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Federal Health Policy Update for January 8

The following is the latest health policy news from the federal government for December 29 to January 8. Some of the language used below is taken directly from government documents. Congress Congress returned from winter recess facing a full policy agenda and health care issues remain prominent. Following the expiration of the Affordable Care Act’s enhanced premium tax credits, the House is expected to vote on a three-year clean extension brought by a discharge petition from Democratic House Leader Hakeem Jefferies (D-NY). The Senate is unlikely to advance the measure [...]

January 8, 2026|Categories: 340b, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy|Tags: 340B, 340B prescription drug pricing program, Affordable Care Act, Affordable Care Act enhanced premium tax credits, CDC and childhood immunization schedule, CMS direct graduate medical education, CMS technical expert panels, eCQMs, hospital outpatient drug acquisition cost survey, hospital quality reporting system, Independent Dispute Resolution entities, Medicaid state plan amendments, Medicare Advantage, Medicare graduate medical education residency slots, Medicare provider enrollment application, MLN Connects, No Surprises Act, telehealth, telehealth flexibilities extension, updated cervical cancer screening guidelines|

Federal Health Policy Update for December 29

The following is the latest health policy news from the federal government for December 19–December 29. Some of the language used below is taken directly from government documents. Rural Health Transformation Fund CMS announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under the 2025 reconciliation bill, H.R. 1, to strengthen and modernize health care in rural communities. In 2026, states will receive first-year awards averaging $200 million, ranging from $147 million to $281 million. The Rural Health Transformation Program’s [...]

December 29, 2025|Categories: Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|Tags: Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) Model, CMS ACCESS Model, CMS BALANCE Model, CMS Guard Model, CMS Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model, CMS Office of Rural Health Transformation, Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model, H-1B Work Visas, HHS and ASTP/ONC request for information on artificial intelligence AI, HHS Office of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC), Medicaid state plan amendments, Medicare Acute Hospital Care at Home program, Medicare and graduate medical education payments, Medicare GLP-1 Payment Demonstration, Medicare GME, Organ Procurement and Transplantation Network (OPTN), Payer Price Transparency Requirements, Rural Health Transformation Fund, Rural Health Transformation Fund grants, state Medicaid interested parties advisory groups|

Federal Health Policy Update for December 18

The following is the latest health policy news from the federal government for December 12-18. Some of the language used below is taken directly from government documents. Congress In a 216-211 vote yesterday, the House passed the Lower Health Care Premiums for All Americans Act, a Republican package aimed at addressing multiple health care policies. The legislation includes provisions for employee tax-advantaged benefits like HSAs and FSAs, cost-sharing reductions (CSR) subsidies, and increased transparency requirements for pharmacy benefit managers (PBMs). It notably did not include an extension of the enhanced [...]

December 18, 2025|Categories: Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: ACCESS Model, Advancing Chronic Care with Effective, Affordable Care Act, ICD-10, LEAD Model, Long-term Enhanced ACO Design Model, MAHA ELEVATE Model, Make America Healthy Again Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence Model, Measures Under Consideration, Medicaid, Medicaid conditions of participation, Medicaid state plan amendments, Medicare, Medicare Advantage, Medicare and skin substitutes, medicare conditions of participation, MLN Connects, proposed Medicaid gender-affirming regulation, proposed Medicaid sex-rejecting regulation, Scalable Solutions Model|

Controversy Over No Surprises Act Continues

Providers and payers continue to wage war over how the No Surprises Act is being implemented. The law, enacted in 2020, was intended to prevent insured consumers from receiving surprise medical bills, especially for out-of-network care. While it has achieved that objective to a considerable degree, it has left behind providers complaining they are being underpaid for their services and payers – health insurers – insisting that the process of adjudicating such disputes, through what is known as the Independent Dispute Resolution process, is forcing them to pay far too [...]

December 18, 2025|Categories: Uncategorized|Tags: Independent Dispute Resolution process, No Surprises Act, Surprise medical bills|

Hospital Bad Debt and Charity Care Rising

Hospital bad debt and charity care are rising, according to a new report. Both are up five percent from October of 2024 to October of 2025 – and 40 percent greater than in 2022. Among the causes are natural demographic changes and post-COVID Medicaid redeterminations, the latter of which is leaving many low-income Americans without health insurance. The impact of rising bad debt and charity care are being felt most in the western U.S. And one bright spot: charity care and bad debt as a percentage of hospital gross revenue [...]

December 17, 2025|Categories: hospitals, Medicaid|Tags: hospital bad debt, hospital charity care, Medicaid eligibility redeterminations|

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