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

The White House

The White House has rescinded Executive Order 13994 of January 21, 2021, titled “Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats.”  In response to this action, CMS rescinded its November 22, 2022 memo “The Importance of Timely Use of COVID-19 Therapeutics,” the purpose of which, according the memo, was “…to highlight the importance of providing timely access to available COVID-19 therapeutics to patients who test positive for the virus.”

Find the rescission in this executive order and learn more about the rescinded policy from this CMS notice, which includes a link to the rescinded CMS memo.

Congress
  • Last week, Congress passed a continuing resolution to fund the federal government through the end of the 2025 federal fiscal year.  The bill extends telehealth flexibilities, the Acute Hospital Care at Home program, and other health extenders through September 30, 2025.  The bill also delays cuts to Medicaid disproportionate share (Medicaid DSH) through September 30, 2025 and extends those cuts through 2028; they had previously been scheduled through 2027.  The bill did not include an increase of Medicare payments to physicians.
  • The Senate Finance Committee held a confirmation hearing to consider Dr. Mehmet Oz’s nomination to serve as Administrator of the Centers for Medicare & Medicaid Services.  Senators raised a wide range of issues with the nominee, including potential Medicaid cuts, rural health care priorities, Artificial Intelligence, and Medicare Advantage.  Find Dr. Oz’s testimony here.  His nomination appears to be on track to advance through the Senate Finance Committee and to the Senate floor in the coming weeks.
  • Members of Congress are working in their states or districts this week so there is no new committee or legislative activity.  The House, Senate, and White House continue reconciliation bill talks.  House and Senate leaders have not yet agreed on the outlines of a joint budget resolution for what spending and cuts would be included in the party-line bill.  Speaker Mike Johnson (R-LA) continues to push for bill passage by Memorial Day but senators say their bill could take until as late as August to pass.  Medicaid and Medicare continue to be targets for massive spending cuts while Speaker Johnson has promised that the final reconciliation bill will include an increase in Medicare payments to doctors.
340B

HHS has filed for summary judgment in response to lawsuits brought by the pharmaceutical companies Eli Lilly, Bristol Myers Squibb, and Novartis seeking summary judgment in response to HHS’s rejection of their attempt to change the manner in which they participate in the section 340B prescription drug discount program into a rebate model of their own devising.  This action signals that the new administration intends to continue its predecessor’s legal opposition to the efforts of the pharmaceutical industry to introduce unilateral changes in the nature of the 340B program.  Learn more about HHS’s continued argument for the court to reject the challenge to the 340B program from HHS’s motion in the case.

Centers for Medicare & Medicaid Services
  • CMS has updated its web site for organizations interested in applying to participate in the Medicare Shared Savings Program beginning on January 1, 2026.  The updated site presents information about participant types, application timelines, and when decisions will be made.  Find the web site here.  CMS will accept applications starting May 29 through its ACO management system and the application deadline is June 12 at noon (eastern).
  • CMS has posted a notice reminding MIPS participants that the data submission window for the 2024 performance year is now open and that they can submit their 2024 data until the submission window closes at 8:00 pm (eastern) on March 31.  The CMS notice includes information about how to submit data and directs affected providers to additional data submission resources.  Find the MIPS data submission notice here.
  • CMS will not be presenting spring 2025 ICD-10-PCS procedure code topics during a public meeting.  Instead, it will post the meeting materials and solicit public comments regarding clinical questions or coding options consistent with the approach it used as of March 2021 for procedure code requests that involve a new technology add-on payment application for the administration of a therapeutic agent.  The deadline to submit comments for procedure code topics being considered for October 1, 2025 implementation is April 18.  Learn more here.
  • CMS has announced that it has signed agreements with the manufacturers of the 15 drugs covered under Medicare Part D selected for the second cycle of the Medicare Drug Price Negotiation Program.  Signing these agreements means the manufacturers have assented to negotiating future Medicare prices for the specific drugs with CMS.  Find a list of the 15 affected drugs and their manufacturers and a review of the negotiation process in this CMS fact sheet.
  • CMS has approved the following state plan amendments for Medicaid and CHIP programs.
    • To Alaska, permitting the state to enter into value/outcome-based contracts with pharmaceutical manufacturers on a voluntary basis.
    • To New Jersey, permitting the state to enter into value-based supplemental rebate agreements with drug manufacturers on a voluntary basis.
    • To New Jersey, authorizing coverage of selected prescribed drugs that do not meet the definition of covered outpatient drugs.  This state plan amendment also provides for reimbursement of prescribed drugs with the same reimbursement methodologies as covered outpatient drugs.
    • To Wisconsin, adding non-routine vaccines recommended by the CDC’s Advisory Committee on Immunization Practices to the alternative benefit plan.
    • To Hawaii, adding services provided by pharmacy interns and pharmacy technicians to the state plan.
    • To Hawaii, updating the payment methodology for prescribed drugs and allowing for coverage of drugs authorized for import by the FDA to mitigate the effects of a drug shortage.
Department of Health and Human Services
  • HHS has renewed the public health emergency declaration addressing the country’s opioid crisis to facilitate sustained federal coordination efforts and preserve key flexibilities that enable HHS to continue leveraging expanded authorities to conduct certain activities in response to the opioid overdose crisis.  HHS has relied on this declaration to facilitate voluntary information collection, expedite demonstration projects related to substance use disorder treatment, and expedite support for research on opioid use disorder treatments.  Learn more from this HHS news release.
  • HHS and the FDA have announced that they will be taking steps to enhance their efforts to ensure the ongoing quality, safety, nutritional adequacy, and resilience of the domestic infant formula supply.  Among those steps will be beginning a nutrient review process, increasing testing for heavy metals and other contaminants, encouraging companies to develop new infant formulas, and clarifying opportunities to help inform consumers about formula ingredients.  Learn more about what the agencies are calling “Operation Stork Speed” from this HHS news release.
  • Medicare Administrative Contractors (MACs) are not consistently and effectively reviewing providers’ cost reports, HHS’s Office of the Inspector General (OIG) explains in a new report.  According to the report, each of the 12 MACs failed to comply with the contract requirements for audit and reimbursement desk review and audit quality for at least one of the three years the OIG reviewed.  In addition, CMS identified 287 total audit issues among all MAC jurisdictions during the review period, including MACs not performing proper reviews; inadequate review of graduate medical education and indirect medical education reimbursement; improper review of the allocation, grouping, or reclassification of charges to cost centers; improper calculation and reimbursement for nursing and allied health programs; and inadequate review of bad debts.  Learn more about what the OIG found, its recommendations, and their potential implications for health care providers from the OIG report “Medicare Administrative Contractors Did Not Consistently Meet Medicare Cost Report Oversight Requirements.”
  • State survey agencies need additional guidance to assess nursing home emergency preparedness programs, HHS’s OIG has concluded in a new report.  Learn more about the OIG’s findings and recommendations from this HHS announcement, which includes a link to the report.
HHS Newsletters and Reports
Center for Disease Control and Prevention (CDC)

