CMS Prior Authorization of Drugs Proposed Rule Under Review by OMB. The Centers for Medicare & Medicaid Services (CMS) proposed regulation titled “Interoperability Standards and Prior Authorization for Drugs (CMS-0062)” is currently under review by the Office of Management and Budget (OMB). This proposed regulation was included most recently in the Spring 2025 Unified Agenda. This rule would propose new requirements for the prior authorization for certain drugs for Medicare Advantage organizations, state Medicaid fee-for service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plans offered on the Federally-facilitated Exchanges. There is a possibility that other requirements related to interoperability standards and prior authorization will be included in this proposed rule. Review by OMB is typically the last step in the regulatory process before the proposed rule is published. OMB reviews are up to 90 days in length. 

ASTP Schedules HITAC Meetings for 2026. The Assistant Secretary for Technology Policy (ASTP) released the 2026 schedule of public meetings for the Health Information Technology Advisory Committee (HITAC). The Committee will meet on February 19, May 7, September 24, and November 5, with each meeting scheduled from approximately 10:00 am to 3:00 pm ET. HITAC was established under the 21st Century Cures Act with the purpose of identifying priorities for standards adoption and making recommendations to ASTP/National Coordinator for Health Information Technology. The meetings are open to the public and will have a virtual option for attending with some meetings having an in-person meeting option. Additional information on the meetings is available in the HITAC calendar on the ASTP website.

U.S. Withdrawal from WHO Is Final. The one year period for the U.S. to withdraw from the World Health Organization (WHO) based on the executive order signed by President Trump has expired and the withdrawal is now final. No longer being a member of WHO raises questions regarding plans for the U.S. to implement the International Classification of Diseases, Eleventh Revision (ICD-11) for mortality reporting, which had been undergoing analysis and implementation planning by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Also unclear is the potential of the U.S. implementing ICD-11 for morbidity (disease classification).

NIST and CISA Seek Feedback on Protecting Tokens Report by January 30. The National Institute of Standards and Technology (NIST) and the Cybersecurity & Infrastructure Security Agency (CISA) released the initial public draft of Interagency Report 8587, "Protecting Tokens and Assertions from Forgery, Theft, and Misuse." The report addresses key implementation guidance for federal agencies and cloud service providers (CSPs) to secure identity tokens and assertions against forgery, theft, and misuse. This information is especially relevant for identity and access management professionals, federal information technology teams, and CSPs serving government clients, as it addresses critical vulnerabilities in modern cloud and federated identity systems. Written feedback on the report is requested by January 30, 2026, via email at iam@list.nist.gov.

CMS Holding Webinar on LEAD Model on January 29. CMS will hold a webinar on Thursday, January 29, 2026, at 2 pm ET to provide an overview on the Long-term Enhancing ACO Design (LEAD) Model. The overview will include information on model goals, participation options, eligibility, and payment methodology. The LEAD Model team will also provide more information on the application process, timeline, and resources. LEAD builds on the CMS Innovation Center’s earlier accountable care work and uses improved benchmarking to appeal to a broader mix of providers, including those with specialized patient populations and those new to Accountable Care Organizations. Registration is available here. Questions can be submitted in advance in the registration form.

CMS 2026 MIPS Payment Adjustments in Effect Based on 2024 Performance. CMS has posted providers’ 2024 Merit-based Incentive Payment System (MIPS) performance feedback, available on the Quality Payment Program (QPP) website. The performance feedback to identify the MIPS payment adjustment factor(s) associated with 2024 final scores was added to the website in October 2025. 2026 MIPS payment adjustments, based on each MIPS eligible clinician’s 2024 MIPS final score, will be applied to payments made for Part B covered professional services payable under the Physician Fee Schedule from January 1 to December 31, 2026. Payment adjustments are determined by the final score associated with a clinician’s Taxpayer Identification Number and National Provider Identifier combination. More information is available in the QPP Resource Library.

CMS Changes to Medicare Telehealth Coverage Starting January 31 without Legislative Action. CMS changes to Medicare telehealth coverage that begin January 31 will limit patients’ access to telehealth services, without legislative action. Starting January 31, Medicare patients must live in a rural area and go to an office or medical facility that is also in a rural area for most telehealth services. Coverage for the following Medicare telehealth services will remain after January 31:

• Monthly End-Stage Renal Disease visits for home dialysis
• Services for diagnosis, evaluation, or treatment of symptoms of an acute stroke at the patient’s location, including in a mobile stroke unit
• Services for the diagnosis, evaluation, or treatment of a mental or behavioral health disorder, including a substance use disorder, in the patient’s home

Telehealth coverage that expires as of January 31 includes:

• Non-mental or behavioral health telehealth services outside of a medical facility or in a non-rural area.
• Physical therapists, occupational therapists, speech-language pathologists, and audiologists can no longer furnish Medicare telehealth services.
• Hospitals may no longer bill for diabetes self-management training and medical nutrition therapy services furnished remotely by hospital staff to beneficiaries in their homes.

TEFCA RCE Releases Four New SOPs. The Sequoia Project, the Trusted Exchange Framework and Common Agreement™ (TEFCA™) Recognized Coordinating Entity^® (RCE^®), along with ASTP, released four new standard operating procedures (SOPs) on the TEFCA Topics in Change Management webpage. The Exchange Purposes (XP) SOP Version 5.0 defines the authorized XPs and provides information on the response obligations, fee permissions, and exceptions to required response for each XP Code. It becomes effective February 15. The XP Implementation SOP: Health Care Operations (HCO) Version 2.0 defines the implementation specifications for asserting the HCO XP and sub-XP codes and enhances flexibility to determine exchange specifications that support core HCO use cases, while protecting individual privacy under TEFCA. It becomes effective February 15. The XP Implementation SOP: Treatment Version 1.2 specifies the implementation requirements and parameters for asserting the Treatment XP. It becomes effective February 15. The Individual Access Service (IAS) Provider Requirements SOP defines the required content of an IAS Provider’s Privacy and Security Notice and procedures for notifying individuals of IAS-related security incidents or breaches. It becomes effective March 17.