Strengthening CMS Oversight of Accrediting Organizations | CMS
Accrediting Organizations (AOs) play an important role in determining whether healthcare providers and suppliers participating in Medicare or Medicaid programs meet health and safety requirements. Each year, CMS-approved AOs survey more than 9,000 healthcare providers for compliance with health and safety requirements. By achieving accreditation through a CMS-approved AO program, these facilities are "deemed" to meet all applicable federal participation requirements. READ MORE
Fact Sheet: Medicare Drug Price Negotiation Program June 2023
On June 16, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would codify policies established in guidance documents for the Medicare Drug Price Negotiation Program for initial price applicability year 2029 and beyond (“Negotiation Program”) (CMS-4215-P). For initial price applicability years 2026 through 2028 of the Negotiation Program, the law directed CMS to implement the Negotiation Program through program instruction and other forms of program guidance. With this program instruction authority expiring, CMS is now proposing to codify the Negotiation Program for 2029 and beyond. In addition to codifying these policies, we are proposing new policies to continue implementation of statutory provisions under the Negotiation Program as well as proposing revisions or clarifications to certain policies previously established to incorporate lessons learned from ongoing experience. READ MORE
Budget Neutrality and Certification by the Chief Actuary of CMS for Section 1115 Medicaid Demonstration Projects
With nearly one-third of all federal Medicaid dollars flowing through demonstration projects, the Centers for Medicare & Medicaid Services (CMS) is issuing new guidance about its plans to strengthen budget neutrality standards for Medicaid section 1115 demonstrations. While states use demonstrations to test innovative ways to deliver care and improve health outcomes, the bounds of what is considered “budget neutral” have expanded over time to reflect evolving policy priorities and increased section 1115 demonstration spending. This new guidance previews CMS’ plans to propose a rule that would ensure consistent oversight and clear budget neutrality requirements for proposed demonstration projects, which will help states cost-effectively enhance programs and ensure fiscal integrity, while lowering costs and improving outcomes. READ MORE
FY 2027 ICD-10-PCS Procedure Code Files
The FY 2027 ICD-10-PCS Procedure Code Files and Guidelines have been posted to the CMS website. These FY 2027 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2026 through March 31, 2027.
FY 2027 ICD-10-CM Diagnosis Code Files
The FY 2027 Code Tables, Tabular and Index files, which contain information on the ICD-10-CM updates for FY 2027 have been posted to the CMS website. These FY 2027 ICD-10-CM codes are to be used for discharges occurring from October 1, 2026 through September 30, 2027 and for patient encounters occurring from October 1, 2026 through September 30, 2027.
The FY 2027 Conversion Table and FY 2027 Present on Admission (POA) Exempt Code List are also available. The FY 2027 ICD-10-CM Coding Guidelines will be posted when available.
All diagnosis code files will also be made available on the CDC/NCHS website at: https://www.cdc.gov/nchs/icd/icd-10-cm/files.html.
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