The Federal Trade Commission (FTC) recently announced updated jurisdictional thresholds and a revised filing fee schedule for reporting transactions under the Hart-Scott-Rodino (HSR) Act, effective February 10, 2025 (press release). Under the Clayton Act, the FTC is required to adjust HSR thresholds annually based on changes in the gross national product. Beginning February 10th, the minimum size of the transaction… (Eisen, January 13, 2025) #Costs, #Hospitals

The Centers for Medicare and Medicaid Services (CMS) released the HHS Notice of Benefit and Payment Parameters for 2026 final rule (fact sheet) – a wide-ranging rule affecting Marketplaces, qualified health plans in the individual and small group markets, as well as requirements for agents, brokers, web-brokers, direct enrollment entities, and assisters. The final rule also includes provisions that impact… (Llamas, January 13, 2025) #Affordable Care Act

The Centers for Medicare and Medicaid Services (CMS) announced the Advance Notice of Methodological Changes for Contract Year (CY) 2026 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (press release, fact sheet) and the Draft CY 2026 Part D Redesign Program Instructions (fact sheet) What it is. The Advance Notice addresses a wide array of MA and Part D-related policies and… (McClurg, January 10, 2025) #Medicare Advantage, #Prescription Drugs

The Senate Budget Committee released a bipartisan report detailing the findings of its investigation into the harmful effects of private equity (PE) investment on the U.S. health care system (press release). The investigation was led by Senate Budget Committee Chairman Sheldon Whitehouse (D-RI) and Ranking Member Chuck Grassley (R-IA) during the 118th Congress. Report Highlights Focus. The Committee’s bipartisan investigation… (Llamas, Eisen, January 8, 2025) #Costs, #Hospitals, #Quality, #Rural Health

The Centers for Medicare & Medicaid Services (CMS) and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) have released new updates and analyses on health insurance coverage ahead of the end of the Marketplace Open Enrollment Period on January 15th. While enrollment gains under the Biden-Harris administration signal progress toward broader access to affordable care, growing concerns… (Eisen, Joyce, Llamas, Marceno, January 8, 2025) #Coverage Decisions, #Delivery Reform, #Insurance Coverage

The Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), issued a proposed rule to update the Health Insurance Portability and Accountability Act (HIPAA) Security Rule, marking its first update since 2013 (fact sheet). The proposed changes aim to enhance cybersecurity protections in the health care sector in response to the escalating number of cyberattacks,… (Colocho, January 7, 2025) #Health Information Technology, #Hospitals, #Prevention, #Privacy, #Transparency

The Department of Health and Human Services (HHS), through Substance Abuse and Mental Health Services Administration (SAMHSA) announced that 14 states and the District of Columbia have received Certified Community Behavioral Health Clinics (CCBHCs) Planning grants. The purpose of the CCBHC Planning, Development, and Implementation (CCBHC-PDI) grant is to transform community behavioral health systems and provide comprehensive, coordinated behavioral health… (Marceno, January 7, 2025) #Demonstration Programs, #Mental and Behavioral Health, #Opioids

Today, the Center for Medicare & Medicaid Innovation (CMMI) announced fifteen state Medicaid agencies (SMAs) have been selected for the Transforming Maternal Health Model (IHPP Model Summary; IHPP NOFO Summary). The model began on January 1, 2025 and will run for ten years. Participating SMAs include: Alabama Arkansas California District of Columbia Illinois Kansas Louisiana Maine Minnesota Mississippi New Jersey Oklahoma South Carolina… (Testa, January 6, 2025) #Costs, #Health Equity, #Quality, #Women’s Health

On December 24, Representatives Diana DeGette (D-CO) and Larry Bucshon (R-IN) released a white paper (summary/press release) titled “A Roadmap for 21st Century Cures,” a document that provides an overview of the next steps for the Cures 2.0 Act and the 21st Century Cures Act. This white paper follows a robust response from stakeholders to the June 2024 request for… (Lewis, January 6, 2025) #Delivery Reform, #Food and Drug Administration, #Health Information Technology, #National Institutes of Health, #Prevention, #Primary Care, #Telehealth, #Transparency

The Agency for Healthcare Research and Quality (AHRQ) issued a request for nominations to serve as members of the U.S. Preventive Services Task Force (USPSTF). The USPSTF is an independent group of medical experts that evaluates and makes evidence-based recommendations on preventive health care services like screenings, counseling, and preventive medications. The Affordable Care Act requires private insurers cover preventive services… (Colocho, December 20, 2024) #Coverage Decisions, #Prevention, #Primary Care