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 federal government remains shut down and the Senate expects to leave Washington today without another vote on the House-passed continuing resolution (CR), ensuring that the shutdown will continue into next week.  Republican leaders believe the lapse in Supplemental Nutrition Assistance Program (SNAP) funding and a recent statement from the American Federation of Government Employees urging an end to the shutdown will encourage Democrats to vote to fund the government in the coming week.   Republican and Democratic lawmakers have introduced stand-alone measures to address individual funding challenges but Senate Majority Leader Thune has stated that he will not bring up those bills for a vote.  Bipartisan discussions among rank-and-file senators have resumed, hoping to find a compromise to end the stalemate, but  Democratic leaders continue to push for an extension of Affordable Care Act enhanced premium subsidies before they will agree to fund the government.  Elected officials from both parties acknowledge that President Trump’s participation will be necessary to end the impasse and some have suggested that a conversation with the White House may be possible after the president’s return to Washington.

As the House-passed CR’s November 21st deadline approaches, Republican leaders have begun additional conversations about an updated stopgap measure with prospective expiration dates in January or March of 2026.  The White House has indicated support for an even longer extension, potentially through December of 2026, but appropriators and defense hawks have expressed concerns with that plan.

House committees continue to discuss health care priorities that could be included in a year-end bill, which may be a necessary piece of the negotiations to extend and reform Affordable Care Act premium tax credits.

HHS/CMS and the Shutdown:  Employees Return to Work

CMS has recalled all of its employees – 3000 people, 47 percent of its workforce – furloughed earlier this month when the federal government shutdown began.  In a published report, a CMS spokesperson explained that “In order to best serve the American people amid the Medicare and Marketplace open enrollment seasons, CMS is temporarily calling back all furloughed employees on Monday, October 27.”

In addition to working on Medicare and Marketplace open enrollment, CMS’s Office of Hearings also has announced that it is now is open to “conduct business in the usual manner.”

Other HHS employees are returning to work as well, including some staff of the Health Resources and Services Administration (HRSA) who will participate in the review of applications for Rural Health Transformation Program funding.  The deadline for states to apply for the first $10 billion pool of funds is November 5 and CMS has indicated that it intends to announce the first round of awards before the end of the year.

Pending HHS and CMS Regulations

A number of major Medicare and Medicaid regulations are currently with the Office of Management and Budget (OMB) for review; it is not clear whether they will be addressed in the current environment.  By statute, the following regulations must be implemented by January 1.

  • CY 2026 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates
  • CY 2026 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B
  • CY 2026 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System and Quality Incentive Program
  • CY 2026 Part A Premiums for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement
  • CY 2026 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts
  • Medicare Part B Monthly Actuarial Rates, Premium Rates, and Annual Deductible Beginning January 1, 2026

CMS traditionally gives 60 days’ notice before the January 1 implementation date.  It is not clear whether that will happen this year.

The following regulation must be implemented sometime in 2026 but has no specific implementation date.

  • Medicare and Medicaid Programs; Repeal of Minimum Staffing Standards for Long-Term Care Facilities

Rules currently with OMB for final review that do not have a statutory deadline for release and implementation include:

  • Medicaid Managed Care State Directed Payments
  • Medicaid Program; Prohibition on Federal Medicaid Funding for Sex Trait Modification Procedures Furnished to Children and Youth
  • Medicare and Medicaid Programs; Hospital Condition of Participation: Limiting Participation Based on the Performance of Sex Trait Modification Procedures on Children
  • Center for Medicare & Medicaid Innovation Payment Models
  • Transparency in Coverage
  • Amendments to Rules Governing Organ Procurement Organizations
  • Contract Year 2027 Policy and Technical Changes to Medicare Advantage, Medicare Prescription Drug Benefit, Medicare Cost Plan, and Programs of All-Inclusive Care for the Elderly Programs
  • Global Benchmark for Efficient Drug Pricing (GLOBE) Model
  • Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model

The progress of proposed and final regulations with OMB for review are listed and can be tracked on this OMB web page.

Centers for Medicare & Medicaid Services

With the Affordable Care Act Marketplace open enrollment period beginning on November 1, CMS has released a fact sheet describing 2026 Marketplace plans and prices.  Find that fact sheet here.

Department of Health and Human Services
  • Medicare improperly paid suppliers $22.7 million over seven years for durable medical equipment, prosthetics, orthotics, and supplies provided to enrollees during inpatient stays, HHS’s Office of the Inspector General (OIG) found in a recent audit. Learn more about what the OIG found and the steps it recommended to address this problem from this audit report.
  • HHS’s OIG has published a data snapshot of participants in its Special Focus Facility program for nursing homes, which was initiated in 2013 to facilitate quality improvements in the poorest-performing nursing homes through increased oversight. The data covers 2013 through 2022. Find the report here.
  • In a companion report, the OIG presents why it has concluded that the Special Focus Facility Program has not yielded lasting improvements. Find that report here.
  • Last week, HHS’s Health Resources and Services Administration (HRSA) held a welcome webinar for new participants in its Nurse Corps Scholarship Program during which it provided answers to questions about program compliance requirements, transitioning to service, and more. Find the video of that webinar and an accompanying transcript here.
  • Last week HRSA also held a technical assistance webinar for participants in its National Health Service Corps’ State Loan Repayment Program. The webinar presented information about the grant opportunity, application requirements, and more.  Go here to view the video and find an accompanying transcript of the webinar.
Centers for Disease Control and Prevention (CDC)

In a review of mpox in the U.S. and around the world, the CDC reports three cases of clade 1 mpox in southern California affecting people with no recent travel.  All three individuals are recovering from the illness.  Learn more from this CDC update.

Food and Drug Administration (FDA)

The FDA has proposed a process for simplifying biosimilarity studies and making it easier for biosimilars to be developed as interchangeable with brand-name biologics.  Learn more about the FDA’s plans from this news release; this draft guidance on proposed changes in how prospective biosimilar products are tested; and this FDA fact sheet on biosimilar drugs.

Congressional Budget Office (CBO)
  • Last week, the Senate Committee on Health, Education, Labor and Pensions held a hearing on the 340 Drug Pricing Program at which the CBO testified on the growth in that program and its implications for the federal budget. Find the CBO’s testimony here.
  • As part of the process that resulted in enactment of the 2025 reconciliation act, the House Committee on Energy and Commerce and the Senate Committee on Finance were instructed to recommend legislative changes that met specified budget targets over the 2025-2034 period. In a new document, the CBO presents its estimate that the provisions in the reconciliation bill in question will reduce the deficit by $886.8 billion over the 2025-2034 period and that the combined effects of these provisions will increase the number of people without health insurance by 7.5 million in 2034.  Learn more from this CBO report.
Stakeholder Events

MedPAC – Commissioners Meeting – November 6-7

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, November 6 and Friday, November 7.  An agenda and registration information are not yet available but when they are they will be posted here.  MedPAC notes that this meeting is contingent on enactment of funding for the federal government.

MACPAC – Commissioners Meeting – December 11-12

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, December 11 and Friday, December 12.  An agenda and registration information are not yet available but when they are they will be posted here.

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.