(Dec. 19, 2025) – CMS Innovation Center Announces ELEVATE Model
The Centers for Medicare & Medicaid Services Innovation Center announced a new model that will provide approximately $100 million in funding for three-year cooperative agreements to promote health and prevention among Original Medicare beneficiaries.
The Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence Model "will utilize evidence-based, whole-person care approaches — including functional or lifestyle medicine interventions — currently not covered by Original Medicare."
CMS will release a Notice of Funding Opportunity for this model in early 2026.
CMS Issues Guidance on OBBBA Mandated Medicaid Community Engagement Requirements
The Centers for Medicare & Medicaid Services issued a guidance document and an informational bulletin to help states prepare for upcoming Medicaid community engagement requirements. Effective Jan. 1, 2027, certain individuals applying for or enrolled in Medicaid expansion will need to participate in community engagement activities, such as work or similar activities.
CMS also announced plans to develop interim final regulations, as required by law, and will issue additional guidance to assist states in implementation.
CMS Releases APM and IOTA Model Proposed Rule
The Centers for Medicare & Medicaid Services released a proposed rule to update and revise the Increasing Organ Transplant Access Model for performance year two. The IOTA model is a six-year mandatory alternative payment model that began on July 1 and is being tested by the CMS Innovation Center.
The model tests whether performance-based incentives paid to or owed by participating kidney transplant hospitals can increase waitlist patients' access to kidney transplants. Comments are due 60 days after publication in the Federal Register.
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews:
Before You Go
AblePay's December 2025 newsletter outlines growing patient collection challenges as deductibles reset and premiums rise in 2026. Learn how APS endorsed partner AblePay helps providers improve collections while easing patient financial burden.