{"description":"Documents matching 'minutes service which providers compensated'","count":1808,"total_pages":50,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=minutes+service+which+providers+compensated&format=json&page=2","results":[{"title":"Incarcerated People's Communication Services; Implementation of the Martha Wright-Reed Act; Rates for Interstate Inmate Calling Services","type":"Rule","abstract":"In this document, the Federal Communications Commission (Commission) modifies the Commission's previous incarcerated people's communications services (IPCS) rate caps in response to record evidence of the significant unintended consequences of those rate caps. It establishes new interim audio and video IPCS rate caps by basing the calculation of the Commission's rate caps only on billed minutes, incorporating all safety and security measure expenses that IPCS providers reported incurring, and creating an additional rate cap tier for extremely small jails. It also creates a separate interim rate additive to ensure recovery of correctional facilities' costs of administering IPCS. Additionally, it sets a new compliance date for providers' compliance with the new rules and clarifies that the rate cap, site commission, and per-minute pricing rules from the Commission's 2021 Order will no longer apply following that date.","document_number":"2025-22125","html_url":"https://www.federalregister.gov/documents/2025/12/05/2025-22125/incarcerated-peoples-communication-services-implementation-of-the-martha-wright-reed-act-rates-for","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-05/pdf/2025-22125.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-22125.pdf?1764855936","publication_date":"2025-12-05","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"why its prior conclusion to rely on solely [paid] <span class=\"match\">minutes</span> was in error.” It cites the Commission's previous conclusion in the \n 2021 ICS Order \n to use paid <span class=\"match\">minutes</span> to derive rate caps “because those are the <span class=\"match\">minutes</span> that <span class=\"match\">providers</span> rely on to recover their costs.” As NCIC noted, using unbilled <span class=\"match\">minutes</span> for <span class=\"match\">which</span> no compensation is received to calculate rate caps leads “to IPCS <span class=\"match\">providers</span>' costs being diluted by non-revenue generating IPCS calls,” <span class=\"match\">which</span> may not ensure <span class=\"match\">providers</span> are fairly <span class=\"match\">compensated</span>, as required by the Martha Wright-Reed Act.\n \n \n 14"},{"title":"Analog Telecommunications Relay Service Modernization","type":"Proposed Rule","abstract":"In this document, the Federal Communications Commission (Commission) proposes to modernize its telecommunications relay services (TRS) rules and seeks comment on phasing out the mandatory status of traditional TTY-based relay services (TTY Relay) under state TRS programs; recognizing additional forms of internet-based TRS, such as internet Protocol Speech-to-Speech (IP STS) and real-time text (RTT)-based relay as compensable forms of TRS; establishing a temporary, national certification process for analog relay providers and user registration and verification requirements; and updating or eliminating obsolete rules to all forms of TRS. Through these proposals, the Commission aims to align TRS with today's communications landscape, better serve the needs of relay users, ensure the continued availability of TRS through the transition from legacy communications network, to modern, IP-based networks, and continue to protect the integrity of the TRS program through the prevention of waste, fraud, and abuse.","document_number":"2025-24210","html_url":"https://www.federalregister.gov/documents/2026/01/02/2025-24210/analog-telecommunications-relay-service-modernization","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-01-02/pdf/2025-24210.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-24210.pdf?1767188718","publication_date":"2026-01-02","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"such standards are needed, should the communications <span class=\"match\">service</span> <span class=\"match\">provider</span> or the equipment manufacturer be subject to the new standards? Does any separate statutory authority give the Commission jurisdiction to impose on communications <span class=\"match\">service</span> <span class=\"match\">providers</span> and equipment manufacturers the minimum standards it imposes on authorized TRS <span class=\"match\">service</span> <span class=\"match\">providers</span>?