Policy Updates

Senate Committee Looks at 340B

Last week the Senate Committee on Health, Education, Labor and Pensions held a hearing on the 340B Drug Pricing Program to discuss its growth and impact on patients. Among other subjects, the committee reviewed the importance of the 340B program; the pharmaceutical manufacturers’ rebate program that begins in January; potential transparency reforms; ensuring that 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 Government Accountability Office, Congressional Budget Office (CBO), UCLA served on the hearing’s witness panel. Go here to find [...]

joe2025-10-23T14:02:22-04:00October 27, 2025|340b|

Federal Health Policy Update for October 23

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 [...]

joe2025-10-23T15:32:04-04:00October 23, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare|

Governors Form New Health Care Coalition

The governors of 15 states have joined forces to create a new organization. The governors – all Democrats – announced the launch of the Governors Public Health Alliance, a group they say is “…designed to protect the health of people across the U.S.” and …will serve as a nonpartisan coordinating hub for governors and their public health leaders. The Governors Public Health Alliance will support Governors and their states in coordinating and collaborating to protect the public’s health by facilitating data sharing and communication about health threat detection, emergency preparedness and response, public health guidance and policy, and deployment of [...]

joe2025-10-21T13:47:11-04:00October 22, 2025|Uncategorized|

Feds Clarify H-1B Visa Payment Requirement

The U.S. Citizenship and Immigration Services has issued guidance on new restrictions on H-1B visas issued in a presidential proclamation on September 19. The new guidance explains that for the requirement of a $100,000 payment to apply for such a visa: The Proclamation does not apply to any previously issued and currently valid H-1B visas, or any petitions submitted prior to 12:01 a.m. eastern daylight time on September 21, 2025. In addition, the Proclamation does not prevent any holder of a current H-1B visa, or any alien beneficiary following petition approval, from traveling in and out of the United States. [...]

joe2025-10-21T10:19:34-04:00October 21, 2025|Uncategorized|

Hospital at Home Program in Limbo

Medicare’s Acute Hospital Care at Home program is in limbo after the law authorizing it lapsed at the end of the 2025 federal fiscal year on September 30. As a result of this loss of authorization, CMS directed the more than 300 hospitals that participate in the program and care for seriously ill patients in their homes to discharge current participants or bring them back into their hospital. The program, created during the COVID-19 pandemic to free hospital beds for sicker patients who also were highly contagious, has been credited with lower mortality rates, reduced crowding in hospital emergency rooms, [...]

joe2025-10-15T12:52:33-04:00October 17, 2025|Medicare|

Federal Health Policy Update for October 16

The following is the latest health policy news from the federal government for October 10 - 16. 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 In its tenth attempt, the Senate today failed to pass a Republican-sponsored continuing resolution (CR). Republicans were unable to gain the 60 votes needed to pass the bill, winning Democratic support only from [...]

joe2025-10-16T16:38:02-04:00October 16, 2025|Affordable Care Act, Medicaid, Telehealth|

Medicaid DSH Cuts Have (Seemingly) Arrived

Cuts in Medicaid disproportionate share payments, mandated in 2010 under the Affordable Care Act to take effect in 2014 but delayed by Congress ever since, are now scheduled to begin taking effect because Congress’s latest extension of the delay lapsed with the end of the federal fiscal year on September 30. As a result, states – and hospitals that qualify for Medicaid DSH – are expected to see federal Medicaid DSH spending slashed by $8 billion a year for the next three years. Medicaid DSH payments are made to selected hospitals based on how many low-income patients they serve who [...]

joe2025-10-15T11:42:36-04:00October 16, 2025|Affordable Care Act, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Protecting Consumers AND Providers? No Surprise

As intended, the No Surprises Act is protecting consumers from unexpected medical bills. But it’s also protecting someone else: providers. In the three years since the No Surprises Act’s Independent Dispute Resolution process was implemented, providers have won about 85 percent of cases. In 2023 and 2024, that amounted to more than $2 billion in additional payments. One aspect of the No Surprises Act that has been a surprise is the frequency with which parties are resorting to it. Originally projected to settle about 17,000 disputes a year, the process has seen more than three million disputes filed during its [...]

joe2025-10-14T15:29:39-04:00October 15, 2025|Uncategorized|

Hospital Financial Progress in Jeopardy

While hospitals and health systems in general continue to move closer to their pre-pandemic level of financial performance, they now face challenges that threaten to undermine that progress. While they have slowly gotten their labor costs under control, providers now face rising non-labor costs, including for drugs and supplies. Meanwhile, two recent policies enacted by Congress may pose an even greater threat. New limits on Medicaid eligibility threaten to transform manageable losses from under-reimbursement for Medicaid services into uncompensated care at the same time that the elimination of enhanced Affordable Care Act insurance premium subsidies could turn lower-income working families [...]

joe2025-10-14T14:19:03-04:00October 15, 2025|Affordable Care Act, Congress, hospitals, Medicaid|

Misinterpretation of Shutdown Plagues Telehealth

When federal authorization for Medicare-covered telehealth services lapsed at the end of the federal fiscal year on September 30, it was only supposed to affect traditional Medicare participants. But not everyone got the message. Some providers, confused about the lapse of Medicare authorization, are refusing to prescribe telehealth services for their non-Medicare patients. In addition, some health insurers are declining to cover telehealth services for their non-Medicare patients, misinterpreting the scope of the loss of Medicare authorization for telehealth care – something they should not be doing, according to a health insurance industry trade group. Older patients, patients with limited [...]

joe2025-10-14T11:45:35-04:00October 14, 2025|Medicare, Telehealth|