RECENT UPDATES
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 individuals who are not parties to a lawsuit. The decision stemmed from litigation over an executive order limiting birthright citizenship… (Colocho, July 16, 2025) #Health Equity, #Social Determinants of Health
.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 to approximately 3,500 hospitals paid under the OPPS, including hospital outpatient departments (HOPDs) and 6,100 ASCs, beginning on… (Slifer, July 15, 2025) #340B, #Ambulatory Surgical Centers, #Hospitals, #Quality, #Transparency
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 vote on and/or host rapid randomized controlled trials (RRCTs) to test specific care delivery strategies aimed at improving model performance and patient outcomes. Slides from… (Colocho, July 15, 2025) #Accountable Care Organizations, #Health Information Technology, #Hospice, #Prevention
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 Fee Schedule (MPFS) proposed rule (press release; fact sheet; MSSP fact sheet; which addresses an array of policies under Medicare Part B and the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program (QPP). What it is. CMS’ major proposed rule affects payments to physicians, nurse practitioners, physician assistants,… (McClurg, July 14, 2025) #Care Coordination, #Demonstration Programs, #Drug Pricing, #Health Equity, #Physicians, #Prevention, #Primary Care, #Program Integrity, #Quality, #Telehealth
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 of 2015, uncertainty surrounding the Biden-era HIPAA Security Rule update, and the implications of recent… (Colocho, July 14, 2025) #Health Information Technology, #Privacy, #Transparency
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 and a doubling of the frequency of Medicaid redeterminations for the Medicaid… (Joyce, July 11, 2025) #Accountable Care Organizations, #Affordable Care Act, #Budget, #Care Coordination, #Chronic Diseases, #Community Health Centers, #Cost-Sharing, #Demonstration Programs, #Health Equity, #Hospitals, #Long-Term Care, #Mental and Behavioral Health, #Pediatrics, #Primary Care, #Skilled Nursing Facilities, #Women’s Health
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