Summary
Big Picture. Republicans will need to introduce a budget resolution if they intend to complete reconciliation 3.0 in July. Details could be released this week. Political appetite for moving forward remains stronger in the House than in the Senate.
In the meantime, the Senate plans to vote on a major bipartisan housing bill that reflects a bicameral agreement. The legislation will then need to return to the House for a final vote before being sent to the President for signature. Other congressional priorities include the FISA reauthorization and FY 2027 appropriations, although a continuing resolution in September is highly likely.
Health Policy to Watch
- Fraud is the focus of three hearings this week. On Wednesday, the Senate Joint Economic Committee will hold a hearing that, based on the witness list, will likely touch on a range of issues – ACA Marketplace enrollment, Medicaid payments, prior authorization in Medicare, and government contracting. On Thursday, the House Energy and Commerce Committee will hold an oversight hearing to examine state Medicaid program integrity. On Thursday, the House Oversight and Government Reform Subcommittee on Delivering Government Efficiency will hold a hearing on SNAP program integrity.
- Senate Democrats are seeking to force a vote to overturn the 2027 Notice of Benefit and Payment Parameters final rule. Sens. Tammy Baldwin (D-WI) and Ron Wyden (D-OR) and Senate Minority Leader Chuck Schumer introduced a resolution of disapproval under the Congressional Review Act last week. They warn that the rule would reduce enrollment in ACA plans by up to 2 million, according to CMS estimates.
- The Senate Appropriations Committee will mark-up several FY 2027 appropriations bills, including legislation to fund the USDA and FDA, on Thursday. This is the first markup in the Senate for this cycle.
- The HHS Office of the Secretary and the Office of the National Coordinator for Health Information Technology will meet to discuss key takeaways from its December request for information on how to accelerate the adoption and use of artificial intelligence in clinical care. The meeting could signal potential plans for rulemaking.
- The HHS Office of the Secretary and the Office of the National Coordinator for Health Information Technology will meet to discuss key takeaways from its December request for information on how to accelerate the adoption and use of artificial intelligence in clinical care. The meeting could signal potential plans for rulemaking.
Regulatory Update
Completed OMB Review
- Fraud and Abuse. Notice: Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Federal Anti-Kickback Statute and Beneficiary Inducements CMP
- Proposed Rule: Supplemental Nutrition Assistance Program: Changes in Federal-State Administrative Cost Sharing
Recently Arrived at OMB
- Gender-Affirming Care. Final Rule: Prohibition on Federal Medicaid and Children’s Health Insurance Program Funding for Specified Sex-Rejecting Procedures Furnished to Children and Youth
- GUARD Mode Final Rule: Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model
Pending OMB Review
Coverage and Payment:
- Medicaid Tax Waivers. Proposed Rule: Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Security Act
- Managed Care. Proposed Rule: Strengthening the Integrity of Medicaid and CHIP Managed Care, Financing, and Access to Care
- Proposed Rules: CY 2027 policy changes and payment rates for hospital outpatient departments, physicians, home health providers, and ESRD facilities
- Proposed Rule: Exchange Pre-Enrollment Eligibility Verification
- ERISA. Proposed Rule: Default Electronic Disclosures by Group Health Plans Under ERISA
- Short-Term Insurance. Proposed Rule: Short-Term, Limited-Duration Insurance
- Prerule: Notice Regarding 340B Rebate Model Pilot Program
- New Drugs. Notice: Expedited Investigational New Drug Pilot Program; Request for Information
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
- WIC. Final Rule: Special Supplemental Nutrition Program for Women, Infants and Children (WIC): WIC Online Ordering and Transactions and Food Delivery Revisions to Meet the Needs of a Modern, Data-Driven Program
- Milk. Final Rule: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Increase to the Maximum Monthly Allowance of Milk for Child, Pregnant, and Breastfeeding Participants
Other Issues
- Notice: Oncology Pharmaceuticals: Streamlined Nonclinical Safety Studies for Biologics and Conjugated Products
- 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
- Final Rule: HIPAA Privacy Rule: Changes to Support Coordinated Care and Individual Engagement and Reduce Regulatory Burdens
- 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
- Final Rule: Rescinding Guidelines for Eliminating Discrimination and Denial of Services on the Basis of Race, Color, National Origin, Sex, and Handicap in Vocational Education Programs