The following is the latest health policy news from the federal government for December 29 to January 8.  Some of the language used below is taken directly from government documents.

Congress

Congress returned from winter recess facing a full policy agenda and health care issues remain prominent.  Following the expiration of the Affordable Care Act’s enhanced premium tax credits, the House is expected to vote on a three-year clean extension brought by a discharge petition from Democratic House Leader Hakeem Jefferies (D-NY).  The Senate is unlikely to advance the measure but a bipartisan group of senators is developing an alternative:  a possible two-year extension with guardrails, including minimum premium payments, income restrictions, and expanded health savings accounts (HSAs).

Additionally, Congress is working to finalize more spending bills ahead of the January 30 expiration of the current continuing resolution (CR) but it is likely that at least some agencies, including the Department of Health and Human Services, will need to be funded through a new CR.  Key health care policies extended in the current CR, including telehealth flexibilities, delays to Medicaid DSH cuts, rural health programs, and others, are expected to be addressed either in one of the spending bills or possibly via a potential health care package that could include longer-term telehealth provisions and reforms to pharmacy benefit managers (PBMs), though details remain uncertain.

340B
  • A federal court has issued a preliminary injunction preventing HHS’s Health Resources and Services Administration (HRSA) from implementing its 340B Rebate Model Pilot Program, a limited model that would test replacing the discounts pharmaceutical companies give providers participating in the 340B drug program when they purchase eligible prescription drugs with post-purchase rebates for those products.  Learn more from the full decision in the case.  HHS has appealed the court’s ruling.
  • As promised in its CY 2026 outpatient prospective payment system final rule, CMS has launched its outpatient drug acquisition cost survey.  The purpose of this survey is to collect hospital acquisition costs for outpatient drugs and biological products – both 340B and non-340B products –  from hospitals paid under the outpatient prospective payment system.  CMS’s survey module is now available for hospitals to submit that data.  Learn more from the survey web page, which includes links to an FAQ, video of a training webinar, and other resources to help hospitals complete the survey.  The deadline for submitting the required data is March 31.
Telehealth

The Drug Enforcement Administration (DEA), jointly with HHS, has extended for another year, through December 31, 2026, all of the telemedicine flexibilities for prescribing controlled medications that were established during the COVID-19 public health emergency.  Among the flexibilities, DEA-registered practitioners may prescribe a schedule II-V controlled substance to patients using telemedicine without conducting an in-person medical evaluation if required conditions are met.  The notice also reminded providers that two final DEA rules from 2025 – the Expansion of Buprenorphine Treatment via Telemedicine Encounter and the Continuity of Care via Telemedicine for Veterans Affairs Patients rules – have now taken effect.  Learn more from this HHS news release; this DEA announcement; and the official rule published by the two agencies.

