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HHS/CMS RIN: 0938-AV93 Publication ID: 2026 
Title: ●Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes (CMS-2452) 
Abstract:

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. 

 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: No 
EO 14192 Designation: Fully or Partially Exempt 
CFR Citation: 42 CFR 433   
Legal Authority: 42 U.S.C. 1903(w)(3)(w)(3)    42 U.S.C. 1903(w)(4)    Public Law 119-21 section 71115   
Legal Deadline:
Action Source Description Date
Final  Statutory  The limit established under OBBBA section 71115 is effective October 1, 2026.   10/01/2026 
Timetable:
Action Date FR Cite
NPRM  07/00/2026 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: Federal, Local, State 
Federalism: Undetermined 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Rory Howe
Director, Financial Management Group
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicaid and CHIP Services, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-4878
Email: rory.howe@cms.hhs.gov