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The following is the latest health policy news from the federal government for August 14-20.  Some of the language used below is taken directly from government documents.

Congress

  • Thirty Senate Democrats have written to HHS Secretary Kennedy seeking to reverse the cancellation of health research grants administered by the Agency for Healthcare Research and Quality (AHRQ).  For more information, see the letter here.
  • Congress remains in recess; the House is expected to return on August 31 and the Senate on September 14.  Funding for the federal government expires after September 30.

No Surprises Act/Independent Dispute Resolution

  • CMS has posted an update on its planned transition to a new “IDR Gateway” for administering the No Surprises Act’s Independent Dispute Resolution process.  Learn more about how the IDR Gateway will change dispute resolution and how organizations can begin preparing now for the planned November transition from this CMS notice (scroll down to “August 14, 2026”).
  • The same CMS notice announces that the agency expects to issue guidance in the near future in response to last week’s court decision rejecting the current methodology some health care payers have used to calculate the Qualifying Payment Amount (QPA) that is used in the adjudication of differences between payers and providers under the No Surprises Act’s Independent Dispute Resolution process.  In that notice, scroll down to “TMA III Statement” to learn more.

Department of Health and Human Services (HHS)

  • HHS and its Health Resources and Services Administration (HRSA) have awarded $102 million in New Access Points program grants to expand the reach of its Health Center Program.  The New Access Points program is a grant initiative that provides funding to help new and existing organizations build service sites that deliver affordable, comprehensive primary care to medically underserved and low-income communities.  The new funding will help 158 new and existing health centers establish 415 new sites and expand access to comprehensive primary care for an additional one million people.  Learn more about the new grant funding and the program from this HHS news release.
  • HHS and its Substance Abuse and Mental Health Services Administration (SAMHSA) have awarded $96.7 million in grants and cooperative agreements to strengthen behavioral health services and supports across the country.  The awards provide funding for a range of behavioral health services and initiatives, including services for people with serious mental illness who are homeless, suicide prevention and early intervention, substance use disorder treatment, training and technical assistance, peer support, and disaster-related emotional support.  Learn more about the funding from this HHS news release, which includes additional information about the individual programs under which grants have been awarded and links to lists of grant recipients.
  • HHS and the Department of Housing and Urban Development have issued a joint letter to behavioral health and housing partners regarding President Trump’s “Treatment First” approach, which pairs safe housing with addiction and mental illness treatment services, rather than a housing-alone solution.  Learn more from this HHS news release.
  • HHS’s Administration for Strategic Preparedness and Response (ASPR) has posted a notice of funding opportunity for its new Trauma Care Readiness and Coordination Program cooperative agreement.  This new agreement seeks to strengthen coordination between states, tribal organizations, trauma centers, hospitals, emergency medical services, and public health agencies.  ASPR will award $2 million to four recipients that will each execute pilot projects that seek to identify scalable, sustainable models to increase trauma readiness and coordination.  Learn more about the program from this ASPR news release and the notice of funding opportunity.  The deadline for submitting applications is September 16.
  • HHS’s Office of the Inspector General (OIG) has sent a memo to state Medicaid fraud control units informing them that they are no longer required to obtain prior approval before conducting and receiving federal financial participation for data mining activities associated with carrying out their responsibilities.  Learn more from this memo from the HHS OIG to state Medicaid fraud control units.
  • HHS’s OIG has updated its plan for new audits and reviews.  Find a list of the new projects here.
  • HHS’s Office of the National Coordinator for Health Information Technology (ONC) has asked the Office of Management and Budget (OMB) for permission to collect routine customer feedback on agency service delivery related to TEFCA (Trusted Exchange Framework and Common Agreement).  ONC seeks data to help it standardize monitoring and performance reports for TEFCA participants.  Learn more about ONC’s intentions and the data it seeks to collect from this HHS notice.  The deadline for stakeholders to submit comments is September 16.

Centers for Medicare & Medicaid Services (CMS)

  • CMS has updated its guidance on ICD-10 and other coding revisions to National Coverage Determinations in two new bulletins.  Go here for changes that take effect on October 1 and here for changes that take effect on January 1, 2027.
  • CMS has published a bulletin presenting its update to hospice payment rates, the hospice cap, the hospice wage index, and its hospice pricer for FY 2027.  Find that bulletin here.  The changes it presents take effect on October 1.
  • CMS is offering web-based training that provides an overview of the Inpatient Rehabilitation Facility Quality Reporting Program.  The course covers reporting requirements, data sources, submission timelines, quality measures, the Internet Quality Improvement and Evaluation System (iQIES), public reporting, compliance, and key CMS resources and help desk support.  Find the training program here.
  • CMS has published a notice that it will implement a new system of records for the Nurses for Nursing Homes Program.  The new system will cover the collection of records on individuals who apply for, participate in, or otherwise support the Nurses for Nursing Homes Program.  Records maintained in the system will include personally identifiable information, including demographic, professional licensure and credential information, education and training information, employment and nursing facility affiliation, payment information, tax reporting, audit records, and other records necessary to administer the program.  Learn more about the data to be collected and its intended use from this CMS notice.  The new system takes effect on August 20 and is subject to a 30-day comment period that ends on September 21.
  • CMS has added the following item to its Quality Payment Program resource library.  (Note:  clicking this may give a prompt to download a file that may be a zip file.)

