Compliance and accreditation news: week of October 10, 2026
CMS proposed a Medicare Advantage and Part D rule on provider directories and pharmacy benefit managers, revised two CLIA policy memos and issued an inpatient rehabilitation facility manual transmittal. HRSA corrected a health center notice. Four of the state Rural Health Transformation Program funding announcements CMS reported are listed.
CMS proposes Medicare Advantage and Part D transparency and affordability reforms
Compliance: On October 16, 2026, CMS issued a proposed rule that would "…improve the accuracy of provider directories for Medicare Advantage plans, establish transparency and compensation requirements for Pharmacy Benefit Managers (PBMs), and deliver enhanced cost-saving protections for low-income Medicare beneficiaries." Under the proposal, plans would have to verify and update their provider directory information at least every 90 days and report an accuracy score to CMS. PBMs would have to report their compensation and cost performance to plan sponsors and CMS once a year. The proposed Contract Year 2028 changes will be open for public comment for 60 days after they are published in the Federal Register. Source: Centers for Medicare & Medicaid Services, "CMS Proposes Reforms to Strengthen Transparency and Affordability in Medicare Advantage and Part D", October 16, 2026. https://www.cms.gov/newsroom/press-releases/cms-proposes-reforms-strengthen-transparency-affordability-medicare-advantage-part-d
CMS revises two CLIA policy memos
On October 14, 2026, CMS posted a revised version of policy memo QSO-23-15-CLIA, its Clinical Laboratory Improvement Amendments of 1988 (CLIA) post-public health emergency guidance. On October 16, 2026, CMS posted a revised version of policy memo QSO-18-14-CLIA, its clarification on fine needle aspiration (FNA) specimen adequacy assessment, rapid on-site evaluation (ROSE) and workload limits. Source: Centers for Medicare & Medicaid Services, "REVISED Clinical Laboratory Improvement Amendments of 1988 (CLIA) Post-Public Health Emergency (PHE) Guidance (QSO-23-15-CLIA REVISED)", October 14, 2026. https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/policy-and-memos-states/clinical-laboratory-improvement-amendments-1988-clia-post-public-health-emergency-phe-guidance Source: Centers for Medicare & Medicaid Services, "REVISED: Clarification Regarding Fine Needle Aspiration(FNA) Specimen Adequacy Assessment, RapidOn-site Evaluation (ROSE) and Workload Limits (QSO-18-14-CLIA REVISED)", October 16, 2026. https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/policy-and-memos-to-states-and-regions-items/qso18-14-clia
CMS manual updates for inpatient rehabilitation facility services
On October 15, 2026, CMS issued transmittal R14001BP (Change Request 14635), Internet Only Manual updates to Publication 100-02 for Inpatient Rehabilitation Facility (IRF) services. The implementation date is November 17, 2026. Source: Centers for Medicare & Medicaid Services, "Internet Only Manual Updates to Publication (Pub.) 100-02 for Inpatient Rehabilitation Facility (IRF) Services (Transmittal R14001BP)", October 15, 2026. https://www.cms.gov/medicare/regulations-guidance/transmittals/2026-transmittals/r14001bp
Correction to Health Center Program performance period extensions
On October 14, 2026, HRSA published a correction to its September 24, 2026 Federal Register notice on performance period extensions for health centers scheduled to compete for a January, February, or March FY 2027 Service Area Competition. The correction adds one service area that was not eligible for an extension when the notice was published but has since become eligible. Source: Health Resources and Services Administration, "Health Center Program Performance Period Extensions; Correction (Notice; correction; FR Doc. 2026-20960)", October 14, 2026. https://www.govinfo.gov/content/pkg/FR-2026-10-14/html/2026-20960.htm
More than $177 million in rural health funding for Nebraska
Program development: In an October 13, 2026 press release, CMS reported that the administration announced more than $177 million in Rural Health Transformation Program (RHTP) funding to strengthen rural healthcare delivery across Nebraska. Source: Centers for Medicare & Medicaid Services, "Trump Administration Announces More Than $177 Million to Recruit Rural Healthcare Workers, Expand Mobile Care, and Modernize Services Across Nebraska", October 13, 2026. https://www.cms.gov/newsroom/press-releases/trump-administration-announces-more-177-million-recruit-rural-healthcare-workers-expand-mobile-care
$209 million in rural health funding for Iowa
In its October 15, 2026 MLN Connects newsletter, CMS reported that the administration announced more than $209 million in Rural Health Transformation Program funding being put to work to strengthen healthcare delivery across rural Iowa through the state's Healthy Hometowns initiative. Source: Centers for Medicare & Medicaid Services, "Iowa: $209M to Expand Advanced Medical Care, Maternal Telehealth & Cancer Prevention", October 15, 2026. https://www.cms.gov/training-education/medicare-learning-network/newsletter/mln-connects-newsletter-october-15-2026
More than $11 million for rural EMS in New Hampshire
In an October 16, 2026 press release, CMS reported that the administration announced more than $11 million in Rural Health Transformation Program (RHTP) funding to strengthen emergency medical services and expand Mobile Integrated Health across rural New Hampshire. Source: Centers for Medicare & Medicaid Services, "Trump Administration Announces More Than $11 Million to Strengthen Rural EMS and Expand Mobile Healthcare Across New Hampshire", October 16, 2026. https://www.cms.gov/newsroom/press-releases/trump-administration-announces-more-11-million-strengthen-rural-ems-expand-mobile-healthcare-across
New rural EMS funding for Montana
In an October 16, 2026 press release, CMS reported that the administration announced $3.63 million in Rural Health Transformation Program (RHTP) funding to expand community integrated health (CIH) services across rural Montana. The funding will deliver awards to 17 rural EMS agencies for new or expanded staff positions, transportation costs, equipment, and clinical integration needs such as training and electronic health records. Source: Centers for Medicare & Medicaid Services, "Trump Administration Announces New Funding to Expand Rural EMS and Bring More Care Directly to Patients Across Montana", October 16, 2026. https://www.cms.gov/newsroom/press-releases/trump-administration-announces-new-funding-expand-rural-ems-bring-more-care-directly-patients-across
Accreditor news pages checked
The news pages of five accreditors were read on October 17, 2026. None carried a new standard or program announcement dated October 10 to 16, 2026. The newest item on each page was: URAC, a blog post on National Case Management Week dated October 11, 2026 (https://www.urac.org/blog/national-case-management-week-the-essential-role-of-case-managers-in-utilization-management/); NCQA, a news release dated September 15, 2026 (https://www.ncqa.org/about-ncqa/news/); ACHC, a release dated September 22, 2026 (https://achc.org/achc-news/); CARF, a news release dated April 21, 2026 (https://carf.org/news-releases/); and NABP, a news release dated October 6, 2026 (https://nabp.pharmacy/news-resources/newsroom/news/).
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