Centers for Medicare & Medicaid Services
  • CMS is accepting applications for as many as 200 new graduate medical education (GME) residency slots.  Learn more from CMS’s Direct Graduate Medical Education web page.  The deadline for submitting applications is March 31.
  • Late last year, CMS announced that it would implement an online form for providers to report complaints about Medicare Advantage plans.  Now, CMS has posted its form for submitting such complaints.  Find the CMS memo about the complaint process here and find the online complaint form here.
  • HHS, the Department of Labor, and the Department of the Treasury have updated the certified Independent Dispute Resolution (IDR) entity fees for 2026 under the No Surprises Act.  The updated fees took effect for disputes initiated on or after January 1, 2026, with the administrative fee $115 per party per dispute and certified IDR entity fees ranging from $200-$840 for single determinations and $268-$1173 for batched determinations.  Learn more from this CMS announcement and the updated CMS web site that lists the certified IDR entities and their respective fees.
  • CMS has sent a letter to state health care officials presenting 2027 updates to the Core Set of Children’s Health Care Quality Measures for Medicaid and the Children’s Health Insurance Program (CHIP) and the Core Set of Adult Health Care Quality Measures for Medicaid and to provide its expectations for 2027 Core Set quality measure reporting that will be due to CMS by December 31, 2027.  This letter also includes updates to the 2026 Core Sets.  Among those updates, states will no longer be required to report data on the immunization status of pregnant women and children.  These updates could affect data that states require from health care providers.  Learn more from this letter from CMS to state health care officials.
  • CMS is introducing changes in the data providers must submit when they enroll or re-certify to participate in the 340B prescription drug discount program.  Go here to see the regulatory announcement of these changes.  The deadline for submitting comments is February 9.
  • CMS has increased its Medicare provider enrollment application fee for selected providers to $750.  Go here to learn more about the fee, including to which providers it applies.
  • CMS has posted a bulletin outlining its implementation of changes in the end-stage renal disease (ESRD) prospective payment system and payment for dialysis furnished for acute kidney injury in ESRD facilities for CY 2026.  Find that bulletin here.  The changes it describes took effect on January 1.
  • CMS has posted a bulletin explaining changes in laboratory national coverage determination edit software.  Find that bulletin here.  The changes took effect on January 5.
  • CMS has posted a bulletin presenting updated chimeric antigen receptor t-cell (CAR T) therapy billing instructions.  Find that bulletin here.  Implementation takes effect on January 26.
  • CMS has hired a contractor to act as quality measure developer and technical content support contractor for Dialysis Facility Care Compare on the Medicare.gov web site and as part of this undertaking, that contractor is forming a technical expert panel to obtain consumer and provider input for quality measure development and the Medicare.gov Dialysis Facility Quality of Patient Care Star Rating.  CMS now seeks nominations from individuals with relevant clinical and methodological experience, expertise, and perspectives to serve on this technical expert panel.  Learn more about the specific background and expertise CMS seeks from potential participants, the time commitment involved, and how to submit nominations from this CMS notice (scroll down and click on “Dialysis Facility Quality of Patient Care Star Rating Technical”).  The deadline for submitting nominations is January 26.
CMS – eCQI Resource Center
  • CMS’s hospital quality reporting (HQR) system is now open and accepting CY 2025 Medicare Promoting Interoperability Program data submissions and attestations from  and critical access hospitals.  Learn more about the program and find resources to assist with data submission from this notice from CMS’s eCQI Resource Center.  The submission deadline is March 2.
  • CMS has updated and re-published technical release notes for the 2026 Performance Period Electronic Clinical Quality Measures (eCQMs) for Eligible Clinicians.  The technical release notes are resource files that provide an overview of technical changes, such as logic and terminology, for each eCQM in the most recent eCQM annual update for CMS reporting/performance periods.  Learn more from this notice from CMS’s eCQI Resource Center.
  • CMS has posted updates to 2026 performance year clinical clinician eCQMs based on Medicare’s physician fee schedule final rule.  Find more, including the new performance measures for 2026, in this notice from CMS’s eCQI Resource Center.
  • CMS and its eCQI Resource Center have invited vendors and implementers to review and provide feedback on supporting resources for the upcoming eCQM annual update publication for the 2027 reporting/performance period.  Vendors and implementers are invited to review and comment on the draft Guide for Reading eCQMs and draft eCQM Logic and Implementation Guidance document for the 2027 reporting/performance period.  Learn more from this CMS notice.  The deadline for submitting comments is January 21.
  • CMS has added the following items 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 Services and Resources Administration (HRSA) has announced updated cervical cancer screening guidelines that include a new option for women to self-collect samples for screening.  The updated guidelines also designate high-risk human papillomavirus (hrHPV) testing, whether collected by a patient or a clinician, as the preferred screening modality for average-risk women ages 30-65 while retaining the option for cervical cytology (Pap) testing.  For average-risk women ages 21-29, cervical cancer screening using cervical cytology (Pap) is recommended.  The guidelines include new language requiring most insurance plans to cover any additional testing needed to complete the screening process for malignancies. These insurance providers are required to begin coverage of this new screening guideline beginning on January 1, 2027.  Learn more from this HRSA news release and the official updated cervical cancer screening guidelines, which include other technical and language changes in the guidelines.
  • HRSA has announced that it is significantly reducing data reporting associated with the receipt of COVID-19-era Provider Relief Fund and American Rescue Plan rural payments, including the elimination of 50 data elements.  Learn more from this regulatory announcement.
  • HHS and the Department of Agriculture have released new national dietary guidelines.  Learn more about the guidelines from this HHS news release and an accompanying fact sheet.
  • HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) has posted an updated fact sheet outlining the resources and services available through its 988 suicide and crisis lifeline program.  Find that updated fact sheet here.
  • HHS’s Office of the Inspector General has issued an unfavorable opinion regarding a proposal for a home care agency to market sign-on bonuses to prospective employees with the intention of employing those individuals for the provision of services to other individuals who most often would be family members of the prospective employees.  Find that opinion here.
Medicaid State Plan Amendments

