</span> next-of-kin is not reasonably accessible, the Chief of Staff, Director"},{"title":"Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability","type":"Proposed Rule","abstract":"This proposed rule would revise standards relating to past-due premium payments; exclude Deferred Action for Childhood Arrivals recipients from the definition of \"lawfully present\"; the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; failure to file and reconcile; income eligibility verifications for premium tax credits and cost-sharing reductions; annual eligibility redetermination; the automatic reenrollment hierarchy; the annual open enrollment period; special enrollment periods; de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements and for income-based cost-sharing reduction plan variations; and the premium adjustment percentage methodology; and prohibit issuers of coverage subject to EHB requirements from providing coverage for sex-trait modification as an EHB.","document_number":"2025-04083","html_url":"https://www.federalregister.gov/documents/2025/03/19/2025-04083/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-03-19/pdf/2025-04083.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-04083.pdf?1741810509","publication_date":"2025-03-19","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":"APTC a taxpayer must repay based on household income.\n \n \n \n 5 \n  The <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act (Pub. L. 111-148, 124 Stat. 119) was enacted on March 23, 2010. The Healthcare and Education Reconciliation Act of 2010 (Pub. L. 111-152, 124 Stat. 1049), which amended and revised several provisions of the <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act, was enacted on March 30, 2010. In this rulemaking, the two statutes are referred to collectively as the “<span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act,” “Affordable Care Act,” or “ACA”.\n \n \n The"},{"title":"Privacy Act of 1974; System of Records","type":"Notice","abstract":"As required by the Privacy Act of 1974, notice is hereby given that VA is modifying the system of records titled \"VHA Corporate Data Warehouses-VA\" (172VA10). This system is used for clinical decision support, mobile applications presenting patient data, and statistical analysis to produce various management, workload tracking, and follow- up reports. It is also used to track and evaluate the ordering and delivery of equipment, services, and patient care; track the planning, distribution, and utilization of resources; monitor the performance of Veterans Integrated Service Networks; and allocate clinical and administrative support to patient medical care.","document_number":"2025-17710","html_url":"https://www.federalregister.gov/documents/2025/09/15/2025-17710/privacy-act-of-1974-system-of-records","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-09-15/pdf/2025-17710.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-17710.pdf?1757681108","publication_date":"2025-09-15","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":"disease-tracking, <span class=\"match\">patient</span> outcomes, bio-surveillance or other health information required for program accountability.\n \n \n 18. \n Contractors: \n To contractors, grantees, experts, consultants, students, and others performing or working on a contract, service, grant, cooperative agreement, or other assignment for VA, when reasonably necessary to accomplish an agency function related to the records.\n \n \n 19. \n Federal Agencies, for <span class=\"match\">Fraud</span> and <span class=\"match\">Abuse</span>: \n To other Federal agencies to assist such agencies in preventing and detecting possible <span class=\"match\">fraud</span> or <span class=\"match\">abuse</span> by individuals"},{"title":"Registering Emergency Medical Services Agencies Under the Protecting Patient Access to Emergency Medications Act of 2017","type":"Rule","abstract":"The \"Protecting Patient Access to Emergency Medications Act of 2017,\" (the Act) which became law on November 17, 2017, amended the Controlled Substances Act (CSA) to allow for a new registration category for emergency medical services agencies that handle controlled substances. It also established standards for registering emergency medical services agencies, and set forth new requirements for delivery, storage, and recordkeeping related to their handling of controlled substances. In addition, the Act allows emergency medical services professionals to administer controlled substances outside the physical presence of a medical director or authorizing medical professional pursuant to a valid standing or verbal order. The Drug Enforcement Administration is publishing this final rule to conform its regulations to the statutory amendments of the CSA and to otherwise implement its requirements. This final rule adopts, with minor modifications, the notice of proposed rulemaking published on October 5, 2020.","document_number":"2026-02288","html_url":"https://www.federalregister.gov/documents/2026/02/05/2026-02288/registering-emergency-medical-services-agencies-under-the-protecting-patient-access-to-emergency","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-05/pdf/2026-02288.