Medicare/CMSMedium ImpactAdministrative

2026-01-29 - CMS Seeks Public Input on Strengthening Domestic Supply Chain for PPE, Essential Medicines

Published January 30, 2026Effective March 1, 2026

AI Summary

CMS issued several policy updates affecting Medicare billing, including new drug price negotiations for 2028, proposed Medicare Advantage payment changes for 2027, and critical compliance reminders. Key immediate actions include switching to electronic CLIA certificates by March 1, 2026, and improving pneumatic compression device billing to reduce the current 61.5% denial rate.

Action Required

By March 1, 2026: Laboratories and providers performing lab testing must switch to electronic CLIA fee coupons and certificates by emailing state agency or contacting accreditation organization. Paper versions will no longer be available and checks will not be accepted - only online payments. Immediately: Review pneumatic compression device billing practices to reduce denial rate from 61.5% - ensure proper documentation of medical necessity and follow coverage guidelines to prevent claim denials.

Plan Types

Traditional Medicare, Medicare Advantage

Specialties

all-specialties