{"description":"Documents matching 'hipaa arizonas medical privacy statutes'","count":170,"total_pages":9,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=hipaa+arizonas+medical+privacy+statutes&format=json&page=2","results":[{"title":"HIPAA Security Rule To Strengthen the Cybersecurity of Electronic Protected Health Information","type":"Proposed Rule","abstract":"The Department of Health and Human Services (HHS or \"Department\") is issuing this notice of proposed rulemaking (NPRM) to solicit comment on its proposal to modify the Security Standards for the Protection of Electronic Protected Health Information (\"Security Rule\") under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act). The proposed modifications would revise existing standards to better protect the confidentiality, integrity, and availability of electronic protected health information (ePHI). The proposals in this NPRM would increase the cybersecurity for ePHI by revising the Security Rule to address: changes in the environment in which health care is provided; significant increases in breaches and cyberattacks; common deficiencies the Office for Civil Rights has observed in investigations into Security Rule compliance by covered entities and their business associates (collectively, \"regulated entities\"); other cybersecurity guidelines, best practices, methodologies, procedures, and processes; and court decisions that affect enforcement of the Security Rule.","document_number":"2024-30983","html_url":"https://www.federalregister.gov/documents/2025/01/06/2024-30983/hipaa-security-rule-to-strengthen-the-cybersecurity-of-electronic-protected-health-information","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-06/pdf/2024-30983.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-30983.pdf?1735334119","publication_date":"2025-01-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Office of the Secretary"}],"excerpts":"of <span class=\"match\">Medical</span> Things,” Health Policy and Technology (Sept. 2021), \n https://doi.org/10.1016/j.hlpt.2021.100549. \n \n \n \n \n 186 \n  “Cybersecurity in the internet of <span class=\"match\">Medical</span> Things,” \n supra \n note 185.\n \n \n \n \n 187 \n  \n Id. \n \n \n \n \n 188 \n  \n Id. \n \n \n \n According to researchers at Brown University, <span class=\"match\">medical</span> devices are a prime target for cybercriminals. In fact, they believe, “More than just technically feasible, the widespread takedown of <span class=\"match\">medical</span> devices is an imminent threat.” \n 189 \n \n A 2023 Government Accountability Office report on <span class=\"match\">medical</span> device"},{"title":"Prohibition on Creditors and Consumer Reporting Agencies Concerning Medical Information (Regulation V)","type":"Rule","abstract":"The Consumer Financial Protection Bureau (CFPB) is issuing a final rule amending Regulation V, which implements the Fair Credit Reporting Act (FCRA), concerning medical information. The FCRA prohibits creditors from considering medical information in credit eligibility determinations. The CFPB is removing a regulatory exception that had permitted creditors to obtain and use information on medical debts notwithstanding this statutory limitation. The final rule also provides that a consumer reporting agency generally may not furnish to a creditor a consumer report containing information on medical debt that the creditor is prohibited from using.","document_number":"2024-30824","html_url":"https://www.federalregister.gov/documents/2025/01/14/2024-30824/prohibition-on-creditors-and-consumer-reporting-agencies-concerning-medical-information-regulation-v","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-14/pdf/2024-30824.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-30824.pdf?1736775917","publication_date":"2025-01-14","agencies":[{"raw_name":"Consumer Financial Protection Bureau","name":"Consumer Financial Protection Bureau","id":573,"url":"https://www.federalregister.gov/agencies/consumer-financial-protection-bureau","json_url":"https://www.federalregister.gov/api/v1/agencies/573","parent_id":null,"slug":"consumer-financial-protection-bureau"}],"excerpts":"IV.B.1, \n <span class=\"match\">Medical</span> Information Related to Debts, \n the CFPB finalizes its definition of <span class=\"match\">medical</span> debt information in final § 1022.3(j), as <span class=\"match\">medical</span> information that pertains to a debt owed by a consumer to a person whose primary business is providing <span class=\"match\">medical</span> services, products, or devices (also referred to herein as a health care provider), or to the person's agent or assignee, for the provision of such <span class=\"match\">medical</span> services, products, or devices. The definition also provides that <span class=\"match\">medical</span> debt information includes, but is not limited to, <span class=\"match\">medical</span> bills that"},{"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":"with a <span class=\"match\">medical</span> power of attorney).\n 15 16 \n \n Under the <span class=\"match\">HIPAA</span> <span class=\"match\">Privacy</span> Rule, the individual's personal representative generally may exercise the right to access the individual's protected health information (PHI).