Government Is Funded, Congress at Home for the Week. On March 15, 2025, President Trump signed a continuing resolution (CR) into law that funds the government and provides short-term extensions of certain healthcare programs...more
3/24/2025
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Executive Orders ,
Federal Trade Commission (FTC) ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Regulatory Agenda ,
Technology Sector ,
Telehealth ,
Trump Administration
On January 14, 2025, the US Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), jointly issued Part 69 of a series of...more
3/18/2025
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Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Disclosure Requirements ,
Dispute Resolution ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
New Guidance ,
No Surprises Act (NSA) ,
Regulatory Requirements ,
Trump Administration
THIS WEEK’S DOSE -
- Congress Debates Government Funding. A continuing resolution (CR) to fund the government through September passed the House and may pass the Senate today.
- Senate HELP Committee Advances NIH, FDA...more
3/17/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Food and Drug Administration (FDA) ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
Proposed Rules ,
Public Health ,
Regulatory Agenda
On March 5, 2025, the Center for Clinical Standards and Quality (CCSQ) within the Centers for Medicare & Medicaid Services (CMS) released a Quality & Safety Special Alert Memo for hospitals related to President Trump’s...more
Senate Passes Budget Resolution. Last week, the Senate and House Budget Committees each passed separate, and very different, budget resolutions as their first steps toward negotiating a unified budget resolution that must...more
RFK Jr. Confirmed as HHS Secretary. In a 52 – 48 Senate vote, Robert F. Kennedy (RFK) Jr. was confirmed as the next HHS secretary. All Democrats voted no, and Sen. McConnell (R-KY) was the only Republican to join them. He...more
2/14/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
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Executive Orders ,
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Legislative Agendas ,
Medicaid ,
Medicare ,
National Institute of Health (NIH) ,
Public Health ,
Regulatory Agenda ,
Trump Administration
Key Nominations Move Forward. The Senate Finance Committee advanced Robert F. Kennedy (RFK) Jr.’s nomination to lead the US Department of Health & Human Services (HHS) in a 14 – 13 vote along party lines. The nomination now...more
2/10/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Executive Orders ,
Gender Identity ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Opioid ,
Presidential Nominations ,
Public Health ,
Senate Committees ,
Senate Confirmation Hearings ,
Trump Administration ,
U.S. House
House Committees Organize, Senate Committees Begin Nomination Hearings. House healthcare committees held organizing meetings and announced subcommittee assignments, while Senate committees held nomination hearings for...more
118th Congress Continues to Grapple with Contentious CR. With the collapse of Republican support for the negotiated continuing resolution (CR) package, as of the time of publication on Friday at 3:00 PM EST, Congress is still...more
12/23/2024
/ Artificial Intelligence ,
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Machine Learning ,
Medicaid ,
Medicare ,
Pharmaceutical Industry ,
Prescription Drugs ,
Proposed Legislation ,
Regulatory Agenda ,
Technology ,
U.S. House
Senate Special Committee on Aging Holds Hearing on People with Disabilities. Senators and witnesses acknowledged the significant barriers that exist for Americans with disabilities and discussed current and proposed federal...more
12/16/2024
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Disabilities ,
Federal Trade Commission (FTC) ,
Final Rules ,
GAO ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Legislative Agendas ,
Medicare Advantage Organizations (MAOs) ,
MedPAC ,
NDAA ,
OIG ,
Regulatory Agenda ,
Senate Committees ,
U.S. House ,
Veterans' Benefits
The No Surprises Act, a law that ended the practice of “balance billing” by certain out-of-network providers, was enacted as part of the Consolidated Appropriations Act of 2021 on December 27, 2020. While the law passed...more
12/12/2024
/ Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Enforcement Actions ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Regulatory Agenda ,
Surprise Medical Bills ,
Trump Administration
Congress Negotiates Healthcare Extenders, Continues to Plan for 2025. Lawmakers continue negotiations to wrap up the 118th Congress and pass remaining must-do policies, including government funding, likely through a...more
12/9/2024
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Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
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Healthcare Reform ,
