Summary
Last week, the House passed a minibus of fiscal year (FY) 2026 appropriations bills, including a bipartisan package of health care extenders (Impact Health summary), and the Senate appeared poised to passed the same package this week ahead of the January 30th continuing resolution (CR) deadline. However, given the unfortunate events that unfolded in Minnesota this weekend, Senate Minority Leader Chuck Schumer is calling for Department of Homeland Security (DHS) funding to be stripped from the minibus to avoid shutdown. Republican leadership plans on proceeding with a vote on the full minibus on Thursday, but other Senate Democrats have indicated that they will not vote on the package unless the DHS funding, including ICE, is renegotiated, potentially teeing up a short-term government shutdown until an agreement is reached.
Regulatory Update
The Office of Management and Budget completed its review of the following:
- The DOL/EBSA proposed rule to improve transparency into PBM fee disclosure.
- The Advance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies
- 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
OMB is also reviewing the following.
- ACA Marketplace:
- The HHS Notice of Benefit and Payment Parameters for 2027 proposed rule
- 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
- 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:
- 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.”