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CMS Fiscal Year 2027 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule CMS-1849-F August 10, 2026 Overview On July 31, 2026, CMS released the Fiscal Year 2027 Hospital Inpatient...
CMS Contract Year 2027 Medicare Advantage Final Rule Updates (CMS-4208-F3/CMS-4212-F) Overview On April 2, 2026, CMS released the Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare...
CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC) December 2025 Overview On November 21, 2025, CMS issued sweeping reforms in the CY 2026 Hospital Outpatient Prospective Payment System (OPPS)...
WISeR (Wasteful and Inappropriate Service Reduction) Model November 2025 Overview CMS has the responsibility to protect the Medicare Trust Funds, and routinely analyzes data associated with all facets of the Medicare program. A 2020 analysis of claims submitted by...
CMS Fiscal Year 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule CMS-1833-F Overview On July 31, 2025 CMS released the Fiscal Year 2026 Hospital Inpatient Prospective Payment System...
CMS Transitions Short Stay Inpatient Reviews From the QIO to the TPE MACs September 1, 2025 Overview On May 22, 2025, CMS announced that the short stay inpatient hospital medical reviews will be transitioning from The Beneficiary and Family Centered Care (BFCC)...
CMS Has Issued the 2024 Medicare Advantage and Part D Final Rule
Providing Explicit Guidance to the Industry
On November 1, 2022, CMS released the CY 2023 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System (ASC) Final Rule with Comment Period (CMS–1772–FC), with the official Federal Register publication scheduled to occur on November 23, 2022. The comment period for the Final Rule will remain open until January 1, 2023.
On August 1, 2022, CMS released the FY 2023 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospitals (LTCH PPS) Final Rule (CMS–1771–F), which was finalized and became effective on November 1, 2022.
Versalus Health Comments on the April 2022, Office of Inspector General Report on “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care” Summary: The Center for Medicare and...
CMS Fiscal Year 2027 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule CMS-1849-F August 10, 2026 Overview On July 31, 2026, CMS released the Fiscal Year 2027 Hospital Inpatient...
CMS Contract Year 2027 Medicare Advantage Final Rule Updates (CMS-4208-F3/CMS-4212-F) Overview On April 2, 2026, CMS released the Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare...
CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC) December 2025 Overview On November 21, 2025, CMS issued sweeping reforms in the CY 2026 Hospital Outpatient Prospective Payment System (OPPS)...
WISeR (Wasteful and Inappropriate Service Reduction) Model November 2025 Overview CMS has the responsibility to protect the Medicare Trust Funds, and routinely analyzes data associated with all facets of the Medicare program. A 2020 analysis of claims submitted by...
CMS Fiscal Year 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule CMS-1833-F Overview On July 31, 2025 CMS released the Fiscal Year 2026 Hospital Inpatient Prospective Payment System...
CMS Transitions Short Stay Inpatient Reviews From the QIO to the TPE MACs September 1, 2025 Overview On May 22, 2025, CMS announced that the short stay inpatient hospital medical reviews will be transitioning from The Beneficiary and Family Centered Care (BFCC)...
CMS Has Issued the 2024 Medicare Advantage and Part D Final Rule
Providing Explicit Guidance to the Industry
On November 1, 2022, CMS released the CY 2023 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System (ASC) Final Rule with Comment Period (CMS–1772–FC), with the official Federal Register publication scheduled to occur on November 23, 2022. The comment period for the Final Rule will remain open until January 1, 2023.
On August 1, 2022, CMS released the FY 2023 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospitals (LTCH PPS) Final Rule (CMS–1771–F), which was finalized and became effective on November 1, 2022.
Versalus Health Comments on the April 2022, Office of Inspector General Report on “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care” Summary: The Center for Medicare and...
CMS Fiscal Year 2027 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule CMS-1849-F August 10, 2026 Overview On July 31, 2026, CMS released the Fiscal Year 2027 Hospital Inpatient...
CMS Contract Year 2027 Medicare Advantage Final Rule Updates (CMS-4208-F3/CMS-4212-F) Overview On April 2, 2026, CMS released the Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare...
CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC) December 2025 Overview On November 21, 2025, CMS issued sweeping reforms in the CY 2026 Hospital Outpatient Prospective Payment System (OPPS)...