\n \n 31. The transition to IP-based <span class=\"match\">services</span>, including IP CTS and technologies using ASR, requires internet access and IP-based specialized equipment <span class=\"match\">which</span> may not be universally available. To help transition"},{"title":"Internet-Based Telecommunications Relay Service Modernization","type":"Proposed Rule","abstract":"The Federal Communications Commission (Commission) proposes to modernize its telecommunications relay services (TRS) rules and seeks comment on the use of automatic speech recognition (ASR) for speech-to- text conversion and advanced text-to-speech technologies for Internet Protocol (IP) Relay Service; the need for metrics for IP Relay quality; the compatibility of IP Relay with Real-Time Text (RTT) technology; adding captioning functionality to Video Relay Service (VRS) platforms; amending VRS calling rules for calls to U.S. embassies and consulates by U.S. residents while traveling abroad; adjusting VRS call center requirements; streamlining TRS provider certification and user registration processes; updating or eliminating obsolete rules; and closing outdated dockets. With these proposals, the Commission presents targeted reforms that align internet-based TRS with twenty-first century technological advancements in relay services that can better serve the needs of persons with disabilities while securing the viability and enhancing the effectiveness and functional equivalency of internet-based TRS.","document_number":"2026-05213","html_url":"https://www.federalregister.gov/documents/2026/03/17/2026-05213/internet-based-telecommunications-relay-service-modernization","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-03-17/pdf/2026-05213.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-05213.pdf?1773665121","publication_date":"2026-03-17","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"compensation rates, <span class=\"match\">which</span> may create a risk of waste, fraud, and abuse when these <span class=\"match\">services</span> are delivered on the same platforms. For the current Fund Year, IP Relay <span class=\"match\">providers</span> are <span class=\"match\">compensated</span> at a per-minute rate of $2.1970. By contrast, CA-assisted IP CTS is <span class=\"match\">compensated</span> at $1.40 a minute (plus a potential supplement), while ASR-only IP CTS is <span class=\"match\">compensated</span> at $1.05 per minute. The substantial difference in compensation rates appears to create a financial incentive for <span class=\"match\">providers</span> offering both <span class=\"match\">services</span> to potentially misclassify <span class=\"match\">minutes</span>, or to design their"},{"title":"Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure","type":"Proposed Rule","abstract":"The Department is proposing a regulation that would require providers of pharmacy benefit management services and affiliated providers of brokerage and consulting services to disclose information about their compensation to fiduciaries of self-insured group health plans subject to the Employee Retirement Income Security Act (ERISA). These disclosures are needed so that fiduciaries can assess the reasonableness of the contracts or arrangements with these service providers, including the reasonableness of the service providers' compensation. These disclosure requirements would apply for purposes of ERISA's statutory prohibited transaction exemption for services arrangements. This proposal implements section 12 of President Trump's Executive Order 14273, Lowering Drug Prices by Once Again Putting Americans First, which instructs the Department to propose regulations to improve employer health plan transparency into the direct and indirect compensation received by pharmacy benefit managers. If finalized, this regulation would affect sponsors and other fiduciaries of self-insured group health plans and certain service providers to such plans.","document_number":"2026-01907","html_url":"https://www.federalregister.gov/documents/2026/01/30/2026-01907/improving-transparency-into-pharmacy-benefit-manager-fee-disclosure","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-01-30/pdf/2026-01907.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-01907.pdf?1769721310","publication_date":"2026-01-30","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"}],"excerpts":"would be covered <span class=\"match\">service</span> <span class=\"match\">providers</span> under the regulation and therefore would have disclosure and related audit obligations. The proposal identifies two types of covered <span class=\"match\">service</span> <span class=\"match\">providers</span>: (i) <span class=\"match\">providers</span> of pharmacy benefit management <span class=\"match\">services</span> (as defined in paragraph (d) of the proposal) and (ii) <span class=\"match\">providers</span> of advice, recommendations, or referrals regarding pharmacy benefit management <span class=\"match\">services</span> who are themselves <span class=\"match\">providers</span> of pharmacy benefit management <span class=\"match\">services</span> or their affiliates.\n 104 \n \n In each case, to be a covered <span class=\"match\">service</span> <span class=\"match\">provider</span>, the entity must"},{"title":"Wireline Competition Bureau and Office of Economics and Analytics Seek Comment on Proposed 2026 Mandatory Data Collection for Incarcerated People's Communications Services","type":"Proposed Rule","abstract":"In this document, the Wireline Competition Bureau (WCB) and the Office of Economics and Analytics (OEA) of the Federal Communications Commission (Commission) seek comment on the contours and specific requirements of the proposed 2026 Mandatory Data Collection for incarcerated people's communications services (IPCS). Consistent with the Commission's direction, in this document, we seek comment on proposals to modify the Commission's previous data collection to obtain data and information necessary for the Commission to set permanent rate caps for audio and video ICPS and, to the extent practicable, lessen the reporting burdens on ICPS providers.","document_number":"2026-12234","html_url":"https://www.federalregister.gov/documents/2026/06/17/2026-12234/wireline-competition-bureau-and-office-of-economics-and-analytics-seek-comment-on-proposed-2026","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-17/pdf/2026-12234.