0938-AV93 202510 The Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions 0938 Centers for Medicare & Medicaid Services CMS 0900 Department of Health and Human Services HHS Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes (CMS-2452)

Section 71115 of One Big Beautiful Bill Act of 2025 (OBBBA) amended the indirect hold harmless threshold, effective October 1, 2026. This provision of OBBBA sets the indirect hold harmless threshold equal to the level of revenue for taxes enacted and imposed as of July 4, 2025. This rule will revise regulations to reflect the new indirect hold harmless limit and establish requirements that will allow CMS to implement this change accurately and effectively. 

]]> Economically Significant First Time Published in The Unified Agenda Proposed Rule Stage Yes No Fully or Partially Exempt 42 CFR 433 42 U.S.C. 1903(w)(3)(w)(3) 42 U.S.C. 1903(w)(4) Public Law 119-21 section 71115 Statutory Final 10/01/2026 The limit established under OBBBA section 71115 is effective October 1, 2026. No NPRM 07/00/2026 No Federal Local State Undetermined No No Rory Howe Director, Financial Management Group 0938 Centers for Medicare & Medicaid Services CMS 410 786-4878 rory.howe@cms.hhs.gov Center for Medicaid and CHIP Services, 7500 Security Boulevard, Baltimore MD 21244