\n \n \n \n 15 \n  \n See \n 45 CFR parts 160 and 164, subparts A and E.\n \n \n 16 \n  United States Department of Health and Human Services. (2020, January 31). Health Information and <span class=\"match\">Privacy</span>. Retrieved from \n https://www.hhs.gov/<span class=\"match\">hipaa</span>/for-professionals/faq/2069/under-<span class=\"match\">hipaa</span>-when-can-a-family-member/index.html \n and \n https://www.hhs.gov/<span class=\"match\">hipaa</span>/for-"},{"title":"Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model","type":"Notice","abstract":"This notice announces a 6-year model focused on reducing fraud, waste (including low-value care), and abuse in Medicare fee-for- service (FFS) via the implementation of technology-enabled prior authorization processes for select services.","document_number":"2025-12195","html_url":"https://www.federalregister.gov/documents/2025/07/01/2025-12195/medicare-program-implementation-of-prior-authorization-for-select-services-for-the-wasteful-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-07-01/pdf/2025-12195.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-12195.pdf?1751055328","publication_date":"2025-07-01","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"assessment. \n \n Given the model participants in WISeR will be third-party entities, CMS <span class=\"match\">privacy</span> and security policies will govern data sharing under the model. \n \n Model participants will be required to comply with all applicable data <span class=\"match\">privacy</span> and security laws, including relevant provisions of the Health Insurance Portability and Accountability Act of 1996 (<span class=\"match\">HIPAA</span>) <span class=\"match\">Privacy</span>, Security, and Breach Notification Rules (45 CFR parts 160 and 164, subparts A through E) (<span class=\"match\">HIPAA</span> Rules). By performing prior authorization functions on behalf of the Medicare FFS health"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2026 Rates; Changes to the FY 2025 IPPS Rates Due to Court Decision; Requirements for Quality Programs; and Other Policy Changes; Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization","type":"Rule","abstract":"This final rule revises the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; makes changes relating to Medicare graduate medical education (GME) for teaching hospitals; updates the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); updates and makes changes to requirements for certain quality programs; and makes other policy- related changes. We are also finalizing the provisions of the interim final action with comment period regarding the changes to the FY 2025 IPPS rates due to the court decision in Bridgeport Hosp. v. Becerra. Lastly, it finalizes certain updates to the ONC Health Information Technology (IT) Certification Program.","document_number":"2025-14681","html_url":"https://www.federalregister.gov/documents/2025/08/04/2025-14681/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-ipps-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-08-04/pdf/2025-14681.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-14681.pdf?1753992911","publication_date":"2025-08-04","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"currently available treatments; \n ++ The new <span class=\"match\">medical</span> service or technology offers the ability to diagnose a <span class=\"match\">medical</span> condition in a patient population where that <span class=\"match\">medical</span> condition is currently undetectable, or offers the ability to diagnose a <span class=\"match\">medical</span> condition earlier in a patient population than allowed by currently available methods, and there must also be evidence that use of the new <span class=\"match\">medical</span> service or technology to make a diagnosis affects the management of the patient; \n ++ The use of the new <span class=\"match\">medical</span> service or technology significantly improves"},{"title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital- related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals; update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); update and make changes to requirements for certain quality programs; and make other policy-related changes.","document_number":"2025-06271","html_url":"https://www.federalregister.gov/documents/2025/04/30/2025-06271/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-04-30/pdf/2025-06271.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-06271.pdf?1744402510","publication_date":"2025-04-30","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"currently available treatments; \n ++ The new <span class=\"match\">medical</span> service or technology offers the ability to diagnose a <span class=\"match\">medical</span> condition in a patient population where that <span class=\"match\">medical</span> condition is currently undetectable, or offers the ability to diagnose a <span class=\"match\">medical</span> condition earlier in a patient population than allowed by currently available methods, and there must also be evidence that use of the new <span class=\"match\">medical</span> service or technology to make a diagnosis affects the management of the patient; \n \n ++ The use of the new <span class=\"match\">medical</span> service or