CMS

2025 Medicare Transmittals and Implementation Dates

The Centers for Medicare & Medicaid Services (CMS) has released its 2025 transmittals, detailing updates and implementation dates for various Medicare programs. These documents outline changes to payment systems, data reporting, and operational procedures for healthcare providers.

Medicare Transmittals: Policy Changes and Coverage Updates

The Centers for Medicare & Medicaid Services (CMS) has issued several transmittals in late 2024 detailing policy changes and coverage updates for Medicare. These updates affect various aspects of Medicare benefits, billing, and claims processing, with implementation dates extending into 2025.

Medicare Policy Updates and Coding Changes

The Centers for Medicare & Medicaid Services (CMS) has issued several transmittals detailing policy updates and coding changes for Medicare in 2026. These updates cover various areas including the Review Choice Demonstration, SSI/Medicare beneficiary data, preventive services, error rate testing, and specific payment systems. The implementation dates for these changes range from April to May 2026.

Medicare and Medicaid CY 2026 Payment Policies Correction

The Centers for Medicare & Medicaid Services (CMS) issued a correction to the Calendar Year 2026 payment policies under the Physician Fee Schedule and other changes to Part B payment and coverage policies. This correction addresses specific aspects of the previously published rule concerning Medicare and Medicaid programs.

Medicare.gov Enhanced Login Options

The Centers for Medicare & Medicaid Services (CMS) has introduced new login options for Medicare.gov, including ID.me, CLEAR, and Login.gov, to enhance user security and protect beneficiary information from fraud and identity theft. These services are free and offer various verification and support methods.

CMS Extends GENEROUS Model Application Deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the application deadline for the GENEROUS Model, a drug pricing initiative for Medicaid, from March 31, 2026, to April 30, 2026. This extension provides additional time for prescription drug manufacturers to apply to participate in the model, which aims to lower drug spending and improve health outcomes.

HHS Proposed Rule for Health Insurance Exchanges 2027 Payment Parameters

HHS, through CMS, has issued a proposed rule outlining benefit and payment parameters for Health Insurance Exchanges for the 2027 plan year. The proposal includes changes to risk adjustment programs, user fees, marketing practices, and plan options, with a public comment deadline of March 13, 2026.

Crackdown on Health Care Fraud

The Trump Administration announced a major crackdown on health care fraud, including deferring $259.5 million in federal Medicaid funding to Minnesota and imposing a nationwide moratorium on Medicare enrollment for certain DMEPOS suppliers. The initiative aims to prevent fraud before it occurs and protect taxpayer dollars.

Medicare and Medicaid Programs; Organ Procurement Organizations Conditions for Coverage Revisions

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule to revise the Conditions for Coverage for Organ Procurement Organizations. This proposal aims to update requirements for OPOs participating in Medicare and Medicaid. Public comments are due by March 31, 2026.

HHS Notice of Benefit and Payment Parameters for 2027 Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule detailing benefit and payment parameters for 2027 under the Patient Protection and Affordable Care Act. The rule also addresses the Basic Health Program. Public comments are due by March 13, 2026.