Summary
The Senate is in recess this week, while the House races to complete the fiscal year (FY) 2026 appropriations process. This morning, House appropriators released the final minibus package that includes funding for Labor-HHS-Education, Department of Defense, Department of Homeland Security, and Transportation-HUD. The bill provides $116.6 billion in discretionary funding for HHS, which mirrors what the Senate approved in July, but exceeds President Trump’s requested $95 billion. A bipartisan health care package (Division F) has also been included in the minibus and highlights include the following:
- An extension of the health care extenders package, including the telehealth flexibilities;
- Pharmacy benefit manager provisions, including Part D and commercial transparency requirements, and commercial rebate pass through;
- Requiring a separate identification number and an attestation for each off-campus outpatient department of a provider
- The Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act, which would require Medicare Advantage organization to update their provider directories; and
- Medicare coverage of multi-cancer early detection screening tests.
Impact Health is working on summary of the health care extenders package and will send that later today.
Regulatory Update
The Centers for Medicare & Medicaid Services (CMS) announced plans to create a public portal to streamline requests for external meetings. The notice must be published in the Federal Register for a 60-day period before the agency can seek approval from the Office of Management and Budget (OMB), making late March the earliest the system could be implemented.
Additionally, the Office of Management and Budget completed its review of the DOL/EBSA proposed rule to improve transparency into PBM fee disclosure. OMB is also reviewing the following.
- ACA Marketplace:
- The HHS Notice of Benefit and Payment Parameters for 2027 proposed rule
- Medicare:
- Procurement of Domestic PPE. An advance notice of proposed rulemaking that would detail program incentives and requirements for Medicare providers and suppliers to invest and phase-in the procurement of American made personal protective equipment (PPE) and essential medicine to secure our nation’s health and safety.
- MA and Part D: Advance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies
- Medicaid:
- State Directed Payments. A proposed rule titled, “Medicaid Managed Care-State Directed Payments.” The proposed rule appears intended to advance a presidential memorandum released on June 6, which directs HHS to “eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law.”
- Medicaid Tax Waivers.
- A proposed rule titled, “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole.”
- A proposed rule titled, “Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes.”
- Fraud and Abuse
- *NEW* A proposed rule entitled, “Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).”
- A proposed rule titled, Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Federal Anti-Kickback Statute and Beneficiary Inducements CMP
- Prescription Drugs:
- *NEW* A proposed rule on interoperability standards and prior authorization for drugs.
- Health Technology:
- A final rule titled, Administrative Simplification: Adoption of Standards for Health Care Attachment Transactions and Electronic Signatures.
- Immigration:
- Unaccompanied Children. An interim final rule titled, “Unaccompanied Children Program Foundational Rule; Update to Include Proof of Identity and Income Verification Standards.”