technology significantly improves"},{"title":"Cyber Incident Reporting for Critical Infrastructure Act (CIRCIA) Reporting Requirements","type":"Proposed Rule","abstract":"The Cyber Incident Reporting for Critical Infrastructure Act of 2022 (CIRCIA), as amended, requires the Cybersecurity and Infrastructure Security Agency (CISA) to promulgate regulations implementing the statute's covered cyber incident and ransom payment reporting requirements for covered entities. CISA seeks comment on the proposed rule to implement CIRCIA's requirements and on several practical and policy issues related to the implementation of these new reporting requirements.","document_number":"2024-06526","html_url":"https://www.federalregister.gov/documents/2024/04/04/2024-06526/cyber-incident-reporting-for-critical-infrastructure-act-circia-reporting-requirements","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-04/pdf/2024-06526.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-06526.pdf?1711543528","publication_date":"2024-04-04","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"}],"excerpts":"\n \n \n • \n The Food and Drug Administration (FDA) <span class=\"match\">Medical</span> Device Regulations. \n Under section 519 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360i), as implemented by the <span class=\"match\">Medical</span> Device Reporting Regulations (21 CFR part 803) and the <span class=\"match\">Medical</span> Device Reports of Corrections and Removals Regulations (21 CFR part 806), manufacturers and importers must report certain device-related adverse events and product problems, including those caused by cyber incidents, to the FDA. For example, <span class=\"match\">medical</span> device manufacturers are required to report to the"},{"title":"Medicare and Medicaid Programs and the Children's Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes","type":"Rule","abstract":"This final rule revises the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; makes changes relating to Medicare graduate medical education (GME) for teaching hospitals; updates the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); and makes other policy- related changes.","document_number":"2024-17021","html_url":"https://www.federalregister.gov/documents/2024/08/28/2024-17021/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-08-28/pdf/2024-17021.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-17021.pdf?1722960072","publication_date":"2024-08-28","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"currently available treatments;\n \n \n ++ The new <span class=\"match\">medical</span> service or technology offers the ability to diagnose a <span class=\"match\">medical</span> condition in a patient population where that <span class=\"match\">medical</span> condition is currently undetectable, or offers the ability to diagnose a <span class=\"match\">medical</span> condition earlier in a patient population than allowed by currently available methods, and there must also be evidence that use of the new <span class=\"match\">medical</span> service or technology to make a diagnosis affects the management of the patient. \n ++ The use of the new <span class=\"match\">medical</span> service or technology significantly improves"},{"title":"Medicaid Program; Community Engagement Requirement for Certain Individuals","type":"Rule","abstract":"This interim final rule with comment period (IFC) interprets and implements the community engagement requirement in Medicaid under section 1902(xx) of the Social Security Act. States are required to implement the new requirement no later than January 1, 2027. This IFC specifies the requirements and expectations for States, including the Medicaid applicants and beneficiaries who must demonstrate community engagement as a condition of their eligibility, the types of qualifying activities that satisfy the community engagement requirement, the criteria to meet an exception from the requirement (that is, be deemed compliant), and the criteria to meet a specified exclusion from the requirement. It also specifies requirements for verification of qualifying activities, outreach to affected populations, steps States must take if they determine individuals are noncompliant, and additional operational considerations for States. Finally, this IFC specifies implementation timing and establishes new State reporting requirements.","document_number":"2026-11094","html_url":"https://www.federalregister.gov/documents/2026/06/03/2026-11094/medicaid-program-community-engagement-requirement-for-certain-individuals","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-03/pdf/2026-11094.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-11094.pdf?1780346707","publication_date":"2026-06-03","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":"this IFC. \n 5. An Individual Who is <span class=\"match\">Medically</span> Frail or Otherwise has Special <span class=\"match\">Medical</span> Needs \n a. Background \n The definition of a specified excluded individual at section 1902(xx)(9)(A)(ii)(V) of the Act includes an individual who is <span class=\"match\">medically</span> frail or otherwise has special <span class=\"match\">medical</span> needs (henceforth referred to as <span class=\"match\">medically</span> frail). Specifically, section 1902(xx)(9)(A)(ii)(V) of the Act provides that specified excluded individuals must include an individual, “(V) who is <span class=\"match\">medically</span> frail or otherwise has special <span class=\"match\">medical</span> needs (as defined by the Secretary)"},{"title":"Nondiscrimination in Health Programs and Activities","type":"Rule","abstract":"The Department of Health and Human Services (HHS or the Department) is issuing this final rule regarding section 1557 of the Affordable Care Act (ACA) (section 1557). Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Section 1557(c) of the ACA authorizes the Secretary of the Department to promulgate regulations to implement the nondiscrimination requirements of section 1557. The Department is also revising its interpretation regarding whether Medicare Part B constitutes Federal financial assistance for purposes of civil rights enforcement. Additionally, the Department is revising provisions prohibiting discrimination on the basis of sex in regulations issued by the Centers for Medicare & Medicaid Services (CMS) governing Medicaid and the Children's Health Insurance Program (CHIP); Programs of All-Inclusive Care for the Elderly (PACE); health insurance issuers and their officials, employees, agents, and representatives; States and the Exchanges carrying out Exchange requirements; agents, brokers, or web-brokers that assist with or facilitate enrollment of qualified individuals, qualified employers, or qualified employees; issuers providing essential health benefits (EHB); and qualified health plan issuers.","document_number":"2024-08711","html_url":"https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-06/pdf/2024-08711.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08711.pdf?1714162519","publication_date":"2024-05-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"related to the grievance.\n \n \n Many section 1557 covered entities must also comply with the <span class=\"match\">HIPAA</span> <span class=\"match\">Privacy</span> and Security Rules, which requires <span class=\"match\">HIPAA</span> covered entities to protect and secure all protected health information that a covered entity or business associate creates, receives, maintains, or transmits. If a covered entity discloses an individual's protected health information in violation of the <span class=\"match\">HIPAA</span> Rules, then the covered entity is subject to OCR's <span class=\"match\">HIPAA</span> enforcement measures.\n 77 \n \n If a section 1557 covered entity maintains grievance records"},{"title":"Medicare and Medicaid Programs and the Children's Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital- related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals; update the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs); and make other policy-related changes.","document_number":"2024-07567","html_url":"https://www.federalregister.gov/documents/2024/05/02/2024-07567/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-02/pdf/2024-07567.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-07567.pdf?1712780118","publication_date":"2024-05-02","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"treatments; \n The new <span class=\"match\">medical</span> service or technology offers a treatment option for a patient population unresponsive to, or ineligible for, currently available treatments; \n The new <span class=\"match\">medical</span> service or technology offers the ability to diagnose a <span class=\"match\">medical</span> condition in a patient population where that <span class=\"match\">medical</span> condition is currently undetectable, or offers the ability to diagnose a <span class=\"match\">medical</span> condition earlier in a patient population than allowed by currently available methods, and there must also be evidence that use of the new <span class=\"match\">medical</span> service or technology"},{"title":"Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges, Merit-Based Incentive Payment System (MIPS) Eligible Clinicians, and Eligible Hospitals and Critical Access Hospitals in the Medicare Promoting Interoperability Program","type":"Rule","abstract":"This final rule will improve the electronic exchange of health care data and streamline processes related to prior authorization through 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). This final rule will also add new measures for eligible hospitals and critical access hospitals (CAHs) to report under the Medicare Promoting Interoperability Program and for MIPS eligible clinicians to report under the Promoting Interoperability performance category of the Merit-based Incentive Payment System (MIPS). These policies, taken together, will reduce overall payer and provider burden and improve patient access to health information while continuing CMS's drive toward interoperability in the health care market.","document_number":"2024-00895","html_url":"https://www.federalregister.gov/documents/2024/02/08/2024-00895/medicare-and-medicaid-programs-patient-protection-and-affordable-care-act-advancing-interoperability","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-02-08/pdf/2024-00895.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-00895.pdf?1705612517","publication_date":"2024-02-08","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":"receive a response with no data if they do so.