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-12234.pdf?1781613919","publication_date":"2026-06-17","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"Ancillary <span class=\"match\">Service</span> Charges and IPCS-Related Payment Processing <span class=\"match\">Services</span>. \n \n \n Since the Commission's rules prohibit ancillary <span class=\"match\">service</span> charges, we propose to eliminate reporting for the categories of ancillary <span class=\"match\">services</span> previously included in the 2023 Mandatory Data Collection and instead propose to require <span class=\"match\">providers</span> to report company-wide data regarding IPCS-related payment processing <span class=\"match\">services</span>, <span class=\"match\">which</span> we propose to define to mean “any <span class=\"match\">service</span>, including fraud detection, provided by a Third Party to process a Customer's financial transaction for <span class=\"match\">which</span> the"},{"title":"Incarcerated People's Communications Services; Implementation of the Martha Wright-Reed Act; Rates for Interstate Inmate Calling Services","type":"Rule","abstract":"In this document, the Wireline Competition Bureau and the Consumer and Governmental Affairs Bureau (the Bureaus) of the Federal Communications Commission (FCC or Commission) adopt an Order revising the instructions, reporting templates, and certification form for the annual reports submitted by providers of communications services to incarcerated people and waiving the filing deadline for the 2025 Annual Reports.","document_number":"2025-03142","html_url":"https://www.federalregister.gov/documents/2025/03/12/2025-03142/incarcerated-peoples-communications-services-implementation-of-the-martha-wright-reed-act-rates-for","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-03-12/pdf/2025-03142.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-03142.pdf?1741697109","publication_date":"2025-03-12","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"Bureaus instruct <span class=\"match\">providers</span> to indicate whether the rate for the interstate portion of the international rate is the same as the applicable interstate rate the <span class=\"match\">provider</span> charges. If the <span class=\"match\">provider</span> answers “yes,” the instructions explain that the IPCS <span class=\"match\">provider</span> does not need to report its highest interstate per-minute rates in Tab D for each calendar quarter. This question reduces the need for <span class=\"match\">providers</span> to enter the same information twice. If a <span class=\"match\">provider</span> answers “no” the Bureaus have included a Word template question directing <span class=\"match\">providers</span> to explain how the"},{"title":"Incarcerated People's Communication Services; Implementation of the Martha Wright-Reed Act; Rates for Interstate Inmate Calling Services","type":"Rule","abstract":"In this document, the Federal Communications Commission (Commission) adopts rules addressing all intrastate, interstate, and international audio and video incarcerated people's communication services (IPCS), including video visitation services. The reforms include adopting permanent rate caps for audio IPCS and interim rate caps for video; prohibiting IPCS providers from making site commission payments associated with IPCS and preempting state and local laws and regulations requiring such commissions; prohibiting IPCS providers from imposing any separate ancillary service charges on IPCS consumers; strengthening the Commission's requirements for access to IPCS by incarcerated people with disabilities; permitting IPCS providers to offer optional alternate pricing plans that comply with the rate caps; strengthening existing consumer disclosure and inactive account requirements; revising the existing annual reporting and certification requirements; facilitating enforcement of the new IPCS rules; and delegating authority to the Commission's Wireline Competition Bureau (WCB), Consumer and Governmental Affairs Bureau (CGB), and Office of Economics and Analytics (OEA).","document_number":"2024-19037","html_url":"https://www.federalregister.gov/documents/2024/09/20/2024-19037/incarcerated-peoples-communication-services-implementation-of-the-martha-wright-reed-act-rates-for","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-20/pdf/2024-19037.