HHS and Education Dept. Advance Rulemaking on Medicare, Native Programs, Accreditation, and Health Grants

Native American Programs: Comment Deadline November 13, 2026

The Department of Health and Human Services, Administration for Children and Families has issued a notice of proposed rulemaking that would further amend the Native American Programs Act regulations to streamline 45 CFR 1336. The agency describes the action as aimed at further reducing bureaucracy and burden from the Administration for Native Americans. Written comments must be received on or before November 13, 2026 to be considered. The proposed rule spans 5 Federal Register pages and covers topics including grant programs for Indians, grant programs for social programs, American Samoa, Guam, Hawaiian Natives, the Northern Mariana Islands, and reporting and recordkeeping requirements.

Medicare Part D and Pharmacy Benefit Managers: Comment Deadline December 15, 2026

The Centers for Medicare & Medicaid Services has issued a proposed rule to implement three sections of the Consolidated Appropriations Act, 2026. Section 6219 addresses adjustments to Medicare Part D cost-sharing reductions for low-income individuals. Section 6220 concerns requiring enhanced and accurate lists of health providers under the REAL Health Providers Act. Section 6224 addresses modernizing and ensuring pharmacy benefit manager accountability. The proposed rule would amend 42 CFR 422 and 42 CFR 423, and covers topics including health facilities, health maintenance organizations, Medicare, penalties, privacy, and reporting and recordkeeping requirements. The rule spans 82 Federal Register pages. To be assured consideration, comments must be received no later than 5 p.m. Eastern Standard Time on December 15, 2026.

Higher Education Accreditation: Final Rule Effective July 1, 2027

The Education Department has issued a final rule revising existing accrediting agency recognition regulations under 34 CFR 600, 34 CFR 602, and 34 CFR 668. The rule states that it implements the directives set forth in Executive Order 14279, Reforming Accreditation to Strengthen Higher Education, as well as other Administration priorities, and is intended to align the regulations more closely with statute and reduce regulatory burden. Topics covered include colleges and universities, consumer protection, foreign relations, grant programs in education, loan programs in education, student aid, and vocational education. The rule spans 109 Federal Register pages and is effective July 1, 2027.

Forecasted Health Grants from the Office of the Assistant Secretary for Health

Two grant opportunities from the Office of the Assistant Secretary for Health are currently forecasted on Grants.gov but are not yet open for applications. Both were retrieved using the Grants.gov eligibility filter for state, county, city, special-district, and tribal governments.

• Coordinating Center for Language Access Services (opportunity number MP-CPI-25-003): No award amount or application deadline has been announced.
• Making America Healthy Again by Addressing Dementia Disparities (opportunity number MP-CPI-25-001): No award amount or application deadline has been announced.

Eligible entities should monitor Grants.gov for updates as these opportunities move to active status.

What to Watch

• November 13, 2026 — Comment deadline for HHS/ACF proposed rule on Native American Programs Act regulations (45 CFR 1336).
• December 15, 2026 — Comment deadline for CMS proposed rule implementing Consolidated Appropriations Act, 2026 sections on Medicare Part D, provider directories, and pharmacy benefit managers (42 CFR 422, 42 CFR 423).
• July 1, 2027 — Effective date for Education Department final rule on accrediting agency recognition (34 CFR 600, 602, 668).
• TBD — Application openings for two forecasted OASH grants (MP-CPI-25-003 and MP-CPI-25-001).

What This Means for Recipients

State, local, special-district, and tribal governments are listed as eligible entities for both forecasted OASH grant opportunities, but no funding amounts or deadlines are yet published, requiring active monitoring of Grants.gov. Tribal governments and entities operating under the Native American Programs Act are directly affected by the HHS/ACF proposed rulemaking and must submit comments by November 13, 2026 to be assured consideration. State and local governments administering Medicare Part D or working with pharmacy benefit managers should review the CMS proposed rule and submit comments by December 15, 2026. Institutions in state and local higher education systems should note that the Education Department's final accreditation rule — implementing Executive Order 14279 — does not take effect until July 1, 2027, providing time to assess impacts on grant and loan program eligibility under the revised 34 CFR parts.

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