The following is the latest health policy news from the federal government for April 17-23.  Some of the language used below is taken directly from government documents.

The White House

President Trump has issued an executive order calling for accelerated access to medical treatments for patients with serious mental illness, with an emphasis on greater access to psychedelic drugs.  Learn more from this executive order and an accompanying White House fact sheet.

Shortly after the White House issued this executive order, HHS’s Advanced Research Projects Agency for Health (ARPA-H) announced the first set of research teams for its Evidence-Based Validation & Innovation for Rapid Therapeutics in Behavioral Health (EVIDENT) initiative, which will fund up to $139.4 million to help spur new, effective therapies for behavioral health.  As part of the executive order, EVIDENT will allocate at least $50 million to match state government investments in psychedelic research for populations with serious mental illness.  Learn more from this HHS news release.

Congress
  • The Senate passed a party-line budget resolution to launch a two-part funding plan narrowly focused on the Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection agencies.  To begin the reconciliation process, the House and Senate must pass identical budget resolutions.  At this point it is unclear whether the House will pass the Senate’s version or if it will send a different resolution back to the Senate.  Congressional leaders are under pressure to move quickly before the Department of Homeland Security runs out of money to pay employees.
    • Even if this reconciliation package excludes health care provisions, lawmakers have not dismissed the possibility of a third reconciliation bill before the mid-term elections.  Such legislation could potentially include any of a number of health care provisions, such as expanded access to health savings accounts (HSAs); changes to the rate at which the federal government matches state Medicaid spending (FMAP); changes to Medicaid pharmacy benefit manager (PBM) spread pricing; expanded site-neutral payment policies; and others.
  • The House Energy and Commerce Committee held a hearing on the President’s FY 2027 Department of Health and Human Services budget.  Lawmakers questioned HHS Secretary Robert F. Kennedy Jr. about improving health outcomes, modernizing federal programs, and making health care more affordable and accessible.  For more information, see the press release here, the Secretary’s testimony here, and a recording of the hearing here.
  • On Wednesday, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on the President’s FY 2027 HHS budget with Secretary Kennedy as a witness.  For more information, read the opening remarks of Chairman Cassidy (R-LA) here and the see a recording of the hearing here.
  • The House Ways and Means Committee held a hearing titled “Protecting Patients and Taxpayers:  Cracking Down on Medicare Fraud.”  Lawmakers heard testimony from multiple witnesses about their experiences with Medicare fraud, waste, and abuse, particularly within hospice and home health services.  Read the witnesses’ testimony and find a recording of the hearing here.
  • The House Ways and Means Committee will hold a hearing with health system CEOs on April 28.  Lawmakers plan to discuss the impact of rising health care costs on patients and families by examining the role of health systems and the current state of health care affordability.  The committee has not released an official list of witnesses.  A recording of the hearing will be available here.
Centers for Medicare & Medicaid Services (CMS)
  • CMS has written to the nation’s governors requesting that they “…undertake a swift revalidation of Medicaid providers of services at high risk of waste, fraud, abuse, and corruption as part of each state’s program integrity obligations under federal law.”  The letter informs governors that their states’ Medicaid leaders “…are being asked to provide a broader strategy on provider revalidations within 30 days.”  Learn more about the CMS request and why the agency is making it from this sample letter from CMS to governors.
  • CMS is delaying full implementation of its BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model, which seeks to increase access to selected GLP-1 medications for Medicare Part D and Medicaid participants.  As part of this voluntary model, CMS is negotiating drug prices and coverage terms with manufacturers of GLP-1 medications on behalf of state Medicaid agencies and Medicare Part D plan sponsors.  CMS intended to launch the program on July 1, and while the Medicaid component will begin as scheduled, implementation of the Medicare Part D component will be delayed through the end of 2027 so CMS can continue to recruit more Part D plans to participate.  In the meantime, CMS will continue to provide eligible Medicare Part D beneficiaries with access to certain GLP-1 drugs through its temporary Medicare GLP-1 Bridge program from July 1, 2026 to December 31, 2027.  This means that Medicare, rather than Part D insurers, will pay for the GLP-1 drugs for Part D beneficiaries who participate in the Bridge program through the end of 2027.  Learn more about these changes from CMS’s BALANCE Model web page; the Medicare GLP-1 Bridge web page; and this CMS memo.
