Summary
Over the next two weeks, the $72 billion budget reconciliation package to fund immigration enforcement and border patrol, as well as White House ballroom security, will be the top priority for Republicans as they try to meet President Trump’s June 1 deadline. Senate committee markups and floor action are expected next week.
Senate Minority Leader Chuck Schumer (D-NY) announced in a new Dear Colleague letter that “Democrats will fight the Republicans’ reconciliation bill with every tool we have.” This includes Byrd Rule challenges and floor amendments. Senate Democrats plan to force votes on affordability issues, including health care costs, at the upcoming vote-a-rama, like they did during the first round.
House Republicans continue to push for a third budget reconciliation package, with many lawmakers interested in addressing the cost-of-living, including health care costs. House Budget Committee Chair Jodey Arrington (R-TX) is calling for stronger measures to crack down on fraud, waste, and abuse.
This afternoon, President Trump is scheduled to speak at an event on maternal healthcare. His remarks will likely highlight Moms.Gov – a new website for new and expecting mothers, as well as the new proposed rule that would create a new category of limited excepted benefits for fertility care. We will share a summary of the proposed rule later today.
Prior Authorization Update
Last week, CMS Administrator Dr. Mehmet Oz released a blog post providing updates on the Administration’s work to implement electronic prior authorization and announced a new pledge for payers, providers, and electronic health records to commit to working toward seamless, interoperable prior authorization.
Regulatory Update
OMB is reviewing the following rules:
- Coverage and Payment:
- Medicaid:
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- State Directed Payments. Proposed Rule: Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments
- Medicaid Tax Waivers. Proposed Rule: Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes
- Work Requirements. Interim Final Rule: Establishing State Community Engagement Requirements for Certain Individuals Under Section 1902(xx) of the Social Security Act
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- Medicare. Proposed Rules: CY 2027 policy changes and payment rates for hospital outpatient departments, physicians, and ESRD facilities
- Marketplace.
- Final Rule: 2027 Notice of Benefit and Payment Parameters
- Proposed Rule: Exchange Pre-Enrollment Eligibility Verification
- No Surprises Act. Final Rule: Independent Dispute Resolution Operations
- Organ Transplant. Final Rule: Alternative Payment Model Updates and the Increasing Organ Transplant Access
- Drug Price Negotiation. Proposed Rule: Medicare Drug Price Negotiation Program
- Accrediting Organizations. Final Rule: Strengthening Oversight of Accrediting Organizations (AO), Burden Reduction, and Related Provisions
- Nutrition
- Work Requirements. Proposed Rule: Supplemental Nutrition Assistance Program: Modification to Work Requirements for Able-Bodied Adults
- Categorical Eligibility. Proposed Rule: Supplemental Nutrition Assistance Program: Reforming Categorical Eligibility
- Cost Sharing. Proposed Rule: Supplemental Nutrition Assistance Program: Changes in Federal-State Administrative Cost Sharing
- Immigration. Interim Final Rule: Unaccompanied Children Program Foundational Rule; Update to Include Proof of Identity and Income Verification Standards
- Medication-Assisted Treatment. Final Rule: Implementation of the SUPPORT Act: Dispensing and Administering Controlled Substances for Medication-Assisted Treatment
- HIPAA. Final Rule: HIPAA Privacy Rule: Changes to Support Coordinated Care and Individual Engagement and Reduce Regulatory Burdens
- Discrimination. Final Rule: Rescinding Portions of Department of Health and Human Services Title VI Regulations to Conform More Closely with the Statutory Text and to Implement Executive Order 14281