Federal Regulations

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026

This final rule finalizes changes and updates to the policies and payment rates used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for fiscal year 2026. This final rule also updates the requirements for the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program.

Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies

Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies

International Traffic in Arms Regulations: Updates to Certain Proscribed Countries and Other Changes

The Department of State is amending the International Traffic in Arms Regulations (ITAR) to update the entries for the Central African Republic, the Democratic Republic of the Congo, Haiti, Libya, Somalia, South Sudan, and Sudan, pursuant to recent United Nations Security Council resolutions (UNSCRs). Further, the Department is updating the list of North Atlantic Treaty Organization (NATO) members and major non-NATO allies and is making other corrections and clarifications within the ITAR.

Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies

This proposed rule would set forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this proposed rule proposes permanent and temporary behavior adjustments and proposes to recalibrate the case-mix weights and update the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2026. Lastly, this proposed rule proposes policy changes to the face-to-face encounter policy. It also proposes changes to the Home Health Quality Reporting Program (HH QRP) and the expanded Health Value-Based Purchasing (HHVBP) Model requirements. In addition, it would update the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Lastly it proposes: a technical change to the HH conditions of participation; updates to DMEPOS supplier conditions of payment; updates to provider and supplier enrollment requirements; and changes to DMEPOS accreditation requirements.

Administrative Updates to the Rear End Marking Device-Passenger, Commuter and Freight Trains Regulations

This rule makes administrative updates to FRA's rear end marking device regulations, including updating addresses in those regulations.

Administrative Updates to the Passenger Train Emergency Preparedness Regulations

This rule makes administrative updates to FRA's passenger train emergency preparedness regulations, including updating addresses in those regulations.

Administrative Updates to the Training, Qualification, and Oversight for Safety-Related Railroad Employees Regulations

This rule makes administrative updates to FRA's training, qualification, and oversight regulations, including updating addresses in those regulations.

Administrative Updates to the Federal Railroad Administration's State Safety Participation Regulations

This rule makes administrative updates to FRA's state safety participation regulations, including updating addresses in those regulations.

Administrative Updates to the Steam Locomotive Inspection and Maintenance Standards Regulations

This rule makes administrative updates to FRA's steam locomotive inspection and maintenance standards regulations, including updating addresses in those regulations.

Administrative Updates to the Federal Railroad Administration's Track Safety Standards

This rule makes administrative updates to FRA's track safety standards, including updating addresses.

Administrative Updates to the Grade Crossing Safety Regulations

This rule makes administrative updates to FRA's grade crossing safety regulations, including updating addresses in those regulations.

Administrative Updates to the Federal Railroad Administration's System Safety Program Regulations

This rule makes administrative updates to FRA's system safety program regulations, including updating addresses in those regulations.

Administrative Updates to the Federal Railroad Administration's Risk Reduction Program Regulations

This rule makes administrative updates to FRA's risk reduction program regulations, including updating addresses in those regulations.

Administrative Updates to the Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of-Train Devices Regulations

This rule makes administrative updates to FRA's brake system safety standards regulations, including updating addresses in those regulations.

Administrative Updates to the Federal Railroad Administration's Safety Integration Plans Governing Railroad Consolidations, Mergers, and Acquisitions of Control Regulations

This rule makes administrative updates to FRA's safety integration plans regulations, including updating addresses in those regulations.

Administrative Updates to the Railroad Safety Appliance Standards Regulations

This rule makes administrative updates to FRA's railroad safety appliance standards regulations, including updating addresses in those regulations.

Administrative Updates to the Bridge Safety Standards Regulations

This rule makes administrative updates to FRA's bridge safety standards regulations, including updating addresses in those regulations.

Administrative Updates to the Instructions Governing Applications for Approval of a Discontinuance or Material Modification of a Signal System or Relief From the Requirements of Part 236 Regulations

This rule makes administrative updates to FRA's instructions governing applications for approval of a discontinuance or material modification of a signal system regulations, including updating addresses in those regulations.

Administrative Updates to the Rules, Standards, and Instructions Governing the Installation, Inspection, Maintenance, and Repair of Signal and Train Control Systems, Devices, and Appliances Regulations

This rule makes administrative updates to FRA's signal and train control regulations, including updating addresses in those regulations.

Administrative Updates to the United States Locational Requirement for Dispatching of United States Rail Operations Regulations

This rule makes administrative updates to FRA's U.S. locational requirement for dispatching of U.S. rail operations regulations, including updating addresses in those regulations.

Administrative Updates to the Signal Systems Reporting Requirements Regulations

This rule makes administrative updates to FRA's signal systems reporting requirements regulations, including updating addresses in those regulations.

Administrative Updates to the Railroad Communications Regulations

This rule makes administrative updates to FRA's railroad communications regulations, including updating addresses in those regulations.

Administrative Updates to the Railroad Locomotive Safety Standards Regulations

This rule makes administrative updates to FRA's railroad locomotive safety standards regulations, including updating addresses in those regulations.

Administrative Updates to the Occupational Safety and Health in the Locomotive Cab Regulations

This rule makes administrative updates to FRA's locomotive cab occupational safety and health regulations, including updating addresses in those regulations.

Administrative Updates to the Reflectorization of Rail Freight Rolling Stock Regulations

This rule makes administrative updates to FRA's reflectorization regulations, including updating addresses in those regulations.

Administrative Updates to the Use of Locomotive Horns at Public Highway-Rail Grade Crossings Regulations

This rule makes administrative updates to FRA's use of locomotive horns at public highway-rail grade crossings regulations, including updating addresses in those regulations.

Administrative Updates to the Safety Glazing Standards Regulations

This rule makes administrative updates to FRA's safety glazing standards regulations, including updating addresses in those regulations.

Administrative Updates to the Railroad Accidents/Incidents: Reports Classification, and Investigations Regulations

This rule makes administrative updates to FRA's railroad accidents/incidents: reports classification, and investigations reporting regulations, including updating addresses in those regulations.

Administrative Updates to the Federal Railroad Administration's Special Notice and Emergency Order Procedures: Railroad Track, Locomotive, and Equipment

This rule makes administrative updates to FRA's special notice and emergency order procedures: railroad track, locomotive and equipment, including updating addresses.