The following is the latest health policy news from the federal government for May 22-28.  Some of the language used below is taken directly from government documents.

Congress
  • When Congress returns from the Memorial Day recess next week, lawmakers will have to address the Republican-led reconciliation bill to fund ICE and CBP. After, they plan to start working on a third party-line bill focusing on affordability—including health care—which leadership aims to pass by the end of July.
  • Next week, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies is scheduled to mark up its Fiscal Year (FY) 2027 spending bill.
H.R. 1 Medicaid Eligibility

CMS released slides from a presentation titled, “Implementation of Section 71109 ‘Alien Medicaid Eligibility’ of the Working Families Tax Cut Legislation,” which provides an overview of changes to noncitizen eligibility and how states can appropriately claim federal financial participation in accordance with provisions of H.R. 1 for individuals enrolled in the Medicaid and Children’s Health Insurance Program (CHIP), beginning October 1, 2026.  For more information, see CMS’s State Health Official letter from April here and the presentation slides here.

Centers for Medicare & Medicaid Services (CMS)
  • HHS, the Department of Labor, the Department of Treasury, and the Office of Personnel Management released the “Federal Independent Dispute Resolution (IDR) Operations” final rule, updating standards for group health plans and health insurance issuers; providers, facilities, and providers of air ambulance services; and certified IDR entities related to the Federal IDR process under the No Surprises Act.  The rule aims to improve the process used to resolve out-of-network payment disputes by streamlining communication between payers, providers, and certified IDR entities and clarifying timelines and processes. For more information, see the HHS press release here, the CMS press release here, the CMS fact sheet here, and the final rule here.
  • CMS issued a change request to provide instructions to Rural Health Clinics and Federally Qualified Health Centers on how to bill distant site telehealth services for dates of service on or after October 1, 2026. Review the change request here.
Department of Health and Human Services
  • Health Resources and Services Administration (HRSA) issued an information collection request for the Health Professions Student Loan Program, Loans for Disadvantaged Students Program, Primary Care Loan Program, and Nursing Student Loan Program Administrative Requirement. The agency seeks comments from schools of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, and pharmacy that have received awards from any of the Public Health Service loan programs listed in the title of the request.  Comments are due July 27, 2026.  See the Federal Register for more information here.
  • HHS and the Department of Justice (DOJ) announced criminal charges against 15 defendants for their alleged roles in over $90 million in various fraud schemes, including the two Medicaid fraud cases. Additionally, the departments announced increased funding for 15 new prosecutors and associated staff to support the Health Care Fraud Strike Force, aimed at combatting Medicaid fraud.  HHS OIG and the FBI also expanded of the Midwest Strike Force to include the District of Minnesota; it was previously based in Detroit, Michigan and Chicago, Illinois.  See the press release here for more information.
  • The Office of Management and Budget (OMB), HHS, and other federal departments and agencies issued a proposed rule to revise the “Guidance for Federal Financial Assistance” to restructure government-wide policies and requirements related to the management of grants, cooperative agreements, and other forms of assistance across all agencies. Comments are due 45 days after publication in the Federal Register.  See the unpublished proposed rule here.
  • HHS, in partnership with CMS and SAMHSA, announced the addition of ten new states into the Certified Community Behavioral Health Clinic Medicaid Demonstration Program: Alaska, Colorado, Hawaii, Louisiana, Maryland, Mississippi, Montana, North Dakota, Washington, and West Virginia.  The program provides states with funding to expand access to comprehensive mental health and substance use disorder and recovery support services.  For more information, see the press release here.
HHS/Office of the Inspector General (OIG)
  • HHS’s Office of Inspector General (OIG) issued a favorable opinion regarding an orthopedic surgery provider’s proposed warranty program pursuant to which the orthopedic surgery provider would refund certain concierge fees to patients who require revision surgery within two years of an initial surgery. The OIG concluded the proposed service would not generate prohibited remuneration under the federal anti-kickback statute or beneficiary inducements civil monetary penalty.  See the advisory opinion here.
Medicaid State Plan Amendments 

CMS has approved the following state plan amendments for Medicaid and CHIP programs.