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-19037.pdf?1726663521","publication_date":"2024-09-20","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"play no role in the process of selecting IPCS <span class=\"match\">providers</span> or the <span class=\"match\">services</span> they offer and have no choice but to pay the rates and charges imposed if they wish to call their family or other loved ones. Consumers have no means of switching to another <span class=\"match\">provider</span> and no means of redress even if the IPCS <span class=\"match\">provider</span> “raises rates, imposes additional fees, adopts unreasonable terms and conditions for use of the <span class=\"match\">service</span>, or offers inferior \n \n <span class=\"match\">service</span>.” As a result, there are no competitive forces to constrain <span class=\"match\">providers</span> from imposing rates and charges that far exceed"},{"title":"Video Relay Service Improvements","type":"Rule","abstract":"In this document, the Federal Communications Commission (FCC or Commission) modifies its rules to promote improvement in the efficacy and quality of video relay service (VRS) supported by the Interstate Telecommunications Relay Services (TRS) Fund. The modifications: increase the portion of monthly VRS minutes that may be handled by communications assistants (CAs) working at home; reduce the amount of prior interpreting experience required of VRS CAs who work at home; and allow VRS providers to use contract CAs, subject to conditions, for up to 30% of their monthly call minutes. These changes increase providers' flexibility to hire communications assistants from a wider pool of qualified sign-language interpreters. The Commission also modifies its rules to improve the process for registered VRS users to place calls to the United States while traveling abroad.","document_number":"2024-05942","html_url":"https://www.federalregister.gov/documents/2024/03/21/2024-05942/video-relay-service-improvements","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-03-21/pdf/2024-05942.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-05942.pdf?1710938716","publication_date":"2024-03-21","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"from the TRS Fund. \n (i) Only an eligible VRS <span class=\"match\">provider</span>, as defined in paragraph (c)(5)(iii)(F) of this section, may hold itself out to the general public as providing VRS.\n \n (ii) VRS <span class=\"match\">service</span> must be offered under the name by <span class=\"match\">which</span> the eligible VRS <span class=\"match\">provider</span> offering such <span class=\"match\">service</span> became certified and in a manner that clearly identifies that <span class=\"match\">provider</span> of the <span class=\"match\">service</span>. Where a TRS <span class=\"match\">provider</span> also utilizes sub-brands to identify its VRS, each sub-brand must clearly identify the eligible VRS <span class=\"match\">provider</span>. <span class=\"match\">Providers</span> must route all VRS calls through a single URL"},{"title":"TRS Fund Support for internet Protocol Captioned Telephone Service Compensation","type":"Rule","abstract":"In this document, the Federal Communications Commission (Commission or FCC) adopts a revised, five-year plan for support of internet Protocol Captioned Telephone Service (IP CTS) by the Interstate Telecommunications Relay Services Fund (TRS Fund). To ensure that IP CTS providers have the appropriate incentive structure to support captioning with communications assistants (CAs) and with only automatic speech recognition (ASR), the Commission establishes separate compensation formulas for CA-assisted and ASR-only IP CTS. In addition, this compensation plan will give providers certainty regarding the applicable compensation levels, provide an incentive to improve efficiency, and allow the Commission an opportunity to timely reassess the compensation formulas in response to potential unanticipated cost changes and other significant developments.","document_number":"2024-19559","html_url":"https://www.federalregister.gov/documents/2024/09/04/2024-19559/trs-fund-support-for-internet-protocol-captioned-telephone-service-compensation","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-04/pdf/2024-19559.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-19559.pdf?1725367514","publication_date":"2024-09-04","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"ASR-only and CA-assisted <span class=\"match\">service</span> will strengthen the incentive for <span class=\"match\">providers</span> to continue providing CA-assisted captions when preferred by the consumer or needed for high-quality <span class=\"match\">service</span>. Conversely, maintaining a single rate is likely to reinforce what appears to be a substantial incentive for <span class=\"match\">providers</span> to limit the use of the CA-assisted mode, even where a consumer would prefer it. Once ASR-only <span class=\"match\">service</span> was introduced by most <span class=\"match\">providers</span>, it quickly became the most commonly used <span class=\"match\">service</span> mode—averaging 43.5% of <span class=\"match\">compensable</span> <span class=\"match\">minutes</span> in 2022, 74.6% in 2023"},{"title":"Video Relay Service Compensation Formula","type":"Rule","abstract":"In this document, to ensure that the providers of Telecommunications Relay Services (TRS) are compensated for the provision of Video Relay Service (VRS), the Federal Communications Commission (Commission) adopts a formula to compensate such providers from the Interstate TRS Fund (TRS Fund) for the provision of service for the next five-year compensation period.","document_number":"2023-22936","html_url":"https://www.federalregister.gov/documents/2023/10/19/2023-22936/video-relay-service-compensation-formula","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-10-19/pdf/2023-22936.