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

  • To Kentucky, removing the September 30, 2025 sunset date for the medication-assisted treatment benefit and making that benefit permanent under the Medicaid state plan in accordance with federal statute.
  • To Michigan, removing the September 30, 2025 sunset date for the medication-assisted treatment benefit and making that benefit permanent under the Medicaid state plan in accordance with federal statute.
  • To Rhode Island, making coverage of medication-assisted treatment services permanent.
  • To Mississippi, making coverage of medication-assisted treatment services permanent.
  • To Tennessee, making coverage of medication-assisted treatment services permanent.
  • To North Dakota, implementing a technical correction to align the effective date of the 1915(i) payment pages with the rest of the 1915(i) renewal plan pages.
  • To Oregon, amending the state’s 1915(i) home- and community-based services (HCBS) benefit by adding an “Agency with Choice” as a service delivery model.  CMS conducted a review of the state’s submittal according to statutory requirements in Title XIX of the Social Security Act and relevant federal regulations.
  • To Oregon, modifying the name of the state’s Medicaid agency, Medical Assistance Unit, updating the assessment tool used for performing evaluations/reevaluations, and adding serious mental illness to the target population criteria.
  • To Oregon, updating state plan language regarding the Community First Choice program to add “Agency with Choice” as a service delivery model.
  • To New Mexico, providing for screening, diagnostic, and targeted case management services to eligible justice-involved youth in accordance with Section 5121 of the Consolidated Appropriations Act, 2023.
  • To Alaska, expanding transportation services permitted under administrative case management for tribal health organizations.
  • To Montana, authorizing the direct care wage supplemental payment and the health insurance supplemental payment for Community First Choice services provided in state fiscal years 2026 and 2027.
  • To Montana, authorizing the direct care wage supplemental payment and the health insurance supplemental payment for personal care services provided in state fiscal years 2026 and 2027.
  • To New Hampshire, continuing the suspension of direct graduate medical education (DME) payments, indirect graduate medical education (IME) payments, and catastrophic aid payments to hospitals.
  • To Connecticut, to disregard VA-administered non-service-connected pension benefits and housebound pension benefits that are granted to a veteran or the surviving spouse of such veteran when determining income eligibility for the Medicare Savings Program eligibility groups.
  • To Arizona, updating All Patient Refined Diagnosis Related Group (APR-DRG) reimbursement rates for inpatient hospital services effective October 1, 2025.
  • To New York, updating the reimbursement methodology for psychiatric residential treatment facilities, including the patient day utilization requirements, the length-of-stay adjustment, and medically necessary services excluded from psychiatric residential treatment facility reimbursements.
  • To Massachusetts, revising the Medicaid PACE rate development methodology.
  • To Massachusetts, updating the methods and standards used by the state for payment for adult day health services.
  • To Maine, memorializing the new income standards for recipients of its optional state supplemental program, recipients of which are eligible for Medicaid under Maine’s state plan.
  • To Maryland, updating references in the Health Homes state plan amendment pages from the old operating system (eMedicaid) to the ASO management system.
  • To Idaho, discontinuing contracting and reimbursing as part of the Healthy Connections Value Care program through value care organizations and the Healthy Connections primary care case management program.
  • To Delaware, disregarding at the time of renewal increases in resources that were determined countable at a Medicaid beneficiary’s most recent Medicaid application.

HHS Newsletters, Reports, and Videos

  • CMS – MLN Connects – January 8
  • HRSA – HRSA has posted video of a November 2025 training system webinar that demonstrated how to use the preliminary reporting environment and two offline uniform data system reporting features that enable health center awardees and look-alikes early access to prepare uniform data system data for timely, accurate, and complete submission.  Find the video and a transcript of that video here.
  • Agency for Healthcare Research and Quality – AHRQ News Now – December 30 and January 6.
Centers for Disease Control and Prevention (CDC)

The CDC has adopted changes in the childhood immunization schedule.  The revised schedule organizes childhood vaccinations into three categories:  immunizations recommended for all children, immunizations recommended for certain high-risk groups or populations, and immunizations based on shared clinical decision-making.  Insurers are required to cover all of these vaccinations without cost-sharing.  Learn more about the CDC’s changes in the childhood immunization schedule from this CDC news release and this HHS fact sheet.

Stakeholder Events

MedPAC – Commissioners Meeting – January 15-16

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, January 15 and Friday, January 16.  An agenda and participation information are not yet available but when they are they will be posted here.

CDC – Managing Histoplasmosis in Returning Travelers – January 15

The CDC will hold a webinar for clinicians on Thursday, January 15 at 2:00 (eastern) during which it will share current evidence on the epidemiology of travel-associated histoplasmosis, with a focus on cave-associated outbreaks in travelers visiting Central and South America.  Presenters will discuss best practices for prevention, diagnosis, and treatment.  Learn more about the webinar, how to participate, and continuing medical education credits for participation from this CDC announcement.

CMS – Medicare Diabetes Prevention Program Webinar – January 22

CMS officials will discuss the Medicare Diabetes Prevention Program and changes in that program resulting from the CY 2026 final Medicare physician payment schedule rule during a webinar on Thursday, January 22 at 1:00 (eastern).  Go here for additional information about the webinar and to register to participate.

MACPAC – Commissioners Meeting – January 29-30

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, January 29 and Friday, January 30.  An agenda is not yet available but go here to register to participate.

HHS/Office of the Assistant Secretary for Technology Policy – ASTP Annual Meeting – February 11-12, 2026

HHS’s Office of the Assistant Secretary for Technology Policy will hold its annual meeting in Washington, DC on February 11-12, 2026.  The meeting will include in-person education and plenary sessions and networking opportunities for the health IT community.  The main stage plenary sessions will also be available for viewing online.  ASTP will soon post information on the meeting’s agenda, how to register, and how to reserve a hotel room through ASTP’s room block.  When it does, that information will be posted here.

CMS – 2026 CMS Burden Reduction Conference – February 25

CMS will hold its 2026 Burden Reduction Conference on Wednesday, February 25.  The conference will be held in Washington, D.C., with options for individuals to attend in person or participate virtually.  Learn more from this CMS notice.  Registration information is not available at this time.

CMS – 2026 CMS Quality Conference – March 16-18

CMS will hold its 2026 Quality Conference on Monday, March 16 through Wednesday, March 18 in Baltimore.  The theme of the conference will be “Make America Healthy Again:  Innovating Together for Better Health.”  Interested parties can participate in person or virtually.  Learn more about the conference and how to participate from this CMS announcement.