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-02288.pdf?1770153307","publication_date":"2026-02-05","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":"Drug Enforcement Administration","name":"Drug Enforcement Administration","id":116,"url":"https://www.federalregister.gov/agencies/drug-enforcement-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/116","parent_id":268,"slug":"drug-enforcement-administration"}],"excerpts":"anonymous commenter stated that <span class=\"match\">proposed</span> § 1304.27 is sensible in theory, but in reality, EMS work is often chaotic with back-to-back calls and distractions between <span class=\"match\">patients</span>. This commenter further stated that it may be nearly impossible for an individual to collect and retain such detailed information as the names of those who are administered critical care involving controlled substances, beyond the timeframe of the event, so to be recorded properly under <span class=\"match\">proposed</span> § 1304.27. This commenter was concerned about the <span class=\"match\">protections</span> that will be put in place"},{"title":"Privacy Act of 1974; System of Records","type":"Notice","abstract":"In accordance with the Privacy Act of 1974, the DoD is modifying and reissuing a current System of Records Notice (SORN) titled, \"Defense Manpower Data Center Data Base,\" DMDC 01. The SORN is being retitled \"Uniformed Services Human Resources Information System,\" to reflect the updated name of the underlying database. The system is designed to collect and maintain records that support a single central facility within the DoD. Its primary functions include assessing manpower trends, supporting personnel and readiness operations, conducting longitudinal statistical analyses, identifying current and former DoD civilians and Armed Forces personnel for the purpose of detecting fraud and abuse of pay and benefits programs, and registering eligible individuals and their authorized dependents for medical examinations, treatment, or other qualified benefits. The system also facilitates the collection of debts owed to the United States Government and to state and local governments. As part of this update, two routine uses are being revised to reflect changes in computer matching activities. Specifically, the proposed revisions expand the eligible population for data sharing with the Department of Education (DoE) to support a new computer matching program, and remove routine uses associated with the Public Assistance Reporting Information System (PARIS), as the DoD no longer participates in that program. Additional modifications throughout the SORN improve clarity and ensure the information reflects current operational practices.","document_number":"2026-04170","html_url":"https://www.federalregister.gov/documents/2026/03/03/2026-04170/privacy-act-of-1974-system-of-records","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-03-03/pdf/2026-04170.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-04170.pdf?1772459113","publication_date":"2026-03-03","agencies":[{"raw_name":"DEPARTMENT OF DEFENSE","name":"Defense Department","id":103,"url":"https://www.federalregister.gov/agencies/defense-department","json_url":"https://www.federalregister.gov/api/v1/agencies/103","parent_id":null,"slug":"defense-department"},{"raw_name":"Office of the Secretary"}],"excerpts":"and Armed Forces personnel for the purpose of detecting <span class=\"match\">fraud</span> and <span class=\"match\">abuse</span> of pay and benefits programs, and registering eligible individuals and their authorized dependents for medical examinations, treatment, or other qualified benefits. The system also facilitates the collection of debts owed to the United States Government and to state and local governments. As part of this update, two routine uses are being revised to reflect changes in computer matching activities. Specifically, the <span class=\"match\">proposed</span> revisions expand the eligible population for data sharing"},{"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":"authorization for laboratory tests and DMEPOS items impacts <span class=\"match\">patient</span> care and provider burden and what can be done to mitigate that burden. \n C. Specific Terms Used in This <span class=\"match\">Proposed</span> Rule \n \n Throughout this <span class=\"match\">proposed</span> rule, we use terms such as “<span class=\"match\">patient</span>,” “consumer,” “beneficiary,” “enrollee,” and “individual.” In this <span class=\"match\">proposed</span> rule, we use the term “<span class=\"match\">patient</span>” as an inclusive term. Each CMS program may use different terms to refer to <span class=\"match\">patients</span> in regulation. Therefore, in this <span