The Centers for Medicare & Medicaid Services (CMS) displayed a Notice of Proposed Rulemaking (NPRM) for comment that would revise standards for determining whether an indirect hold harmless arrangement exists for a health care-related tax. This NPRM is necessary to implement section 71115 of the Working Families Tax Cut (WFTC) legislation, which established new indirect hold harmless thresholds for health care-related taxes, effective October 1, 2026. The deadline to submit public comments is September 21, 2026.

CMS has also drafted a fact sheet, which provides additional information and an overview of the provisions of the NPRM.