The following is the latest health policy news from the federal government for March 29 – April 4.  Some of the language used below is taken directly from government documents.

The White House

The White House has announced that the Office of Management and Budget (OMB) has issued a government-wide policy to attempt to mitigate the risks of artificial intelligence (AI) and harness its benefits.  The order directs action to strengthen AI safety and security, protect privacy, advance equity and civil rights, stand up for consumers and workers, and promote innovation and competition.  It includes components on addressing risks from the use of AI, expanding the transparency of AI use, advancing and strengthening responsible AI innovation, and growing the AI workforce.  Learn more from this White House fact sheet and the OMB memo to all federal departments and agencies.

CMS – Proposed Medicare Rate Regulations
  • CMS has published a proposed regulation that would increase Medicare payments to skilled nursing facilities by 4.1 percent.  The proposed rule also includes provisions that would update the market basket update year from 2018 to 2022; update the skilled nursing facility quality reporting program (QRP); update the skilled nursing facility prospective wage index; make changes in Patient-Driven Payment Model (PDPM) ICD-10 Code mappings; revise CMS’s current nursing home enforcement authority; add four new social determinants of health items and make other changes in the skilled nursing facility QRP; and make several changes in the skilled nursing facility value-based purchasing program.  Learn more from this CMS fact sheet and the proposed rule.  The deadline for submitting stakeholder comments is May 28.
  • CMS has published a proposed regulation that would increase Medicare payments for hospice services by 2.6 percent in FY 2025.  The proposed regulation would cap Medicare’s annual payments per patient; add new measures to the hospice QRP; make changes in the geographic wage index; introduce a new data collection tool for hospice patients; and more.  Learn more from this CMS fact sheet; and the proposed rule.  The deadline for submitting stakeholder comments is May 28.
  • CMS has published a proposed regulation that would increase Medicare payments for inpatient psychiatric facilities by 2.7 percent in FY 2025.  The proposed rule also would change the outlier threshold, add a quality measure to the inpatient psychiatric facility QRP, change quality reporting from annually to quarterly, and make other changes.  Learn more from this CMS fact sheet and the proposed rule.  The deadline for submitting stakeholder comments is May 28.
  • CMS has issued its calendar year 2025 rate announcement for the Medicare Advantage and Medicare Part D Prescription Drug (Part D) programs that update payment policies for these programs.  While CMS projects spending 3.7 percent more for payments to Medicare Advantage plans in the coming year, the base rate payment to those plans will decrease an average of 0.16 percent.  Under Medicare Part D, participants’ annual out-of-pocket costs will be capped at $2,000.  Learn more from this CMS news release; this formal CMS rate announcement; CMS’s rate announcement fact sheet; and CMS’s final CY 2025 Part D redesign program instructions fact sheet.
Centers for Medicare & Medicaid Services
  • CMS has posted an online validator tool to help hospitals determine whether the machine-readable files they develop comply with federal hospital price transparency requirements.  Go here to find the validator tool and learn how to use it.
  • Based on increasing concerns about the absence of informed patient consent prior to allowing practitioners or supervised medical, advanced practice provider, or other applicable students to perform training- and education-related examinations outside the medically necessary procedure (such as breast, pelvic, prostate, and rectal examinations), particularly on anesthetized patients, CMS has reinforced hospitals’ informed consent obligations through new guidance it has sent to the states clarifying that providers must obtain patients’ written consent for such examinations.  Find that guidance here and this letter from HHS and CMS to teaching hospital and medical school leaders explaining the new guidance.
  • CMS has posted a bulletin with updates of its hospital outpatient prospective payment system that take effect on April 1.  Find that bulletin here.
  • CMS has extended a temporary special enrollment period to help people who are no longer eligible for Medicaid or CHIP transition to marketplace coverage in states using  The deadline for enrolling in new marketplace insurance has been extended from July 31 to November 30.  As part of this extension, CMS also has released new guidance and other resources to help protect coverage.

Learn about these and other actions CMS has taken to facilitate the transition of people losing their Medicaid or CHIP coverage to private health insurance from this CMS news release.

