07/21/2025

CMS Issues Anticipated PFS Proposed Rule amid Turbulent Backdrop

During a week in which headlines seized on a U.S. Supreme Court decision paving the way for thousands of layoffs of federal health workers, a reported billion-dollar grant backlog at the U.S. Department of Health and Human Services (HHS), and newly filed federal litigation by six major professional groups over what they call “unlawful, unilateral vaccine changes” made at HHS, the Centers for Medicare & Medicaid Services (CMS) quietly issued one of its most significant annual proposed rulemaking adjustments.

Officials said the calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule would advance primary care management through new quality measures, reduce waste and unnecessary use of skin substitutes, and introduce a new payment model focused on improving care for chronic disease management, according to a news release and fact sheet issued by CMS.  

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