Billy Wynne

MACPAC March 2025 Report to Congress Addresses External Quality Review in Managed Care Oversight and Improving Medicaid Home and Community-Based Services The Medicaid and CHIP Payment and Access Commission (MACPAC) released its March 2025 Report to Congress, with (1) recommendations to improve the transparency and usability of external quality review findings in managed care oversight…

Senate HELP Committee Advances FDA and NIH Nominees to Full Floor; White House Withdraws CDC Nomination The Senate Health, Education, Labor & Pensions (HELP) Committee voted to advance Dr. Martin Makary for Commissioner of the Food and Drug Administration (FDA) and Dr. Jayanta Bhattacharya to serve as Director of the National Institutes of Health (NIH)…

House Ways & Means Health Subcommittee Examines Challenges in Post-Acute Care; Highlights Bipartisan Concerns with Medicare Advantage The House Ways & Means (W&M) Health Subcommittee convened a hearing to examine challenges in post-acute care access, particularly focusing on Medicare Advantage (MA) plans, Medicaid funding, and nursing home staffing standards. Lawmakers from both parties raised concerns about…

CMS Innovation Center Cancels Eight Models Ahead of New Strategy Announcement The Center for Medicare & Medicaid Innovation (CMMI) issued a statement announcing certain models will be canceled or end by December 31, 2025. The declaration was made after a review of the model portfolio by the Trump administration, which asserts that models must reduce spending…

Proposed Rule Addresses ACA Marketplace Integrity and Affordability; Comments Due Mid-April The Centers for Medicare and Medicaid Services (CMS) issued the “Marketplace Integrity and Affordability Proposed Rule,” which includes a series of proposals intended to address improper enrollments in Marketplace coverage and reduce improper federal spending on advanced premium tax credits (APTCs) (press release; fact…

Commissioners Explore Preliminary Work on Medigap: Future Analysis to Address Premium Variability, Trends in Medigap Enrollment and the Role of State Guaranteed-Issue Policies The Medicare Payment Advisory Committee (MedPAC) convened a session on preliminary work related to Medigap, the supplemental insurance available to beneficiaries enrolled in fee-for-service Medicare to cover cost-sharing and coinsurance. Commissioners requested background…

CBO Letter Confirms House Budget Resolution Requires Deep Medicaid Cuts While New Poll Data Shows Majority of Americans Opposed to Cutting Medicaid Yesterday, the Congressional Budget Office (CBO) released a letter confirming that the only path to follow the House’s instructions would require deep spending cuts in the Medicaid program. Last month, the House passed…

Commissioners Discuss I-SNPs for Long-Stay Nursing Home Residents The Medicare Payment Advisory Commission (MedPAC) held a meeting to discuss Institutional Special Needs Plans (I-SNPs). This was the second of three sessions this meeting cycle focused on long-stay nursing home residents, the first of which was an overview of the workplan in October 2024 (Impact summary). Chair Michael Chernew…

National Governors Association Releases Statement on Potential Medicaid Cuts  Today, the National Governors Association (NGA)  released a statement expressing concern regarding Medicaid cuts that are currently being considered in Congress as part of Budget Reconciliation.  The statement is from NGA Chair Governor Polis (Colorado) and NGA Vice Chair Governor Stitt (Oklahoma) on behalf of the…

CMS Rescinds Guidance on Medicaid and CHIP Coverage of Health-Related Social Needs (HRSNs);  Annouces Plans to Review Waivers on a Case-by-Case Basis in the Future On March 4, the Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin (CIB) rescinding CMS’ previous 2023 and 2024 guidance on Medicaid and Children’s Health Insurance Program (CHIP) coverage of…