The CDC has issued a health alert to provide information to health care providers, public health departments, and the public about the ongoing risk of dengue virus (DENV) infections and updates to testing recommendations in the U.S.  Dengue virus activity remains high in some parts of the U.S. and globally, with many countries reporting higher-than-usual number of dengue cases in 2024 and 2025.  Learn more from this CDC health alert, which includes background information about dengue viruses, recommendations for providers, public health agencies, and the public, and links to additional resources.

Medicare Payment Advisory Commission (MedPAC)

Last week MedPAC released “Report to the Congress:  Medicare Payment Policy,” its required March report to Congress.  In addition to addressing a variety of Medicare issues, MedPAC presented its 2026 Medicare rate recommendations to Congress.  Those recommendations are:

  • Hospital inpatient and outpatient services – the rate increase in current law plus one percent.  MedPAC also reiterated its past recommendation that Medicare redistribute current Medicare disproportionate share (Medicare DSH) and uncompensated care payments through MedPAC’s own mechanism, the Medicare Safety-Net Index (MSNI) it introduced in 2023, maintaining that doing so, when supplemented with an additional $4 billion in federal funds, “…would better target limited Medicare resources toward those hospitals that are key sources of care for low-income Medicare beneficiaries and are facing particularly significant financial challenges.”
  • Physician fees – MedPAC called for replacing the updates included in current law, which would be approximately a 0.75 percent increase for clinicians participating in advanced alternative payment models (APMs) and 0.25 percent for others – with “…a single update equal to the projected increase in MEI [the Medicare Economic Index] minus one percentage point,” which would amount to an increase of approximately 1.3 percent.
  • Dialysis rates – the rate increase in current law.
  • Skilled nursing facilities – a base rate reduction of three percent.
  • Home health services – a base rate reduction of seven percent.
  • Inpatient rehabilitation facilities – a base rate reduction of seven percent.

In addition, MedPAC recommends eliminating both the 190-day lifetime limit on covered days at inpatient psychiatric facilities and the reduction of the number of covered inpatient psychiatric days available to some beneficiaries during their initial benefit period.

Learn more from MedPAC’s “Report to the Congress:  Medicare Payment Policy” and the news release that accompanies the report.

Stakeholder Events

CDC – Clinician Outreach and Communication Activity – March 27

The CDC will hold a call for clinicians about the re-emergence of murine typhus as a threat in the U.S. on Thursday, March 27 at 2:00 (eastern).  During this call, presenters will review the epidemiology, diagnosis, and treatment of murine typhus and discuss its re-emergence in the U.S.  Learn more about the call, including how to participate, the presenters, its objectives, and the continuing education credits available to participants, from this CDC notice.

MACPAC – Commissioners Meeting – April 10-11

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, April 10 and Friday, April 11.  An agenda and registration information are not yet available but when they are they will be posted here.

MedPAC – Commissioners Meeting – April 10-11

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, April 10 and Friday, April 11.  An agenda and registration information are not yet available but when they are they will be posted here.