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Recent Amendments

2023–2026 significant regulatory actions

DateActionRegulatory basisKey impact
Feb 2026QMSR effective21 CFR Part 820 amendedISO 13485:2016 incorporated; all manufacturers must comply
May 2024LDT Final Rule published21 CFR Parts 807, 820, 803, 806, 830 amendedFDA to exercise oversight of laboratory-developed tests; 5-year phase-in from May 2024
Feb 2024QMSR Final Rule published21 CFR Part 820Aligns QSR with ISO 13485:2016; replaces the 1996 QSR
2024PCCP Guidance finalisedFD&C Act § 515CFramework for Predetermined Change Control Plans for AI/ML SaMD
Oct 2023eSTAR mandatoryFDA programme requirementAll 510(k) and De Novo submissions required in eSTAR format
CDS Guidance 2022Clinical Decision Support Software Guidance finalisedFD&C Act § 520(o)Clarifies when CDS software is and is not a regulated device

QMSR transition (most significant recent change)

The Quality Management System Regulation (QMSR) final rule is the most significant amendment to 21 CFR Part 820 since the original Quality System Regulation in 1996:

  • Incorporates ISO 13485:2016 by reference
  • Manufacturers with a conforming ISO 13485:2016 QMS substantially satisfy the QMSR
  • US-specific additions remain: DHF, MDR-integrated complaint handling, CAPA data requirements, distribution records
  • Effective date: February 2, 2026 (QMSR took effect on this date)

LDT oversight (ongoing phase-in)

FDA's Laboratory-Developed Test (LDT) Final Rule (May 2024) begins a 5-stage phase-in of FDA oversight over tests designed, manufactured, and used within a single laboratory. Previously FDA exercised enforcement discretion over LDTs. The phase-in runs from 2024 through 2029.


Staying current

The QMSR took effect on February 2, 2026; manufacturers previously operating under the 1996 QSR were required to transition by that date. Manufacturers already certified to ISO 13485:2016 were able to demonstrate substantial equivalence upon the QMSR effective date.