This final rule from the Centers for Medicare & Medicaid Services (CMS), issued on November 5 finalized payment updates and policy changes to Medicare’s physician fee schedule.

CMS is permanently adopting the definition of direct supervision that allows the physician or supervising practitioner to provide supervision through real-time audio and visual interactive telecommunications (excluding audio-only), creating an optional add-on code for Advanced Primary Care Management (ACPM) services that would provide behavioral health integration or psychiatric Collaborative Care Model (CoCM) services, modifications to the way that CMS will pay for skin substitutes, a negative 2.5% adjustment to certain non-time-based Relative Value Units (RVUs), and a new mandatory alternative payment model, the Ambulatory Specialty Model. The rule becomes effective on January 1, 2026.

Click here for more more information: CMS Final Rule: Medicare Physician Fee Schedule Payments for Calendar Year 2026.

Recent legislation authorized an extension of many of the Medicare telehealth flexibilities including waiving geographic and originating site restrictions through January 30, 2026.

In support of the extensions, the Centers for Medicare & Medicaid Services (CMS) published a related FAQ document for calendar year 2026. To support access to care in rural communities, telehealth policies allow:

• Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can serve as Medicare distant site providers for non-behavioral/mental telehealth services through January 30, 2026,
• Non-behavioral/mental telehealth services in Medicare can be delivered using audio-only communication platforms through January 30, 2026, and
• FQHCs and RHCs can permanently serve as a Medicare distant site provider for behavioral/mental telehealth services and the in-person visit requirement for mental health services furnished via communication technology to beneficiaries in their homes is not required through January 1, 2026.

Visit Telehealth.HHS.gov for FAQs on telehealth policies for RHCs and FQHCs.

The Centers for Medicare & Medicaid Services (CMS) recently announced a new initiative aimed at lowering prescription drug spending in Medicaid and improving health outcomes by increasing access to critical medications.

Medicaid programs that choose to participate in the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model will be able to purchase drugs included in the pilot at prices aligned with those paid in select other countries.

The model will launch in January 2026 and run for five years. State Medicaid agencies interested in participating in this model will need to submit letters of intent to CMS and then later will have the opportunity to formally apply.

For more information on the GENEROUS Model, visit https://www.cms.gov/priorities/innovation/innovation-models/generous.

The Department of Veterans Affairs National Cemetery Administration (NCA) released a new Outreach Toolkit (#5) to help raise awareness about VA burial and memorial benefits for Veterans living in rural communities. It includes ready-to-use talking points, social media posts, flyers, info sheets, and digital posters that highlight available benefits and how to apply for them. Organizations and partners may use these materials to provide clear and helpful information to Veterans and their families.

Access the toolkit here: New Toolkit for Rural Veterans

KFF has published an Implementation Tracker for the 2025 Reconciliation Law focused on Medicaid Work Requirements. State and national data along with current state policies related to Medicaid Enrollments, renewal and application processing times are available for view.

Several states have submitted Section 1115 Work Requirements waivers since January 2025. Seven states are pending approval while Georgia’s “Pathways to Coverage” waiver was implement in July 2023. The waiver was approved for a temporary extension that included changes such as allowing parents or caretakers of children up to age 6 (in households at or below 100% FPL) to receive Medicaid without work requirements and eliminating the requirement of monthly reporting of work activities (in exchange for annual reporting). Georgia’s waiver is now set to expire December 2026. Georgia will likely need to comply with federal work requirements beginning January 1, 2027.

Overall, work requirements are estimated to reduce federal Medicaid spending by $326 Billion over 10 years. Capital Link analyzed the impact of potential policy changes on patient volume and health center revenues. They estimated percentage that 72% of Medicaid adults subject to reporting requirements may drop coverage because they are unable to verify either compliance with work requirements or an exemption. The total projected loss from annual revenue shortfalls from 2029 to 2032 could be almost $900 million.