\n \n j. Interaction With <span class=\"match\">HIPAA</span> <span class=\"match\">Privacy</span>, Security, and Administrative Transaction Rules \n \n Under our policies, all data shared and received via the Provider Access API must be handled in a way that is consistent with all applicable laws and regulations. Payers and health care providers that are covered entities under the <span class=\"match\">HIPAA</span> Rules \n 46 \n \n are subject to the <span class=\"match\">HIPAA</span> <span class=\"match\">Privacy</span> and Security Rules.\n 47 \n \n Adherence to both the <span class=\"match\">HIPAA</span> <span class=\"match\">Privacy</span> and Security Rules helps to ensure that the covered entity disclosing"},{"title":"Older Americans Act: Grants to State and Community Programs on Aging; Grants to Indian Tribes and Native Hawaiian Grantees for Supportive, Nutrition, and Caregiver Services; Grants for Supportive and Nutritional Services to Older Hawaiian Natives; and Allotments for Vulnerable Elder Rights Protection Activities","type":"Rule","abstract":"ACL is issuing this final rule to modernize the implementing regulations of the Older Americans Act of 1965 (\"the Act\" or OAA). These changes advance the policy goals of the Act as articulated by Congress, including equity in service delivery, accountability for funds expended, and clarity of administration for ACL and its grantees. This final rule ultimately facilitates improved service delivery and enhanced benefits for OAA participants, particularly those in greatest economic need and greatest social need consistent with the statute.","document_number":"2024-01913","html_url":"https://www.federalregister.gov/documents/2024/02/14/2024-01913/older-americans-act-grants-to-state-and-community-programs-on-aging-grants-to-indian-tribes-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-02-14/pdf/2024-01913.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-01913.pdf?1707227113","publication_date":"2024-02-14","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":"Administration for Community Living","name":"Community Living Administration","id":587,"url":"https://www.federalregister.gov/agencies/community-living-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/587","parent_id":221,"slug":"community-living-administration"}],"excerpts":"One commenter noted that expressly including <span class=\"match\">HIPAA</span> in this provision may cause confusion and might imply that all OAA-funded activities are implicated under that law.\n \n \n Response: \n ACL appreciates this comment. To avoid confusion, we have removed the reference to <span class=\"match\">HIPAA</span> and have clarified that State agencies' policies and procedures must comply with all applicable Federal \n \n requirements. However, we note that it is increasingly common for OAA recipients to be engaged in activities that make them <span class=\"match\">HIPAA</span>-covered entities and we encourage grantees"},{"title":"Medicare Program; Contract Year 2027 and Certain Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program","type":"Rule","abstract":"This final rule revises the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), and Medicare cost plan regulations to implement changes related to Star Ratings, marketing and communications, drug coverage, enrollment processes, special needs plans, and other programmatic areas.","document_number":"2026-06600","html_url":"https://www.federalregister.gov/documents/2026/04/06/2026-06600/medicare-program-contract-year-2027-and-certain-contract-year-2026-policy-and-technical-changes-to","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-04-06/pdf/2026-06600.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-06600.pdf?1775160908","publication_date":"2026-04-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"beneficiary <span class=\"match\">privacy</span> protections and enforcing robust safeguards through data sharing agreements and <span class=\"match\">privacy</span> and security requirements with expanded data sharing to ensure confidentiality and compliance with applicable Federal laws. A couple of commenters called for additional <span class=\"match\">privacy</span> protections, de-identification standards, and controlled-access environments.\n \n \n Response: \n As noted in the proposed rule, CMS will maintain existing guardrails that protect beneficiary information in accordance with applicable Federal laws such as the <span class=\"match\">Privacy</span> Act of"},{"title":"Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies","type":"Rule","abstract":"This final rule will set forth routine updates to the Medicare home health payment rates; the payment rate for the disposable negative pressure wound therapy (dNPWT) devices; and the intravenous immune globulin (IVIG) items and services payment rate for CY 2025 in accordance with existing statutory and regulatory requirements. In addition, it finalizes changes to the Home Health Quality Reporting Program (HH QRP) requirements and provides an update on potential approaches for integrating health equity in the Expanded Health Value Based Purchasing (HHVBP) Model. It also finalizes a new standard for an acceptance-to-service policy in the HH conditions of participation (CoPs). Lastly, it updates provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses.","document_number":"2024-25441","html_url":"https://www.federalregister.gov/documents/2024/11/07/2024-25441/medicare-program-calendar-year-cy-2025-home-health-prospective-payment-system-hh-pps-rate-update-hh","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-07/pdf/2024-25441.