News & Analysis as of

Centers for Medicare & Medicaid Services (CMS) Regulatory Reform Proposed Legislation

McDermott+

The ongoing saga of the PFS conversion factor: will it get fixed?

McDermott+ on

July 2, 2025 – There has been a lot of talk recently about the future of the Medicare Physician Fee Schedule (PFS) conversion factor (CF) – the standardized dollar amount used to convert relative value units (RVUs) into...more

Sheppard Mullin Richter & Hampton LLP

Congressional Budget Proposal Includes Adjustments to Dual-Eligible Enrollment Pathways and Medicare Savings Program Rules

In June 2025, the U.S. House of Representatives introduced a budget reconciliation bill titled the One Big Beautiful Bill Act (OBBBA). The legislation proposes a number of administrative changes to existing federal health...more

Sheppard Mullin Richter & Hampton LLP

Understanding the Federal Reconciliation Bill’s Implications for MCO Tax Structure

New York’s Medicaid financing strategy—particularly its use of a managed care organization (MCO) tax—has come under renewed federal scrutiny amid recent legislative proposals and regulatory developments. The federal...more

Holland & Knight LLP

Holland & Knight Health Dose: June 3, 2025

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Looking Ahead: Fiscal Year 2026 Appropriations - This week, the U.S. House of Representatives and U.S. Senate return to Capitol Hill following the Memorial Day recess. The Senate is expected to begin work behind the scenes on...more

Mintz - Health Care Viewpoints

PBM Legislation in the Reconciliation Bill is Far From Sweeping PBM Reform

Over the past few years, Congress has attempted to pass “federal PBM reform.” Members of Congress have held numerous hearings related to PBMs and introduced numerous bills seeking to regulate PBMs (we regularly track these...more

McDermott+

A Preview of the Preview: Our CY 2026 PFS Proposed Rule Webinar Is Next Wednesday

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It’s getting hot outside, which means that the summer regulatory season is almost upon us. In June or July, the Centers for Medicare & Medicaid Services (CMS) will release proposed regs impacting Medicare payments in...more

McGuireWoods Consulting

Summary of the House Energy and Commerce Committee’s Reconciliation Provisions on Energy, Environment, Communications and Health

On Tuesday, May 13, 2025, the House Energy and Commerce Committee started their 26-hour consideration of their portion of the budget reconciliation bill. The House Energy and Commerce Committee budget reconciliation...more

Epstein Becker & Green

Medicare Drug Price Negotiation Program: The Inflation Reduction Act “Pill Penalty” and Other IRA Reforms on the Horizon for 2026

Epstein Becker & Green on

When Congress adopted the Inflation Reduction Act (IRA) in 2022, creating the Medicare Drug Price Negotiation Program (MDPNP), the bill did not receive support from any Republican senators....more

Latham & Watkins LLP

Healthcare Life Sciences Drug Pricing Digest - April 2025 #2

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On April 15, 2025, President Trump signed an executive order titled “Lowering Drug Prices by Once Again Putting Americans First.” The order includes various provisions that are relevant to the pharmaceutical industry,...more

Alston & Bird

Health Care Week in Review | President Trump Announces Actions to Lower Drug Prices; Trump Administration Initiates Section 232...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott+

Regulatory Implications of the Continuing Resolution Healthcare Package

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Earlier this week, Congress released the text of a continuing resolution that includes a more-robust-than-anticipated healthcare package. While the bill’s primary purpose is to keep the government open through March 14, 2025,...more

Goodwin

A Look Ahead in Life Sciences: What We Are Tracking in Q2 2024 and Beyond

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As the life sciences, medtech, and diagnostic industries continue to expand and grow increasingly complex, so does the legal, regulatory, and compliance landscape. To help companies and investors navigate the many evolving...more

Latham & Watkins LLP

Health Care & Life Sciences: Drug Pricing Digest - December 2022

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Inflation Reduction Act Implementation: On Dec. 1, 2022, the Centers for Medicare & Medicaid Services (CMS) distributed an invitation addressed to “All Drug Manufacturers” announcing that CMS “will host monthly one-hour calls...more

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