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CMS has released additional tools to help health plans, vendors, and providers demonstrate compliance with Administrative Simplification Transaction Testing standards.

CMS has posted the January 2015 update to the Medicare average sales price (ASP) drug pricing files, which contain the payment amounts that CMS will use to pay for Part B covered drugs for the first quarter of 2015.

Preliminary 2020 Medicare clinical laboratory fee schedule (CLFS) payment determinations for new and reconsidered clinical lab test codes are now available for review.

CMS has posted revised Medicare gapfill prices, including the 2014 National Limit Amount (NLA), for new molecular pathology codes under the Medicare Clinical Laboratory Fee Schedule (CLFS).

CMS has posted corrections to the 2016 Medicare physician fee schedule payment files. Among other things, CMS has revised the conversion factor, reducing it slightly from $35.8279 to $35.8043.

CMS recently sent several major proposed rules to the White House Office of Management and Budget for regulatory clearance – the last step before publication in the Federal Register.

The CMS recently published a proposed rule that sets forth financial integrity and oversight standards for participants in ACA Affordable Insurance Exchanges/Marketplaces.

CMS has issued a proposed rule to make changes to the PERM and MEQC programs to align with changes to state adjudication of Medicaid and Children's Health Insurance Program eligibility under the Affordable Care Act.

At the same time Republican Congressional leaders are attempting to develop legislation to repeal and replace the ACA, CMS has published a proposed rule that is intended to help stabilize...

On April 16, 2015, CMS published a proposed rule that would revise the definition of Medicaid mechanized claims processing and information retrieval systems to include Medicaid eligibility and enrollment systems.

CMS proposed a rule to update prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities for FY 2015.

The proposed rule was published on April 10, 2015, and comments are due by June 9, 2015.

CMS is proposing numerous changes to the regulations governing the PACE program, which is a Medicare/Medicaid managed care service delivery model designed to enable nursing home-eligible elderly individuals to remain in the community.

CMS has proposed removing 10 longstanding Medicare national coverage determinations under an expedited process outlined in an August 7, 2013 Federal Register notice.

On September 23, 2013, CMS published a proposed rule that would establish the methodology and payment rates for the new Medicare Federally Qualified Health Center (FQHC) PPS, as mandated by the ACA.

CMS published a proposed rule to ensure that same-sex spouses in legally-valid marriages are recognized and afforded equal rights in Medicare and Medicaid participating facilities.

On December 2, 2014, CMS published a correction to its November 6, 2014 final 2015 Medicare home health prospective payment system (PPS) rule to correct a technical error related to the applicability date for a therapy reassessment provision.