  • CMS has announced policies for the Affordable Care Act marketplaces that seek to make it easier for low-income people to enroll in coverage, authorizes states to increase access to routine adult dental services and change other essential health benefits (EHB), sets network adequacy standards for the time and distance people travel for appointments with in-network providers, and standardizes certain operations across the marketplaces to encourage greater reliability and consistency for consumers.  The rule extends the special enrollment period for consumers with household incomes at or below 150 percent of the federal poverty level to any month rather than only during open enrollment; aligns the dates of open enrollment periods across almost all marketplaces to generally begin on November 1 and end no earlier than January 15, with the option to extend the open enrollment period beyond January 15; seeks to prevent coverage gaps for those transitioning between different marketplaces or from other insurance coverage by permitting those selecting coverage during certain special enrollment periods to receive coverage beginning the first day of the month after choosing a plan, as opposed to coverage beginning at a later date if the consumer enrolls between the 15th and the end of the month; and standardizes operations among the federally-facilitated and state-based marketplaces to ensure a more streamlined consumer experience.  Learn more about this 2025 Notice of Benefit and Payment Parameters final rule from this CMS news release; this CMS fact sheet; this HHS news release; and this pre-publication version of the final rule, which will take effect 60 days after it is officially published.
  • Members of the staff of CMS’s Center for Medicare and Medicaid Innovation have written about their agency’s strategy for supporting person-centered, value-based specialty care and provided an update on those efforts in a blog post on the Health Affairs web site.  Find that post here.
  • The New England Journal of Medicine has published a blog piece written by CMS staff that highlights the Center for Medicare and Medicaid Innovation’s efforts to strengthen providers’ focus on quality, particularly in patient outcomes and experiences, through its new “Quality Pathway.”  Find the blog entry here.
Department of Health and Human Services
  • HHS’s Office of the Assistant Secretary for Planning and Evaluation has published a white paper addressing policy considerations to prevent drug shortages and mitigate prescription drug supply chain vulnerabilities in the U.S.  The paper calls for a program with a ten-year budget of as much as $5 billion, legislation to support planned initiatives, and regulation of manufacturers and financial incentives and penalties for hospitals through a new Manufacturer Resiliency Assessment Program and a Hospital Resilient Supply Program.  Go here for an overview of the paper and a link to the full paper.
  • HHS’s Health Resources and Services Administration (HRSA) has announced that it has increased by 50 percent the initial loan repayment amount available to primary care providers – MDs and DOs, including OB-GYNs and pediatricians; nurse practitioners; certified nurse midwives; and physician assistants – who commit to practicing in areas with significant shortages of primary care providers.  HRSA also is offering up to an additional $5,000 in loan repayment to National Health Service Corps Loan Repayment Program participants who can demonstrate fluency in Spanish and who commit to practicing in a high-need area serving patients with limited English proficiency.  Learn more from this HRSA news releaseHHS’s Health Sector Cybersecurity Coordination Center and its Office of Information Security have issued an alert warning of social engineering attacks targeting IT help desks in the health sector.  The alert describes the attacks, offers information about patches, mitigation, and workarounds, and directs interested parties to additional resources.  Find the sector alert here.
  • A lack of behavioral health providers in Medicare and Medicaid impedes enrollees’ access to care, HHS’s Office of the Inspector General (OIG) has concluded in a new report.  Go here for an introduction to that report and links to a summary of the report and the full report itself.
  • Nursing home residents with endangering behaviors and mental health disorders may be vulnerable to facility-initiated discharges, HHS’s OIG has concluded in a new report.  Go here for an introduction to that report and links to a summary of the report and the complete report itself.
  • A related report by the OIG addresses concerns about safeguards to protect residents during facility-initiated discharges from nursing homes.  Go here for an introduction to that report and links to a summary of the report and the full report itself.
HHS Newsletters
Centers for Disease Control and Prevention (CDC)
  • The CDC has issued a health advisory to alert providers and the public about an increase in the prevalence of invasive meningococcal disease in the U.S.  The alert describes the disease, discusses the extent of its recent spread, describing symptoms, explains how to treat it, offers recommendations for public health departments, providers, and the public, and directs interested parties to additional resources.  Learn more from this CDC health advisory.
  • The CDC has announced that a person in Texas has tested positive for the highly pathogenic avian influenza virus, often referred to as bird flu.  It is only the second such case reported in the U.S.; the first was in 2022.  Learn more about the diagnosed case, the CDC’s response, transmission of the disease, prevention, and more from this CDC news release.
Medicare Payment Advisory Commission (MedPAC)

MedPAC hired the Urban Institute to perform an analysis of hospital-specific relative weights, cost-based weights, and their implications for Medicare payments to inpatient rehabilitation facilities.  Find the report here.

