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Federal Health Policy Update for September 24

Don’t Miss: CMS plans major cuts in Medicare clinical lab payments Administration reconsiders shifting NIH grant decisions to White House All states enroll in CMS model to reduce prices of selected Medicaid-covered drugs The following is the latest health policy news from the federal government for September 18-24. Some of the language used below is taken directly from government documents. The White House The White House has issued the executive order “Enhancing Program Integrity and Interagency Coordination in the Administration of the H-1B Nonimmigrant Visa Program.” The order increases federal [...]

September 24, 2026|Categories: Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and homelessness, Medicaid regulations, Medicare, Medicare reimbursement policy|Tags: Affordable Care Act, Affordable Care Act broker moratorium, Affordable Care Act unauthorized enrollments, CMS GENEROUS Model, H-1B visas, HHS Office of the Inspector General, Justice Department and gender-affirming care, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid most-favored nation prescription drug prices, Medicaid provider taxes, Medicaid state plan amendments, Medicare, Medicare clinical laboratory services payment rates, MLN Connects, National Vaccine Advisory Committee, NIH and merit review process for grants, proposed CMS regulation governing Medicaid provider taxes, Rural Health Transformation Program funding, Treatment First funding|

Where Have All the Nursing Home Beds Gone?

Across the country, the supply of nursing homes is dwindling. Nationally, the Centers for Medicare & Medicaid Services reports 900 fewer certified nursing homes in 2025 than in 2015. Why the decline? The most commonly cited reason is inadequate payments from Medicaid, the leading payer for nursing home care, which generally pays less than the daily cost of care. Another is staffing: nursing home jobs pay poorly and are considered stressful, making it difficult to attract and retain staff. Even the erosion in the number of beds may not completely [...]

September 24, 2026|Categories: Uncategorized|

CMS Eyes Major Cuts in Medicare Clinical Lab Rates

Medicare payments for clinical laboratory services will soon be coming down. The Centers for Medicare & Medicaid Services is working to bring Medicare’s clinical laboratory services rates into line with those paid by commercial insurers. Asserting that Medicare is now paying 16 percent more for clinical lab tests than commercial payers, the agency has posted proposed rates for calendar year 2027 that reflect the beginning of what in some cases will be a multi-year process of aligning public and private lab payments – “aligning” by reducing Medicare payments. Hospital laboratories [...]

September 23, 2026|Categories: Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|Tags: Medicare, Medicare clinical laboratory payments, Medicare clinical laboratory rates, Medicare reimbursement|

Immigrant Families Skipping Health Care for Kids

Immigrant families with children appear to be avoiding seeking health care over concern about their immigration status, according to a new survey of pediatricians. The survey, conducted on behalf of the American Academy of Pediatrics, found that: Forty percent of pediatricians reported that immigrant families with children are avoiding seeking care for their children because of concern about their immigration status. Thirty-one percent said those same families were avoiding applying for any government programs, including Medicaid, the Children’s Health Insurance Program (CHIP), and the Supplemental Nutrition Assistance Program (SNAP). More [...]

September 21, 2026|Categories: Medicaid|Tags: immigrants and Medicaid and CHIP, immigrants and public charge regulations, Pediatricians and immigrant patients|

Federal Health Policy Update for September 17

Don’t Miss: CMS advises on “medical frailty” as qualification for Medicaid eligibility CMS unveils long-anticipated IDR Gateway Medicare ACCESS Model to expand The following is the latest health policy news from the federal government for September 11-17. Some of the language used below is taken directly from government documents. Congress The House Energy & Commerce Committee’s Health Subcommittee held a hearing to discuss bills seeking to modify certain physician payments under Medicare, to address cybersecurity in the health care system, and to expand seniors’ access to care. See the [...]

September 17, 2026|Categories: Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicaid regulations, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: CMS AHEAD Model, CY 2027 Medicare physician fee schedule, FY 2027 Medicare inpatient prospective payment system, FY 2027 Medicare long-term-care hospital prospective payment system, HR 4093 Apples to Apples Comparison Act of 2025, HRSA Rural Maternal Health Data Support Program, IDR Gateway, independent dispute resolution, low-volume hospital criteria, Medicaid eligibility, Medicaid state plan amendments, medical frailty and Medicaid eligibility, Medicare ACCESS Model, Medicare Advancing Chronic Care with Effective, Medicare Advantage, Medicare area wage index, Medicare disproportionate share, Medicare DSH, Medicare Part D plans, Medicare Payment Advisory Commission, Medicare physician payments, Medicare post-acute transfer policy, MedPAC, MLN Connects, No Surprises Act, Office of Minority Health DRIVE, Quality Innovation Network-Quality Improvement Organization QIN-QIO, Rural Health Transformation Program funding, Scalable Solutions Model, U.S. Preventive Services Task Force|

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