class=\"match\">proposed</span> rule, we use “<span class=\"match\">patients</span>” collectively across programs. However, when discussing"},{"title":"Privacy Act of 1974; System of Records","type":"Notice","abstract":"Pursuant to the Privacy Act of 1974, notice is hereby given that the VA is modifying the system of records titled, \"Veteran, Patient, Employee, and Volunteer Research and Development Project Records-VA\" (34VA10). This system of records is used to determine eligibility for research funding, to determine handling of intellectual properties, to manage proposed and/or approved research endeavors, and to evaluate the research and development program. This system may also be used for data analysis to address specific questions and gain generalizable knowledge and deepen understanding of a topic or issue.","document_number":"2025-15588","html_url":"https://www.federalregister.gov/documents/2025/08/15/2025-15588/privacy-act-of-1974-system-of-records","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-08-15/pdf/2025-15588.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-15588.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":"proposals submitted by that individual, except that information concerning a third party, such as the name or other identifying information about the qualified reviewer of the proposal.\n \n \n 17. \n Federal Agencies, <span class=\"match\">Fraud</span> and <span class=\"match\">Abuse</span>: \n To other Federal agencies to assist such agencies in preventing and detecting possible <span class=\"match\">fraud</span> or <span class=\"match\">abuse</span> by individuals in their operations and programs.\n \n \n 18. \n Data Breach Response and Remediation, for VA: \n To appropriate agencies, entities, and persons when (1) VA suspects or has confirmed that there has been a"},{"title":"Whistleblower Incentives and Protections","type":"Proposed Rule","abstract":"FinCEN is proposing a rule to establish a whistleblower program that offers incentives and protections to encourage individuals who have information about potential violations of the Bank Secrecy Act (BSA), International Emergency Economic Powers Act (IEEPA), Trading With the Enemy Act of 1917 (TWEA), and Foreign Narcotics Kingpin Designation Act (Kingpin Act) to voluntarily report such information (the \"Whistleblower Program\"). The proposed rule would implement section 6314 of the Anti-Money Laundering Act of 2020 (AML Act) and the Anti-Money Laundering Whistleblower Improvement Act (AML Whistleblower Improvement Act), which were enacted into law as part of the National Defense Authorization Act for Fiscal Year 2021 (FY21 NDAA) and the Consolidated Appropriations Act of 2023, respectively. The Whistleblower Program will contribute to the U.S. government's efforts to safeguard the financial system from illicit use, promote national security, and combat money laundering, terrorist financing, proliferation financing, and related crimes. This notice of proposed rulemaking invites comments from the public regarding all aspects of the proposed rule, as well as comments in response to specific questions.","document_number":"2026-06271","html_url":"https://www.federalregister.gov/documents/2026/04/01/2026-06271/whistleblower-incentives-and-protections","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-01/pdf/2026-06271.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-06271.pdf?1774961111","publication_date":"2026-04-01","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":"Financial Crimes Enforcement Network","name":"Financial Crimes Enforcement Network","id":194,"url":"https://www.federalregister.gov/agencies/financial-crimes-enforcement-network","json_url":"https://www.federalregister.gov/api/v1/agencies/194","parent_id":497,"slug":"financial-crimes-enforcement-network"}],"excerpts":"INFORMATION: \n I. Scope \n In this notice of <span class=\"match\">proposed</span> rulemaking, FinCEN is <span class=\"match\">proposing</span> and seeking comment on regulations that would implement the statutory framework set forth in section 5323 of title 31 of the United States Code, 31 U.S.C. 5323, for a whistleblower program—the “Whistleblower Program.” The <span class=\"match\">proposed</span> rule sets out the procedures a whistleblower must follow to be eligible for payment of an award by FinCEN and the <span class=\"match\">protections</span> afforded to whistleblowers who provide information. Specifically, the <span class=\"match\">proposed</span> rule would: \n • Define key terms; \n •"},{"title":"Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions To Unleash Prosperity","type":"Proposed Rule","abstract":"This proposed rule focuses on deregulatory actions identified in HHS regulations regarding Health information technology standards, implementation specifications, and certification criteria and certification programs for health information technology, and information blocking. This proposed rule seeks to reduce burden, offer flexibility to both developers and providers, and support innovation through the removal and revisions of certain certification criteria and regulatory provisions. This proposed rule also seeks to address reported misuse and abuse of information blocking definitions and exceptions.","document_number":"2025-23896","html_url":"https://www.federalregister.gov/documents/2025/12/29/2025-23896/health-data-technology-and-interoperability-astponc-deregulatory-actions-to-unleash-prosperity","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-29/pdf/2025-23896.