  • CMS has posted timelines for implementation of the Medicaid and CHIP components of last year’s H.R. 1, often referred to as the “Big Beautiful Bill Act.”  Go here for links to those timelines – one a high-level timeline and another a more detailed look at the steps to come.  The timelines are intended for state governments to help them with their implementation of the act’s relevant provisions but may be useful for providers as well.
  • CMS has created a new “Make Hospital Food Healthier Pledge” to encourage hospitals to include nutrition among its tools for promoting patient well-being, safety, and quality outcomes.  It encourages hospitals to take a pledge to reflect their commitment to reviewing the latest nutrition science and aligning hospital food services with recognized dietary practices.  Learn more about this initiative and how hospitals can sign the pledge from the new CMS “Make Hospital Food Healthier Pledge” web page.
  • CMS has posted a bulletin about the FY 2026 extension of certain temporary changes to the low-volume hospital payment adjustment and the Medicare-Dependent Hospital program as directed by the Consolidated Appropriations Act of 2026.  Find that bulletin here.
  • CMS has posted a bulletin presenting the quarterly update of its Medicare national fee schedule for vaccine administration.  Find the bulletin here.  The changes it describes take effect on July 1.
  • CMS and the FDA have announced the creation of a new Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway designed to expedite access to certain FDA-designated Class II and Class III breakthrough devices for people with Medicare.  The RAPID coverage pathway will enable CMS and the FDA to work together, with innovators, earlier in the technology development lifecycle so that evidence generated for FDA review can also support Medicare coverage decisions.  By aligning regulatory and coverage expectations in advance, the RAPID coverage pathway is designed to reduce delays between FDA market authorization and Medicare national coverage determinations.  Learn more about the RAPID coverage pathway and how it will work from this CMS news release.
  • CMS has added the following item to its Quality Payment Program resource library.  (Note:  clicking these links may give a prompt to download a file that may be a zip file.)
Department of Health and Human Services
  • HHS’s Health Resources and Services Administration (HRSA) has released its “National Strategy for the Home Visiting Workforce,” an effort to strengthen and grow the home visiting workforce.  The strategy focuses on building clear career pathways, investing in professional development opportunities, and supporting workforce well-being as components for advancing maternal and child health.  Learn more about the strategy from this HRSA news release and the HRSA strategy document.
  • HHS has declared a public health emergency for the state of Hawaii to address the health effects of severe storms, flooding, landslides, and mudslides that occurred from March 10 through March 24.  CMS will assist with resources and waivers to ensure that hospitals and other facilities can continue to operate and provide access to care for those affected by recent events.  Among the types of assistance CMS will provide are blanket waivers and other flexibilities for affected providers in Hawaii retroactive to March; a Marketplace Special Enrollment Period (SEP) for hurricane victims; a disaster toolkit for the state Medicaid and CHIP agency; assistance with dialysis care; medical equipment and supplies replacement; access to covered Part D drugs; and more.  Learn more from this CMS news release, which includes links to additional information and resources.
  • HHS’s Office of the Inspector General has issued a favorable opinion regarding a proposal by an entity and its Medicare Advantage subsidiaries to offer employer group waiver plans an opportunity to share a percentage of their savings with certain groups to which they provide coverage in certain circumstances.  Find that opinion here.
  • HHS’s Agency for Healthcare Research and Quality (AHRQ) is inviting nominations of individuals to serve as members of the U.S. Preventive Services Task Force, which is an independent, volunteer panel of national experts in prevention and evidence-based medicine that works to improve health nationwide by issuing evidence-based recommendations on clinical preventive services for patients without symptoms.  Learn more about the task force, its work, the backgrounds it seeks among prospective members, and how to submit nominations from this AHRQ notice.  The deadline for submitting nominations is May 23.
  • HHS’s Office of the National Coordinator for Health Information Technology (ONC) has published a data brief on electronic health record adoption and exchange capabilities among substance use and mental health treatment facilities in 2024.  Find it here.
Medicaid State Plan Amendments

CMS has approved the following state plan amendments for Medicaid and CHIP programs.

