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The following is the latest health policy news from the federal government for September 18-24.  Some of the language used below is taken directly from government documents.

The White House

  • The White House has issued the executive order “Enhancing Program Integrity and Interagency Coordination in the Administration of the H-1B Nonimmigrant Visa Program.”  The order increases federal oversight of the H-1B visa program because “The abuse of cheaper H-1B labor places downward pressure on domestic pay.  H-1B visa holders earn far less than comparable United States-born workers, despite the statutory mandate that H-1B workers be paid equally to their domestic peers…”  The order calls on federal labor and immigration agencies to work together to determine whether employers sponsoring H-1B visa workers have laid off workers with comparable skills in the recent past or if they plan future layoffs that could affect such workers.  Companies found to have engaged in such practices will face closer scrutiny when they request future H-1B visas for foreign workers.  Learn more from the executive order and an accompanying White House fact sheet.
  • A separate presidential proclamation, “Restriction on Entry of Certain Nonimmigrant Workers,” bars the entry of foreign nationals seeking H-1B specialty occupation visas unless their employer’s petition includes an additional $100,000.  This is an extension of a similar executive order issued in September of 2025 that a federal court barred.  Find this proclamation here.

National Institutes of Health (NIH)

The administration is expected to halt plans for an executive order that would give the White House control over NIH grants and its merit-review process.  Leading up to this decision, Senator Susan Collins (R-ME), chair of the Senate Appropriations Committee, sent a letter to Director of the Office of Management and Budget (OMB) Russell Vought and NIH Director Jay Bhattacharya expressing concern about establishing a new committee to review NIH grants, arguing that it would undermine the congressionally-mandated peer review process.

In May, OMB published a proposed rule to restructure government-wide policies and requirements governing the management of grants, cooperative agreements, and other forms of assistance; that rule is paused through December 11, 2026 as part of the FY 2027 continuing resolution.  For more information, see Senator Collins’ letter here and the OMB proposed rule here.

Responses to CMS’s Proposed Regulation Governing Provider Taxes

  • The Attorneys General of 25 states have written a joint letter to CMS expressing their opposition to a proposed regulation that would impose new limits on states’ ability to use revenue from health care provider taxes to finance their share of their state Medicaid programs.  In their letter, the Attorneys General maintain that the extent of the limits CMS proposes exceed those established in the enabling legislation, last year’s federal budget reconciliation bill, H.R. 1 (often referred to as the “One Big Beautiful Bill Act”); include provisions that contradict current laws enacted by Congress; and would interfere with states’ ability to fund their Medicaid programs.  The letter is signed by the Attorneys General of Arizona, California, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Massachusetts, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and Wisconsin.  Learn more from the Attorneys General letter to CMS and this news release summarizing the major issues presented the letter.
  • The Medicare and CHIP Payment and Access Commission (MACPAC) has submitted a comment letter to CMS in response to CMS’s proposed rule with comment period on “Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes (CMS-2452-P).”  In its letter, MACPAC expressed support for provisions that require ongoing reporting of health care-related taxes, including information on the amount of tax collections and what the taxes are used to fund.  MACPAC also asked CMS to collect additional reporting elements, such as provider-level information, but also expressed concern that the combination of the newly proposed provider class and elimination of the 75/75 test removes a pathway for states to raise revenues more broadly when the tax revenues have a minimal tie to Medicaid expenditures.  For more information, see MACPAC’s letter to CMS.

Congress

  • The Senate Finance Committee voted 15-12 to advance the nomination of Chris Klomp to serve as Deputy Secretary of HHS and 14-13 to advance the nomination of Dr. Ge Bai, PhD/CPA, to serve as an Assistant Secretary of HHS.  Both nominations now head to the full Senate for a final vote.  See a recording of the session here.
  • The Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on the nomination of Dr. Heidi Overton to serve as Commissioner of the Food and Drug Administration.  The committee has not yet held a vote to advance her nomination to the full Senate.  See a recording of the hearing here.
  • Only the Senate was in session this week; it is scheduled to recess on October 2.  Both chambers of Congress will reconvene after the mid-term elections in November.  Upon their return, a major priority will be advancing a government funding package because the current continuing resolution (CR) expires on December 11.