Telehealth policy updates for recent legislation authorized an extension of many of the Medicare telehealth flexibilities including waiving geographic and originating site restrictions through January 30, 2026. In support of the extensions, the Centers for Medicare & Medicaid Services (CMS) published a related FAQ document for calendar year 2026. To support access to care in rural communities, telehealth policies allow:

• Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can serve as Medicare distant site providers for non-behavioral/mental telehealth services through Jan. 30, 2026.
• Non-behavioral/mental telehealth services in Medicare can be delivered using audio-only communication platforms through Jan. 30, 2026, and
• FQHCs and RHCs can permanently serve as a Medicare distant site provider for behavioral/mental telehealth services and the in-person visit requirement for mental health services furnished via communication technology to beneficiaries in their homes is not required through Jan. 1, 2026.

As part of the Pennsylvania Department of Health’s (DOH) efforts to increase surveillance for illnesses related to harmful algal bloom (HAB) throughout Pennsylvania, the Division of Environmental Health Epidemiology at DOH has developed a short survey to gauge health care provider awareness of HABs and HAB-related illness. This survey is anonymous and voluntary.

All medical professionals are eligible to complete the survey, which will be open until April 2026. Please reach out to the Division of Environmental Health Epidemiology at dehe@pa.gov with any questions.

The Pennsylvania Trauma Systems Foundation (PTSF) announced the revised list of trauma centers. A trauma center is a hospital capable of providing continuous specialized services and resources to patients suffering from traumatic injuries. Appropriate treatment by specially trained staff has been shown to reduce the likelihood of death and permanent disability. In Pennsylvania, there are four levels of trauma centers. Learn more at: What is a Trauma Center?

Adult Level IV Trauma Center Accreditation has been granted to five additional hospitals in Pennsylvania effective January 1, 2026.

1. Geisinger Medical Center Muncy – Muncy, PA
2. Indiana Regional Medical Center – Indiana, PA
3. Mount Nittany Medical Center – State College, PA
4. St. Luke’s Hospital – Easton Campus – Easton, PA
5. Wellspan Gettysburg Hospital – Gettysburg, PA

Effective January 1, 2026, there will be 57 accredited trauma centers in Pennsylvania.
Combined Adult Level I/Pediatric Level I Trauma Centers

1. Hershey — PennState Health Milton S. Hershey Medical Center/PennState Health Children’s Hospital

Combined Adult Level I/Pediatric Level II Trauma Centers

1. Allentown — Lehigh Valley Health Network — Lehigh Valley Hospital-Cedar Crest/Lehigh Valley Reilly Children’s Hospital
2. Danville — Geisinger Medical Center/Geisinger Janet Weis Children’s Hospital
   Adult Level I Trauma Centers
3. Bethlehem — St. Luke’s University Health Network — St. Luke’s University Hospital
4. Johnstown — Conemaugh Health System — Conemaugh Memorial Medical Center
5. Lancaster — Penn Medicine — Penn Medicine Lancaster General Health
6. Philadelphia — Jefferson Health — Jefferson Einstein Hospital
7. Philadelphia — Jefferson Health — Thomas Jefferson University Hospital
8. Philadelphia — Penn Medicine — Penn Presbyterian Medical Center
9. Philadelphia — Temple Health — Temple University Hospital
10. Pittsburgh — Allegheny Health Network — AHN Allegheny General Hospital
11. Pittsburgh — University of Pittsburgh Medical Center — UPMC Mercy
12. Pittsburgh — University of Pittsburgh Medical Center — UPMC Presbyterian
13. Sayre — Guthrie Robert Packer Hospital
14. West Reading — Tower Health — Reading Hospital
15. Wilkes-Barre — Geisinger Wyoming Valley Medical Center
16. York — WellSpan Health – WellSpan York Hospital

Pediatric Level I Trauma Centers

1. Philadelphia — Children’s Hospital of Philadelphia
2. Philadelphia — Tower Health — St. Christopher’s Hospital for Children
3. Pittsburgh — University of Pittsburgh Medical Center — UPMC Children’s Hospital of Pittsburgh

