Policy Updates

Federal Health Policy Update for July 30

Don’t Miss: Two new final Medicare payment rules CMS seeks data on 340B prescriptions Agency seeks potentially confidential ER data The following is the latest health policy news from the federal government for July 24-30. Some of the language used below is taken directly from government documents. Congress Senate Republicans remain focused on advancing a short-term continuing resolution (CR) before the August recess; it is expected to differ from the CR the House passed last week. The Senate appears unlikely to consider a budget resolution for a third party-line reconciliation bill before September. The Senate Budget Committee announced a hearing [...]

joe2026-07-30T15:52:57-04:00July 30, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

SAMHSA Reports on the State of the American Mind

The Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration has released its 2025 National Survey on Drug Use and Health, its primary source of data on how Americans report their experience with mental health conditions, substance use and addiction, pursuit of treatment, and recovery. This year’s survey presents five years of data examining trends among key substance use and mental health outcomes. SAMHSA presents its findings are declines as increases in the prevalence of various behaviors, including: mental health substance use suicidal thoughts and behaviors non-suicidal self-harm substance use treatment services mental health treatment [...]

joe2026-07-28T16:55:39-04:00July 30, 2026|Uncategorized|

Agency Seeks Confidential Accident Data From Hospitals

The Consumer Product Safety Commission is seeking to require some hospitals to participate in its National Electronic Injury Surveillance System (NEISS), the nation's principal system for tracking consumer product-related injuries. Currently relying on manual review and coding of medical records from roughly 70 of the nation's more than 5,000 hospital emergency departments, the agency has announced that it will expand its surveillance network across all 50 states and to about 100 hospitals and health systems. Under the updated program, NEISS-R would exchange data with participating hospitals through federally designated Qualified Health Information Networks in an effort to strengthen the CPSC’s ability to detect product hazards. It would search for [...]

joe2026-07-28T14:36:16-04:00July 29, 2026|Uncategorized|

Developments in No Surprises Act/Independent Dispute Resolutions

Recent weeks have seen several developments and new information in the use of the No Surprises Act’s independent dispute resolution process for health care billing disputes between payers and providers over out-of-network care. The number of disputes directed to independent dispute resolution continues to rise – 16 percent more during the second half of 2025 than during the first half of that year. Providers continue to initiate about three-quarters of the disputes and to win about 85 percent of those cases. Most of the provider-driven disputes are intiated by small provider groups, many of them represented by just a few [...]

joe2026-07-23T15:42:59-04:00July 27, 2026|Uncategorized|

CMS Proposes Medicaid Provider Tax Regulation

The Centers for Medicare & Medicaid Services has published a proposed rule that would implement a portion of H.R. 1, last year’s federal budget reconciliation bill, that called for establishing new indirect hold-harmless thresholds for health care-related taxes – primarily, provider taxes, which are currently employed in 49 states and the District of Columbia. Major changes include: Replacing the six percent safe harbor with state-specific thresholds based on July 4, 2025 structures. Prohibiting states from introducing new Medicaid provider taxes or increasing existing provider taxes that were in effect on that same date. Phasing down the provider tax ceiling [...]

joe2026-07-23T16:11:10-04:00July 24, 2026|Medicaid, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for July 23

Don’t Miss: Congress advances health care bills CMS proposes provider tax rule Courts act on ACA changes, 340B The following is the latest health policy news from the federal government for July 17-23. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee held a markup for 29 bills, advancing the following health care transparency measures with bipartisan support: H.R. 9390, Prices on the Wall Act of 2026 H.R. 9393, Lower Costs, More Transparency Act of 2026, part of a package that also includes: H.R. 3514, Improving Seniors’ Timely Access [...]

joe2026-07-23T16:29:15-04:00July 23, 2026|340b, Affordable Care Act, MACPAC, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, MedPAC|

Court Pauses Parts of ACA Rule

A federal court in Maryland has issued a temporary stay in the implementation of eight provisions in CMS’s Affordable Care Act marketplace rule – provisions that were to take effect on July 20. In a challenge to the legality of portions of the regulation in the case of City of Columbus v. Kennedy, the court concluded that the plaintiffs were likely to succeed in their challenge to some provisions in question even before further proceedings and therefore vacated: the expansion of eligibility for catastrophic plans through an income-based hardship exemption; expansion of annual maximum out-of-pocket limits and revised cost-sharing requirements [...]

joe2026-07-21T17:09:25-04:00July 22, 2026|Affordable Care Act|

CMS Touts ACO REACH Model Results

An evaluation commissioned by the Center for Medicare and Medicaid Innovation has found that the agency’s Medicare ACO REACH (Realizing Equity, Access, and Community Health) Model is saving money and improving health care outcomes. A summary of an evaluation of the program’s 2023 performance year explained that The ACO REACH Model is an advanced accountable care organization (ACO) initiative to promote patient-centered care, lower costs, and align payment systems for Original Medicare beneficiaries through ACO risk-sharing and prospective payment. In performance year (PY) 2023, the model showed stronger improvements in quality than prior years and lowered gross spending across all [...]

joe2026-07-16T16:33:57-04:00July 20, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for July 16

Don’t Miss: CMS proposed 2027 physician payment regulation House Ways and Means passes health care bills DHS publishes new, final public charge rule HHS pursues delivery models for potential psychedelic drugs for behavioral health treatment The following is the latest health policy news from the federal government for July 10-16. Some of the language used below is taken directly from government documents. CMS – Proposed 2027 Medicare Physician Fee Schedule Rule CMS has published its proposed physician fee schedule rule for 2027. Highlights include: A proposed reduction in Medicare physician rates. A reduction of payments for evaluation and management (E/M) [...]

joe2026-07-16T16:13:25-04:00July 16, 2026|340b, Accountable Care Organization, ACO, Alternative payment models, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

HHS Regulatory Agenda Revealed

The federal Office of Management and Budget has posted an updated version of the administration’s 2026 unified regulatory agenda and among the items posted are more than 180 for the Department of Health Services. Among the HHS items are 44 for the Centers for Medicare & Medicaid Services, which administers the Medicare and Medicaid programs. Most of the items are proposed rules, and among the issues CMS is expected to address through regulation during the rest of 2026 are the Medicare inpatient and outpatient prospective payment systems, the Medicare physician fee schedule, Medicaid managed care and state-directed payments, hospital price [...]

joe2026-07-09T14:19:30-04:00July 13, 2026|Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|