The following is the latest health policy news from the federal government for March 21-27.  Some of the language used below is taken directly from government documents.

Congress
  • The House and Senate need to pass a joint budget resolution as a first step before committees can begin writing legislation to pass under reconciliation.  Each chamber has passed its own budget resolution and while the two are very different, congressional leaders have agreed to write a less prescriptive resolution that will permit each chamber’s committees to determine the level of spending and saving required and then will try to work out the differences in their approaches later in the process of negotiating legislative language.
    • The Senate parliamentarian is expected to decide shortly if the Senate’s rules will permit Congress to extend expiring tax provisions at no cost.  If so, committees may be under less pressure to find such large budgetary savings – and may be able to shrink the expected level of cuts to Medicaid and other social programs.
    • House Speaker Mike Johnson (R-LA) and Senate majority leader John Thune (R-SD) hope to pass a joint budget resolution by April 11.
  • The Congressional Budget Office this week announced that the U.S. government will not be able to pay its debts unless Congress acts before August or September.  President Trump has stated that he wants Congress to address the debt limit as part of reconciliation.
Reorganization of the Department of Health and Human Services

HHS has announced a major restructuring of its operations.  The changes include:

  • Terminating an additional 10,000 of the agency’s employees, over and above 10,000 employee reduction that already has taken place, thereby reducing its staff from 82,000 to 62,000 full-time employees.  The terminations include:
    • 300 full-time employees at CMS, with HHS noting that this “…will not impact Medicare and Medicaid.”
    • 3500 at the FDA, with HHS explaining that this reduction “…will not affect drug, medical device, or food reviewers, nor will it impact inspectors.”
    • 1200 at the NIH.
    • 2400 at the CDC.
  • Reducing its annual spending by $1.8 billion.
  • Reducing from 28 to 15 divisions.
  • Reducing from ten regional offices to five.
  • Creating a new Administration for a Healthy America (AHA) that will combine the Office of the Assistant Secretary for Health, Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry, and National Institute for Occupational Safety and Health (NIOSH) into a new, unified entity.
  • Transferring to the CDC the Administration for Strategic Preparedness and Response (ASPR).  HHS explains that with staff reductions at the CDC, the agency will “…focus on returning to its core mission of preparing for and responding to epidemics and outbreaks.”
  • Creating a new Assistant Secretary for Enforcement to oversee the Departmental Appeals Board, Office of Medicare Hearings and Appeals, and Office for Civil Rights.
  • Merging the Assistant Secretary for Planning and Evaluation (ASPE) with the Agency for Healthcare Research and Quality (AHRQ) to create the Office of Strategy.
  • Reorganizing the Administration for Community Living by integrating programs that support older adults and people with disabilities into other HHS agencies, including the Administration for Children and Families, ASPE, and CMS.

Learn more from this HHS news release and an accompanying fact sheet.

