Medicare and Medicaid Programs; CY 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program (CMS-1832-P)
Summary
This proposed rule updates how Medicare pays doctors and other healthcare providers for services in 2026, and also modifies drug pricing programs. The changes affect Medicare patients, healthcare providers, and prescription drug costs for seniors.
Key Points
- 1Updates payment rates that Medicare reimburses doctors and healthcare providers for patient care in 2026
- 2Modifies rules for the Shared Savings Program, which rewards healthcare providers who reduce costs while maintaining quality care
- 3Adjusts the prescription drug inflation rebate program that requires drug manufacturers to pay Medicare when drug prices rise faster than inflation
- 4Changes affect Medicare beneficiaries (seniors and some disabled people), healthcare providers, and pharmaceutical companies
- 5Public comment period closes July 18, 2025, before the rule becomes final
Impact Assessment
If you are a healthcare provider, this means your Medicare reimbursement rates for 2026 will change, requiring billing system updates and potential adjustments to your practice operations.
National
Significant
Key Dates
July 14, 2025
Regulatory Connections
Medicare and Medicaid Programs: Calendar Year 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
Medicare and Medicaid Programs: Calendar Year 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
Medicare and Medicaid Programs: Calendar Year 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
Medicare and Medicaid Programs: Calendar Year 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
This summary is for informational purposes only. It may not capture all nuances of the regulation. Always refer to the official text for authoritative information.
The Digest Network
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