Centers for Medicare and Medicaid Services

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The Centers for Medicare & Medicaid Services (CMS), a federal agency within the U.S. Department of Health and Human Services, is one of the largest purchasers of health care in the world. Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) provide health care for one in four Americans. The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor. Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Source

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Scope National
Language English
Country United States of America
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June 1-5 is Medicare Fraud Prevention Week. Here’s How Americans Can Help Protect Themselves and Medicare.

| Centers for Medicare and Medicaid Services
By Dr. Mehmet Oz, CMS Administrator, and Mary Lazare, ACL Principal Deputy Administrator, serving as the senior official performing the duties of the ACL Administrator and Assistant Secretary for Aging June 1-5 is Medicare Fraud Prevention Week. Here’s How Americans Can Help Protect Themselves and Medicare. June 1 marked the start of Medicare Fraud Prevention Week. While this week shines a spotlight on fraud prevention, protecting Medicare is a year-round mission.
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Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC)

| Centers for Medicare and Medicaid Services
Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) As required by law, on June 1, 2026, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule implementing a new statutory requirement for certain adults in Medicaid to meet an 80 hours per month work requirement (sometimes referred to as Medicaid community engagement) as a condition of eligibility.
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CMS Launches Nationwide Framework to Implement Medicaid Work Requirements

| Centers for Medicare and Medicaid Services
CMS Launches Nationwide Framework to Implement Medicaid Work Requirements The Centers for Medicare & Medicaid Services (CMS) released an Interim Final Rule with Comment (IFC) requiring that certain adult Medicaid applicants and enrollees must, as a condition of Medicaid eligibility, meet an 80 hours per month work requirement, through employment, education, work programs, or community service.
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Federal Independent Dispute Resolution Operations Final Rule

| Centers for Medicare and Medicaid Services
Federal Independent Dispute Resolution Operations Final Rule In the Federal Independent Dispute Resolution (IDR) Operations final rules released today, the Departments of Health and Human Services, Labor, and Treasury (the Departments) and the Office of Personnel Management finalized updated standards for group health plans and health insurance issuers (also known as “payers”); providers, facilities, and providers of air ambulance services (also known as “providers”); and certified IDR...
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Federal Rule Takes Aim at Health Care Bureaucracy, Reducing Dispute Fees, and Boosting Transparency

| Centers for Medicare and Medicaid Services
Federal Rule Takes Aim at Health Care Bureaucracy, Reducing Dispute Fees, and Boosting Transparency Major reforms were finalized today to strengthen the No Surprises Act by making the Federal Independent Dispute Resolution (IDR) process more efficient and transparent, while also saving money for millions of Americans. The final rule improves the process used to resolve out-of-network payment disputes between providers and payers—cutting administrative costs and improving how disputes are handled.
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Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments Proposed Rule (CMS-2449-P)

| Centers for Medicare and Medicaid Services
Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments Proposed Rule (CMS-2449-P) The Centers for Medicare & Medicaid Services (CMS) believes that Medicaid recipients in both managed care and fee-for-service (FFS) delivery systems deserve access to quality care in a system free from fraud, waste, and abuse.
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CMS Moves to Rein In Misused Medicaid Dollars and Reward Quality Care

| Centers for Medicare and Medicaid Services
Share CMS Moves to Rein In Misused Medicaid Dollars and Reward Quality Care Proposed Rule Caps Excessive State Payment Practices, Potentially Saving Taxpayers More Than $775 Billion Over 10 Years The Centers for Medicare & Medicaid Services (CMS) proposed today a sweeping crackdown on state Medicaid payment practices that have driven payment rates well above Medicare levels, leading to excessive federal costs.
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CMS Final Rule Lowers Costs, Cracks Down on Fraud, and Expands State Control

| Centers for Medicare and Medicaid Services
CMS Final Rule Lowers Costs, Cracks Down on Fraud, and Expands State Control The Centers for Medicare & Medicaid Services (CMS) issued a sweeping rule to strengthen oversight of the Affordable Care Act (ACA) Exchanges for plan year 2027 by lowering user fees, tightening eligibility verification, and giving states greater authority over plan oversight.
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HHS Notice of Benefit and Payment Parameters for 2027 Final Rule

| Centers for Medicare and Medicaid Services
HHS Notice of Benefit and Payment Parameters for 2027 Final Rule Introduction Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued the “HHS Notice of Benefit and Payment Parameters for 2027; Basic Health Program” final rule (the 2027 Payment Notice final rule) that sets standards for the Health Insurance Exchanges, as well as for health insurance issuers, and agents, brokers, and web-brokers who connect millions of...
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CMS Announces Early Adopters to Advance Solutions for Electronic Prior Authorization, Accelerating Momentum Ahead of 2027 Requirements

| Centers for Medicare and Medicaid Services
CMS Announces Early Adopters to Advance Solutions for Electronic Prior Authorization, Accelerating Momentum Ahead of 2027 Requirements The Centers for Medicare & Medicaid Services (CMS), through its Health Tech Ecosystem, is advancing its electronic prior authorization efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements.
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