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Federal Health Policy Update for December 11

The following is the latest health policy news from the federal government for December 5-11. Some of the language used below is taken directly from government documents. Congress The Senate voted today on competing proposals to address health care affordability: Democrats sought a clean extension of the Affordable Care Act premium tax credits set to expire on December 31 while Republicans tried to consolidate support around an alternative plan. Neither bill gained the 60-vote threshold needed for passage. In the House, Speaker Mike Johnson (R-LA) intends to bring a vote [...]

December 11, 2025|Categories: Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: Affordable Care Act, Affordable Care Act premium tax credit, Basic Health Program, CDC advisory committee on immunization practices, CMS and PEPPER, Department of Health and Human Services artificial intelligence strategy, Department of Health and Human Services’ Office of the Inspector General, FDA TEMPO Model, Health Savings Accounts, HHS AI strategy, HSAs, Increasing Organ Transplant Access Model, IOTA model, Medicaid eligibility community engagement requirements, Medicaid eligibility work requirements, Medicare ACCESS Model, Medicare Advancing Chronic Care with Effective Scalable Solutions Model, Medicare and rural emergency hospitals, Medicare and techology supported care options, Medicare home health payments, Medicare hospice payments, Medicare inpatient hospital payments, Medicare inpatient rehabilitation facility payments, Medicare outpatient dialysis payments, Medicare outpatient hospital payments, Medicare Payment Advisory Commission, Medicare site-neutral payments, Medicare skilled nursing facility payments, MedPAC, MedPAC Medicare payment recommendations, OPTN, organ procurement and transplantation network|

CMS Fleshes Out Medicaid Work Requirement

The Centers for Medicare & Medicaid Services has issued additional guidance to the states on how to implement the work and community engagements established as part of the criteria for Medicaid eligibility under H.R. 1, commonly known as the One Big Beautiful Bill Act, which was signed into law in July. The requirements seek to connect able-bodied, working-age adults with work and community engagement activities and reduce inappropriate Medicaid enrollment. The states are required to implement these requirements by January 1, 2027 but may do so sooner if they wish. [...]

December 11, 2025|Categories: Centers for Medicare & Medicaid Services, Medicaid|Tags: Medicaid eligibility criteria, Medicaid work and community engagement requirement, Medicaid work requirement|

MedPAC Discusses Preliminary 2027 Rate Recommendations

The members of the Medicare Payment Advisory Commission met virtually last week and reviewed and discussed preliminary proposals for 2027 Medicare rates and other Medicare payment issues. Leading the agenda for the two days of meetings was a review of the adequacy of current Medicare payments and discussion about rate 2027 rate recommendations for: hospital inpatient and outpatient services physician and other health professional services inpatient rehabilitation facility services skilled nursing facility services home health care services hospice services outpatient dialysis services MedPAC members also discussed: their mandated report on [...]

Urban Safety-Net Hospitals Most Vulnerable to Looming Health Care Cuts

While a great deal of attention has been paid to the potential implications for rural hospitals of the coming $1 trillion in federal health care spending cuts over the next decade, it turns out that urban safety-net hospitals, not rural hospitals, may be even more vulnerable to the effects of these cuts. According to an analysis by the New York Times and Harvard’s T.H. Chan School of Public Health, of the 109 hospitals in the country that will be most vulnerable to these cuts, 85 percent are urban safety-net hospitals [...]

December 8, 2025|Categories: Congress, hospitals, Medicaid|Tags: federal health care cuts, medicaid spending cuts, Rural hospitals, safety-net hospitals, urban safety-net hospitals|

Federal Health Policy Update for December 4

The following is the latest health policy news from the federal government for November 21 through December 4. Some of the language used below is taken directly from government documents. Congress Congress is back in session to discuss the Affordable Care Act tax credits set to end on December 31and other extenders that will expire on January 30, 2026 along with the latest continuing resolution (CR). Members continue to negotiate potential solutions to the expiring enhanced Affordable Care Act premium subsidies but there is no consensus on whether or how [...]

December 4, 2025|Categories: 340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: ACCESS Model, Advancing Chronic Care with Effective Scalable Solutions Model, Affordable Care Act, ARPA-H, Health and Human Services Office of the Inspector General, health care extenders, Hospital Inpatient Services Modernization Act, hospital price transparency, Inflation Reduction Act of 2022, Medicaid and ICE, Medicaid and Immigration and Customs Enforcement, Medicaid state plan amendments, Medicare Advantage, Medicare and durable medical equipment prosthetics orthotics and supplies, Medicare and ESRD, Medicare and Medicaid nursing home staffing requirement, Medicare and telehealth, Medicare DMEPOS, Medicare Drug Price Negotiation Program, Medicare end-stage renal disease prospective payment system, Medicare home health prospective payment system, Medicare Hospital Acute Care at Home program, Medicare Part D, Medicare star ratings, Medicare TEAM model, MLN Connects, Review Choice Demonstration for Inpatient Rehabilitation Facility Services, state directed Medicaid payments, technology-supported care, TEFCA|

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