Goodsurance

Policy & oversight

CMS Launches 10-Year Chronic Care Innovation Model for Original Medicare Beneficiaries

The ACCESS Model began July 5, letting Original Medicare beneficiaries with high blood pressure, diabetes, chronic pain, or depression receive technology-supported care at little or no out-of-pocket cost.

By the Goodsurance editorial teamJuly 10, 2026

The CMS Innovation Center launched the ACCESS Model, short for Advancing Chronic Care with Effective, Scalable Solutions, on July 5, 2026. The voluntary, 10-year model expands access to technology-supported management of chronic conditions affecting more than two-thirds of people with Medicare, including high blood pressure, diabetes, chronic musculoskeletal pain, and depression. Participating organizations such as digital health companies and care management programs enroll in Medicare and offer beneficiaries tools including remote monitoring devices, digital coaching applications, wearables, and medication management support, at little or no cost to beneficiaries. The model tests outcome-aligned payments, a design in which organizations receive predictable monthly amounts from Medicare but earn the full amount only when patients reach measurable health targets, such as lower blood pressure or reduced pain scores. ACCESS is available only for people in Original Medicare; Medicare Advantage organizations may independently adopt similar payment arrangements with their providers. Four clinical tracks launched: early cardio-kidney-metabolic, cardio-kidney-metabolic, musculoskeletal, and behavioral health. CMS reported that private health plans covering 165 million lives across Medicare Advantage, Medicaid, and commercial markets have pledged to align their provider payment approaches with ACCESS.

In plain words

Medicare started a new program called ACCESS on July 5, 2026. If you are in traditional Medicare and not a Medicare Advantage plan, and you have conditions like high blood pressure, diabetes, back pain, or depression, you may be able to join. Companies in the program use apps, remote monitors, and other tools to help you manage your health at little or no cost to you. Those companies only get full payment from Medicare if your health actually improves.

Source: CMS
Read at the source →

More news

Other stories on what is moving in Medicare.

Policy & oversight

OIG Found More Than 15 Million Dollars in Medicare Payments Where Emergency Room Billing Codes Were Used at Non-Emergency Sites

A March 2026 federal audit identified improper and potentially improper Medicare payments made when physicians and hospitals used emergency department billing codes for care not actually delivered in an emergency department, and found that Medicare lacked automated safeguards to catch the mismatches.

August 8, 2026

Policy & oversight

Federal Audit Found at Least 4.7 Million Dollars in Medicare Overpayments at an Arkansas Hospital

An OIG audit of Jefferson Regional Medical Center found a high rate of billing errors on claims flagged as elevated risk, producing an estimated 4.7 million dollars in improper Medicare payments. The hospital disputed most of the findings.

August 7, 2026

Policy & oversight

CMS Publishes Plan to Speed Medicare Coverage for Breakthrough Medical Devices

A new pathway would give FDA-cleared breakthrough devices a national Medicare coverage decision within weeks of regulatory approval, rather than waiting years under the standard process.

August 7, 2026

Policy & oversight

Federal Audit Found 97 Cybersecurity Gaps in Medicare Billing Contractors for Fiscal Year 2024, Though the Most Serious Deficiencies Declined

An OIG annual report to Congress found information security deficiencies across all seven Medicare administrative contractors in fiscal year 2024, while noting that high-risk and moderate-risk gaps fell compared with the prior year.

August 6, 2026

Policy & oversight

CMS Published Second-Quarter 2026 Drug Coding Decisions That Shape How Medicare Identifies and Pays for New Medicines

The quarterly HCPCS drug coding update, posted July 29 and highlighted in the August 6 MLN Connects newsletter, determines which new medications and biologicals get a dedicated Medicare billing code.

August 6, 2026

Policy & oversight

CMS Sets a Sunset Date for the NTAP Alternative Track for Breakthrough Devices and Advances the RAPID Pathway

The fiscal year 2027 hospital payment final rule phases out the alternative NTAP track that breakthrough-designated devices used to qualify for Medicare reimbursement, while a new CMS-FDA program called RAPID is positioned to take its place.

August 5, 2026