CMS Proposes Inadequate IPPS Update for FFY 2026
What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) released the federal fiscal year (FFY) 2026 inpatient prospective payment system (IPPS) proposed rule — which falls short of what hospitals need to keep up with rising costs and health care needs.
What else to know: As a result of all proposed changes, CMS estimates that hospital inpatient payments will increase by $4 billion in FFY 2026. Comments on the proposed rule are due June 10.
CMS Issues Post-Acute Care Payment Proposed Rules
What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) issued its proposed payment policies for inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and long-term care hospitals (LTCHs) for federal fiscal year (FFY) 2026.
What else to know: Comments on the proposed rules are due to CMS by June 10.
Expanded Hospital Supplier Diversity Reports Due July 1
What’s happening: The first round of expanded Hospital Supplier Diversity Reports required under Assembly Bill (AB) 1392 (2023) are due to the Department of Health Care Access and Information (HCAI) on July 1.
What else to know: In 2024, the Office of Administrative Law approved HCAI’s regulations to implement AB 1392. This year, the new reporting requirements are fully in effect — and HCAI has developed a new template to support and inform this updated reporting.
CMS Finalizes Medicare Advantage, Part D Rule for 2026
What’s happening: In its finalized changes to the Medicare Advantage (MA) and Part D prescription drug programs for contract year 2026, the Centers for Medicare & Medicaid Services (CMS) struck most of the Biden-era proposals and declined to finalize additional insurer accountability provisions.
What else to know: The rule, which did not address several other proposals (detailed below), is effective Jan. 1, 2026.
CDPH Issues New Guidance to Support Doula Access in Hospitals
What’s happening: The California Department of Public Health (CDPH) released All Facilities Letter (AFL) 25-13 on March 24 that offers guidance to hospitals on supporting the Medi-Cal doula benefit — available since January 1, 2023 — and outlines recommendations for patient visitation policies and procedures.
Court Rules FDA Cannot Regulate Laboratory-Developed Tests
What’s happening: In a final judgment filed March 31, the U.S. District Court for Eastern Texas ruled that the Food & Drug Administration (FDA) does not have the authority to regulate laboratory-developed tests, rendering a final rule issued May 6, 2024, null and void.
What else to know: This final rule phased out the FDA’s general enforcement discretion approach for most laboratory-developed tests to instead provide greater oversight.
Summary on Affordable Care Act Marketplace Integrity Proposed Rule Now Available
What’s happening: A summary of the Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability proposed rule for health insurance marketplaces — including issuers, agents, and brokers who assist marketplace enrollees — is available for CHA members.
What else to know: Comments on the proposed rule, which alters several policies, are due to the Centers for Medicare & Medicaid Services (CMS) by April 11.
CHA Comments on Proposed Changes to HIPAA Rule
What’s happening: On March 7, CHA submitted comments on proposed modifications to the Health Insurance Portability and Accountability Act (HIPAA) security rule.
What else to know: CHA urged the Office of Civil Rights to rescind the proposed rule and instead focus policymaking on coordinated federal efforts to prevent and deter cyberattacks in the broader health care sector.
Comments on Proposed EMSA Critical, Specialty Care Program Regulations Due April 3
What’s happening: The Emergency Medical Services Authority (EMSA) is proposing to update a chapter of the California Code of Regulations (CCR) that covers critical and specialty care programs, including as trauma, ST-elevation myocardial infarction (STEMI), stroke, and emergency medical services for children (EMSC) systems. Written comments on the proposed regulations are due April 3.
What else to know: The proposed revisions — to CCR Title 22, Division 9, Chapter 6 on Specialty Programs — were developed in collaboration with the California state technical advisory committees for trauma, STEMI, stroke, and EMSC. Each committee included CHA representatives.
Medicare Patient Reclassification Notices Now in Effect
What’s happening: Effective Feb. 14, providers are required to issue a Medicare Change of Status Notice (MCSN) to eligible patients who were admitted as hospital inpatients, but the hospital subsequently reclassified them as outpatients who are receiving observation services.
What else to know: This requirement only applies to patients with traditional Medicare as the primary payer. The form and its instructions are available to download.