Centers for Medicare & Medicaid Services (CMS)

  • CMS has announced its intention to align the rates that Medicare pays for clinical laboratory services in 2027 with the rates paid by the private sector – an effort it believes will save an estimated $1 billion a year.  While it will not release final rates until later this year, CMS is releasing the data and information used to determine its preliminary 2027 Medicare rates for laboratory services; this data shows that Medicare has been paying about 16 percent more for laboratory services than commercial payers.  While the preliminary rates seek to align Medicare laboratory test payments with commercial rates, by law Medicare cannot reduce its payments for clinical diagnostic laboratory tests by more than 15 percent a year, so CMS will gradually phase in some of the reduced rates through 2029.  Learn more from this CMS news release, an accompanying fact sheet, and CMS’s preliminary 2027 Clinical Laboratory Fee Schedule rates and supporting data.  CMS anticipates finalizing its CY 2027 payment rates for clinical diagnostic laboratory tests in November and those rates will go into effect on January 1, 2027.  The deadline for submitting comments is October 21.
  • CMS is canceling approximately 315,000 “unauthorized enrollments” in Affordable Care Act plans purchased through the federal marketplace that together cover more than 760,000 individuals.  In addition, the agency has issued termination notices to more than 200 non-compliant marketplace agents and brokers this year and this summer issued 569 notices of intent to terminate agents and brokers who submitted 2026 applications without key applicant information.  The agency has published an interim final rule announcing a temporary moratorium on new registrations for the 2027 plan year for agents and brokers without an active exchange agreement for 2026 and outlining new requirements and limits for existing agents and brokers.  Learn more about these actions from this CMS news release, an accompanying fact sheet, and the interim final rule imposing the temporary moratorium on the registration of agents and brokers not currently registered with the federal exchange.  The interim final rule takes effect immediately and the deadline for submitting comments in response to it is November 21.
  • CMS has announced that all 50 states, the District of Columbia, and Puerto Rico have applied to participate in its GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model, which will provide most-favored-nation pricing for certain prescription drugs for Medicaid participants.  CMS estimates the program will save $64.3 billion over the next ten years and improve access to many prescription medicines.  Under the program, participating manufacturers will make covered outpatient drugs available at most-favored nation prices to participating state Medicaid programs and will be invoiced by states for supplemental rebates to effectuate international prices, with CMS monitoring  pricing accuracy and sharing rebates with states by reducing the federal share of Medicaid payments.  The GENEROUS Model, launched in January 2026, will run for five years.  Learn more about participation in the model from this CMS news release, the GENEROUS Model web page, this White House fact sheet, and this separate White House release.
  • CMS has released $12 billion in supplemental Medicaid payments to the state of Texas that it had withheld in a dispute over how the state used provider tax revenue to draw down federal Medicaid matching funds.  Learn more about the release of the federal money from this news release from the office of Texas’s governor.
  • CMS has posted a bulletin presenting changes in the Laboratory National Coverage Determination (NCD) edit software for January 2027.  Find that bulletin here.  The changes the bulletin presents take effect on January 1.
  • CMS has launched a review of its National Coverage Determination for screening for the hepatitis C virus in adults.  Learn more about the current policy, the concerns that interested parties have raised, and the process for reviewing the current policy from this CMS announcement.  The deadline for interested parties to submit written comments is October 23.
  • CMS has updated Electronic Form CMS-10455, “Report of a Hospital Death Associated with Restraint or Seclusion.”  Go here for a link to a CMS memo that explains the update and includes a link to the updated form and an instructional video on its use.
  • CMS has added the following items to its Quality Payment Program resource library:

Department of Health and Human Services (HHS)

  • HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded $42.3 million in new supplemental funding to states and territories to advance the administration’s “Treatment First” approach to helping individuals suffering from addiction or mental illness.  Of the $42.3 million, $17.3 million was awarded to Community Mental Health Services Block Grant recipients to help states and territories build the systems, partnerships, workforce capacity, policies, and technical infrastructure needed to put Treatment First principles into practice.  Another $25 million was awarded to Substance Use Prevention, Treatment, and Recovery Services Block Grant recipients to expand capacity for safe, licensed, certified, or chartered sober and recovery housing nationwide.  Learn more about the funding and its intended uses from this HHS news release.
  • HHS’s Health Resources and Services Administration (HRSA) has awarded nearly $19 million in grants to expand access to health care through telehealth and technology-enabled learning.  The awards will increase access to nutrition services, expand the use of emerging technologies to improve care delivery, and strengthen the health care workforce in rural communities and other areas with limited access to care.  Learn more about the programs through which the grants were awarded and find links to lists of the grant recipients from this HRSA news release.
  • HRSA is seeking permission from OMB to collect information on the operation of approximately 20 hotlines, chatlines, and online portals operated by the agency itself or contractors.  In addition to collecting basic demographic information, the information collections would include questions such as reasons for inquiry, topics covered by inquiry, and feedback on provided guidance or the hotline/chatline/online portal user experience.  Learn more about the proposed data collection, how the data would be used, and the projected burden for participants from this formal HRSA notice.  HRSA originally proposed this data collection in November of 2024.  The deadline for submitting written comments is October 22.
  • HHS and HRSA have awarded $51 million in grants to 28 HRSA-funded health centers to improve access to dental care for children with neurodevelopmental disorders, including autism spectrum disorder, Down syndrome, cerebral palsy, and intellectual disabilities.  The money will help health centers build on evidence-based models and test innovative approaches to improving dental care for children with neurodevelopmental disorders.  Learn more from this HHS news release.
  • HHS’s Office of the Assistant Secretary for Health has extended the solicitation period for nominations for appointments to the National Vaccine Advisory Committee to October 21, 2026.  Learn more from this HHS notice.
  • HHS and its Office of the Assistant Secretary for Financial Resources (ASFR) have established a new “HHS Personal Protective Equipment (PPE) Forecast,” described as “… the first official, recurring process to identify, consolidate, and publish anticipated HHS purchases of personal protective equipment covered by the Make PPE in America Act.”  The new forecast will give American PPE manufacturers a clearer and more predictable signal of future HHS demand and enable them to make better-informed decisions about hiring, production, capital investment, and manufacturing capacity while strengthening HHS supply chains.  Learn more from this HHS news release.

Rural Health Transformation Program Funding

In the past week CMS has announced that it has awarded Rural Health Transformation Program money to the following states:

  • To Arkansas, $54.6 million to fight chronic disease, expand maternal health care services, and build the state’s rural workforce
  • To Delaware, $23 million to modernize rural health centers, expand mobile care, and make it easier to manage chronic disease
  • To New Mexico, $74 million to expand specialty, maternal, and behavioral health care across rural parts of the state
  • To Missouri, $45 million to upgrade rural hospitals, connect families to rapid psychiatric consultations and maternal care, and train more EMS professionals
  • To South Dakota, $13 million to expand behavioral health care and create a 24/7 mobile crisis response service

Medicaid State Plan Amendments

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

  • District of Columbia, updating the rebasing schedule for section 1915 housing supportive services
  • Georgia, updating independent laboratory services
  • Hawaii, providing mandatory coverage for eligible juveniles who are incarcerated in a public institution post-adjudication of charges
  • Kentucky, updating reimbursement for emergency transport services
  • New Mexico, resuming the Recovery Audit Contractor (RAC) program
  • Utah, clarifying the reimbursement methodology for school-based services
  • Utah, providing for an annual rebasing for all outpatient services
  • Wisconsin, extending postpartum coverage from 60 days to 12 months
  • Wisconsin, updating the prenatal care coordination targeted case management benefit

Health Policy Newsletters, Reports, and Videos

  • CMS
    • MLN Connects – September 24
    • “Bundled Payments for Care Improvement Advanced Model:  Final Evaluation Report” – August report
    • “Linking your CMS Enterprise Portal account Script and Video” – instructional video on linking providers’ CMS enterprise portal accounts with two different CMS Program Statistics:  Login.gov and ID.me
  • HHS
    • Health Resources and Services Administration (HRSA)