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-25441.pdf?1730492128","publication_date":"2024-11-07","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"data reporting and recommended establishing policies to ensure that resident <span class=\"match\">privacy</span> is protected.\n \n \n Response: \n We appreciate the commenter's support for acute respiratory illness data reporting as well as the recommendation to ensure that residents' <span class=\"match\">privacy</span> is protected. Existing provisions at § 483.10(h), ”<span class=\"match\">Privacy</span> and Confidentiality,” require LTC facilities to ensure and respect a resident's right to personal <span class=\"match\">privacy</span> and the confidentiality of their personal and <span class=\"match\">medical</span> records. This includes but is not limited to using appropriate administrative"},{"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":"defined in 42 U.S.C. 300gg-91(b)(1) as “benefits consisting of <span class=\"match\">medical</span> care (provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as <span class=\"match\">medical</span> care) under any hospital or <span class=\"match\">medical</span> service policy or certificate, hospital or <span class=\"match\">medical</span> service plan contract, or health maintenance organization contract offered by a health insurance issuer.”\n \n \n \n \n 222 \n  Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (<span class=\"match\">Medical</span> Insurance) and covers services such as inpatient hospital"},{"title":"Nondiscrimination on the Basis of Sex in Education Programs or Activities Receiving Federal Financial Assistance","type":"Rule","abstract":"The U.S. Department of Education (Department) amends the regulations implementing Title IX of the Education Amendments of 1972 (Title IX). The purpose of these amendments is to better align the Title IX regulatory requirements with Title IX's nondiscrimination mandate. These amendments clarify the scope and application of Title IX and the obligations of recipients of Federal financial assistance from the Department, including elementary schools, secondary schools, postsecondary institutions, and other recipients (referred to below as \"recipients\" or \"schools\") to provide an educational environment free from discrimination on the basis of sex, including through responding to incidents of sex discrimination. These final regulations will enable all recipients to meet their obligations to comply with Title IX while providing them with appropriate discretion and flexibility to account for variations in school size, student populations, and administrative structures.","document_number":"2024-07915","html_url":"https://www.federalregister.gov/documents/2024/04/29/2024-07915/nondiscrimination-on-the-basis-of-sex-in-education-programs-or-activities-receiving-federal","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-29/pdf/2024-07915.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-07915.pdf?1713530716","publication_date":"2024-04-29","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":"Department continues to maintain that <span class=\"match\">medical</span>, psychological, and similar records made in connection with treatment are particularly sensitive and warrant heightened <span class=\"match\">privacy</span> protections. \n \n The Department appreciates the comments regarding <span class=\"match\">HIPAA</span>, which protects the <span class=\"match\">privacy</span> and security of certain health information; however, the Department does not enforce <span class=\"match\">HIPAA</span> and lacks authority under Title IX to require recipients to comply with <span class=\"match\">HIPAA</span> through these Title IX regulations. The Department also notes that <span class=\"match\">HIPAA</span> specifically excludes from its coverage"},{"title":"Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly","type":"Rule","abstract":"This final rule revises the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to prescription drug coverage, the Medicare Prescription Payment Plan, dual eligible special needs plans (D-SNPs), Part C and D Star Ratings, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This final rule also codifies existing sub-regulatory guidance in the Part C and Part D programs.","document_number":"2025-06008","html_url":"https://www.federalregister.gov/documents/2025/04/15/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-04-15/pdf/2025-06008.