On July 5, the CMS Innovation Center begins the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, a 10-year pilot program designed to expand access to technology-supported care for Traditional Medicare beneficiaries with chronic conditions.

Visit ACCESS for Primary Care Providers and Referring Clinicians for more information on beneficiary eligibility, billing guidance, and tools to stay informed about patients’ progress.  Contact ACCESSModelTeam@cms.hhs.gov with questions.

In this request for information (RFI), the Centers for Medicare & Medicaid Services (CMS) seeks public input to support their comprehensive review of the Essential Health Benefits (EHB) in Affordable Care Act (ACA) Marketplace plans and the statutory requirement that the scope of EHB be equal to the scope of benefits provided under a typical employer plan.

CMS seeks comments on current interpretations of EHB, State approaches to selecting and updating EHB-benchmark plans, and methodologies used to determine the scope of benefits included as EHB. CMS also seeks comments on variation across States in the scope of benefits included as EHB, cost pressures affecting EHB, limitations in available data used to evaluate EHB, and potential impacts of possible future policy changes. The feedback will help CMS decide whether changes to current regulations should be considered through future rulemaking.

Comment by July 15, 2026.

The Centers for Medicare & Medicaid Services (CMS) issued a final rule with comment period to strengthen federal oversight of Accrediting Organizations (AOs), which are independent organizations approved by CMS to evaluate whether health care providers and suppliers meet Medicare health and safety requirements.

The rule addresses potential conflicts of interest, establishes more consistent accreditation standards and survey processes, and enhances CMS monitoring of AOs. It also finalizes policies restricting certain consulting services provided by AOs, requiring additional surveyor training, strengthening performance and validation requirements, and establishing new safeguards for providers that have been terminated from Medicare and seek to reenter the program.

The rule is effective June 16, 2027, and CMS will accept comments on the information collection and regulatory impact provisions through August 17, 2026.

Comment by August 17, 2026.

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule that would codify policies for the Medicare Drug Price Negotiation Program beginning in 2029.

Established by the Inflation Reduction Act, the Drug Price Negotiation Program allows CMS to negotiate maximum fair prices for certain high-cost, single-source prescription drugs and biological products covered by Medicare. This proposed rule would formalize policies previously implemented through guidance, increase transparency in the negotiation process, establish requirements for manufacturers, and address potential loopholes related to certain drug formulations. CMS also proposes revisions and clarifications based on lessons learned from the program’s first years of implementation.

Comment by August 17, 2026.

The Centers for Medicare & Medicaid Services (CMS) released new guidance explaining how budget neutrality will be evaluated and certified for Medicaid Section 1115 demonstrations, which allow states to test innovative approaches to delivering and paying for Medicaid services.

Per statute, beginning January 1, 2027, new, renewed, and amended Section 1115 demonstrations must be certified by the CMS Chief Actuary as not increasing federal Medicaid spending compared with what would occur without the demonstration. To help states prepare, CMS is providing this early notice of the approach it plans to propose and, until a final rule is in place, will use this guidance when reviewing and approving new, amended, and renewed Section 1115 demonstrations on or after January 1, 2027.