The complete edition, organized by topic. Every published finding remains available.
13 articles: 13 new or updated, 0 continuing, 0 closed.
All articles are listed below, including continuing and closed findings. The approved report also includes horizons, trends and implementation material.
13 articles shown, grouped by category.
Active high- and medium-priority findings, organized by topic.
Long-term-care providers face separate attending and referring NPI requirements from February 1, 2027. Initial, discharge and transfer claims need both; ongoing claims still need the attending NPI. Submitted identifiers must be valid individual NPIs for the billed service date.
Medium priority · Oct 18, 2026 editionRead story →
DHCS’s October 15 draft proposes ending mandatory PSC-35 administration and corresponding FAST submissions, while preserving assessment-tool choices. Feedback is requested by November 3. The file retains draft markings, notice-number inconsistencies and an unspecified effective date, so current workflows should not be stopped on this evidence.
Medium priority · Oct 18, 2026 editionRead story →
CMS reported identifying 189,000 subsidized Federal Marketplace enrollees with duplicate public coverage or deceased records in 2026. HHS describes 30-day dispute processes and approximately $1.5 billion in potential savings over the next year. The figure is a projection, not recovered funds or an adjudicated fraud total.
Medium priority · Oct 18, 2026 editionRead story →
CMS’s October 16 public-inspection proposal implements CAA 2026 provisions on low-income Part D cost sharing, MA directories and PBM contracts. It preserves distinct 2028/2029 phases and proposes detailed remuneration, reporting and enrollee protections. The posted text requests comments by December 15, 5 p.m. EST.
Medium priority · Oct 18, 2026 editionRead story →
DME and clinical-laboratory claims require a valid individual ordering NPI from February 1, 2027. The ordering provider must be actively enrolled in Medi-Cal by May 1. The announcement preserves specified DME replacement-code exceptions and requires a separate referring NPI when otherwise applicable.
Medium priority · Oct 18, 2026 editionRead story →
DHCS’s October 15 notice addresses claims affected by the October 1 DRG Mapper update. It identifies three denial codes for resubmission, calls for present-on-admission indicators and describes a separate erroneous-payment correction for eligible claims reimbursed incorrectly during system implementation.
Medium priority · Oct 18, 2026 editionRead story →
CMS restored three nursing-home complaint-procedure sections deleted in error, covering investigation preparation, past noncompliance and reporting sustained individual findings.
Medium priority · Oct 18, 2026 editionRead story →
The October 15 Treasury proposal addresses premium tax credit verification, eligibility and reconciliation across different effective periods. Its Medicaid community-engagement provision has a narrow sole-basis condition and timing exceptions. Comments are due November 30; the December 8 hearing depends on submitted outlines.
Medium priority · Oct 18, 2026 editionRead story →
An October 13 determination recognizes public health emergencies dating from October 6 in Florida and October 7 in Alabama. HHS’s October 14 announcement describes authority for temporary healthcare flexibilities. The declaration alone does not establish the terms of every waiver.
Medium priority · Oct 18, 2026 editionRead story →
DHCS announced an updated English DHCS 7077 notice for people residing in or expecting to enter long-term care. The October 16 announcement describes reinstated non-MAGI asset limits and preserves spousal-protection exceptions; translated versions were still being prepared.
Medium priority · Oct 18, 2026 editionRead story →
The October 13 CANS alignment file describes a January 2027 Phase II start, age-specific IP-CANS use, administrator training transitions and reporting through 2029. Its notice numbers and appendix dates conflict. Confirm the authoritative issued version before using the stated timetable for implementation.
Medium priority · Oct 18, 2026 editionRead story →
Lower-priority and watch items, plus closed matters kept for the edition record.
Lower priority · Oct 18, 2026 editionRead story →
Watch · Oct 18, 2026 editionRead story →
No articles in this topic. Choose All topics to return to the complete edition.