Consolidated Appropriations Act, 2026

Adds new Medicaid State plan requirements: (1) a streamlined enrollment process for eligible out-of-State providers (a new paragraph added to section 1902(kk)); and (2) a new paragraph requiring State plans, beginning January 1, 2030, to treat certain active duty relocated individuals as residents for medical assistance eligibility and related protections for home-and-community-based services waiting lists. See amendments adding paragraph (10) to 1902(kk) and adding paragraph (90) to section 1902.

Amends provisions in section 1834(m) of the Social Security Act to extend multiple telehealth flexibilities (removing geographic requirements, expanding originating sites, permitting audio-only services, extending telehealth for FQHCs and rural health clinics) through December 31, 2027; delays certain in-person requirements for tele-mental health until January 1, 2028; and adds a new paragraph requiring use of one or more codes or modifiers for certain telehealth claims (deadline January 1, 2027).

Amends section 1890(d)(2) to adjust funding language related to endorsement/input/selection of quality measures and extends funding language/dates to include 2027 (modifies phrasing and extends referenced funding years).

Makes a targeted amendment to a provision referenced at section 1905(v)(1)(A) (codified at 42 U.S.C. 1396d(v)(1)(A)) by striking specified text as part of changes to optional buy-in groups and eligibility-related definitions. The statutory amendment text shows removal of specified language in that subsection.

Amends section 1833(z) (codified at 42 U.S.C. 1395l(z)) to modify incentive payment rules for participation in eligible alternative payment models, including extending certain dates (e.g., extending participation/incentive periods to 2028) and making conforming changes.

Amends provisions related to inpatient hospital payment adjustments and the Medicare-dependent hospital (MDH) program (e.g., section 1886(d)(12) and related clauses) to extend increased inpatient hospital payment adjustments and related date references—shifting various date ranges from 2026 to 2027 and adjusting subsequent fiscal-year references.

Extends the expiration/authorization dates in specified provisions of the United States Grain Standards Act by substituting September 30, 2026 for prior September 30, 2025 effective in the cited subsections.

Applies a substitution to section 8302(b) (Agricultural Act of 2014) so that the termination/expiration date in 16 U.S.C. 3851a(b) is changed to October 1, 2026 (from October 1, 2023).

Amends section 1309(a) of the National Flood Insurance Act of 1968 by striking 'September 30, 2023' and inserting 'September 30, 2026', extending the financing authority date for the NFIP.

Amends the program-expiration provision of the National Flood Insurance Act of 1968 by striking 'September 30, 2023' and inserting 'September 30, 2026', extending the date after which no new flood insurance contracts may be entered.