Department of Homeland Security

The Department of Homeland Security’s U.S. Citizenship and Immigration Services (USCIS) has issued policy guidance to address the public charge ground of inadmissibility to the U.S.  The guidance presents how the federal government will decide whether to deny lawful permanent resident status to individuals based on public charge grounds.  Find the USCIS policy guidance here.  The guidance takes effect on September 18.

Justice Department

The Justice Department’s National Fraud Enforcement Division issued a memorandum regarding its enforcement priorities and plans to add approximately 500 attorneys and staff by late August 2026.   The division’s five priority areas will be public trust and financial integrity;  health care; internal revenue; global trade and commerce; and corporate misconduct.  Specifically for health care, the division will focus on Medicare and Medicaid fraud, controlled substance diversion, home health and hospice schemes, telemedicine fraud, and deceptive marketing of unsafe products and services.  Learn more from the Justice Department’s memorandum and this news release.

Medicaid State Plan Amendments

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

  • Michigan, modifying the reimbursement methodology for readmissions within 15 days to separate hospitals for the same condition
  • Minnesota, reducing selected behavioral health services rates
  • Nevada, updating the state plan to reflect 2022 federal changes addressing recoveries associated with commercial insurance
  • New Mexico, updating the Medicaid reimbursement methodology for prescription drugs
  • Oregon, restoring missing plan information addressing family planning services and family planning clinic rates
  • Oregon, updating rate modification for fee-for-service and substance use disorder services
  • South Dakota, revising the state’s payment methodology for Rural Health Clinics and Federal Qualified Health Centers (FQHCs)
  • Washington, enhancing the state plan’s description of how the state oversees Medicaid managed care plans
  • Washington, updating fees for selected Medicaid services
  • Utah, adding non-state government-owned or -operated nursing facility upper payment limits and other routine updates

State-Directed Medicaid Payments

CMS has approved preprints for Medicaid state-directed payments for the following states:

  • Delaware, renewing the minimum fee schedule for nursing facility services
  • Florida, renewing the minimum fee schedule for dental services
  • Illinois, renewing a rate increase for nursing facilities based on quality-weighted Medicaid days
  • Louisiana, renewing increased rates for traditional, in-network non-emergency medical transportation providers
  • Louisiana, amending a value-based payment arrangement for general and pediatric dentists practicing in a variety of settings
  • Massachusetts, renewing a performance improvement initiative for the state’s clinical quality incentive program
  • Mississippi, renewing a rate increase for ground emergency ambulance service
  • New Hampshire, amending the minimum fee schedule for durable medical equipment
  • New Mexico, renewing the maximum fee schedule for eligible non-contract providers
  • New Mexico, renewing a value-based purchasing and uniform increase arrangement established to increase nursing facility per diem rates
  • New Mexico, renewing the maximum fee schedule for eligible non-contract providers
  • New York, amending a rate increase for inpatient and outpatient services delivered by qualifying financially distressed hospitals
  • North Carolina, renewing a minimum fee schedule and rate increase for home- and community-based services and behavioral health outpatient services
  • North Carolina, renewing a rate increase for eligible behavioral health inpatient services
  • Oklahoma, renewing increased inpatient and outpatient services rates
  • Utah, renewing a rate increase for outpatient hospital services for state teaching hospitals
  • Utah, renewing a rate increase for professional services for state teaching hospitals at an academic medical center
  • Utah, renewing a rate increase for inpatient hospital services for state teaching hospitals
  • Virginia, amending a rate increase for inpatient hospital services and outpatient hospital services for non-state government-owned hospitals
  • Virginia, renewing increased rates for nursing facility-like services provided to individuals under 21
  • Virginia, renewing a rate increase for selected services for providers employed or contracted with an acute care hospital chain with a level one trauma center in the Tidewater Metropolitan Statistical Area
  • Virginia, implementing rate increases for an academic medical center
  • Virginia, renewing a rate increase for inpatient and outpatient services
  • Virginia, renewing a different rate increase for inpatient and outpatient services

The Courts

A federal court has vacated an HHS policy that barred individual and small group plans offered on Affordable Care Act health insurance exchanges from including coverage for gender-affirming care for transgender individuals as an essential health benefit.  In reaching its summary judgment, the court found that HHS failed to follow the required process in the Affordable Care Act’s enabling legislation for revising the scope of essential health benefits.  Learn more from the court’s decision in the case.

