CY 2026 MA and Part D Policy and Technical Changes Final Rule Released, CMS Does not Finalize Coverage of Anti-Obesity Medications, AI Guardrails, Pharmacy Network Transparency, or Beneficiary Protections

CY 2026 MA and Part D Policy and Technical Changes Final Rule Released, CMS Does not Finalize Coverage of Anti-Obesity Medications, AI Guardrails, Pharmacy Network Transparency, or Beneficiary Protections

The Centers for Medicare and Medicaid Services (CMS) released the Contract Year (CY) 2026 Policy and Technical Changes to the Medicare Advantage (MA) program and Medicare Prescription Drug Benefit Program (Part D), Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (PACE) final rule (fact sheet). What it is. The final rule includes policies aimed at meeting… (Slifer, April 4, 2025) #Dual Eligibles, #Medicare Advantage, #Medicare Part D, #Prescription Drugs, #Risk Adjustment

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USDA Cracks Down on SNAP Application Processing Times

USDA Cracks Down on SNAP Application Processing Times

The US Department of Agriculture (USDA) announced a set of steps that it will take to bring states into compliance with timeliness requirements for Supplemental Nutrition Assistance Program (SNAP) application processing. USDA issued a letter to state agencies demanding that they take immediate action to address delays in processing applications and recertification. 33 state agencies are out of compliance with timeliness requirements for… (McClurg, April 3, 2025) #Nutrition, #Program Integrity

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Committee Examines Employer-Sponsored Coverage; Republicans Push Trump-Era AHP Reforms

Committee Examines Employer-Sponsored Coverage; Republicans Push Trump-Era AHP Reforms

The House Education and Workforce, Health, Employment, Labor, and Pensions (HELP) Subcommittee convened a hearing focused on expanding access and affordability in employer-sponsored health care. With rising health care costs, lawmakers debated policies aimed at reducing costs, increasing flexibility, and ensuring access to health insurance for employees. Opening Statements: Chair Rick Allen (R-GA) (opening statement) discussed the challenges businesses, particularly small employers,… (Eisen, April 2, 2025) #Association Health Plans

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Senate Democrats Inquire About Rumored TEFAP Cancellations

Senate Democrats Inquire About Rumored TEFAP Cancellations

25 Democratic and Independent Senators, led by Ranking Member of the Committee on Agriculture, Nutrition, and Forestry Amy Klobuchar (D-MN), sent a letter to the Department of Agriculture (USDA) inquiring about reports that previously approved funding in The Emergency Food Assistance Program (TEFAP) was cancelled.TEFAP provides assistance to food banks and other emergency food providers by helping purchase food deliveries. The senators… (McClurg, March 28, 2025) #Nutrition

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Paragon Institute Releases New Report Targeting Provider Taxes Amidst National Advocacy Pushback Against Medicaid Cuts

Paragon Institute Releases New Report Targeting Provider Taxes Amidst National Advocacy Pushback Against Medicaid Cuts

Nationwide efforts in opposition to Medicaid cuts continue as Senators and Representatives return to Washington with three weeks of session planned before recessing again. While members continue to hear from concerned citizens and groups about potential cuts, Energy and Commerce Chair Brett Guthrie recently stated that he is confident House Republicans can make significant spending cuts without impacting Medicaid benefits…. (Marceno, March 27, 2025) #Affordable Care Act, #Insurance Reform, #Primary Care, #Public Health

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Department Launches Deregulatory Task Force; Request Comments by May 26 on State and Federal Regulations that Pose Barriers to Competition in Health Care Markets

Department Launches Deregulatory Task Force; Request Comments by May 26 on State and Federal Regulations that Pose Barriers to Competition in Health Care Markets

The Department of Justice (DOJ) launched the Anticompetitive Regulations Task Force within its Antitrust Division to identify and advocate for the elimination of state and federal regulations that hinder free market competition. The initiative aims to remove regulatory barriers that unnecessarily burden businesses, increase costs for consumers, and limit market entry for new competitors. This aligns with President Trump’s Executive… (Colocho, March 27, 2025) #Hospitals, #Physicians, #Quality

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Department Announces Major Reorganization and Reduction in Force of 20,000

Department Announces Major Reorganization and Reduction in Force of 20,000

Today, the Department of Health and Human Services (HHS) announced plans for a reduction in force (RIF) that it says will save $1.8 billion per year. The department is reducing its workforce by about 10,000 full-time employees, which totals 20,000 when combined with other efforts by the administration, including early retirement and buyout offers. HHS will go from 82,000 workers… (Testa, March 27, 2025) #Grants, #National Institutes of Health, #Pediatrics, #Prevention, #Primary Care, #Program Integrity, #Public Health, #Quality, #Women’s Health, #Workforce

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Trump Executive Order Mandates Full Access to Agency Data for Designated Officials to Eliminate Waste, Fraud, and Abuse

Trump Executive Order Mandates Full Access to Agency Data for Designated Officials to Eliminate Waste, Fraud, and Abuse

President Donald Trump signed Executive Order (EO) 14243 titled “Stopping Waste, Fraud, and Abuse by Eliminating Information Silos,” aimed at increasing government transparency and efficiency. The order seeks to eliminate barriers to data sharing across federal agencies to identify and prevent waste, fraud, and abuse. The administration argues that bureaucratic inefficiencies and restricted data access have led to billions in… (Colocho, March 26, 2025) #Costs, #Prevention, #Transparency

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Committee Advances Federal Reorganization Bill, Paves Way for Potential Agency Cuts

Committee Advances Federal Reorganization Bill, Paves Way for Potential Agency Cuts

The Committee on Oversight and Government Reform convened a full committee markup of nine bills aimed at expanding the power of the Trump Administration and authorizing the continuation of Department of Government Efficiency (DOGE) activities. Throughout the lengthy session, Democratic members pushed for amendments to strengthen checks and balances, defend federal agencies, and protect federal workers, while Republicans framed the bills as… (Eisen, March 25, 2025) #Workforce

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Senate Finance Committee Advances Dr. Oz’s Nomination to the Senate Floor

Senate Finance Committee Advances Dr. Oz’s Nomination to the Senate Floor

The Senate Finance Committee voted to advance Dr. Mehmet Oz as Administrator of the Centers for Medicare and Medicaid Services (CMS) sending his nomination to the full Senate for confirmation. The markup follows his confirmation hearing with the Committee on March 14th (Impact summary). Dr. Oz was approved in a  14-13 party-line vote. With a GOP Senate majority,  Dr. Oz is expected to be… (McClurg, March 25, 2025) #Insurance Coverage, #Medicare Advantage

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