The following is the latest health policy news from the federal government for February 14-20.  Some of the language used below is taken directly from government documents.

Congress
  • The current continuing resolution funding the federal government expires on March 14 and a number of health care extenders, including preventing cuts to Medicaid disproportionate share (Medicaid DSH), an extension of telehealth flexibilities, an extension of the Acute Hospital Care at Home program, and other rural programs will expire on March 31.  It is yet unclear how Congress will meet either of those deadlines.
  • Provisions that had been included in the bipartisan health care package proposed in December, including PBM reform and relief from Medicare physician payment cuts, remain a high priority for numerous members of Congress.
  • Last week, the House Budget Committee passed, along party lines, a budget resolution for FY 2025 setting forth spending levels for FY 2026 through FY 2034.  Among other provisions, the resolution calls for the House Energy and Commerce Committee to cut spending by $880 billion over ten years.  Because that committee has primary jurisdiction over Medicaid, it would most likely be expected to find those reductions through Medicaid spending cuts.  When the House returns from recess next week, House leadership is expected to attempt to pass the resolution on the House floor; it is not certain that enough Republican representatives will support the resolution for it to pass.
  • Eight Republican House members representing districts with large Hispanic populations have written to House Speaker Johnson to urge him not to “… slash programs that support American communities across our nation…”  The letter notes that “Nearly 30% of Medicaid enrollees are Hispanic Americans, and for many families across the country, Medicaid is their only access to healthcare.  Slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities where hospitals and nursing homes are already struggling to keep their doors open.  Moreover, the possibility of cutting Medicaid Disproportionate Share Hospital (DSH) funding threatens hospitals that serve low-income and uninsured patients.”  Find their letter here.
  • The Senate is expected to pass its budget resolution this week.  That resolution includes provisions directing both Senate committees with jurisdiction over health care – the Health, Education, Labor, and Pensions (HELP) Committee and the Senate Finance Committee – each to cut spending by $1 billion over ten years.
  • The House and Senate are taking different approaches to a budget resolution.  The House is pursuing a single, all-encompassing budget resolution while the Senate intends to adopt two resolutions:  the first focused on border security, defense spending, and energy and a second that will address tax policy and other issues.  The chambers will have to work out the differences between the resolutions they have adopted if they are to proceed to work on reconciliation legislation.
The Administration
  • President Trump has signed an executive order establishing a new “President’s Make America Healthy Again Commission.”  The executive order presents the rationale for the new commission, describes its objectives, and lists the executive branch positions that will constitute the commission’s membership.  The commission will be chaired by the HHS Secretary, with the Assistant to the President for Domestic Policy to serve as its executive director.  Learn more from the President’s executive order and an accompanying fact sheet.
  • President Trump has signed an executive order titled “Expanding Access to In Vitro Fertilization” that states that “…to support American families, it is the policy of my Administration to ensure reliable access to IVF treatment, including by easing unnecessary statutory or regulatory burdens to make IVF treatment drastically more affordable.”  The executive order directs the Assistant to the President for Domestic Policy to submit to the President within 90 days a list of policy recommendations for protecting IVF access and aggressively reducing out-of-pocket and health plan costs for IVF treatment.  Find that executive order here and an accompanying fact sheet here.
Telehealth

On January 17, HHS and the Drug Enforcement Administration published two final rules addressing the practice of telemedicine, titled “Expansion of Buprenorphine Treatment via Telemedicine Encounter” and “Continuity of Care via Telemedicine for Veterans Affairs Patients.”  These final rules, which called for extending the flexibility for practitioners to prescribe buprenorphine via telemedicine through the end of the year, were scheduled to become final on February 18.  In accordance with the presidential memorandum of January 20 titled “Regulatory Freeze Pending Review,” the agencies are delaying the effective dates of these two final rules to March 21 and are soliciting public comments specifically regarding this delayed effective date.  Learn more from this regulatory announcement.  The deadline for submitting comments is February 28.

Centers for Medicare & Medicaid Services
  • CMS has announced a reduction of funding for the Affordable Care Act Navigator program, from $98 million in 2024 to $10 million.  According to the agency, the program produces a relatively low number of enrolled consumers at a high cost per enrollee and the savings from the reduction will enable health insurance exchanges to focus on more effective strategies for enrolling members and reduce user fees and health insurance premiums in the future.  Learn more about the reduced funding for the Navigator program, the rationale underlying the reduction, the program’s performance data from this CMS news release.
  • Effective February 14, CMS has ceased implementation of the Hospice Special Focus Program for CY 2025 so the agency may further evaluate the program.  Find the announcement here.
  • CMS has updated its organizational chart; find it here.  Please note that individuals working in an acting capacity are identified with an asterisk.
Department of Health and Human Services
  • HHS has released guidance to the U.S. government, external partners, and the public to expand on the sex-based definitions in Executive Order 14168:  “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”  The guidance states that there are only two sexes:  male and female.  HHS notes that it will use these definitions and promote policies stating that women are biologically female and men are biologically male.  HHS also announced that it is taking steps to implement policies protecting children from chemical and surgical mutilation, as directed by Executive Order 14187, and keeping men out of women’s sports as specified in Executive Order 14201.  HHS’s Office on Women’s Health has launched a new web page to promote the agency’s guidance on sex-based definitions and providing other resources on efforts to protect women and children.  Learn more from this HHS announcement and find the Office on Women’s Health new web page here.
  • HHS’s Office of Civil Rights has rescinded previous guidance titled “HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy,” which was issued on March 2, 2022.  The stated purpose of this recission is to support the new administration’s policy in Executive Order 14187 that HHS will not promote, assist, or support the transition of a child from one sex to another and will enforce all laws that prohibit or limit such procedures.  This rescission also aligns with the policy described in Executive Order 14168, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”  Learn more from this HHS announcement.
  • Not all Medicare enrollees are continuing treatment for opioid use disorder, HHS’s Office of the Inspector General (OIG) concludes in a new report.  According to the report, about 40 percent of Medicare enrollees who started treatment with buprenorphine continued and fewer enrollees who continued treatment died compared to those who did not continue treatment.  In addition, only one-third of enrollees who started buprenorphine received at least one behavioral therapy service and those who did not receive any of these services were less likely to continue treatment.  Few enrollees, the report notes, received services billed to Medicare under payments aimed, in part, at helping enrollees stay in treatment.  Learn more about what the OIG found and its recommendations to address the problems it identified from this report.
  • HHS’s OIG has updated its work plan for audits and reviews in February.  Find the updated work plan here.
HHS Newsletters and Reports
  • CMS – MLN Connects – February 14
  • AHRQ News Now – February 18
  • CDC – Morbidity and Mortality Weekly Report – “First Clade Ib Monkeypox Virus Infection Reported in the Americas” – February 13.
Stakeholder Events

MACPAC – Commissioners Meeting – February 27-28

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, February 27 and Friday, February 28.  An agenda and registration information are not yet available but when they are they will be posted here.

MedPAC – Commissioners Meeting – March 6-7

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, March 6 and Friday, March.  An agenda and registration information are not yet available but when they are they will be posted here.