May 20, 2026: The Centers for Medicare & Medicaid Services (CMS) proposed a sweeping crackdown on state Medicaid payment practices that have driven payment rates well above Medicare levels, leading to excessive federal costs. The Medicaid Managed Care State Directed Payments (SDP) and Medicaid Fee-for-Service (FFS) Targeted Practitioner Payments Proposed Rule would set clear caps and better align Medicaid payments with Medicare standards. If finalized, the proposed rule would generate an estimated $775 billion in total savings over 10 years, including $510 billion in federal savings. CMS’s goal: to refocus Medicaid dollars on individuals and families instead of inefficient payment schemes.
An SDP is an arrangement in which the state directs the health plan on how to pay provider reimbursement rather than allowing the plan to negotiate provider payment. Use of SDPs has rapidly expanded, from two states in 2016 to 41 states today, and accounts for over a quarter of all Medicaid managed care spending in FY 2025. Unchecked, annual SDP spending is projected to nearly triple from $107 billion in FY 2024 to $296 billion by FY 2034. This proposed rule is being released to implement section 71116 of the Working Families Tax Cut (WFTC) legislation and to propose additional policy changes consistent with a Presidential Memorandum, “Eliminating Waste, Fraud, and Abuse in Medicaid,” issued on June 6, 2025.
CMS is proposing these and other revisions to Medicaid managed care and FFS payment arrangements to improve fiscal and program integrity over a transitional timeframe so that states and providers would have the time they need to adjust payment arrangements.
The proposed rule would:
CMS is seeking public comment on the proposed rule, including feedback on implementation. To view the proposed rule on the Federal Register, visit: www.federalregister.gov/public-inspection/
To view the fact sheet, visit: https://www.cms.gov/newsroom/fact-sheets/medicaid-managed-care-state-directed-payments-medicaid-fee-service-targeted-medicaid-practitioner
Source: CMS
In today’s rapidly shifting policy and operational landscape, communication and coordination between NACHC, Primary Care Associations (PCAs), Health Center Controlled Networks (HCCNs), National Technical Assistance Programs, and Community Health Centers (CHCs) is critical. NACHC is holding a monthly national call to facilitate immediate response to emerging federal and executive actions.
The monthly F.A.S.T. call will occur on the first Wednesday of every month at 3:00 pm ET. Register for the June 3rd session HERE.
NACHC’s Policy Pulse will occur on the second Wednesday of each month at 3:00 pm ET and is intended for CHCs, PCAs and HCCNs to stay informed about the latest policy and advocacy updates in Washington. Register for the June 10th session HERE.
Source: NACHC
HHS released the CY27 Notice of Benefit & Payment Parameters final rule governing the Federally Facilitated Marketplace and individual and small group insurance markets. Thanks to incredible stakeholder engagement during the comment period, the percentage of Essential Community Providers (including CHCs) that plans must contract with will remain at 35%, rather than dropping to the proposed 20% threshold. This is a huge win for CHCs and a direct result of your advocacy efforts! NACHC will share a summary of the rule, which goes into effect July 20, 2026.
Source: NACHC
May 13, 2026: The Centers for Medicare & Medicaid Services (CMS), through its Health Tech Ecosystem, is advancing its electronic prior authorization efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements. 29 healthcare organizations—including health systems, electronic health record developers, physician practices, networks, and digital health developers—have signed on as early adopters in this cross-sector effort.
Early adopters in this next phase of CMS’s broader effort to modernize healthcare through the Health Tech Ecosystem include:
CMS encourages organizations across the healthcare system—including providers, technology developers, and network partners—to join this initiative and help accelerate progress toward a more efficient, transparent, and patient-centered prior authorization process.
Source: CMS
HRSA issued a Dear Colleague Letter encouraging health centers to strengthen and expand nutrition-focused care as part of efforts to prevent and manage chronic disease.
The Dear Colleague Letter:
Source: HRSA
May 7, 2026: The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced an Interim Final Rule (IFR) extending, for one-year, the compliance dates that recipients of HHS funding must meet for conforming web content and mobile applications to specific accessibility standards under Section 504 of the Rehabilitation Act of 1973 (Section 504).
Under the revised timeline:
This action responds to concerns that a significant number of recipients of federal financial assistance, such as community health centers, large and small hospitals, and primary care centers, among other recipients, would not be able to meet the upcoming deadlines and extends the timeline for compliance with the standards of WCAG 2.1 AA. This extension also aligns Section 504 requirements with those in the Department of Justice’s (DOJ) parallel rulemaking for Title II of the Americans with Disabilities Act, ensuring consistency for entities covered by both laws. OCR enforces laws that prohibit disability discrimination, including Section 504.
Read the full press release HERE.
Source: HHS
May 28th, 2026
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