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-22936.pdf?1697633121","publication_date":"2023-10-19","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"multi-<span class=\"match\">provider</span> competition based on quality of <span class=\"match\">service</span>. The record supports the Commission's prior findings that, by offering VRS users a choice among multiple <span class=\"match\">providers</span>, the Commission can efficiently and effectively ensure that functionally equivalent VRS is available to all eligible users. The availability of multiple <span class=\"match\">service</span> offerings encourages VRS <span class=\"match\">providers</span> to compete for customers by exceeding minimum <span class=\"match\">service</span> quality standards. In addition, a multi-<span class=\"match\">provider</span> environment encourages diverse <span class=\"match\">service</span> offerings, including specialized <span class=\"match\">services</span> and"},{"title":"Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies","type":"Rule","abstract":"This final rule sets forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this final rule finalizes permanent and temporary behavior adjustments and recalibrates the case- mix weights and update the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2026. This final rule also finalizes changes to the face-to-face encounter policy and changes to the Home Health Quality Reporting Program (HH QRP) and the expanded Health Value-Based Purchasing (HHVBP) Model requirements. In addition, it updates the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Lastly it finalizes: a technical change to the HH conditions of participation; updates to DMEPOS supplier conditions of payment; updates to provider and supplier enrollment requirements; and changes to DMEPOS accreditation requirements.","document_number":"2025-21767","html_url":"https://www.federalregister.gov/documents/2025/12/02/2025-21767/medicare-and-medicaid-programs-calendar-year-2026-home-health-prospective-payment-system-hh-pps-rate","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-02/pdf/2025-21767.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-21767.pdf?1764364516","publication_date":"2025-12-02","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":"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":"an initial LUPA in a sequence of adjacent periods are 29.91 <span class=\"match\">minutes</span> for the first visit if SN, 28.08 <span class=\"match\">minutes</span> for the first visit if PT, and 31.57 <span class=\"match\">minutes</span> for the first visit if SLP. The average <span class=\"match\">minutes</span> for all non-first visits in non-LUPA episodes are 41.54 <span class=\"match\">minutes</span> for SN, 45.11 <span class=\"match\">minutes</span> for PT, and 47.15 <span class=\"match\">minutes</span> for SLP. To determine the LUPA add-on factors for each discipline, we calculated the ratio of the average excess <span class=\"match\">minutes</span> for the first visits in LUPA claims to the average <span class=\"match\">minutes</span> for all non-first visits in non-LUPA claims. We then added"},{"title":"Video Relay Service Compensation","type":"Proposed Rule","abstract":"The Federal Communications Commission (FCC or Commission) seeks comment on amending its rules on compensation from the Telecommunications Relay Services (TRS) Fund for providers of Video Relay Service (VRS) to address a number of special situations. The Commission proposes to allow VRS providers additional compensation for responding to a consumer's justified request that a Deaf Interpreter be added to a call. The Commission believes that providing additional compensation for such calls will advance the statutory objective to make functionally equivalent TRS available. The Commission also seeks comment on whether the TRS Fund should support: other methods of communication with eligible TRS users, such as cued language, as a specialized form of VRS; the routing of VRS calls to a Communication Assistant (CA) with a particular skill set or knowledge of a specific subject matter; calls between a VRS user who is deafblind and another VRS user; and, voice carry over (VCO) calls between a TRS user who is deafblind and a hearing user.","document_number":"2024-05461","html_url":"https://www.federalregister.gov/documents/2024/03/14/2024-05461/video-relay-service-compensation","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-03-14/pdf/2024-05461.