Health Policy Newsletters, Reports, and Videos

Centers for Disease Control and Prevention (CDC)

The CDC released 2025-2026 school year vaccination data showing an overall 0.1 percent decline in vaccination coverage for diphtheria, tetanus, acellular pertussis vaccine, measles, mumps, and rubella vaccine (MMR), and polio vaccine among children entering kindergarten.  Additionally, exemptions from one or more vaccines among kindergarteners increased to 4.2 percent from 3.6 percent the year before.  For more information, see the press release here and the data here.

Food and Drug Administration

  • The White House has announced that President Trump will nominate Heidi Overton, M.D., to serve as FDA Commissioner.  Dr. Overton currently serves as Deputy Director of the White House Domestic Policy Council and Deputy Assistant to the President for Domestic Policy.  The position is subject to Senate confirmation and Senator Bill Cassidy (R-LA), chairman of the Senate Committee on Health, Education, Labor, and Pensions (HELP), which will initiate the confirmation process, has expressed concern about Dr. Overton’s role in last week’s executive order calling for changes in childhood vaccination policy.
  • The FDA issued a discussion paper on the considerations for the assessment of risk and pre-market evaluation of generative artificial intelligence-enabled medical devices.  The FDA seeks feedback from device manufacturers, clinicians, researchers, the public, and other interested parties to inform regulatory approaches by October 19.  See the press release here and the discussion paper here.

Stakeholder Events

CMS – Advisory Panel on Hospital Outpatient Payment – August 24

CMS’s Advisory Panel on Hospital Outpatient Payment will meet virtually on Monday, August 24 at 9:30 (eastern).  The purpose of this panel is to advise CMS on the clinical integrity of the Ambulatory Payment Classification groups and their associated weights, which are major elements of the Medicare hospital outpatient prospective payment system and the ambulatory surgical center payment system and supervision of hospital outpatient therapeutic services.  Interested parties are invited to submit comment letters and presentations.  Learn more about submitting such materials and how to participate in the meeting from this CMS notice.

CMS – PEPPER Training for LTCHs, IRFs, and IPFs – August 25

On Tuesday, August 25 at 1:00 (eastern), CMS will hold a webinar to provide training for long-term-care hospitals, inpatient rehabilitation facilities, and inpatient psychiatric facilities on how to access, interpret, and use their latest PEPPER (Program for Evaluating Payment Patterns Electronic Report) report to support data-driven decision-making.  Go here to register to participate.

CMS – CCSQ Quarterly Stakeholder Webinar – August 26

CMS’s Center for Clinical Standards and Quality (CCSQ) will provide an update on its work to strengthen health care quality, safety, and coverage and share recent policy developments on Wednesday, August 26 at 11:00 (eastern).  Go here to register to participate.

CMS – Healthcare Advisory Committee – August 31

The Healthcare Advisory Committee, created by HHS and CMS to provide non-binding recommendations on modernizing and improving the health care system, will hold its next public meeting virtually on Monday, August 31 at 8:00 (eastern); registration is not required.  The deadline for submitting comment letters is August 18.  Learn more about the committee, its work, and how to submit comment letters from this formal notice and from the committee’s web site.  Webinar information will appear on the meeting’s agenda, which will be posted here; the agenda for the August 31 meeting has not yet been posted.  Additional meetings have been scheduled for November 19; February 22, 2027; and May 10, 2027.

MedPAC – Commissioners Meeting – September 3-4

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, September 3 and Friday, September 4.  An agenda for the meeting and information about how to participate has not yet been posted; when they are, they will be found here.

CMS – PEPPER Training for Home Health Agencies and Partial Hospitalization Programs – September 24

On Thursday, September 24 at 1:00 (eastern), CMS will hold a webinar to provide training for home health agencies and partial hospitalization program facilities on how to access, interpret, and use their latest PEPPER (Program for Evaluating Payment Patterns Electronic Report) report to support data-driven decision-making.  Go here to register to participate.

MACPAC – Commissioners Meeting – September 24-25

MACPAC’s commissioners will hold their next public meeting on Thursday, September 24 and Friday, September 25.  An agenda for the meeting and information about how to participate has not yet been posted; when they are, they will be found here.

CMS – PEPPER Training for Skilled Nursing Facilities – September 29

On Tuesday, September 29 at 1:00 (eastern), CMS will hold a webinar to provide training for skilled nursing facilities on how to access, interpret, and use their latest PEPPER (Program for Evaluating Payment Patterns Electronic Report) report to support data-driven decision-making.  Go here to register to participate.

CMS – 2026 CMS National Provider Enrollment Conference – November 18-19

CMS will hold a national provider enrollment conference on Wednesday, November 18 and Thursday, November 19 in Kissimmee, Florida.  The event will provide direct access to the staff responsible for shaping and administering Medicare provider enrollment.  Through keynote presentations, panel discussions, interactive Q&A sessions, and expert-led training, participants will gain insight into enrollment policy, program integrity initiatives, compliance requirements, operationally friendly best practices, and upcoming changes affecting the Medicare provider enrollment landscape.  Learn more from this CMS conference notice.