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CMS Forms. The Centers for Medicare Medicaid Services (CMS) is a Federal agency within the U.S. Department of Health and Human Services. Many CMS program related forms are available in Portable Document Format (pdf).
AND SUPPLIER AGREEMENT (CMS-460) To sign a participation agreement is to agree to accept assignment for all covered services that you provide to Medicare patients.
The 2026 proposed rule for Medicare Advantage plans would update requirements related to the plan-level annual health equity analysis and report, clarify and expand on rules restricting an MA plans ability to create and use internal coverage criteria, and increase transparency of MA plan policies, among other
Effective January 1, 2025, CMS is reducing the review timeframe for standard prior authorization requests to no more than 7 calendar days. The review timeframe for expedited requests will remain 2 business days.
Prior authorization and pre-claim review are similar, but differ in the timing of the review and when services can begin. Under prior authorization, the provider or supplier submits the prior authorization request and receives the decision before services are rendered.
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The head of CMS is the administrator of the Centers for Medicare Medicaid Services. The position is appointed by the president and confirmed by the Senate. On May 27, 2021, Chiquita Brooks-LaSure was sworn in as administrator, the first black woman to serve in the role.
Beginning primarily in 2026, impacted payers (not including QHP issuers on the FFEs) will be required to send prior authorization decisions within 72 hours for expedited (i.e., urgent) requests and seven calendar days for standard (i.e., non-urgent) requests for medical items and services.
The rule enhances certain policies from the CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and adds several new provisions to increase data sharing and reduce overall payer, healthcare provider, and patient burden through improvements to prior authorization practices and data exchange practices.

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