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-05461.pdf?1710333933","publication_date":"2024-03-14","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"equivalent communications while recognizing the additional costs small and other <span class=\"match\">providers</span> will encounter to provision these <span class=\"match\">services</span>. Further, allowing such compensation is an alternative to adopting and imposing a specific requirement for VRS <span class=\"match\">providers</span> to provide such <span class=\"match\">services</span> and would help ensure specialized <span class=\"match\">services</span> are voluntarily offered and minimize the cost to <span class=\"match\">providers</span> by allowing <span class=\"match\">providers</span> the opportunity to recover costs incurred in the provision of such <span class=\"match\">services</span> beyond the cost of providing traditional VRS. In the alternative, the Commission"},{"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":"typical employer plan, and that they cover at least the following 10 general categories: ambulatory patient <span class=\"match\">services</span>; emergency <span class=\"match\">services</span>; hospitalization; maternity and newborn care; mental health and substance use disorder <span class=\"match\">services</span>, including behavioral health treatment; prescription drugs; rehabilitative and habilitative <span class=\"match\">services</span> and devices; laboratory <span class=\"match\">services</span>; preventive and wellness <span class=\"match\">services</span> and chronic disease management; and pediatric <span class=\"match\">services</span>, including oral and vision care. \n Section 1302(b)(4)(A) through (D) of the Affordable Care Act establish"},{"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":" (3) <span class=\"match\">Provider</span> Directory API \n \n In the 2020 CMS Interoperability and Patient Access final rule, we finalized a requirement that impacted payers (excluding QHP issuers on the FFEs) must implement and maintain a <span class=\"match\">Provider</span> Directory API to make available specific information about their <span class=\"match\">provider</span> networks.\n 51 \n \n Impacted payers were required to implement and maintain the <span class=\"match\">Provider</span> Directory API by January 1, 2021.\n 52 \n \n To further standardize implementation, we are now proposing to require impacted payers to implement and maintain a <span class=\"match\">Provider</span> Directory"},{"title":"Facilitating Implementation of Next Generation 911 Services (NG911); Location-Based Routing for Wireless 911 Calls","type":"Rule","abstract":"In this document, the Federal Communications Commission (the FCC or Commission) adopted a Report and Order to advance the nationwide Next Generation 911 (NG911) transition rules that define the responsibilities and set deadlines for originating service providers (OSPs) to implement NG911 capabilities on their networks and deliver 911 calls to NG911 systems established by 911 authorities. In addition, the rules preserve the authority of state, territorial, regional, Tribal, and local government to adopt alternative approaches to the configuration, timing, and cost responsibility for NG911 implementation within their jurisdictions.","document_number":"2024-18603","html_url":"https://www.federalregister.gov/documents/2024/09/24/2024-18603/facilitating-implementation-of-next-generation-911-services-ng911-location-based-routing-for","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-24/pdf/2024-18603.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-18603.pdf?1727095514","publication_date":"2024-09-24","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"increased vulnerability and risk of 911 outages. \n \n To facilitate the NG911 transition, we adopt rules that will require wireline <span class=\"match\">providers</span>, Commercial Mobile Radio <span class=\"match\">Service</span> (CMRS) <span class=\"match\">providers</span>, covered text <span class=\"match\">providers</span>, <span class=\"match\">providers</span> of interconnected Voice over internet Protocol (VoIP) <span class=\"match\">services</span>, and <span class=\"match\">providers</span> of internet-based Telecommunications Relay <span class=\"match\">Service</span> (internet-based TRS) (collectively “originating <span class=\"match\">service</span> <span class=\"match\">providers</span>” or “OSPs”) \n 1 \n \n to take actions to start or continue the transition to NG911 in coordination with 911 Authorities.\n 2 \n \n The rules"},{"title":"Exemption From Operating Authority Regulations for Providers of Recreational Activities","type":"Rule","abstract":"FMCSA amends its regulations to implement the statutory exemption from its operating authority registration requirements for providers of recreational activities. The exemption applies to motor carriers operating a motor vehicle designed or used to transport between 9 and 15 passengers (including the driver), whether operated alone or with a trailer attached to the transport vehicle, if the motor vehicle is operated by a person that provides recreational activities within a 150 air-mile radius of the location at which passengers initially boarded the motor vehicle at the beginning of the trip. FMCSA also defines recreational activities to clarify the exemption, adopting, in response to a comment, a definition modified from that proposed in the notice of proposed rulemaking (NPRM).","document_number":"2024-03782","html_url":"https://www.federalregister.gov/documents/2024/02/26/2024-03782/exemption-from-operating-authority-regulations-for-providers-of-recreational-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-02-26/pdf/2024-03782.