Stakeholder Events

CMS – Physicians, Nurses and Allied Health Professionals Open Door Forum – April 10

CMS will hold an open-door forum for physicians, nurses, and allied health professionals on Wednesday, April 10 at 2:30 (eastern).  Go here to register to participate.

CMS – Ambulance Open Door Forum – April 11

CMS will hold an open-door forum for ambulance service providers on Thursday, April 11 at 2:00 (eastern).  Go here to register to participate.

MedPAC – Commissioners Meeting – April 11-12

MedPAC’s commissioners will hold their next public meeting on Thursday, April 11 and Friday, April 12.  An agenda and directions on how to participate in the meeting are not yet available but when that information is announced it will be posted here.

MACPAC – Commissioners Meeting – April 11-12

MACPAC’s commissioners will hold their next public meeting on Thursday, April 11 and Friday, April 12.  Go here to register to participate remotely.

CMS – Hospital Open Door Forum – April 16

CMS will hold an open-door forum for hospitals on Tuesday, April 16 at 2:00 (eastern).  Go here to register to participate.

CMS – “Understanding Medicare” Webinars – April 16-17

CMS will offer two interactive training webinars covering Medicare basics.  Subjects include Medicare enrollment and eligibility; Social Security Administration and CMS roles and responsibilities; cost and coverage under Medicare Part A (hospital insurance) and Medicare Part B (medical insurance); why enrolling on time is important; an overview of Medicare Supplement Insurance (Medigap) policies; Medicare drug coverage (Part D); Medicare Advantage plans; coordination of benefits; how to detect and report suspected Medicare fraud, waste, and abuse; and different resources to help find answers to Medicare policy and coverage questions.  Go here to register to participate; enrollment for the two days will be limited; the event will  be recorded and posted here.

HHS – Office of Climate Change and Health Equity – Webinars on Taking Advantage of Provisions in the Inflation Reduction Act –April 18

HHS’s Office of Climate Change and Health Equity is holding a series of webinars to help health care providers, and especially safety-net organization, take advantage of the tax credits, grants and other supports made available by the Inflation Reduction Act, which creates opportunities for health sector organizations to invest in clean energy, building efficiency, infrastructure resilience, and more.  The next webinar will be held on Thursday, February 8, with additional events scheduled on February 22, March 7 and 21, and April 4 and 18.  Separate break-out sessions will be held for essential hospitals, community health centers, and rural providers.  Go here to learn more about the webinar series, future events, and the break-out sessions; go here for a recording of a November briefing on Inflation Reduction Act resources available to health care providers; and go here to register to participate.

CMS – Long-Term Care Support and Services Open Door Forum – April 23

CMS will hold an open-door forum for long-term-care support and services providers on Tuesday, April 23 at 2:00 (eastern).  Go here to register to participate.

CMS – Rural Hospitals Open Door Forum – April 25

CMS will hold an open-door forum for rural hospitals on Thursday, April 25 at 2:00 (eastern).  Go here to register to participate.

CMS – Health Equity Conference – May 29-30

CMS will hold its second annual CMS Health Equity Conference on Wednesday, May 29 and Thursday, May 30.  The free, hybrid conference will be held in person in Bethesda, Maryland and available online for virtual participation and involve health equity leaders from federal and local agencies, health provider organizations, academia, community-based organizations, and others. Conference participants will hear from CMS leadership on recent developments and updates to CMS programs; explore the latest health equity research; discuss promising practices and creative solutions; and collaborate on community engagement strategies.  Go here for information about how to register to participate.