The following is the latest health policy news from the federal government February 27 – March 6.  Some of the language used below is taken directly from government documents.

Congress 

  • On Thursday, the House Energy and Commerce Committee held a full committee markup of nine bills addressing cybersecurity and digital safety.  See that list here.
  • Also on Thursday, Senate HELP Committee conducted a hearing titled “Transforming Health Care with Data:  Improving Patient Outcomes Through Next-Generation Care.”  Find video of the hearing here.
  • Speaker Mike Johnson (R-LA) expressed interest in passing another reconciliation bill this year that would address health care affordability and drivers of rising health care costs.  The Ways and Means Committee and Energy and Commerce Committee are expected to continue their hearings on health care affordability and the next will likely focus on hospital costs and consolidation.  While details have not yet been announced, they are anticipated to be scheduled for late March or the second week of April.  Updates will be posted to the committees’ official calendars:  Energy & Commerce; Ways & Means.
  • Next week:  the Senate will be in session and the House will be in recess. 

Centers for Medicare & Medicaid Services

  • As part of its approach to addressing fraud in Medicare, CMS is proposing to revise the Medicare enrollment application for physicians and non-physician practitioners.  The primary function of this form is to gather information from individual providers or suppliers that tells CMS who they are, whether they meet certain qualifications to be a Medicare provider or supplier, where they practice or render services, and other information necessary to establish correct claims payments.  Learn more about the changes CMS proposes from this regulatory notice.  The deadline for stakeholders to submit comments is April 1.
  • CMS has proposed updating how Quality Improvement Organizations (QIO) review written complaints submitted by Medicare beneficiaries about the quality of care they have received.  Historically, each QIO used its own unique form on which beneficiaries submitted their complaints but CMS previously introduced a single, standardized Medicare Quality of Care Complaint Form.  Now, CMS proposes updating that form to remove lengthy instructions, provide clarification, and ensure that demographic data collection aligns with specific agency statistical directives.  Learn more about the proposed change from this regulatory notice.  The deadline for stakeholders to submit comments is April 1.
  • CMS has extended the application deadline for prescription drug manufacturers to apply to participate in the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model.  The original deadline, March 31, has been extended to April 30.  Under the program, state Medicaid programs that participate in the model will be able to purchase drugs included in the pilot program at prices aligned with those paid in selected other countries.  Learn more about the GENEROUS Model and the process of securing participating drug companies from this CMS news release.
  • CMS has introduced new options for new and existing Medicare beneficiaries to log into the Medicare.gov web site.  The new options are free, offer enhanced security, and do not require use of a smartphone.  Learn more about the new options and how to use them from this CMS fact sheet.
  • CMS has published a state Medicaid and CHIP toolkit for children’s behavioral health services and Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements.  In the document, CMS notes that it developed the toolkit to support state Medicaid and CHIP agencies in ensuring that children and youth experiencing behavioral health conditions get the care they need.  The main body of the toolkit is divided into four sections that include actionable state strategies and sub-strategies:  1) developing and supporting a behavioral health care delivery system that can meet a range of children’s needs; 2) promoting early intervention for children’s behavioral health conditions; 3) improving children’s access to behavioral health care through service coordination and integration; and 4) increasing the workforce capacity for children’s behavioral health services.  Find the toolkit here.
  • CMS has posted a draft 2027 CMS Quality Reporting Document Architecture Category I Implementation Guide, Schematron, and Sample File for Hospital Quality Reporting.  The deadline for stakeholders to submit comments is March 25.  Learn more about the proposed changes from this CMS notice. 

Department of Health and Human Services 

HHS has posted six videos drawn from the recent two-day meeting of its Physician-Focused Payment Model Technical Advisory Committee (PTAC) that focused on improving multi-payer alignment in value-based care.  PTAC is an independent federal advisory committee that makes recommendations to the Secretary of HHS on stakeholder-submitted physician-focused payment models and related topics.  Go here to find the videos and transcripts of the videos. 

Medicaid State Plan Amendments

CMS has approved the following state plan amendments for Medicaid and CHIP programs.

  • To New Hampshire, updating the quarterly pool amount and total Medicaid day count (used in the distribution formula) for New Hampshire’s nursing facility supplemental payment, also known as MQIP, for both private and non-state government-owned and operated facilities.
  • To South Carolina, updating the inpatient disproportionate share hospital (DSH) methodology to use state FY 2024 cost reporting to calculate interim DSH payments, updating inflation trending to 2024 calendar year costs, and updating swing bed and administrative day rates to match current nursing facility rates.  This amendment also updates the demonstration year and base cost report period for the inpatient and outpatient upper payment limit (UPL) methodology.
  • To Utah, removing the end date for medication-assisted treatment services in accordance with the Consolidated Appropriations Act of 2024.
  • To Utah, modifying coverage for physical therapist and occupational therapist services.
  • To Colorado, updating the state’s alternative benefit plan.
  • To Nebraska, providing coverage for dental screenings provided by public health dental hygienists as Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services.
  • To Nebraska, removing the end date for coverage of medication-assisted treatment in accordance with the Consolidated Appropriations Act of 2024.
  • To Idaho, removing the end date for the medication-assisted treatment benefit in accordance with the Consolidated Appropriations Act of 2024.
  • To Oklahoma, updating the state plan’s current medication-assisted treatment section using the new CMS-issued template.
  • To Tennessee, updating the state’s limitations on the amount, duration, and scope of coverage for selected prescribed drugs.
  • To Kansas, adding mandatory coverage for eligible juveniles who are inmates of a public institution post adjudication of charges.
  • To Rhode Island, updating the state’s alternative benefit plan to include services added to the Medicaid state plan between 2013 and 2025 and to reflect the elimination of the Primary Care Case Management (PCCM) program.  This amendment to the Medicaid state plan is strictly intended to align the state’s alternative benefit plan with all services currently covered by Rhode Island Medicaid.
  • To Michigan, clarifying behavioral health treatment and applied behavior analysis service access for Medicaid beneficiaries and increasing the ability for children with a diagnosis of autism spectrum disorder to receive early interventions and supports.
  • To Nevada, changing the reimbursement methodology for freestanding psychiatric hospitals to a flat statewide per diem rate to be in parity with Nevada general acute hospitals providing psychiatric services.