  • To Connecticut, updating the payment methodology for private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) services.  Specifically, it rebases facility rates for state FY 2026, applies a 1.4 percent increase, and eliminates the minimum per-diem rate beginning July 1, 2025.
  • To Massachusetts, updating the payment methodology for durable medical equipment by rebasing certain rates to 2024 Medicare rates while maintaining existing rates for items without Medicare equivalents.
  • To Michigan, updating Michigan’s Alternative Benefit Plan to add coverage for licensed midwifery services in alignment with the state’s traditional Medicaid state plan.
  • To Montana, updating the fee schedule methodology for outpatient hospital services.
  • To Nebraska, updating inpatient provider rates for state FY 2026.
  • To New Hampshire, memorializing the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under New Hampshire’s state plan.
  • To North Carolina, removing non-quantitative treatment limitations (prior authorization, concurrent review, or reauthorization requirements) for psychotherapy and mobile crisis management.  In addition, this amendment terminates the Alcohol Drug Addiction Treatment Center Detoxification Crisis stabilization service and adds Clinically Managed Residential Withdrawal Management and Non-Hospital Medical Detoxification services to align CMS-approved updates to the state’s Medicaid state plan.
  • To North Carolina, revising hospital readmission review requirements from 72 hours to 30 days to align with clinical policy.
  • To Ohio, authorizing a one-time supplemental payment to freestanding dialysis centers as the final installment of a state-legislated, time-limited provider relief initiative.
  • To Ohio, amending Attachment 2.6-A to remove the payment of premium requirement and the premium calculation methodology for the Ticket to Work Basic Coverage Group and Medical Improvement Group as a result of recent state legislation.
  • To Rhode Island, implementing income disregards for its qualified Medicare beneficiary and qualified individual eligibility groups.
  • To Texas, updating the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program fee schedules.
  • To Virginia, implementing supplemental payments for private hospitals.
HHS Newsletters, Reports, and Videos
Centers for Disease Control and Prevention (CDC)

This week CDC’s Epidemic Intelligence Services held its annual conference, with officials sharing their work on outbreak investigations, new scientific findings, and strategies to improve public health.  Learn more from this CDC media advisory and other resources.

Government Accountability Office (GAO)

The GAO has published a report on CMS’s use of data analytics to identify and prevent Medicare fraud.  Learn about what the GAO learned from this report.

Stakeholder Events

OPTN – National Town Hall Meetings – April 28 and May 13

The Organ Procurement and Transplantation Network (OPTN) will hold town hall meetings for members of the community and the public on Tuesday, April 28 at 4:00 and Wednesday, May 13 at 3:00 (both are eastern time).  These town halls will provide updates on the current state of the OPTN and its modernization efforts.  Participants will have the opportunity to submit questions in advance and each session will include a moderated question-and-answer period.  Go here to learn more and to register to participate.

CDC – Clinician Outreach Call on Rabies – April 30

The CDC will hold a call for clinicians on Thursday, April 30 at 2:00 (eastern) during which it will discuss the current rabies landscape in the U.S. and CDC resources to help clinicians and health departments with risk assessments.  Presenters also will highlight animal-related costs and effects from rabies and how risk assessments can help avoid financial damage from costs associated with rabies exposures.  Learn more about the event and its objectives, additional resources, how to participate, and how to obtain continuing education credits for participating from this CDC notice.

MACPAC – Commissioners Meeting – May 7

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, May 7.  Go here to register to participate.

HHS Office of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology/Health Information Technology Advisory Committee – May 7

The Health Information Technology Advisory Committee of HHS’s Office of the Assistant Secretary for Technology Policy will hold its next meeting on Thursday, May 7.  This committee’s role is to identify priorities for standards adoption and make recommendations to the Assistant Secretary for Technology Policy.  Learn more about the committee, its structure, and its purpose from this HHS notice, which also outlines the meeting’s agenda.  Information about how to participate in the meeting is not yet available but when it is it will be posted here.  Other 2026 meetings will be held on September 24 and November 5.

CMS – HCPCS Level II Public Meetings – June 1

CMS will hold its 2026 HCPCS level II public meeting, in person and virtually, on June 1, 2026 at 9:00 (eastern), with an overflow date of Tuesday, June 2, 2026 to be held virtually, if necessary, to discuss CMS’s preliminary coding, Medicare benefit category, and Medicare payment determinations.  Learn more about the meeting, including how to submit questions and comments and register to participate, 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 have not yet been posted; when they are, they will be found here.