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Machine Learning ,
Medicaid ,
Medicare ,
Pharmaceutical Industry ,
Prescription Drugs ,
Proposed Legislation ,
Regulatory Agenda ,
Section 340B ,
Technology ,
U.S. House
Congress Returns for Lame Duck Session. The House and Senate returned this week, kicking off the post-election lame duck session. The focus this week was not on legislating, but on organizing for the upcoming 119th Congress,...more
11/18/2024
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Department of Health and Human Services (HHS) ,
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Healthcare ,
Healthcare Reform ,
Lame Duck Session ,
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Medicaid ,
Medicare ,
Members of Congress ,
Presidential Elections ,
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Senate Committees ,
Trump Administration
Republicans Win Control of White House and Senate, Seem Poised to Maintain Control of House. Former President Donald Trump will return to the White House, and Republicans also gained control of the Senate. Some toss-up House...more
11/11/2024
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Drug Pricing ,
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Medicare Advantage ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Presidential Elections ,
Proposed Rules ,
Senate Committees ,
Senate Judiciary Committee ,
U.S. House
On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Final Rule [CMS-1809-F],...more
On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more
Have Medicare physician fee-for-service payment rates increased for X-ray services? How have remote patient monitoring prices evolved over the last five years? How much is your service paid in Alaska compared to Alabama?...more
Congress Continues Election Recess. Members are on the campaign trail and are scheduled to return for the lame duck session on November 12, 2024.
CMS Releases Proposed NBPP for 2026. The proposed Notice of Benefit and...more
10/14/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
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GAO ,
Healthcare ,
Healthcare Reform ,
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Pharmaceutical Industry ,
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U.S. House
Congress Votes on CR, Health-Related Legislation. After reaching a deal over the weekend, both chambers passed a CR to avoid a government shutdown and fund the federal government through December 20, 2024. This tees up a push...more
9/30/2024
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Centers for Medicare & Medicaid Services (CMS) ,
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Cybersecurity ,
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Final Rules ,
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HELP ,
HRSA ,
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Medicaid Drug Rebate Program ,
New Legislation ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
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State Bans ,
Telehealth ,
Telemedicine
Senate Judiciary Human Rights and the Law Subcommittee Holds Hearing on Georgia Abortion Ban. The field hearing examined how Georgia’s abortion ban impacts women’s health, and featured patient and physician witnesses....more
9/23/2024
/ Abortion ,
Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Food and Drug Administration (FDA) ,
Georgia ,
HRSA ,
Human Rights ,
Inflation Reduction Act (IRA) ,
Medicaid ,
Medicare ,
Medicare Part D ,
Proposed Legislation ,
Proposed Regulation ,
State Bans ,
Telehealth
House Education & the Workforce Health, Employment, Labor, and Pensions Subcommittee Holds Hearing on ERISA’s 50th Anniversary. Members and witnesses assessed how the Employee Retirement Income Security Act of 1974 (ERISA)...more
9/16/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
Final Rules ,
GAO ,
Healthcare Reform ,
HRSA ,
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Medicare ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
New Legislation ,
NQTLs ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Regulatory Agenda ,
Regulatory Reform ,
U.S. House
CMS Finalizes New TCET Pathway. The final procedural notice, effective immediately, creates a new pathway that uses existing national coverage determination and coverage with evidence development (CED) processes to expedite...more
On August 5, 2024, the US Department of Health and Human Services (HHS) Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP) published the Health Data,...more
On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the Hospital Inpatient Prospective Payment System (IPPS) final update for fiscal year (FY) 2025, along with proposed policy and regulation changes....more
Senate HELP Committee Marks Up Public Health Program Reauthorizations. The bills would reauthorize several programs related to older adults, individuals with developmental disabilities and individuals with traumatic brain...more