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-06008.pdf?1743797708","publication_date":"2025-04-15","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"management review of inpatient admissions to determine whether the complex <span class=\"match\">medical</span> factors documented in the <span class=\"match\">medical</span> record support <span class=\"match\">medical</span> necessity of the inpatient admission under § 412.3. MA <span class=\"match\">medical</span> necessity reviews may be conducted before the service is provided (that is, prior authorization), during (that is, concurrent case review), or after the service is provided (that is, claim review). In all of these circumstances, MA organizations must comply with the rules on <span class=\"match\">medical</span> necessity determinations at § 422.101(c). \n Finally, with respect to IRE"},{"title":"Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, Including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Formerly in Custody of Penal Authorities; Revision to Medicare Special Enrollment Period for Formerly Incarcerated Individuals; and All-Inclusive Rate Add-On Payment for High-Cost Drugs Provided by Indian Health Service and Tribal Facilities","type":"Rule","abstract":"This final rule with comment period revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2025 based on our continuing experience with these systems. We describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. Also, this final rule updates the requirements for the Hospital Outpatient Quality Reporting Program, Rural Emergency Hospital Quality Reporting Program, Ambulatory Surgical Center Quality Reporting Program, and Hospital Inpatient Quality Reporting Program. We also summarize information received in response to a Request for Information on potential modifications to the Safety of Care measure group in the Overall Hospital Quality Star Rating methodology. In this final rule, we are also finalizing our proposal to narrow the description of \"custody\" in the Medicare payment exclusion rule and to revise the special enrollment period criteria for formerly incarcerated individuals. We are also finalizing our Medicaid and Children's Health Insurance Program (CHIP) continuous eligibility provisions. We are also finalizing the proposal to reduce the review timeframe for standard prior authorization requests for certain covered outpatient department services paid under the OPPS from 10-business days to 7-calendar days. Further, this rule finalizes updates to the Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs) in an effort to advance the health and safety of pregnant, birthing, and postpartum women. This rule also finalizes our proposed policy to separately pay Indian Health Service (IHS) and Tribal hospitals for high-cost drugs furnished in hospital outpatient departments through an add-on payment in addition to the all-inclusive rate (AIR) under the authorities used to calculate the AIR starting January 1, 2025. Finally, we are finalizing exceptions to the Medicaid clinic services four walls requirement for IHS and Tribal clinics, and, at state option, for behavioral health clinics and clinics located in rural areas.","document_number":"2024-25521","html_url":"https://www.federalregister.gov/documents/2024/11/27/2024-25521/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-25521.pdf?1730492130","publication_date":"2024-11-27","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"deviating from the <span class=\"match\">statute</span> and requiring an additional FDA-approved indication for use for <span class=\"match\">medical</span> devices that was not in <span class=\"match\">statute</span>. Commenters believed that CMS should not require <span class=\"match\">medical</span> devices to have an indication that specifies that the device is used to deliver a therapy to reduce postoperative pain or produce post-surgical or regional analgesia. Commenters believed Congress had clear and distinct intentions regarding the statutory criteria for <span class=\"match\">medical</span> devices compared to drugs and biologicals and chose not to subject <span class=\"match\">medical</span> devices to the same"},{"title":"Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicaid, Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to Star Ratings, marketing and communications, agent/broker compensation, health equity, drug coverage, dual eligible special needs plans (D-SNPs), utilization management, network adequacy, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This proposed rule also includes proposals to codify existing subregulatory guidance in the Part C and Part D programs.","document_number":"2024-27939","html_url":"https://www.federalregister.gov/documents/2024/12/10/2024-27939/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-10/pdf/2024-27939.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-27939.pdf?1732656194","publication_date":"2024-12-10","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"excerpts":"potential enrollee <span class=\"match\">privacy</span> issues. However, out of an abundance of caution, CMS is considering whether to include a provision to allow suppression of certain data points should disaggregation present an issue regarding enrollee <span class=\"match\">privacy</span>. For example, if reporting by each covered item and service would result in such a small data set that it could put enrollee <span class=\"match\">privacy</span> at risk, an MA plan would be permitted to suppress that data set. CMS solicits feedback on whether cell suppression is necessary in order to ensure that enrollee <span class=\"match\">privacy</span> is protected and"}]}