2026 is shaping up to be a pivotal year for health care reimbursement.
From major CMS payment rules to evolving disclosure requirements, AI scrutiny, and mounting pressure on providers across the care continuum, the 2026...more
1/22/2026
/ Centers for Medicare & Medicaid Services (CMS) ,
Disclosure Requirements ,
Enforcement Actions ,
Enrollment ,
Guidance Update ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Home Health Care ,
Hospice ,
Hospitals ,
Medical Devices ,
Medical Equipment ,
Medical Reimbursement ,
Medicare ,
PECOS ,
Physician Fee Schedule ,
Physicians ,
Price Transparency ,
Regulatory Oversight ,
Regulatory Requirements ,
Reimbursements ,
Revocation ,
Rural Health Care Providers
Key Takeaways -
CMS launches Drug Acquisition Cost Survey beginning Jan. 1, 2026. OPPS hospitals must submit NDC-level pricing data for both 340B and non-340B drugs, which CMS will use to inform CY 2027 reimbursement...more
Summary:
On October 30, 2025 despite HRSA being impacted by the government shutdown, the agency approved 8 drug manufacturers / 9 drugs for participation in HRSA’s 340B Rebate Model Pilot Program (340B Rebate Pilot)....more
Key Takeaways -
HRSA’s 340B rebate pilot shifts financial and operational burden to covered entities, requiring upfront drug purchases with delayed, uncertain rebate recovery....more
The HHS Office of Inspector General (“OIG”) released a Special Fraud Alert to inform health care professionals (“providers”) and Medicare Advantage Organizations (“MAOs”) about the OIG’s view of potentially abusive marketing...more
The Centers for Medicare & Medicaid Services (“CMS”) continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment regulations and policies through recent regulatory and...more
Recently the Centers for Medicare & Medicaid Services (“CMS”) announced in a newly released MedLearn Matter (MLN7867599, July 2023) that effective as of July 13, 2021, any “new hospice agency” located in the states of Texas,...more