News
- CMS Strengthens Patient Protections & Accountability in Organ Donation System
- Hospitals: Submit Data for OPPS Drug Acquisition Cost Survey by March 31
- Hospital Price Transparency: Enforcement of 2026 Requirements Starts April 1
- Clinical Diagnostic Laboratories: Get Ready to Report Starting May 1
- Optimal Health for All Within Nation’s Health & Long-Term Care Systems
- Emergency Preparedness: Find Out How to Prevent Deficiencies
Compliance
Claims, Pricers & Codes
- Quality Payment Program: Claim Adjustments to Correct Conversion Factor
- HCPCS Application Summaries & Coding Determinations: Non-Drug and Non-Biological Items & Services
Publications & Multimedia
Information for Patients
News
CMS Strengthens Patient Protections & Accountability in Organ Donation System
CMS issued new guidance to strengthen public trust and ensure patients and their families are treated with dignity and care throughout the organ donation process. The guidance clarifies and reinforces the responsibilities of Organ Procurement Organizations (OPOs) and donor hospitals, both in providing patients full medical care regardless of potential donor status and allowing families the time to make decisions regarding organ donation without coercion. This action follows reports that some OPOs have rushed aspects of the organ donation and procurement process, pressuring families to make decisions during moments of grief.
More information:
- Full press release
- OPOs & Donor Hospitals’ Responsibilities (PDF) memo
- Revisions to the OPO Interpretive Guidance – State Operations Manual Appendix Y (Advance Copy) (PDF) memo
- Health Resources & Services Administration Organ Procurement & Transplantation Network Modernization webpage
Hospitals: Submit Data for OPPS Drug Acquisition Cost Survey by March 31
The Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey (ODACS) is live. Hospitals paid under OPPS and listed on this ODACS provider table (PDF) must submit their drug acquisition cost data to CMS by March 31, 2026, at 11:59 pm ET.
To complete the survey, you must:
- Follow the steps in the Registration User Guide (PDF) to register for the online system
- Upload your drug acquisition cost data using this template (ZIP)
- Follow the steps in the Submitter User Guide (PDF) to complete the online attestation form
- Submit your data by March 31
More Information:
- Visit the ODACS webpage for official guidance on the survey
- Read FAQs (PDF)
- Contact OPPSDrugSurvey@cms.hhs.gov with questions
Hospital Price Transparency: Enforcement of 2026 Requirements Starts April 1
Enforcement of new and updated Hospital Price Transparency (HPT) requirements finalized in the CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule starts April 1, 2026. Make sure your hospital’s machine-readable file conforms to these requirements. See the updated HPT (PDF) fact sheet to learn more.
CMS has resources to help hospitals understand and comply with the new requirements:
- CY 2026 OPPS and ASC Final Rule – HPT Policy Changes fact sheet
- HPT: Reviewing the CY 2026 OPPS and ASC Payment System Final Rule (PDF) webinar slides
- HPT FAQs (PDF)
- HPT – Data Dictionary GitHub Repository
- HPT Tools GitHub
Clinical Diagnostic Laboratories: Get Ready to Report Starting May 1
Are you an independent laboratory, physician office laboratory, or hospital outreach laboratory that meets the definition of an applicable laboratory under the Clinical Laboratory Fee Schedule (CLFS)? If so, you must report data from May 1 – July 31, 2026, based on an updated data collection period of January 1 – June 30, 2025, including:
- Applicable HCPCS codes (ZIP)
- Associated private payor rates
- Volume data
For more information, visit the CLFS Reporting webpage.
Optimal Health for All Within Nation’s Health & Long-Term Care Systems
CCSQ FY 2025–2028 Strategic Roadmap
The Center for Clinical Standards and Quality (CCSQ) at CMS is committed to improving health care and outcomes, and strengthening accountability, across the nation’s health- and long-term care systems.
Over the next several years, CCSQ will focus on 5 strategic goals—Prevention, Quality and Safety, Coverage Innovation, Data and Technology, and Burden Reduction. These priorities build on CCSQ’s core mission to establish national health and safety standards; implement quality measurement, reporting and improvement; and support Medicare’s coverage determinations. Together, they represent a roadmap for health- and long-term care systems that are safer, stronger, and more transparent.
More Information:
Emergency Preparedness: Find Out How to Prevent Deficiencies
CMS and the Administration for Strategic Preparedness and Response's Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) analyzed frequently cited emergency preparedness deficiencies. Visit the updated CMS Health Care Provider Guidance webpage for more information, including top trending citations (PDF).
More Information:
- CMS:
- ASPR/TRACIE:
- Continuity of Operations / Business Continuity Planning Topic Collection
- Emergency Operations Plans / Emergency Management Program Topic Collection
- Hazard Vulnerability / Risk Assessment Topic Collection
- Training & Workforce Development Topic Collection
- Challenges & Considerations for Healthcare Facilities and Residents Affected by Planned Power Outages Sidebar
- Populations with Access & Functional Needs Topic Collection
Compliance
Skilled Nursing Facilities: Identify & Prevent Improper Part D Payments for Drugs
In a report, the Office of Inspector General found that Medicare Part D improperly paid for drugs during Part A skilled nursing facility (SNF) stays. Drugs prescribed for a Part D-enrolled patient aren’t covered by Part D if Part A or Part B can pay for them.
Learn how to avoid improper payments. See the SNF Billing Reference educational tool to find out when to bill your patients prescription drugs to Part A, instead of their Part D drug plan.
Claims, Pricers & Codes
Quality Payment Program: Claim Adjustments to Correct Conversion Factor
Starting in CY 2026, the update to the qualifying alternative payment model (APM) conversion factor is +0.75%, while the update to the nonqualifying APM conversion factor is +0.25% (Final Rule fact sheet). CMS identified inaccurate Medicare Physician Fee Schedule payments to some Quality Payment Program physicians and practitioners.
We corrected this issue. Your Medicare Administrative Contractor will adjust affected claims processed January 1 – February 26, 2026. You don’t need to take any action. Most of the affected claims should be adjusted by early May.
We recognize that the increases in Medicare payment described above may result in small increases in beneficiary cost-sharing liability. OIG addressed the issue of providers, practitioners, and suppliers waiving enrollee cost-sharing amounts attributable to retroactive increases in payment rates resulting from the operation of new Federal statutes or regulations in a 2010 policy statement (the Policy Statement). The purpose of the Policy Statement is to assure providers, practitioners, and suppliers affected by retroactive increases in payment rates resulting from the operation of new Federal statutes or regulations that they will not be subject to OIG administrative sanctions if they waive retroactive beneficiary liability (as defined in the Policy Statement), subject to the conditions noted in the Policy Statement. This Policy Statement is applicable to claims impacted by this correction.
HCPCS Application Summaries & Coding Determinations: Non-Drug and Non-Biological Items & Services
CMS published the second biannual 2025 HCPCS Level II coding, Medicare benefit category, and Medicare payment determinations for non-drug and non-biological items and services. Visit the HCPCS Level II Coding Decisions webpage for more information.
Publications & Multimedia
Medicare Payment Systems — Revised
Learn about updates for 2026. See the What’s Changed sections under each payment system for the latest information.
Information for Patients
Medicare.gov Enhanced Log In
CMS released Medicare.gov Enhanced Login options. By providing people with Medicare these options, Medicare.gov is helping users better manage their health care information by delivering more login choices. People with Medicare do not need to create an account to access general Medicare information or their individualized Medicare information. If someone chooses to create an account, Medicare is providing new and free options with enhanced security to help protect their Medicare information.
Read the full press release.
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