Billy Wynne

Commissioners React to Draft Medicare Payment Adequacy and Update Recommendations for 2027 On December 4-5, the Medicare Payment Advisory Commission (MedPAC) held a public meeting at which it considered a series of draft 2027 payment update recommendations to Medicare payment systems for inclusion in its March 2027 Report to Congress. MedPAC will vote on the…

ACIP Votes to Change Hepatitis B Birth Dose Vaccine Recommendation On December 5, 2025 the Advisory Committee on Immunization Practices (ACIP) held a meeting and voted on two measures regarding hepatitis B vaccination for infants. The vote was postponed yesterday due to confusion surrounding last-minute changes to voting language. The committee voted “yes” to both measures, recommending that hepatitis B…

Committee Reintroduces PBM Package Focused on Medicare Part D and Medicaid Provisions, Support for PBM Reform Grows on Capitol Hill The Senate Finance Committee formally introduced the Pharmacy Benefit Manager (PBM) Price Transparency and Accountability Act (press release). Overall, the bill features many of the same provisions from its 2023 package, including the following: Limiting PBM…

Committee Underscores Immediate Need to Address Expiring Subsidies, but Senators Find Little Common Ground on Proposals The Senate Health, Education, Labor, and Pensions (HELP) Committee convened a hearing to discuss strategies to make health care more affordable as the expiration of enhanced premium tax credits (EPTCs) approaches. While Senators remained divided on short-term options to…

Updates on EPTC Extension: New Bipartisan Framework and a GAO Report on Fraud As we approach the expiration of the enhanced premium tax credits (EPTCs) at the end of the year and the promised vote on an extension next week, lawmakers remain split on whether or how to extend the subsidies. Below, we highlight developments including…

Members Discuss Allegations Against Organ Procurement Organizations The Ways & Means (W&M) Committee Oversight Subcommittee held a hearing about ways to improve the accountability of organ procurement organizations (OPOs). The hearing follows a request for information in April seeking input on potential violations of Medicare reimbursement, misallocation of resources, and abuses of U.S. tax law by OPOs. In November 2025, W&M Chair…

Agency Issues Interim Final Rule to Repeal Minimum Staffing Standards for Long-Term Care Facilities Today, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare and Medicaid Programs; Repeal of Minimum Staffing Standards for Long-Term Care (LTC) Facilities interim final rule with comment period. What it is. The interim final rule repeals the staffing-related…

CMS Finalizes Estimated Payment Decrease of 1.3 Percent to Home Health Agencies in CY 2026; Finalizes PDGM Adjustment to Account for Behavioral Changes The Centers for Medicare and Medicaid Services (CMS) issued the calendar year (CY) 2026 home health prospective payment and rate update proposed rule (fact sheet). What it is. The proposed rule outlines…

Democratic AGs Sue USDA Over SNAP Immigrant Eligibility Guidance A group of 21 Democratic attorneys general (AGs) sued the Department of Agriculture (USDA) over guidance on implementing the restrictions on immigrant eligibility for the Supplemental Nutrition Assistance Program (SNAP) in the One Big Beautiful Bill Act (OBBBA). Under the law, immigrant eligibility is now restricted to lawful permanent…

Maximum Fair Prices for IPAY 2027 Selected Drugs Announced; CMS Boasts 44 Percent Savings from 2024 Spending on the Drugs The Centers for Medicare and Medicaid Services (CMS) announced the maximum fair prices (MFPs) for the 15 drugs selected for initial payment year (IPAY) 2027 (fact sheet, infographic). Below are additional details. Impact of negotiated…