MLN Connects Newsletter for August 6, 2026

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Date
2026-08-06
Title
In This Edition: Health Technology Ecosystem | Skilled Nursing Facility
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News

Compliance

Claims, Pricers & Codes

Events


 

News

Readout: CMS Celebrates Delivery of the Health Technology Ecosystem, One Year After Launch

CMS recently hosted the one-year celebration of the Health Technology Ecosystem, bringing together leaders from the government, health care, and technology sectors to feature the significant progress made over the past year in advancing interoperability, improving health data sharing, and expanding patient access to digital health tools.

Read the full press release.
 

Skilled Nursing Facility Value-Based Purchasing Program: Download Your August 2026 Performance Score Reports

Download your August 2026 Performance Score Reports for the FY 2027 Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program from iQIES. The reports include the incentive payment multiplier CMS will apply to your Part A claims. For FY 2027 claims payments, we’ll multiply the adjusted federal per diem rate by your incentive payment multiplier.

We expanded the SNF VBP Program to assess performance on 8 quality measures instead of 4. See the FY 2027 Program Year (PDF) fact sheet for more information.

Submit corrections until August 30. See the Confidential Feedback Reporting & Review and Corrections webpage for more information.

Questions?

Home Health Agencies: Download Your 2025 PEPPER

CMS released the 2025 Program for Evaluating Payment Patterns Electronic Report (PEPPER) for home health agencies. Your PEPPER helps you review your billing data to make sure claims are accurate. Use it to:

  • Spot billing patterns that may need review or improvement
  • Identify areas that may need closer monitoring or internal audits
  • Find services that may be under-coded or over-coded
  • Track trends like longer patient stays

How to Get Your PEPPER

Authorized officials (AOs), access managers (AMs), and staff end users (SEUs) can download their organization’s report from the PEPPER Portal.

How to become an SEU:

  • Sign in to the CMS Identity & Access (I&A) System using your existing NPPES or PECOS credentials.
  • Request the PEPPER business function for your organization. The Comparative Billing Report business function is also available and you can request it at the same time.
  • Your AO or AM must approve your request.

More Information:

 

Compliance

Global Surgery: Accurately Report Postoperative Visits 

In a report, the Office of Inspector General found that although practitioners aren’t required to provide Medicare patients the number of postoperative visits that CMS considered in valuing the global surgery fee, overall, fewer visits are provided than are considered in the valuation.

Practitioners must report post-operative evaluation and management visits if they practice in a group of 10 or more practitioners in 1 of these 9 states: Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island. You’re exempt from required reporting if your practice has less than 10 practitioners, but we encourage you to report if possible.

See the Global Surgery (PDF) booklet for information on how to report postoperative visits in inpatient and outpatient settings.
 

Glucose Monitoring Supplies: Prevent Claim Denials

In 2024, the improper payment rate for glucose monitors was 25.2%, with a projected improper payment amount of $278.5M.  Learn how to bill correctly for these services.  Review the Glucose Monitoring Supplies  provider compliance tip for more information, including:

  • Billing codes
  • Denial reasons and how to prevent them
  • Refill and documentation requirements
  • Resources 

 

Claims, Pricers & Codes

HCPCS Application Summaries & Coding Determinations: Drugs & Biologicals

CMS published the 2026 HCPCS Application Summary for Quarter 2, 2026 Drugs and Biologicals. Visit the HCPCS Level II Coding Decisions webpage for more information.

 

Events

PEPPER Updates for Long-Term Acute Care Hospitals, Inpatient Rehabilitation Facilities & Inpatient Psychiatric Facilities – August 25

Tuesday, August 25 from 1–2 pm ET

Register for this webinar.

Join CMS to review the FY 2025 Program for Evaluating Payment Patterns Electronic Report (PEPPER) for:

  • Long-term acute care hospitals and inpatient rehabilitation facilities released in July 2026
  • Psychiatric facilities released in August 2026

The session will provide participants with guidance on navigating the recent changes, including a review of the reports.

Prior to the webinar, send your questions to CMS_CBRPEPPER@cms.hhs.gov. Visit the Training & Resources webpage for more information.
 

CCSQ Quarterly Stakeholder Webinar – August 26

Wednesday, August 26 from 11 am – 12 pm ET

Register for this webinar.

You’re invited to join Dr. Dora Hughes, Chief Medical Officer of CMS and Director of the Center for Clinical Standards and Quality (CCSQ), and the CCSQ leadership team for an engaging update on our work to strengthen health care quality, safety, and coverage. Hear the latest on recent policy developments and how these efforts are accelerating progress toward improving care and outcomes for beneficiaries in Medicare, Medicaid, and the Marketplace.
 


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