  • To Alaska, extends the state’s exception to the Recovery Audit Contractor requirements under section 1902(a)(42)(B) of the Act through June 30, 2028.
  • To Arkansas, revises reimbursement for certain dental services, including oral and maxillofacial surgery, pediatric dental services, and services for adults with special needs.
  • To California, permanently memorialize this expansion in the State Plan to allow the population ‘Aged 65 or older’ to be covered by Hospital Presumptive Eligibility.
  • To Illinois, proposing a rate increase for facilities licensed by the Department of Public Health under the state law.
  • To Maryland, provides for mandatory coverage in accordance with section 1902(a)(54)(D) of the Social Security Act (the Act) for eligible juveniles that are incarcerated in a public institution post-adjudication of charges.
  • To Maryland, implements a requirement that the Non-Emergency Medical Transportation (NEMT) program cover related travel expenses to include lodging and meals for non-emergency transportation services.
  • To Massachusetts, increasing psychiatric admissions supplemental payment pool amount by $5 million for privately-owned psychiatric inpatient hospitals.
  • To Massachusetts, implementing new and increases existing acute inpatient hospital supplemental payments for a total amount of $85 million for privately-owned acute inpatient hospitals.
  • To Nevada, increasing the rate for two substance use disorder service codes and updates the methodology reference for MAT for OUD services.
  • To Oklahoma, increase reimbursement rates for Children First targeted case management and nursing assessment services.
HHS Newsletters, Reports, and Videos
  • CMS – MLN Connects – May 28
  • CDC – Morbidity and Mortality Weekly Report (MMWR) – May 21 and May 28
Centers for Disease Control and Prevention (CDC)
  • The CDC issued an interim final rule revising a previous order that temporarily limits the entry of specific people into the United States due to the Ebola outbreak. Now, the suspension applies to U.S. lawful permanent residents (green card holders) who have been in the Democratic Republic of Congo (DRC), Uganda, or South Sudan within the last 21 days.  The amended order provides exceptions for U.S. citizens and U.S. nationals and other categories of individuals under certain conditions.  For more information, see the update here.
  • The CDC has expanded enhanced public health entry screening for Ebola to Hartsfield-Jackson Atlanta International Airport, in addition to screening at Washington-Dulles International Airport. For more information, see the press release here.
  • In a recent CDC Clinician Outreach and Communication Activity (COCA) call, the agency discussed the history and ecology of Bundibugyo virus, and how U.S. clinicians should prepare, diagnose, and manage patients with suspected or confirmed Ebola disease. See this link for more information.
  • The CDC issued an alert for Salmonella illnesses and outbreaks linked to moringa leaf products. 22 new individuals across four new states have gotten sick; six new people have been hospitable and there are no reported deaths.  See the alert update for more information.
Food and Drug Administration (FDA)

The FDA approved Hepcludex injection to treat chronic hepatitis delta virus (HDV) infection in adults without cirrhosis (advanced liver scarring).  This drug is the first FDA approved treatment for chronic HDV infection—a condition that can cause rapid development of liver fibrosis, liver cancer, liver failure, and death.  For more information, see the press release here. 

Government Accountability Office (GAO)

GAO identified three new priority recommendations for the Department of Veterans Affairs, highlighting improved quality and timely access to health care; modernized information technology; and enhanced acquisition management.  For more information see the press release here, and the full report here. 

Congressional Research Service (CRS)

The Congressional Research Services (CRS) has prepared an overview of Medicare’s site-neutral payment policy, which includes background, statutory authority, CMS rules and implementation, legal challenges, and considerations for Congress.  Find that report here.

Medicaid and CHIP Payment and Access Commission (MACPAC)
  • MACPAC published an issue brief providing an overview of pharmacy benefit managers (PBMs) and their interactions with Medicaid’s managed care and fee for service drug benefit programs. The brief summarizes clinical and operational services PBMs provide, PBM revenue, stakeholder concerns, and federal and state legislative and regulatory responses to oversight of these entities.  See the publication here.
  • MACPAC published an issue brief about the transition to adult Medicaid coverage for children and youth with special health care needs. See the publication here. 
Stakeholder Events

CMS – HCPCS Level II Public Meetings – June 1

CMS will hold its 2026 HCPCS level II public meeting, in person and virtually, on June 1, 2026 at 9:00 (eastern), with an overflow date of Tuesday, June 2, 2026 to be held virtually, if necessary, to discuss CMS’s preliminary coding, Medicare benefit category, and Medicare payment determinations.  Learn more about the meeting, including how to submit questions and comments and how to register to participate, from this CMS notice.

MedPAC – Commissioners Meeting – September 3-4

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, September 3 and Friday, September 4.  An agenda for the meeting and information about how to participate has not yet been posted; when they are, they will be found here.

MACPAC – Commissioners Meeting – September 24-25

MACPAC’s commissioners will hold their next public meeting on Thursday, September 24 and Friday, September 25.  An agenda for the meeting and information about how to participate has not yet been posted; when they are, they will be found here.