Billy Wynne

CMS Staff Provide an Overview of WISeR Prior Authorization Model; Answer Common Questions The Centers for Medicare and Medicaid Services (CMS) hosted a webinar office hour to describe and answer questions about the new Wasteful and Inappropriate Service Reduction (WISeR) Model. WISeR will implement technology-enabled prior authorization in Original Medicare for a select set of services…

Committee Members Debate Key Elements of Employment Benefits for Independent Workers The Senate Committee on Health, Education, Labor and Pensions (HELP) held a hearing on July 17, 2025, to discuss employment benefits for independent workers. The hearing focused on four pieces of proposed legislation to address accessibility, portability, and security of these benefits: Unlocking Benefits for Independent…

Department Issues Guidance Directing Federal Agencies to Minimize Multilingual Services; Will Release Updated Guidance for Public Comment to Help Agencies Prioritize English within Six Months The Department of Justice (DOJ) released guidance to implement President Trump’s Executive Order No. 14224, which establishes English as the official language of the United States (press release). This directive…

Agency Lays out Implications of Supreme Court Decision on Nationwide Injunctions and Potential Congressional Responses In its June 27, 2025 decision in Trump v. CASA, Inc., the U.S. Supreme Court significantly curtailed the authority of federal courts to issue nationwide injunctions – court orders that prevent the federal government from enforcing laws or policies against…

.4 Percent Increase Proposed for CY 2026 OPPS Payments; Comments Due September 15 The Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule (press release, fact sheet). What it is. CMS’ wide-ranging proposed rule affects payments…

Agency Provides Rapid Cycle Innovation Program (RCIP) Overview for CMS Model Participants; Vote on Next Test Topic Due July 25 The Centers for Medicare and Medicaid Services (CMS) hosted a webinar to introduce the Rapid Cycle Innovation Program (RCIP), a voluntary initiative where CMS model participants (like ACO REACH, KCC, and PC Flex ACOs) can…

CY 2026 MPFS Proposed Rule Increases Payment by 3.8% for APM Participants and 3.6% for Non-APM Physicians; Includes Proposals Related to Practice Expenses, Prevention and Wellness, and a Mandatory Model on Heart Failure and Back Pain; Comments Due Sept. 12 The Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2026 Medicare Physician…

Committee Examines Health Care Cybersecurity Threats and Federal Policy Gaps The Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing focused on cybersecurity challenges in the health care sector. Witnesses emphasized critical concerns including the termination of the Critical Infrastructure Partnership Advisory Council (CIPAC), the looming expiration of the Cybersecurity Information Sharing Act…

OBBBA Medicaid Provisions and Timeline for Implementation The One Big Beautiful Bill Act (OBBBA, H.R. 1) was signed into law on July 4, 2025 and includes significant changes to Medicaid ranging from limitations on provider taxes utilized to fund the state portion of Medicaid financing to limitations on enrollment such as new Medicaid work requirements…

Committee Advances President Trump’s Nominee to Lead CDC The Senate Health, Education, Labor and Pensions (HELP) Committee voted 12-11 along party lines to advance Dr. Susan Monarez, President Donald Trump’s nominee to lead the Centers for Disease Control and Prevention (CDC). Dr. Monarez was praised by Republicans for her commitment to transparency and science-based guidance…