Billy Wynne

Democrats Call on CMS to Open Window Shopping for the Marketplace

By Billy Wynne / October 27, 2025

Democrats Call on CMS to Open Window Shopping for the Marketplace A group of 28 Democratic senators led by Senate Finance Committee Ranking Member Ron Wyden (D-OR) and Democratic Leader Chuck Schumer (D-NY) sent a letter calling on the Administration to immediately open “window shopping” ahead of Affordable Care Act (ACA) Marketplace open enrollment. Typically, the Centers…

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Senate Special Committee Explores Shoppable Services and Price Transparency to Improve Competition in the Healthcare Market

By Billy Wynne / October 27, 2025

Senate Special Committee Explores Shoppable Services and Price Transparency to Improve Competition in the Healthcare Market The Senate Special Committee on Aging held a hearing to discuss shoppable services and their effects on healthcare costs and outcomes. The hearing focused on ways that price transparency increases consumer choice and therefore introduces competition into the healthcare market.…

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Agency Says It Cannot Use Contingency Funds for SNAP During Shutdown and States Will Not Be Reimbursed; Will Continue to Fund WIC

By Billy Wynne / October 24, 2025

Agency Says It Cannot Use Contingency Funds for SNAP During Shutdown and States Will Not Be Reimbursed; Will Continue to Fund WIC The Department of Agriculture (USDA) Food and Nutrition Service (FNS) circulated a memorandum obtained by reporters saying that it cannot use contingency funds to pay for Supplemental Nutrition Assistance Program (SNAP) benefits in November and…

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Federal District Judge Temporary Blocks Reductions in Force During Government Shutdown; Senate Fails to Advance Federal Worker Relief Bills Amid Partisan Disagreements

By Billy Wynne / October 23, 2025

Federal District Judge Temporary Blocks Reductions in Force During Government Shutdown; Senate Fails to Advance Federal Worker Relief Bills Amid Partisan Disagreements According to court filings, around 4,000 federal employees were laid off on October 10, following threats from the Trump Administration and Office of Management and Budget (OMB) Director Russ Vought to continue reductions-in-force…

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Committee Expresses Support for Increased Transparency of 340B Program, Including Revenue, PBMs, and Contract Pharmacies

By Billy Wynne / October 23, 2025

Committee Expresses Support for Increased Transparency of 340B Program, Including Revenue, PBMs, and Contract Pharmacies The Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing to examine the growth of the 340B Drug Pricing Program. A representative from the Government Accountability Office (GAO) spoke to recommendations to improve the program and a representative…

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Agency Releases WISeR Model Operational Guide for Providers and Suppliers

By Billy Wynne / October 23, 2025

Agency Releases WISeR Model Operational Guide for Providers and Suppliers The Centers for Medicare and Medicaid Services (CMS) released an operational guide for providers and suppliers impacted by the Wasteful and Inappropriate Service Reduction (WISeR) model. The Innovation Center’s WISeR model will implement technology-enabled prior authorization in Traditional Medicare for a select set of services to help providers steer…

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Agency Issues Guidance Furthering Restricting Emergency Medicaid for Non-Citizens, Updates Instructions for Medicaid Managed Care Plans

By Billy Wynne / October 22, 2025

Agency Issues Guidance Furthering Restricting Emergency Medicaid for Non-Citizens, Updates Instructions for Medicaid Managed Care Plans The Centers for Medicare and Medicaid Services (CMS) released guidance to states that the agency is updating its interpretation of section 1903(v) of the Social Security Act, which sets the conditions for federal funds to be used for the…

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Committee Releases Report on Generic Pharmaceutical Supply Chain; Provide Policy Recommendations

By Billy Wynne / October 21, 2025

Committee Releases Report on Generic Pharmaceutical Supply Chain; Provide Policy Recommendations The Senate Special Committee on Aging released a report titled “Protecting Seniors’ Access to Essential Medications: Securing the Foreign Generic Pharmaceutical Supply Chain” (press release). This follows two Committee hearings on the national security and public health crisis caused by America’s dependence on foreign-made…

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Agency Releases Innovation in Behavioral Health (IBH) Model Notice of Funding Opportunity for Cohort 2; Applications Due June 3, 2026

By Billy Wynne / October 17, 2025

Agency Releases Innovation in Behavioral Health (IBH) Model Notice of Funding Opportunity for Cohort 2; Applications Due June 3, 2026 The Center for Medicare & Medicaid Innovation (CMMI/Innovation Center) released a notice of funding opportunity (NOFO) for the second cohort of the Innovation in Behavioral Health Model (IHPP Summary). Previously, Michigan, New York, Oklahoma, and South…

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President Trump Announces Actions to Lower IVF Drug Costs and Expand Fertility Care Access; Unveils Third Most-Favored-Nation Agreement with EMD Serono

By Billy Wynne / October 17, 2025

President Trump Announces Actions to Lower IVF Drug Costs and Expand Fertility Care Access; Unveils Third Most-Favored-Nation Agreement with EMD Serono Yesterday, President Trump announced new actions aimed at reducing the cost and improving access to in vitro fertilization (IVF) and fertility care. This includes the third Most-Favored-Nation (MFN) agreement with EMD Serono, the manufacturer…

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