Adult Level II Trauma Centers

1. Abington — Jefferson Health — Jefferson Abington Hospital
2. Bethlehem — Lehigh Valley Health Network — Lehigh Valley Hospital-Muhlenberg
3. Camp Hill — PennState Health Holy Spirit Medical Center
4. DuBois — Penn Highlands DuBois — Penn Highlands Healthcare
5. Easton — St. Luke’s University Health Network — St. Luke’s Hospital Anderson Campus
6. Erie — University of Pittsburgh Medical Center — UPMC Hamot
7. Langhorne — Trinity Health Mid-Atlantic — St. Mary Medical Center
8. Monroeville — Allegheny Health Network — AHN Forbes
9. Paoli — Main Line Health — Paoli Hospital
10. Philadelphia — Jefferson Health — Jefferson Torresdale Hospital
11. Scranton — Geisinger Community Medical Center
12. Sellersville — Grand View Health — Grand View Campus
13. Williamsport — University of Pittsburgh Medical Center — UPMC Williamsport
14. Wynnewood — Main Line Health — Lankenau Medical Center

Level III Trauma Centers

1. Altoona — University of Pittsburgh Medical Center — UPMC Altoona
2. East Stroudsburg — Lehigh Valley Health Network — Lehigh Valley Hospital-Pocono
   Level IV Trauma Centers
3. Coaldale — St. Luke’s University Health Network — St. Luke’s Hospital – Miners Campus
4. Easton — Lehigh Valley Health Network — Lehigh Valley Hospital-Hecktown Oaks
5. Easton – St. Luke’s University Health Network – St. Luke’s Hospital – Easton Campus
6. Gettysburg – Wellspan Gettysburg Hospital
7. Grove City — Allegheny Health Network — AHN Grove City
8. 42. Hastings — Conemaugh Health System — Conemaugh Miners Medical Center
9. Hazleton — Lehigh Valley Health Network — Lehigh Valley Hospital-Hazleton
10. Honesdale — Wayne Memorial Hospital
11. Indiana – Indiana Regional Medical Center
12. Jersey Shore — Geisinger Jersey Shore Hospital
13. Lehighton — St. Luke’s University Health Network — St. Luke’s Hospital -Carbon Campus
14. Lewistown — Geisinger Lewistown Hospital
15. McConnellsburg — Fulton County Medical Center
16. Muncy – Geisinger Medical Center Muncy
17. Orwigsburg — St. Luke’s University Health Network — Geisinger St. Luke’s Hospital
18. Pottsville — Lehigh Valley Health Network — Lehigh Valley Hospital-Schuylkill
19. Quakertown — St. Luke’s University Health Network — St. Luke’s Hospital-Upper Bucks Campus
20. Roaring Spring —Conemaugh Health System — Conemaugh Nason Medical Center
21. State College – Mount Nittany Medical Center
22. Stroudsburg — St. Luke’s University Health Network — St. Luke’s Hospital-Monroe Campus
23. Troy — Guthrie Troy Community Hospital

The Pennsylvania Trauma Systems Foundation (PTSF) is a nonprofit corporation recognized under the Emergency Medical Services Act (Act 1985.45) and serves as the accrediting body for trauma centers throughout Pennsylvania.

Contact: Amy Kempinski, PTSF President. Akempinski@ptsf.org or 717-857-7383

The Centers for Medicare & Medicaid Services (CMS) through the Centers for Medicare and Medicaid Innovation (CMMI) announced a new payment model titled Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE).

The model aims to supports chronic disease initiatives for fee-for-service Medicare beneficiaries. A total of $100 million dollars will fund up to 30 proposals for three years. The proposals will include evidence-based whole-person care approaches currently not covered by original Medicare.

CMMI will release a Notice of Funding Opportunity (NOFO) in early 2026 for the first cohort, and the voluntary model will launch on September 1, 2026.