The following is the latest health policy news from the federal government for August 8-14.  Some of the language used below is taken directly from government documents.

Congress

The House and Senate are both in recess and will return to Washington D.C. on September 2.  Funding for the federal government, along with health care extenders including extensions of telehealth flexibilities, the Acute Hospital Care at Home program, the Medicare-dependent hospital and low-volume hospital programs, and delays to Medicaid disproportionate share (Medicaid DSH) allotments, all expire September 30.

In the fall, Congress is considering pursuing health care legislation along two tracks, one a potentially bipartisan package and another a potential reconciliation bill.  Lawmakers are preparing a broad health care package for action this fall that could address expiring health care programs along with potential reforms in Medicare Advantage, pharmacy benefit manager regulation, Medicare site-neutral payment policies for hospitals, and Medicare reimbursement changes for long-term acute-care hospitals – all proposals that could move with support from both sides of the aisle.  Regarding a second reconciliation bill, today the Republican Study Committee, a group of nearly 200 fiscally conservative House members, will receive a briefing from the Paragon Institute that is expected to touch on site-neutral payments for Medicare, 340B, the federal Medicaid matching percentage (FMAP), enhanced tax credits for Affordable Care Act premiums, and more.

The White House

The White House has issued an executive order calling for supplying the U.S. Strategic Active Pharmaceutical Ingredients Reserve with critical drug components, starting with the development of a list of about 26 critical drugs vital to “national health and security” and then ensuring that the reserve maintains a six-month supply of the components needed for the domestic manufacture of those drugs.  Learn more from this White House executive order.

Department of Health and Human Services
  • HHS’s Office of the Assistant Secretary for Technology Policy (ASTP) has developed three new indices to measure hospitals’ progress toward interoperability.  Learn more about how ASTP developed these indices, what they will measure, and how they will be used from this ASTP blog post.
  • HHS’s Health Resources and Services Administration (HRSA) has requested permission to initiate a new data collection requirement to support its Substance Use Disorder Treatment and Recovery Loan Repayment Program and its Pediatric Specialty Loan Repayment Program.  These programs authorize HRSA to repay eligible education loans to individuals working in certain areas of practice in specific geographic areas and the purpose of this information collection is to obtain data that will be used to assess applicants’ eligibility and qualifications for the programs and to obtain information for eligible facilities or sites.  Clinicians interested in participating in these programs must apply to participate.  Learn more about this data collection and the eligible provider types from this HRSA notice.  The deadline for submitting comments about this proposed data collection is October 14.
  • HRSA has posted a video explaining its new, one-time identity verification process for applicants, grantees, service providers, consultants, and technical analysts using its electronic handbooks.  Those handbooks are web-based interfaces used for all health center program awards or designated management activities.  Find that video here.  The new verification process takes effect on August 28.
  • HHS’s Office of the Inspector General (OIG) has issued a favorable opinion about remuneration to physicians with an ownership interest in a device manufacturer.  Find that opinion here.
Centers for Medicare & Medicaid Services
  • CMS has updated its web-based training course on combating Medicare Part C and D fraud, waste, and abuse.  Find the updated course here.
  • CMS has posted a bulletin on bypassing common working file edits on inpatient Medicare Part B ancillary 12X claims; the bulletin also notes a change in the effective date of this procedure.  Find the bulletin here.
  • CMS has posted a fact sheet on Medicare coverage provided to patients in custody under penal authority.  Find that fact sheet here.
  • CMS has published its “2025-2026 Medicaid Managed Care Rate Development Guide” for states to use when setting capitation rates for any managed care program subject to federal actuarial soundness requirements during rating periods starting between July 1, 2025, and June 30, 2026.  The guide details CMS’s expectations of information to be included in actuarial rate certifications and will be used as a basis for CMS’s reviews.  Find the guide here.
Medicaid State Plan Amendments

CMS has approved a state plan amendment for the Medicaid program in Hawaii, revising state plan language concerning nursing facility services to comport with the requirement that nursing facility services are ordered by and provided under the direction of a physician.

State-Directed Medicaid Payments

CMS has approved the following state applications for Medicaid state-directed payments.

  • To Louisiana, implementing a uniform dollar increase for pediatric home health nurses established by the state for home health services for the rating period July 1, 2025 through June 30, 2026, to be incorporated into capitation rates through a separate payment term up to $3.3 million.
  • To California, implementing a uniform dollar increase for inpatient and outpatient services provided by eligible network children’s hospitals in the Children’s Hospital Increased Reimbursement Program for the portion of the rating period covering July 1, 2024 through December 31, 2024, which was incorporated into capitation rates through a separate payment term amount of up to $115 million.
  • To Michigan, implementing a uniform dollar increase for nursing facility services for the rating period covering January 1, 2025 through December 31, 2025, to be incorporated into capitation rates through a separate payment term of up to $34 million.
HHS Newsletters, Reports, and Videos
Centers for Disease Control and Prevention (CDC)

The CDC has launched a new campaign to address youth substance use and mental health.  Learn more about the campaign from this CDC announcement.

Food and Drug Administration (FDA)
  • The FDA has announced that the nationwide shortage of sodium chloride 0.9 percent injection products, a form of intravenous (IV) saline, has officially ended.  Learn more from this FDA news release.
  • The FDA has introduced a new program to strengthen the domestic pharmaceutical supply chain by increasing regulatory predictability and facilitating the construction of manufacturing sites in U.S.  Learn more about the program from this FDA news release.
Medicaid and CHIP Payment and Access Commission (MACPAC)

MACPAC has updated its issue brief on Medicaid financing to reflect changes introduced since its last edition, including changes enacted through the recently passed FY 2025 budget reconciliation bill.  The brief provides information on the components of Medicaid financing, including federal matching rates and exceptions, state funding sources, and the process used by states to claim federal matching funds.  Find it here.

Stakeholder Events

CMS – Advisory Panel on Hospital Outpatient Payment Meeting – August 25

CMS’s Advisory Panel on Hospital Outpatient Payment will meet virtually on Monday, August 25 at 9:30 (eastern).  The panel advises CMS on the clinical integrity of the Ambulatory Payment Classification (APC) groups and their associated weights.  Learn more about the panel and the meeting’s agenda from this CMS formal notice.

MedPAC – Commissioners Meeting – September 4-5

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, September 4 and Friday, September 5.  An agenda and registration information are not yet available but when they are they will be posted here.

HHS – Using Data to Empower Patients – September 8-9

HHS’s Physician-Focused Payment Model Technical Advisory Committee will hold a two-day event building on its series of discussions on developing and implementing PB-TCOC (Reducing Barriers to Participation in Population-Based Total Cost of Care) models.  These meetings, to be held on Monday, September 8 and Tuesday, September 9, will focus on using data and health information technology to empower patients and support providers.  Interested parties may attend in person, follow a live stream, or dial in for audio only.  Go here to learn more about the two-day event, including registration information (registration is required) and agendas.

MACPAC – Commissioners Meeting – September 18-19

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, September 18 and Friday, September 19.  An agenda and registration information are not yet available but when they are they will be posted here.