Centers for Medicare & Medicaid Services

Rule Changes

Approved NTAP for Bayesian's sepsis monitor in FY 2027 Final Rule

Starting October 1, 2026, hospitals using Bayesian Health's continuous AI sepsis monitor can bill Medicare for an extra payment of up to $61.84 per eligible discharge. The Centers for Medicare and Medicaid Services (CMS) approved the add-on payment in its FY 2027 Inpatient Prospective Payment System Final Rule, covering an estimated 739 Medicare Severity-Diagnosis Related Groups (MS-DRGs)—roughly 97% of all DRGs in the inpatient system.

Updated Sep 4

New Capabilities

Covers tests only after symptoms appear; ASAP Act pending

Alzheimer's diagnosis used to require a $5,000 brain scan or a painful spinal tap. As of August 2026, the FDA has cleared four blood tests for the disease, from Roche's Elecsys pTau217 to C2N's PrecivityAD2, approved for adults as young as 40.

Updated Aug 25

Rule Changes

Issuing proposed procedural notice; TCET pathway paused for new candidates

For nearly a decade, medical device makers have faced the same bottleneck: the FDA clears a breakthrough device, and then Medicare spends another year or more deciding whether to pay for it. On April 23, 2026, the two agencies jointly announced the Regulatory Alignment for Predictable and Immediate Device (RAPID) pathway — it cuts that timeline to as little as two months. They simultaneously paused the existing Transitional Coverage for Emerging Technologies (TCET) program for new applicants, consolidating all breakthrough-device coverage work under RAPID.

Updated May 31

Rule Changes

Source of baseline spending projections and historical data

For decades, American health care spending grew faster than the economy. Government actuaries projected in 2010 that it would hit 21.2 percent of GDP by 2024 (about $6.3 trillion), but actual spending came in at 18%, roughly $977 billion less.

Updated May 31

Rule Changes

Administering BALANCE model to expand GLP-1 access

Medicare has been banned from covering weight loss drugs since 2003. CMS launched BALANCE in December 2025, a voluntary model offering $50-per-month Ozempic and Wegovy access for 10% of Medicare enrollees starting July 2026.

Updated May 16

Rule Changes

Linked to a new CBD access pilot described alongside the executive order

Trump's executive order instructing DOJ to fast-track marijuana's move to Schedule III immediately triggered a familiar split. Public health and industry groups cheered the potential research and tax impacts, while House Republicans organized opposition, urging Trump to keep marijuana in Schedule I.

Updated May 15