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Policy Snapshot

April 13, 2026

LEAD ACO Model Applications Available

The LEAD (Long-term Enhanced ACO Design) Model Request for Applications is now available. Accountable care organizations (ACOs) interested in participating have until May 17, 2026, to apply. LEAD builds upon the Innovation Center’s earlier accountable care work and utilizes an innovative benchmarking appro...
Policy Snapshot

April 13, 2026

CMS Proposes New Standards for Electronic Prior Authorization of Drugs

The Centers for Medicare & Medicaid Services (CMS) has released the 2026 CMS Interoperability Standards and Prior Authorization for Drugs proposed rule (CMS 0062 P), advancing its ongoing effort to streamline and modernize electronic prior authorization. The proposal is intended to provide patients and...
Policy Snapshot

April 6, 2026

CMS Invites ACOs to Apply to the New LEAD Model

CMS released the Request for Applications (RFA) for the Long-term Enhanced ACO Design (LEAD) Model, which aims to expand the benefits of Accountable Care Organizations (ACOs) to more Medicare beneficiaries. The model supports a broad range of participants and providers by offering enhanced support to small...
Policy Snapshot

April 6, 2026

CMS Updates State Operations Manual for Nursing Homes

The Centers for Medicare & Medicaid Services (CMS) has finalized revisions to the State Operations Manual (SOM) governing nursing home surveys and complaint investigations. The guidance was initially released through QSO 26 03 NH on January 30, 2026, with revisions to Chapters 5 and 7, and was subseque...
Policy Snapshot

April 6, 2026

CMS Releases Proposed FY 2027 SNF PPS Rule

The Centers for Medicare & Medicaid Services (CMS) has released the Fiscal Year (FY) 2027 Skilled Nursing Facility Prospective Payment System (SNF PPS) Proposed Rule, outlining several proposed updates to Medicare payment rates, quality programs, and data reporting requirements for skilled nursing faci...
Policy Snapshot

March 31, 2026

Make Your Voice Heard: Fix Practice Expense Cuts in Skilled Nursing Facilities

Contact the Centers for Medicare & Medicaid Services regarding recent reductions to Practice Expense (PE) RVUs for services in Skilled Nursing Facilities (POS 31). These cuts create an artificial payment difference that does not reflect clinical reality. There is no meaningful difference in the cost of...
Policy Snapshot

March 20, 2026

2026 MIPS Annual Call for Quality and Cost Measures is Open

The Centers for Medicare & Medicaid Services (CMS) encourages you to submit quality and cost measures for consideration for future years of the Merit-based Incentive Payment System (MIPS). The MIPS Annual Call for Quality and Cost Measures process allows clinicians, professional associations, and medic...