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The following is the latest health policy news from the federal government for July 3-9.  Some of the language used below is taken directly from government documents.

Congress

Congress will return to session on July 13.  Committees with jurisdiction over health care will continue focusing on legislation that could ultimately be incorporated into a reconciliation package, FY 2027 appropriations legislation, or other end-of-year legislation.

Centers for Medicare & Medicaid Services (CMS)
  • In the wake of passage of H.R. 1, last year’s federal budget reconciliation act, and its new requirement that the CMS Chief Actuary must certify budget neutrality for Medicaid section 1115 demonstrations, CMS has rescinded 2015 guidance on a fast-track federal review process for section 1115 demonstration extensions.  Learn more from this informational bulletin from CMS to state Medicaid programs.
  • CMS has posted a bulletin presenting updates of its ambulatory surgical center payment system.  The update includes new HCPCS codes, revised code descriptors, and ambulatory surgical center payment indicator changes.  Find that bulletin here.  The updates took effect on July 6.
  • CMS has posted a bulletin presenting guidance on continuing to use the KF modifier on durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claims.  Find that bulletin here.  Implementation of this guidance took effect on July 6.
  • CMS has posted a bulletin presenting changes in the National Laboratory Coverage Determination (NCD) edit software that will take effect in October.  The changes include added and deleted ICD-10-CM codes.  Find that bulletin here.
Department of Health and Human Services (HHS)
  • The Office of Management and Budget (OMB) has published the administration’s 2026 regulatory plan and unified agenda of federal regulatory and deregulatory actions.  This agenda includes the regulations HHS will propose in 2026 and provides links to additional information about those rules.  Find HHS’s agenda here.
  • HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) has announced more than $281 million in funding opportunities.  SAMHSA will award grants through 15 separate programs addressing trauma, mental illness, substance use prevention, addiction treatment, overdose prevention and response, and suicide prevention.  Learn more about the individual grant programs and find links to the formal notices of funding opportunities and information about how to apply for grants in this HHS news release.
  • HHS and CMS have launched the “Make Hospital Food Healthier Pledge,” a nationwide initiative inviting hospitals to serve healthier, more nutritious meals.  The voluntary pledge encourages hospitals to reduce highly processed foods and prioritize nutrient-dense options that align with official government dietary guidelines, reinforcing the critical role of nutrition in improving patient health, supporting recovery, and promoting long-term wellness.  Learn more about the pledge and the dietary guidelines from this HHS news release.
  • HHS’s Office of the National Coordinator for Health IT (ONC) has launched a new publication:  the “Coordinator’s Quarterly.”  The ONC writes that “… the publication… will provide critical information and updates on ONC policies and activities from the previous quarter, along with research findings.”  Find the first edition here.
  • The Sequoia Project, which serves as the recognized coordinating entity for ONC’s Trusted Exchange Framework and Common Agreement (TEFCA), has published updated standard operating procedures for individual access providers.  Learn more from this updated operating procedure document and an accompanying updated FAQ.
Medicaid State Plan Amendments

CMS has approved state plan amendments for Medicaid and CHIP programs in the following states:

  • California, delaying consideration of resource increases for Medicaid renewal applicants
  • Colorado, updating delegation of authority to conduct fair hearings
  • Colorado, implementing income and resource disregards for participation in the Medicaid Advisory Committee and Beneficiary Advisory Council
  • Kansas, addressing services under the EPSDT program
Health Policy Newsletters, Reports, and Videos
Medicaid and CHIP Payment and Access Commission (MACPAC)

MACPAC has published an issue brief titled “Demographic Characteristics of Medicaid Beneficiaries Enrolled in the Program of All-Inclusive Care for the Elderly” that examines differences in demographic characteristics and long-term nursing facility use between PACE enrollees who are full-benefit dually eligible beneficiaries and those who are Medicaid-only using linked Medicare and Medicaid administrative data from calendar year 2023.  For more information, see the issue brief here.

Stakeholder Events

CMS – Hospital Outpatient Quality Reporting Program webinar – July 22

CMS’s eCQI Resource Center will hold a webinar titled “Review of Electronic Clinical Quality Measures” on Wednesday, July 22 at 2:00 (eastern).  The webinar will address electronic clinical quality measure (eCQM) details, specifications, and logic and review scenarios for eCQMs, discuss Quality Reporting Document Architecture Category I requirements, submission deadlines, and more.  Learn more about the webinar, available continuing education credits, and how to participate from this CMS notice.  Registration is required.

CMS – 2026 National Provider Compliance Conference – August 11–12

On Tuesday, August 11 and Wednesday, August 12, CMS will hold a national provider compliance conference that will bring together Medicare Administrative Contractors (MACs) and Center for Program Integrity experts to provide compliance professionals with the information and tools they need to submit Medicare Part A, Part B, home health and hospice, and durable medical equipment claims.  Learning opportunities will include individual presentations, Q&A segments, panel discussions, and a dedicated exhibit area for engagement between MACs and providers.  The target audience for this conference is Medicare fee-for-service providers only, including medical review contractors, compliance officers, nurse and billing managers, medical record staff, coders, and provider associations.  Go here to learn more about the conference and to register to participate.  The conference will be held in Charlotte and will have no virtual component and a limited number of participants.

CMS – Advisory Panel on Hospital Outpatient Payment – August 24

CMS’s Advisory Panel on Hospital Outpatient Payment will meet virtually on Monday, August 24 at 9:30 (eastern).  The purpose of this panel is to advise CMS on the clinical integrity of the Ambulatory Payment Classification groups and their associated weights, which are major elements of the Medicare hospital outpatient prospective payment system and the ambulatory surgical center payment system and supervision of hospital outpatient therapeutic services.  Interested parties are invited to submit comment letters and presentations.  Learn more about submitting such materials and how to participate in the meeting 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.