HHS Newsletters, Reports, and Videos

Centers for Disease Control and Prevention (CDC) 

  • The CDC reports 1,136 confirmed measles cases in 28 states as of February 26.  There have been 10 new outbreaks this year and six were among international visitors; there have been no measles-related deaths this year.  Learn more from the CDC’s Measles Cases and Outbreaks website.
  • An outbreak of C botulinum in infants caused by ByHeart powdered infant formula has ended, the CDC has announced.  The outbreak included 28 confirmed cases and 20 probable cases, with no new cases since last December.  Learn more from this CDC announcement. 

Medicare Payment Advisory Commission (MedPAC) 

  • MedPAC’s commissioners held public meetings on Monday, March 2 and Tuesday, March 3.  The subjects on the meetings’ agenda were:
    • a mandated report assessing the Medicare ground ambulance data collection system
    • access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease and beneficiaries with cancer
    • provider participation in Medicare Advantage networks
    • considerations for implementing Medicare Advantage encounter data in risk adjustment
    • the complexity of Medicare enrollment decisions for beneficiaries
    • Medicare Part B premium payment basics

Learn more from this transcript of the meetings.

  • MedPAC has submitted comments to CMS in response to CMS’s advance notice of methodological changes for CY 2027 for Medicare Advantage capitation rates and Part C and D payment policies.  MedPAC’s letter addresses CMS’s hierarchical condition category risk-adjustment model and sources of diagnoses for risk-score calculation; Medicare Advantage coding pattern difference adjustment; and the prescription drug hierarchical condition category risk-adjustment model.  Learn more from MedPAC’s letter to CMS.

Stakeholder Events 

CMS – eCQI Resource Center – 2026 eCQM Annual Updates Webinars – March 12 (and others)

CMS’s eCQI Resource Center is holding expert-to-expert webinars offered in collaboration with the Joint Commission, CMS, and eCQM stewards.  The webinars address the eCQM annual updates for 2026 implementation and offer continuing education credits for the live broadcast.  The webinars will address frequently asked questions and participants can submit questions for response.  The remaining sessions, to be held at 1:00 (eastern) are as follows: 

  • March 12 – Annual Updates for Opioid Related Adverse Events eCQM for 2026 Reporting Year – for more information and to register, go here.
  • March 19 – Annual Updates for Hospital Harm-Pressure Injury eCQM for 2026 Reporting Year – for more information and to register, go here.

CMS – 2026 CMS Quality Conference – March 16-18

CMS will hold its 2026 Quality Conference on Monday, March 16 through Wednesday, March 18 in Baltimore.  The theme of the conference will be “Make America Healthy Again:  Innovating Together for Better Health.”  Interested parties can participate in person or virtually.  Learn more about the conference and how to register to participate from this CMS announcement.

CMS/eCQI Resource Center – 2026 Pre-Rulemaking Cycle Kick-Off Webinar – March 24

CMS’s eCQI Resource Center will hold a 2026 pre-rulemaking kick-off webinar on Tuesday, March 24 at 2:00 (eastern).  During the session, CMS will cover measure selection considerations; present an overview of the pre-rulemaking process; describe resources available on the measure selection hub pre-rulemaking web page; and outline updates for the 2026 submission cycle.  CMS staff also will take questions from participants.  Learn more about the event from this CMS notice and go here to register to participate.

CMS – Medicare Drug Price Negotiation Program Public Engagement Events – April 6-23

From April 6 through April 23, CMS hold a series of public information events to gather stakeholder information about its Medicare Drug Price Negotiation Program and the specific prescription drugs covered by that program.  The agency invites patients, caregivers, clinicians, and others to share their experience relevant to the drugs selected for negotiation and renegotiation under the program.  Learn more from this CMS bulletin about the public informational events and learn more about the individual events, the specific drug or drugs each event will address, and how to participate from this CMS web page.

MedPAC – Commissioners Meeting – April 9-10

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, April 9 and Friday, April 10.  An agenda for the meeting and information about how to participate have not yet been posted; when they are, they will be found here.

MACPAC – Commissioners Meeting – April 9-10

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, April 9 and Friday, April 10.  An agenda for the meeting and information about how to participate have not yet been posted; when they are, they will be found here.

HHS Office of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology/Health Information Technology Advisory Committee – May 7

The Health Information Technology Advisory Committee of HHS’s Office of the Assistant Secretary for Technology Policy will hold its next meeting on Monday, February 19 at 10:00 (eastern).  This committee’s role is to identify priorities for standards adoption and make recommendations to the Assistant Secretary for Technology Policy.  Learn more about the committee, its structure, and its purpose from this HHS notice, which also outlines the meeting’s agenda.  Information about how to participate in the meeting is not yet available but when it is it will be posted here.  Other 2026 meetings will be held on September 24 and November 5.