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-03782.pdf?1708695917","publication_date":"2024-02-26","agencies":[{"raw_name":"DEPARTMENT OF TRANSPORTATION","name":"Transportation Department","id":492,"url":"https://www.federalregister.gov/agencies/transportation-department","json_url":"https://www.federalregister.gov/api/v1/agencies/492","parent_id":null,"slug":"transportation-department"},{"raw_name":"Federal Motor Carrier Safety Administration","name":"Federal Motor Carrier Safety Administration","id":181,"url":"https://www.federalregister.gov/agencies/federal-motor-carrier-safety-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/181","parent_id":492,"slug":"federal-motor-carrier-safety-administration"}],"excerpts":"for <span class=\"match\">which</span> the activity offered or sold is occurring simultaneously with the transportation; or (2) for <span class=\"match\">which</span> the transportation is the primary <span class=\"match\">service</span> offered for sale.\n \n AWM \n \n Comment: \n AWM objected to the creation of an exemption from the operating authority registration rules for <span class=\"match\">providers</span> of recreational activities and questioned whether the cost of compliance for <span class=\"match\">providers</span> of recreational activities under the current regulations is burdensome. Going beyond the exemption at issue, AWM stated that the FMCSRs are unclear regarding <span class=\"match\">which</span> motor"},{"title":"Transparency in Coverage","type":"Proposed Rule","abstract":"These proposed rules set forth proposed requirements that would amend the regulations under the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code regarding price transparency reporting requirements for non-grandfathered group health plans and health insurance issuers offering non-grandfathered group and individual health insurance coverage. Specifically, these proposed rules would improve the standardization, accuracy, and accessibility of public pricing disclosures in line with the goals of the Executive Order 14221. With respect to the in-network rate and out-of-network allowed amount machine-readable files, these proposed rules would achieve these goals by adding new contextual files and additional data elements like product type, network name, and enrollment counts; changing the reporting level for aggregation of data; removing in-network rates for unlikely provider-to-service mappings; increasing the reporting period and lowering the claims threshold for out-of-network historical data; and reducing the reporting cadence. These proposed rules would also improve the findability of all of the publicly disclosed machine- readable files required under the Transparency in Coverage rules, including the prescription drug file, by requiring a text file and footer with website URLs and contact information for the files. These proposed rules would also require pricing information that is made available through an online consumer tool and paper (upon request), to also be made available by phone, and establish that the satisfaction of such requirement also satisfies the requirements of section 114 of the No Surprises Act (including for grandfathered group health plans and health insurance issuers offering grandfathered group and individual health insurance coverage that are not otherwise subject to these proposed rules).","document_number":"2025-23693","html_url":"https://www.federalregister.gov/documents/2025/12/23/2025-23693/transparency-in-coverage","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-23/pdf/2025-23693.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-23693.pdf?1766178909","publication_date":"2025-12-23","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"new paragraph (b)(1)(i)(F) to require plans and issuers to exclude any <span class=\"match\">provider</span> and their negotiated rate (<span class=\"match\">provider</span>-rate combination) for an item or <span class=\"match\">service</span>, if the <span class=\"match\">provider</span> is unlikely to be reimbursed for the item or <span class=\"match\">service</span> given that <span class=\"match\">provider's</span> area of specialty, according to the plan's or issuer's internal <span class=\"match\">provider</span> taxonomy used during the claims adjudication process. The Departments also propose to amend newly redesignated paragraph (b)(1)(i)(D)(\n 2 \n ) to account for this proposed required exclusion.\n \n \n The Departments also propose to require"},{"title":"Access to Video Conferencing","type":"Rule","abstract":"In this document, the Federal Communications Commission (FCC or Commission) takes steps to ensure the accessibility of interoperable video conferencing services (IVCS). The Commission provides additional clarity on how the Commission's accessibility performance objectives apply to interoperable video conferencing services (IVCS), modifies those performance objectives to ensure access to IVCS, and addresses how the Interstate telecommunications relay services (TRS) Fund will support the provision of Video Relay Service (VRS) and other forms of TRS in video conferences.","document_number":"2024-27479","html_url":"https://www.federalregister.gov/documents/2024/12/13/2024-27479/access-to-video-conferencing","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-12-13/pdf/2024-27479.