Recently, the Centers for Medicare & Medicaid Services (CMS) issued all the fiscal year (FY) 2026 Medicare final regulations for different facility types: hospice facilities, inpatient psychiatric facilities, inpatient...more
Senate HELP Committee advances legislation, examines healthcare affordability. The legislation would reauthorize expiring programs, including the Over-the-Counter Monograph Drug User Fee Program.
Senate Appropriations...more
CBO releases final scores for OBBBA. The Congressional Budget Office (CBO) estimates that the One Big Beautiful Bill Act (OBBBA) will increase the uninsurance rate by 10 million individuals over 10 years.
House Energy and...more
7/28/2025
/ Congressional Committees ,
Department of Health and Human Services (HHS) ,
Federal Funding ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare Advantage ,
New Legislation ,
Regulatory Agenda ,
Regulatory Reform ,
Trump Administration ,
Ways and Means Committee
THIS WEEK’S DOSE -
- OBBBA implementation begins. While the administration focuses on implementing the new law, some lawmakers are already discussing adjustments to health provisions in the One Big Beautiful Bill Act...more
7/21/2025
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Department of Health and Human Services (HHS) ,
Fraud ,
GAO ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicare ,
MIPS ,
New Legislation ,
OPPS ,
Outpatient Prospective Payment System (OPPS) ,
Proposed Legislation ,
Proposed Rules ,
Senate Committees ,
Technology ,
Telehealth ,
Trump Administration
On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule [CMS-1834-P],...more
7/18/2025
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Financial Services Industry ,
Healthcare ,
Healthcare Reform ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Payment Systems ,
Proposed Rules ,
Regulatory Requirements ,
Reporting Requirements
On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B [CMS-13271]...more
7/17/2025
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Healthcare ,
Healthcare Reform ,
Insurance Industry ,
Medicare ,
Medicare Part B ,
Medicare Shared Savings Program ,
New Regulations ,
Physician Fee Schedule ,
Proposed Rules ,
Regulatory Agenda ,
Technology ,
Telehealth
THIS WEEK’S DOSE -
- President Trumps signs OBBBA into law. After months of debate, Congress passed and President Trump signed H.R. 1, the One Big Beautiful Bill Act (OBBBA), into law on July 4, 2025.
- Senate HELP...more
7/14/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
ESRD ,
Executive Orders ,
Federal Budget ,
Healthcare ,
Healthcare Reform ,
HELP ,
Immigrants ,
Legislative Agendas ,
Medicaid ,
Medicare ,
New Legislation ,
Proposed Legislation ,
Public Health Emergency ,
SCOTUS ,
Senate Committees ,
Trump Administration
Senate Reconciliation Process Continues. Republicans are adjusting language to comply with Senate rules and appease various wings of the party....more
THIS WEEK’S DOSE -
- Senate Finance Committee Releases Reconciliation Text. The language is subject to change as negotiations continue and the Byrd rule process plays out.
- CMS Releases MA Risk Adjustment Audit Methodology...more
6/19/2025
/ Affordable Care Act ,
Budget Reconciliation ,
Centers for Medicare & Medicaid Services (CMS) ,
Federal Funding ,
Government Agencies ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
National Institute of Health (NIH) ,
New Legislation ,
Proposed Legislation ,
Senate Finance Committee
Patient engagement. Information blocking. Interoperability. These buzz words are flying around the health information technology (HIT) world as the Trump administration starts to make its mark on the HIT policy landscape....more
6/18/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Data Privacy ,
Department of Health and Human Services (HHS) ,
Digital Health ,
Health Care Providers ,
Health Information Technologies ,
Healthcare ,
Healthcare Reform ,
Regulatory Reform ,
Regulatory Requirements ,
Technology ,
Trump Administration
THIS WEEK’S DOSE -
- Reconciliation Moves Forward. Senate committees continue to release their reconciliation provisions.
- NIH Director Testifies on FY 2026 Budget. National Institutes of Health (NIH) Director Bhattacharya...more
6/16/2025
/ Biden Administration ,
Budget Reconciliation ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Executive Orders ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
National Institute of Health (NIH) ,
New Legislation ,
Proposed Legislation ,
Trump Administration
THIS WEEK’S DOSE -
- Senate Begins Work on Reconciliation. Democrats prepared to file points of order to exclude certain provisions under the Byrd rule, while Republicans discussed key health provisions.
- White House Sends...more
UPDATE: On May 30, 2025, the Fifth Circuit granted the TMA III plaintiffs’ petition for rehearing en banc, which was previously filed on December 16, 2024. Of note, the Fifth Circuit’s mandate has not yet been issued, so as a...more
On May 28, 2025, the Centers for Medicare & Medicaid Services (CMS) sent a letter to “select hospitals” that provide gender-affirming care services, requesting information about how those hospitals adhere to quality standards...more
6/2/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Gender Identity ,
Government Agencies ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicare ,
Reporting Requirements ,
Trump Administration
Senate Prepares to Take Up Reconciliation Bill. Discussions about the bill’s real-world implications continued during this week’s recess....more
On May 28, 2025, the Centers for Medicare & Medicaid Services (CMS) sent a letter to “select hospitals” that provide gender-affirming care services, requesting information about how those hospitals adhere to quality standards...more
5/30/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Gender Identity ,
Government Agencies ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Medicaid ,
Medicare ,
Regulatory Requirements ,
Reporting Requirements ,
Trump Administration
The US House of Representatives passed its One Big Beautiful Bill Act on May 22, 2025 (the Act), but nonprofit health systems may not find much about the Act that’s attractive. If passed by the US Senate and signed into law,...more
THIS WEEK’S DOSE -
- House Passes Reconciliation Package. The package now moves to the Senate, where substantive changes, including in healthcare, will likely be made.
- HHS Secretary Kennedy, FDA Commissioner Makary...more
5/27/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Executive Orders ,
Healthcare ,
Healthcare Reform ,
Inflation Reduction Act (IRA) ,
Medicaid ,
Medicare Advantage ,
New Legislation ,
Prescription Drugs ,
Senate Committees ,
U.S. House
THIS WEEK’S DOSE -
- Key House Health Committees Advance Reconciliation, Bill Held Up in Budget Committee. The Energy and Commerce Committee and Ways and Means Committee passed their recommendations for reconciliation out of...more
5/19/2025
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Executive Orders ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmacy Benefit Manager (PBM) ,
Proposed Legislation ,
Proposed Rules ,
Senate Judiciary Committee ,
Trump Administration
THIS WEEK’S DOSE -
- Republicans Advance Reconciliation Debate. Work continued behind the scenes among Republicans to reach consensus on Medicaid policies, with a House Energy and Commerce Committee markup announced for May...more
THIS WEEK’S DOSE -
- House Committees Begin Reconciliation Markups. Non-health-related committees moved forward this week, with the House Energy and Commerce Committee tentatively scheduled to mark up its legislative text in...more
HELP Committee Releases 340B Report. Health, Education, Labor, and Pensions (HELP) Chair Cassidy (R-LA) released findings from his investigation and laid out potential reforms to the 340B Drug Pricing Program....more
On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2026 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment...more
THIS WEEK’S DOSE -
House Passes Concurrent Budget Resolution for Reconciliation Process. Passage of the resolution didn’t resolve the policy differences between the House and the Senate. Those still need to be addressed as...more
THIS WEEK’S DOSE -
- Reconciliation Moves Forward with Senate Introduction of Concurrent Budget Resolution. This move initiates the next stage in the reconciliation process, which requires House and Senate passage of a...more