Bulletin Board

Federal Health Policy Update for July 3

The following is the latest health policy news from the federal government for June 27 – July 3. Some of the language used below is taken directly from government documents. Congress/Budget Reconciliation After more than 36 hours of intense lobbying by the administration and House Republican leadership and an all-night legislative session that carried well into Thursday afternoon, the House approved the Senate-passed version of H.R. 1, the reconciliation bill, by a vote of 218-214. Voting was almost entirely along party lines, with all House Democrats voting against it and [...]

July 3, 2025|Categories: 340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|Tags: 2026 Medicare physician payments, 340B, access to Medicaid dental services for people with intellectual and developmental disabilities, access to Medicaid services for people with intellectual and developmental disabilities, Affordable Care Act mandatory covered preventive health services, CMS approved Medicaid state plan amendments, CMS Wasteful and Inappropriate Service Reduction Model, CMS WISeR model, Department of Justice-Department of Health and Human Services False Claims Act Working Group, Federal FY 2025 budget reconciliation, federal Medicaid matching funds, FY 2025 Medicare hospital outpatient prospective payment system rate update, FY 2025 Medicare inpatient prospective payment system rate update, HHS Office of the Inspector General, House reconciliation bill, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH cuts, Medicaid eligibility redetermination, Medicaid managed care state directed payments, Medicaid provider taxes, Medicaid retroactive eligibility, Medicaid state directed payments, Medicaid work requirements, Medicare beneficiary data breach, Medicare end-stage renal disease prospective payment system, Medicare home health prospective payment system, proposed 2026 Medicare end-stage renal disease prospective payment system rates, proposed 2026 Medicare prospective payment system rates, Senate reconciliation bill, traditional Medicare prior authorization|

Health Care Implications of Senate Reconciliation Bill

On Tuesday the Senate passed an FY 2026 budget reconciliation bill by a vote of 51-50, with Vice President Vance casting the tie-breaking vote. The bill cuts $1 trillion in Medicaid spending and keeps most of the Medicaid provisions included in the version released by the Senate Finance Committee in mid-June. The bill passed by the Senate creates a fund for rural providers of $50 billion over five years. The major Medicaid provisions in the bill include: A freeze on the size of Medicaid provider taxes, phased down reductions of [...]

CMS Introduces First Prior Authorization Program for Traditional Medicare

Some Medicare-covered services will be subject to prior authorization in some parts of the country under a new model to be launched by the Centers for Medicare & Medicaid Services next year. To run from 2026 through 2031, the “Wasteful and Inappropriate Service Reduction Model,” or WISeR, will test a new process for determining whether enhanced technologies, including artificial intelligence, can expedite prior authorization for selected items and services that have been identified by CMS as particularly vulnerable to fraud, waste, abuse, or inappropriate use. The model will not include [...]

July 2, 2025|Categories: Centers for Medicare & Medicaid Services, CMMI, Medicare, Medicare reimbursement policy|Tags: Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, CMS, Medicare, Medicare prior authorization, Wasteful and Inappropriate Service Reduction Model, WISeR|

State Spending on Medicaid Rising – Fast

The states are experiencing almost unprecedented increases in their Medicaid spending – both more money and a larger share of their overall state budgets. According to a new Pew Research Center report, In fiscal year 2023, the combination of expiring federal COVID-19 pandemic aid, slowing tax revenue growth, and rising costs for Medicaid led to an increase in the share of state revenue dedicated to Medicaid of 17.8%, or $44.4 billion, over the previous year – the largest single-year rise in at least two decades. States spent 15.1% of every [...]

June 30, 2025|Categories: Medicaid|Tags: increased state medicaid spending, state Medicaid spending|

Federal Health Policy Update for June 26

The following is the latest health policy news from the federal government for June 20-26. Some of the language used below is taken directly from government documents. Congress Senate Majority Leader Thune and House Speaker Johnson continue to press for passage of the “One, Big, Beautiful Bill” by July 4, the deadline set by President Trump. Leader Thune had hoped to bring the bill to the Senate floor early this week but continued disagreements over cuts to Medicaid have slowed progress. Earlier this week, in an attempt to assuage senators’ [...]

June 26, 2025|Categories: Uncategorized|

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