August 2026 Newsletter

We’ve assembled the latest news for healthcare revenue cycle leaders to help you stay on top of industry challenges and adapt your revenue cycle management services. We encourage you to fully review all original government sources for details, updates, and accuracy.

CMS Requesting Update from Alternative Payment Model Participants

The agency has released a notice pertaining to clinicians who are Qualifying Alternative Payment Model Participants and are considered eligible to receive APM incentive payments. The advisory provides guidance on how to update information to receive 2026 payment under physician billing services [1].

Hospital IPPS for FY 2027 Released

CMS has issued a final rule updating payment policies for inpatient rates. The increase rate is 2.3%, reflecting a projected FY 2027 hospital market basket percentage increase of 3.2%. This was reduced by a 0.9% point productivity adjustment [2]. 

What this means for your team: Medical billing accounts receivable leaders should review these changes for impact to billing processes.  

Changes to LTCH PPS Payment Rates

Additionally for FY 2027, CMS finalized changes to LTCH standard payment rates for medical billing. It has been finalized at 2.3% to the LTCH standard payment rates. This also reflects a projected LTCH PPS market basket percentage increase of 3.2%, a reduction of 0.9 percentage point productivity. The agency expects LTCH PPS payments to increase by 2.2%, an equivalent of $54M [3].

CMS Rescinds Residents Rights Requirement

CMS has announced that it has rescinded compliance with Residents’ Rights Requirement related to a nursing home residents’ right to vote. Initially issued in September 26, 2024, it was rescinded July 20, 2026. The memo applies to fiscal year 2026 [4].

OIG Semiannual Report to Congress

The Office of Inspector General has published the most recent edition of its semiannual report to Congress. The report summarizes oversight activities between October 1, 2025 and March 31, 2026 [5]. 

What this means for your team: Revenue cycle and hospital billing leaders will find value in recent activities focused on financial integrity.

CMS Expands Joint Replacement Program 

CMS has announced that it’s expanding the Comprehensive Care for Joint Replacement Expanded (CJR-X) Model. The model is part of the FY 2027 Inpatient and Long-Term Care Hospital Prospective Payment System Final Rule and should be a point of awareness for medical coding leaders [6].

Payer Policy Changes Identified as Key Area of Revenue Leakage

Becker’s has published an article stating that payer policies not reflected in contracts lead to sources of revenue leakage for providers. The survey covered 161 healthcare leaders at health systems, hospitals, and other provider organizations. It was identified that 68% of respondents found payer policy changes that were not reflected in contracts as a component of revenue leakage risk [7]. 

What this means for your team: This topic intersects with medical billing denials. Survey results should be reviewed for pertinence at individual organizations.  

Nebraska Medicaid Purge Begins

As work requirements checks begin, Nebraska members are losing Medicaid coverage. The state estimates that about 200 people have lost coverage August 1 from its first work requirements check. The state spokesperson reports that they do not have exact renewal figures for the month of July yet [8].

Rural Hospital Special Payments Expire End of 2026

Becker’s announced that add-on payments for Medicare-dependent hospitals as well as temporary low-volume hospital adjustment will lapse on December 21, 2026 under current laws. These have been extended in the past but if they aren’t renewed, rural and community hospitals will face additional financial strain amid more medical billing pressures [9].

Rural Health Transformation Final Reports Due

Annual reports for the Rural Health Transformation Program are due August 30, 60 days before the end of the annual budget period. Required reporting data includes state policy action commitments, initiative progress narratives, initiative metrics, checkpoints, use of funds, success stories, and sustainability planning [10].