CMS explains that it is proposing to establish in regulations the factors it has historically used in making "reasonable and necessary" determinations under Section 1862(a)(1)(A), with "some ...

On March 17, 2021, the Centers for Medicare & Medicaid Services (CMS) published a notice in the Federal Register delaying the effective date of the final rule titled, “Medicare Program; Medicare ...

The U.S. Centers for Medicare & Medicaid Services (CMS) has posted a proposed rule for coverage of FDA-designated breakthrough devices, a programmatic objective that has been front and center for the ...

On June 1, 2026, the Centers for Medicare and Medicaid Services (CMS) issued a long-anticipated interim final rule that will guide state implementation of Medicaid work requirements.

CMS issued a final rule Jan. 12 that updates the agency’s definition of “reasonable and necessary” coverage for services that fall under Medicare Parts A and B. The agency said codifying the ...

Lawmakers from the U.S. House of Representatives are asking the Centers for Medicare and Medicaid Services to expand the definition of medically necessary dental coverage for Medicare beneficiaries, ...

CMS' Medicaid managed care proposal broadens the definition of "care coordination," according to healthcare advocates in New Jersey, where the state's Medicaid program has been under fire. Across the ...