HHS Leadership Staffing
  • The Senate has confirmed the nominations of Marty Makary, M.D., to serve as Commissioner of the Food and Drug Administration and Jay Bhattacharya, M.D., Ph.D., as Director of the National Institutes of Health.
  • The Senate Finance Committee has voted to recommend the nomination of Mehmet Oz, M.D., to the full Senate to serve as Administrator of the Centers for Medicare & Medicaid Services.  A Senate vote on the nomination has not yet been scheduled.
  • The administration has nominated individuals for four positions at HHS that require Senate confirmation:
    • Susan Monarez, Ph.D., for Director of the Centers for Disease Control and Prevention
    • Thomas March Bell, for Inspector General
    • Brian Christine, M.D., for Assistant Secretary for Health
    • Alex Adams, for Assistant Secretary for Family Support
Department of Health and Human Services
  • HHS and the Drug Enforcement Agency (DEA) have published a formal notice delaying the effective date of two final rules published earlier this year – “Expansion of Buprenorphine Treatment via Telemedicine Encounter”  and “Continuity of Care via Telemedicine for Veterans Affairs Patients” – to December 31, 2025.  The final rule has no effect on current practice:  the current, temporary extension of telehealth flexibilities that took effect earlier this year remains in effect through the end of the year, enabling DEA-registered practitioners to prescribe up to six months’ worth of buprenorphine via telehealth without a prior personal visit with a patient and enabling Department of Veterans Affairs providers to prescribe controlled substances via telehealth without benefit of a personal visit with the patient.  While this notice states that the current extensions become permanent as of the end of the year, it also notes that “… the Department of Justice wishes to further postpone the effective dates for the purpose of further reviewing any questions of fact, law, and policy that the rules may raise,” which suggests that they may be subject to further consideration and rulemaking before the end of the year.  Learn more from this formal regulatory notice.
  • HHS has terminated more than 300 NIH program and research grants; find a list of those terminated grants here.  Most of the terminations appear to reflect executive orders issued earlier this year.
  • HHS is closing its Office of Long COVID Research and Practice.  An internal HHS memo announcing the closure is reproduced here (scroll down).
  • HHS’s Health Resources and Services Administration (HRSA) will award up to 12 four-year grants totaling $3.9 million through its Regional Telehealth Resource Center program and National Telehealth Resource Center program to establish telehealth resource centers to support health care organizations, networks, and providers with telehealth implementation and training for rural areas, frontier communities, and medically underserved areas and for medically underserved populations.  Learn more about the funding from this grant opportunity notice.  The deadline for submitting applications is April 14.
  • Another HRSA funding opportunity through the agency’s Telehealth Rapid Response Center and its Telehealth Research Center offers a single five-year grant of up to $950,000 for research that expands the evidence base to inform policy and programs for telehealth services in underserved populations.  Learn more about this funding from this grant opportunity notice.  The deadline for submitting applications is April 15.
  • HHS’s Office of the Inspector General (OIG) has concluded that the findtreatment.gov web site operated by HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) contained inaccurate information about substance use and mental health treatment facilities.  More than half of the facilities the OIG reviewed listed inaccurate addresses and inaccurate information about the services the facilities offer.  Learn more from this OIG report.
  • A new brief from HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) describes how enhancing linked data infrastructure across health and human services programs can improve efficiency, increase transparency through strengthening outcomes research, and empower patients and families to make more informed choices.  Find that brief here.
Centers for Medicare & Medicaid Services
  • In response to the continuing national IV fluid shortage, CMS will reopen the 2024 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception Application to provide relief to practices affected by that shortage.  The application window will reopen on Monday, March 31 and will close April 14.  The agency will only accept applications citing the shortage as the basis for requesting reweighting under the MIPS Extreme and Uncontrollable Circumstances Exception.  CMS also is extending the MIPS data submission deadline until April 14.  The deadline for certain clinicians, groups, and Alternative Payment Model entities to elect to participate in MIPS – because they are opt-in eligible due to the low-volume threshold or are partially qualifying APM participants – is still March 31, 2025.  Learn more from this CMS fact sheet.
  • CMS has proposed a regulation that calls for changes in Medicare cost reports to accommodate new payments for stockpiling medicines and respirators.  The proposed changes to Form CMS-2552-10 would add Worksheet E-90, Payment Adjustment For Establishing And Maintaining Access to a Buffer Stock Of Essential Medicines, and Worksheet E-95, Payment Adjustments For Domestic NIOSH-Approved Surgical N95 Respirators.  Learn more from this CMS announcement.  The deadline for submitting comments is May 27.
  • CMS has fined seven hospitals for failing to comply with requirements for hospital price transparency.  Go here to learn about these infraction enforcement actions.
  • CMS has updated its fact sheet on hospital billing transparency.  Find that updated fact sheet here.
  • CMS has posted a bulletin updating its policy for roster billing for hepatitis B vaccines.  Find that bulletin here.
  • CMS has posted a bulletin with a quarterly update for clinical laboratory fee schedule and laboratory services subject to reasonable charge payment.  Find that bulletin here.  The changes the bulletin describes take effect on April 1.
  • CMS has posted a bulletin describing Healthcare Common Procedure Coding System (HCPCS) codes subject to and excluded from Clinical Laboratory Improvement Amendments (CLIA) edits.  Find that bulletin here.  The changes it describes take effect on April 1.
  • CMS has posted a bulletin about changes to improve payment accuracy for physician services provided in skilled nursing facilities.  Find that bulletin here.  The changes the bulletin describes take effect on July 1.
  • CMS has posted a bulletin describing updates in reporting for processing hospice claims and principal diagnosis coding.  Find that bulletin here.  The changes the bulletin describes take effect for claims received on or after April 1.
  • CMS has posted a bulletin updating its Rural  Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Medicare benefit policy manual.  The effective date of the manual changes was January 1 and the implementation date is April 21.  Find the bulletin here.
  • CMS has updated its web-based training program for 2025 Medicare Part C and Part D reporting requirements and data validation.  Find the updated program here.
  • CMS has amended the Electronic Clinical Quality Measures (eCQMs) Annual Update Pre-Publication Document, which provides the versions of the standards and code systems used within the updated eCQMs for potential use in CMS quality reporting programs for the 2026 reporting/performance period. CMS has updated the pre-publication document to remove references to two code systems that will no longer be used in updated eCQMs for the 2026 reporting/performance period.  Learn more about the updated document, including where to find it when CMS posts it later this year, from this CMS announcement.
  • CMS’s Center for Clinical Standards and Quality has sent a memo to state survey agencies updating its 2016 guidance on preconfigured hemodialysis systems to expand its applicability to any pre-configured hemodialysis system that has received FDA clearance for home and in-center use.  Find the updated memo here.  The revised guidelines take effect immediately.
  • CMS has updated its fact sheet on Medicare coverage of diabetes supplies.  Find the updated fact sheet here.
  • CMS has approved the following state plan amendments for Medicaid and CHIP programs.
    • To Iowa, updating state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set.
    • To Louisiana, making provisions governing the medical transportation program to establish guidelines for the administration and distribution of Elevated Level of Care services by non-emergency medical transportation vendors that meet the criteria to provide an Elevated Level of Care service to medical beneficiaries and clarifying language regarding non-emergency medical ambulance transportation services.
    • To New Jersey, updating rates for COVID-19 vaccine administration.
    • To Maine, updating the pool amount for outpatient supplemental payments made to non-critical access hospitals.
    • To Maine, updating the payment methodology for case management services.
    • To Massachusetts, updating rates for mental health centers.
    • To Maine, removing the approved annual inflationary increases for certain home health items.
    • To Florida, updating the methodology for setting reimbursement rates for Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC).
    • To New York, updating the reimbursement methodology for covered outpatient and prescribed drugs as well as physician-administered drugs.
    • To Massachusetts, updating rates for acute outpatient hospitals.
HHS Newsletters, Reports, and Videos
Department of Agriculture

The Department of Agriculture has announced that it will spend up to $100 million on avian flu research to explore prevention, therapeutics, research, and potential vaccines.  Learn more from this news release.

Stakeholder Events

CMS – AHEAD Medicare Fee-for-Service Hospital Global Budget Methodology Overview – April 8

CMS will host a webinar to review the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model’s Medicare fee-for-service hospital global budget methodology – specifically, enhancements reflected in the forthcoming version 3.0 hospital global budget methodology financial specifications – on Tuesday, April 8 at 2:00 (eastern).  Learn more about the subjects the webinar will address, how to submit questions, and how to register to participate from this CMS 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.  Go here to register to participate.

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.