The following is the latest health policy news from the federal government for October 17 – 23.  Some of the language used below is taken directly from government documents.

Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown.

Congress and the Shutdown
  • The Senate postponed its 13th vote on the House-passed continuing resolution (CR), scheduled for today; without bipartisan negotiations on Affordable Care Act enhanced premium subsidies, the measure – whenever the next vote is held – is expected again to fall short of the 60 votes needed.  Recognizing that the shutdown will extend at least into next week, the Senate voted today on a bill aimed at maintaining pay for active-duty military personnel and some government workers, but that bill was rejected in a 54-45 vote.  While these and other relief measures have some support, members of Congress also acknowledge that if passed, this relief would reduce the pressure on Congress to negotiate an end to the shutdown.

The continuing resolution passed by the House – and repeatedly rejected by the Senate – would fund the federal government through November 21.  As that date approaches, members of Congress acknowledge that the House may be forced to return to session to vote on a revised CR.  Congressional leaders have not agreed on the length of a new CR but members are proposing a wide range of funding end-dates, including a short-term patch through mid-December, or a longer-term patch, with some members proposing a funding patch to last as long as through December of 2026.

  • Thirteen Republican House members representing highly competitive districts have written to House Speaker Mike Johnson expressing their support for his leadership during the current federal government shutdown but calling on him, once the shutdown ends, to work with them to address “…the growing crisis of healthcare affordability and the looming expiration of the enhanced Affordable Care Act (ACA) premium tax credits.”  Find their letter here.
340B

Today, the Senate Committee on Health, Education, Labor and Pensions, led by Chairman Bill Cassidy (LA) and ranking member Tammy Baldwin (WI), conducted a full committee hearing on the 340B Drug Pricing Program to evaluate its growth and impact on patients.  Support for the program as well as calls to reform the program came from both sides of the aisle.  Senators and witnesses addressed the importance of the 340B program; the pharmaceutical manufacturers’ rebate program that begins in January; potential transparency reforms; making sure 340B entities do not receive duplicate drug discounts; revising the definition of a patient for a covered entity; and reforms involving the use of contract pharmacies.  Representatives from the U.S. Government Accountability Office (GAO), Congressional Budget Office (CBO), and the University of California, Los Angeles served as the witness panel.

Go here to find the testimony of the witnesses and to view a video of the hearing.

Centers for Medicare & Medicaid Services
  • CMS has instructed all Medicare Administrative Contractors (MACs) to lift claims holds and process Medicare claims with dates of service of October 1 and later for certain services affected by selected expired Medicare legislative payment provisions passed earlier this year.  This includes claims paid under the Medicare physician fee schedule, ground ambulance transport claims, and Federally Qualified Health Center (FQHC) claims.  This also includes telehealth claims that CMS can confirm are definitively for behavioral and mental health services.  CMS has directed all MACs to continue to temporarily hold claims for other telehealth services – those that CMS cannot confirm are definitively for behavioral and mental health services – and for Acute Hospital Care at Home claims.  Learn more from this CMS notice.
  • CMS has revised its guidance to state survey agencies on contingency plans for state survey and certification activities in the event of a federal government shutdown.  Find the updated guidance here.
  • CMS has published an operational guide for providers and suppliers participating in its Wasteful and Inappropriate Service Reduction (WISeR) Model.  The purpose of the guide is to provide an overview of the prior authorization submission and determination process for Medicare-enrolled providers and suppliers that furnish and bill items and services included in the WISeR model in the states in which the WISeR model is being tested.  The guide also addresses the pre-payment medical review process that will be triggered if claims for items and services included in the WISeR model in states where the WISeR model is operating are submitted without first obtaining prior authorization.  The states participating in the WISeR model are Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.  Find the guide here.
  • CMS has posted a video demonstrating how initiating parties should complete the Notice of Independent Dispute Resolution (IDR) Initiation web form to create a dispute and start the Federal IDR process.  Find that video here.
  • CMS has awarded proof-of-concept contracts of one dollar each to four companies for the development of a national provider directory.  The contracts expire on November 13.  Learn more here.
  • 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, some of which may be zip files.)
H-1B Visas

The U.S. Citizenship and Immigration Services has issued guidance on new restrictions on H-1B visas issued in a presidential proclamation in September that require a $100,000 payment to apply for such a visa.  The guidance explains that the fee requirement does not apply to those who have current or previously issued H-1B visas but does apply to those outside the country who do not have H-1B visas.  Learn more from this U.S. Citizenship and Immigration Services guidance.

Food and Drug Administration

The FDA has announced nine voucher recipients under the new Commissioner’s National Priority Voucher pilot program.  Each recipient has a product with “…significant potential to address a major national priority…,” such as meeting a large unmet medical need, reducing downstream health care utilization, addressing a public health crisis, boosting domestic manufacturing, or increasing medication affordability with most favored nation pricing.  Voucher recipients will receive a decision within one to two months following filing of a complete application for a drug or biologic.  In addition, sponsors will receive enhanced communications with review staff throughout the development process prior to their final submission and during the review period.  Learn more about the program and the initial products to receive vouchers from this FDA news release.

Stakeholder Events

MACPAC – Commissioners Meeting – October 30-31

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, October 30 and Friday, October 31.  An agenda and registration information are not yet available but when they are they will be posted here.  Please note that if the federal government shutdown continues, this meeting will probably be canceled.

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.