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-23896.pdf?1766438109","publication_date":"2025-12-29","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":" On April 18, 2023, the Secretary published a <span class=\"match\">proposed</span> rule titled “Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing” (88 FR 23746) (HTI-1 <span class=\"match\">Proposed</span> Rule). The HTI-1 <span class=\"match\">Proposed</span> Rule <span class=\"match\">proposed</span> to implement the EHR Reporting Program provision of the Cures Act by establishing new Conditions and Maintenance of Certification requirements for health IT developers under the Certification Program. The HTI-1 <span class=\"match\">Proposed</span> Rule also <span class=\"match\">proposed</span> several updates to certification criteria and implementation"},{"title":"Agency Information Collection Activities: Proposed Collection; Comment Request","type":"Notice","abstract":"The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.","document_number":"2025-13042","html_url":"https://www.federalregister.gov/documents/2025/07/14/2025-13042/agency-information-collection-activities-proposed-collection-comment-request","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-07-14/pdf/2025-13042.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-13042.pdf?1752237908","publication_date":"2025-07-14","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":"federal agencies are required to publish notice in the \n Federal Register \n concerning each <span class=\"match\">proposed</span> collection of information (including each <span class=\"match\">proposed</span> extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the <span class=\"match\">proposed</span> action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the <span class=\"match\">proposed</span> information collection for the proper performance of the agency's functions, the accuracy"},{"title":"Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2026; and Basic Health Program","type":"Rule","abstract":"This final rule includes payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2026 benefit year user fee rates for issuers that participate in the HHS-operated risk adjustment program and the 2026 benefit year 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 requirements related to modifications to the calculation of the Basic Health Program (BHP) payment; and changes to the Initial Validation Audit (IVA) sampling approach and Second Validation Audit (SVA) pairwise means test for HHS-RADV. It also addresses HHS' authority to engage in compliance reviews of and take enforcement action against lead agents of insurance agencies for violations of HHS' Exchange standards and requirements; HHS' system suspension authority to address noncompliance by agents and brokers; an optional fixed-dollar premium payment threshold; permissible plan-level adjustment to the index rate to account for cost-sharing reductions (CSRs); reconsideration standards for certification denials; changes to the approach for conducting Essential Community Provider (ECP) certification reviews; a policy to publicly share aggregated, summary- level Quality Improvement Strategy (QIS) information on an annual basis; and revisions to the medical loss ratio (MLR) reporting and rebate requirements for qualifying issuers that meet certain standards.","document_number":"2025-00640","html_url":"https://www.federalregister.gov/documents/2025/01/15/2025-00640/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2026-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-15/pdf/2025-00640.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-00640.pdf?1736802922","publication_date":"2025-01-15","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Office of the Secretary"}],"excerpts":"health disparities, and alleviate discrimination.\n \n \n \n 1 \n  The <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act (Pub. L. 111-148, 124 Stat. 119) was enacted on March 23, 2010. The Healthcare and Education Reconciliation Act of 2010 (Pub. L. 111-152, 124 Stat. 1049), which amended and revised several provisions of the <span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act, was enacted on March 30, 2010. In this rulemaking, the two statutes are referred to collectively as the “<span class=\"match\">Patient</span> <span class=\"match\">Protection</span> and Affordable Care Act,” “Affordable Care Act,” or “ACA.”\n \n \n \n "}]}