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-27479.pdf?1734011114","publication_date":"2024-12-13","agencies":[{"raw_name":"FEDERAL COMMUNICATIONS COMMISSION","name":"Federal Communications Commission","id":161,"url":"https://www.federalregister.gov/agencies/federal-communications-commission","json_url":"https://www.federalregister.gov/api/v1/agencies/161","parent_id":null,"slug":"federal-communications-commission"}],"excerpts":"then manufacturers and <span class=\"match\">service</span> <span class=\"match\">providers</span> must make their products and <span class=\"match\">services</span> compatible with existing peripheral devices or specialized CPE commonly used by people with disabilities to achieve access, subject to the achievability criterion. The Commission is directed to adopt “performance objectives to ensure the accessibility, usability, and compatibility of advanced communications <span class=\"match\">services</span> and the equipment used for such <span class=\"match\">services</span>.” \n \n 2. The Act defines \n advanced communications <span class=\"match\">services</span> \n as: (A) interconnected VoIP <span class=\"match\">service</span>; (B) non-interconnected"},{"title":"Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots","type":"Proposed Rule","abstract":"This proposed rule would revise the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2027 based on our continuing experience with these systems. We also 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 systems. In addition, this proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting Program and the Ambulatory Surgical Center Quality Reporting Program. There are no changes to the Rural Emergency Hospital Quality Reporting Program. We propose to expand the prior authorization requirement to include additional Botulinum Toxin Injection services. We also propose to implement certain provisions of the Consolidated Appropriations Act, 2026, for off-campus outpatient departments of a provider. In addition, this proposed rule announces notices of closure of teaching hospitals and opportunities to apply for available slots. This rule also requests information regarding potential approaches to improve comparability and standardization, particularly for complex contracting methodologies, of the HPT information reported in machine- readable files and consumer-friendly displays. We propose hospital AOs with deeming authority to assess compliance with certain Emergency Medical Treatment and Labor Act (EMTALA) administrative requirements during accreditation and reaccreditation surveys. Finally, we are soliciting comments on a potential separate payment under the Inpatient Prospective Payment System (IPPS) for domestic procurement of personal protective equipment and essential medicines.","document_number":"2026-13656","html_url":"https://www.federalregister.gov/documents/2026/07/07/2026-13656/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-07-07/pdf/2026-13656.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-13656.pdf?1782996328","publication_date":"2026-07-07","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":"comprehensive <span class=\"match\">service</span> (78 FR 74865 and 79 FR 66799). Payments for adjunctive <span class=\"match\">services</span> are packaged into the payments for the primary <span class=\"match\">services</span>. This results in a single prospective payment for each of the primary, comprehensive <span class=\"match\">services</span> based on the costs of all reported <span class=\"match\">services</span> at the claim level. One example of a primary <span class=\"match\">service</span> would be a partial mastectomy, and an example of a secondary <span class=\"match\">service</span> packaged into that primary <span class=\"match\">service</span> would be a radiation therapy procedure. \n \n <span class=\"match\">Services</span> excluded from the C-APC policy under the OPPS include <span class=\"match\">services</span> that are"},{"title":"Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices Model","type":"Rule","abstract":"This final rule updates and revises the End-Stage Renal Disease (ESRD) Prospective Payment System for calendar year 2026. This rule also includes updates to the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. In addition, this rule updates the requirements for the ESRD Quality Incentive Program and terminates and modifies requirements for the ESRD Treatment Choices Model.","document_number":"2025-20681","html_url":"https://www.federalregister.gov/documents/2025/11/24/2025-20681/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-11-24/pdf/2025-20681.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-20681.pdf?1763673309","publication_date":"2025-11-24","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"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":"higher-than-typical average value, <span class=\"match\">which</span> resulted in a lower-than-typical budget neutrality factor for CY 2025. For CY 2026, many ESRD facilities <span class=\"match\">which</span> received a capped value in 2025 are now set to receive a lower value. Thus, the average wage index value for CY 2026 is lower than that of CY 2025, <span class=\"match\">which</span> results in a budget neutrality factor greater than 1, <span class=\"match\">which</span> increases the ESRD PPS base rate. It would not be appropriate to consider relative CY 2026 decreases resulting from the application of the cap in CY 2025, the transition year in <span class=\"match\">which</span> the current wage index"}]}