The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) conducted a review of Medicare and Medicaid provider networks to assess the usefulness and limitations of selected plan networks, and to review compliance with network adequacy standards. In conducting the review, OIG found that networks of behavioral health providers contracted under Medicare Advantage (MA) and Medicaid… (Ray, Eisen, October 7, 2025) #Insurance Coverage, #Medicare Advantage, #Mental and Behavioral Health, #Rural Health

Today, Frank Pallone (D-NJ), Ranking Member of the Committee on Energy and Commerce and Richard Neal (D-MA), Ranking Member of the Committee on Ways and Means, sent a letter to HHS Secretary Kennedy and CMS Administrator Oz criticizing CMS for failing to provide timely and clear guidance to providers in advance of the September 30 expiration of Medicare telehealth flexibilities… (Testa, October 9, 2025) #Hospitals, #Telehealth, #Waivers

Yesterday, Sen. Bernie Sanders (I-VT), Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, released a report warning of the projected impact of health care cuts in H.R. 1 (press release; report). Last week, Ranking Member Sanders invited people across the country to share how cuts to Medicaid and the Affordable Care Act (ACA) would affect them,… (Eisen, October 7, 2025) #Affordable Care Act, #Budget, #Costs, #Insurance Coverage

The Food and Drug Administration (FDA) issued a Request for Public Comment (RFC) to gather input on how AI-enabled medical devices perform in clinical settings after deployment. The agency notes that the RFC is for discussion purposes only and is not intended to set policy or guidance, but rather seeks early feedback from the public to inform future FDA discussions… (Colocho, October 7, 2025) #Artificial Intelligence, #Health Information Technology, #Medical Devices, #Transparency

This week, the Food and Drug Administration (FDA) approved another generic version of mifepristone, one of the two drugs used in medication abortion. With this approval, three U.S. companies are now authorized to manufacture the medication: Danco Laboratories, which first received FDA approval in 2000; GenBioPro, which secured approval of the first generic in 2019; and now Evita Solutions. The… (Eisen, October 3, 2025) #Generic Drugs, #Women’s Health

Sen. Gary Peters (D-MI), Ranking Member of the Senate Homeland Security and Governmental Affairs Committee, released a report revealing that the Department of Government Efficiency (DOGE) is operating outside federal law with unchecked access to Americans’ personal data. The investigation, backed by whistleblower accounts across the Social Security Administration (SSA), the General Services Administration (GSA), and the Office of Personnel… (Colocho, October 3, 2025) #Health Information Technology, #Privacy, #Transparency

The Trump administration has outlined a proposal that, if approved by a federal judge, would allow immigration officials to resume processing new applications for Deferred Action for Childhood Arrivals (DACA) after a four-year pause. The plan was filed late Monday by the Department of Justice (DOJ) in federal court in Brownsville, Texas, as part of a long-running lawsuit led by… (Colocho, October 2, 2025) #Health Equity

Today, the CMS Center for Clinical Standards and Quality released a memo (QSO-26-01-ALL) outlining which survey and certification functions will continue during the federal government shutdown, which will pause, and how state agencies and contractors should proceed. The agency emphasized that protecting beneficiaries from immediate harm remains the top priority. Enforcement and immediate jeopardy investigations will continue, but routine surveys… (Testa, October 1, 2025) #Clinical Labs, #Grants, #Hospice, #Quality

The Centers for Medicare and Medicaid Services released final guidance for initial price applicability year (IPAY) 2028 of the Medicare Drug Price Negotiation Program and effectuation of maximum fair prices (MFPs) in IPAYs 2026, 2027, and 2028 (press release, fact sheet). What is it. The draft guidance described how CMS will implement the Negotiation Program for IPAY 2028 and included… (Slifer, September 30, 2025) #Drug Pricing, #Medicare Part D, #Prescription Drugs

Today, President Trump announced the administration’s first Most-Favored-Nation (MFN) agreement with Pfizer to bring drug prices in line with the lowest paid by other developed nations (MFN pricing) (press conference). The agreement features the following: Providing every state Medicaid program access to MFN prices on all Pfizer products; Ensuring that foreign nations can no loner use price controls to “freeride… (Slifer, September 30, 2025) #Drug Pricing, #Prescription Drugs