Centers for Disease Control and Prevention (CDC)

  • The CDC published a notice seeking public input on how data intermediaries can advance broader goals to prevent disease, detect emerging threats, drive state-of-the-art solutions that empower communities, and strengthen public health systems.  The deadline for submitting comments is November 20.  For more information, see the notice here.
  • Beginning October 5, David Sugerman will serve as acting director of the National Center for Immunization and Respiratory Diseases (NCIRD).  Sugerman is a career official who has worked at the CDC for nearly 20 years.  The position has not had a permanent director since 2025.

Justice Department

  • The Justice Department has announced agreements with two large health systems to resolve investigations into potential violations of federal law arising from their provision of gender-affirming care to minors.  Under the agreements, the two health systems will cease providing these services to minors and pay fines of $8.5 million and $950,000, respectively.  Learn more from this Justice Department news release.
  • The Justice Department has announced revisions to its Justice Manual to strengthen its fight against fraud under the False Claims Act through clearer standards that promote fair and effective enforcement.  These revisions seek to clarify the limits on the use of sub-regulatory guidance across department litigation and when the department will seek dismissal of whistleblower actions that do not serve the interests of the United States.  A provision in the revised manual explains that some of its provisions apply more broadly in the health care arena, where guidance documents such as CMS’s Medicare Benefit Policy Manual or Local Coverage Determinations are relevant evidence of, among other things, violations of the principal requirement that procedures billed to Medicare or Medicaid be medically “reasonable and necessary.”  Learn more from this Justice Department news release and the guidance documents.

Stakeholder Events

MACPAC – Commissioners Meeting – September 25

MACPAC’s commissioners will hold the second day of their two-day September meeting on Friday, September 25.  Go here to download meeting’s agenda and register to participate.

CMS – Inpatient Rehabilitation Facility FY 2027 Final Rule Webinar – September 29

CMS will hold a webinar on Tuesday, September 29 at 1:00 (eastern) during which it will present a review of FY 2027 inpatient rehabilitation facility (IRF) prospective payment system final rule policies and related Medicare coverage updates.  The session will summarize key payment updates and finalized IRF requirement changes, including the 36-hour requirement, initial interdisciplinary team meeting requirement, and related documentation considerations.  Go here to learn more about the webinar and the subjects it will address and go here to register to participate.

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.

HRSA – Grand Rounds – Screening and Treatment of Pediatric Depression and Anxiety – October 7

HRSA will hold a webinar focused on screening and treatment approaches for pediatric depression and anxiety on Wednesday, October 7 at 2:00 (eastern).  Learn more about the webinar and how to register to participate by going here and scrolling down to “Upcoming Grand Rounds.”

MedPAC – Commissioners Meeting – October 8-9

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, October 8 and Friday, October 9.  An agenda for the meeting and information about how to participate have not yet been posted; when they are, they will be found here.

CMS – Healthcare Common Procedure Coding System (HCPCS) Level II Public Meeting – November 11-12

CMS will hold its second biannual Healthcare Common Procedure Coding System (HCPCS) Level II public meeting of 2026 on Monday, November 2 and Tuesday, November 3 (if necessary) to discuss the CMS preliminary coding, Medicare benefit category, and Medicare payment determinations, if applicable, for new revisions to the HCPCS Level II code set for non-drug and non-biological items and services.  Find the meeting’s agenda and learn more about how to speak at the conference, submit comments, and register to participate either virtually or in person in this CMS announcement.

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.

HHS/Office of the Assistant Secretary for Planning and Evaluation – Physician-Focused Payment Model Technical Advisory Committee Meeting – December 8-9

HHS’s Physician-Focused Payment Model Technical Advisory Committee (PTAC) will hold a public meeting on Tuesday, December 8 and Wednesday, December 9 at 9:00 (eastern).  An agenda has not yet been posted.  Go here to learn more about the meeting and how to participate in person or virtually.