CMS Opens New Reporting Package; Medicaid Plans Enter Prior-Auth Transparency
Reporting mechanics are hardening ahead of procurement cycles.
Federal Register | CMS opens 30-day PRA review (comments due Mar 20)
CMS published a 30-day Paperwork Reduction Act (PRA) notice that tees up specific information collections for OMB review. This is the moment the actual mechanics become visible before they harden into operating requirements that show up in SOWs, audit exhibits, and vendor deliverables. Decision window: now → March 20 for operators and vendors to shape feasibility, automation language, and file-spec clarity while it still moves.
KFF | MCPAR expands to plan-level prior-authorization metrics starting June 2026 submissions
Beginning with MCPAR reports submitted in June 2026, states will report new plan-level prior authorization data (requests, approval/denial rates, appeal reversals, and decision-time medians). This creates a near-term defensibility shift: plans’ utilization controls become more comparable, legible, and monitorable at the plan level, which increases the value of clean workflows, consistent rationales, and auditable timeliness performance.
AHCCCS | RFI due today for Secured Behavioral Health Residential Facility capacity (S-BHRF)
AHCCCS has an RFI with responses due Feb 19 ( 3:00 PM AZ time) for secured behavioral health residential facility capacity. This is a discharge-adjacent infrastructure signal: states and plans are formalizing step-down / placement pathways where avoidable ED revisits and extended lengths of stay often originate, and procurement teams will translate that into defined requirements, referral criteria, and operational reporting.
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Post-Acute Exposure: Standardization Increases; 2027 Margin Defense Shifts Upstream
Multi-State Provider Bulletins | Post-Discharge Review Standardization Accelerates