21 July 2025 This Week in Health Policy for July 21 House Ways and Means Health and Oversight Subcommittees will hold a hearing on Medicare Advantage: Past Lessons, Present Insights, Future Opportunities
House Energy and Commerce Oversight and Investigations Subcommittee will hold a hearing on "Ensuring Patient Safety: Oversight of the U.S. Organ Procurement and Transplant System."
Congress passes recissions package. On July 17, the House voted 216-213 to clear the Senate's amended $9 billion package of rescissions to previously appropriated funds (H.R. 4). The amended version, which passed the Senate by a vote of 51-48 after another late-night vote-a-rama on amendments, did not include a $400 million cut to the President's Emergency Plan for AIDS Relief (PEPFAR). Two Republican senators — Susan Collins (ME) and Lisa Murkowski (AK) — joined all Democrats present in voting against it. In the House, two Republicans — Reps. Brian Fitzpatrick (PA) and Mike Turner (OH) — joined all Democrats in opposing the bill. The bill included about $8 billion in cuts to foreign aid programs managed by USAID and the State Department, in areas such as health, development, disaster relief, food/nutrition and democracy programs. It also cuts $1.1 billion for the Corporation for Public Broadcasting, impacting local PBS and NPR stations. White House budget director Russ Vought said Thursday that a second request to rescind congressionally approved spending may be coming soon. HALT Fentanyl Act. On July 16, President Trump signed the HALT Fentanyl Act into law. The bill permanently classifies fentanyl derivatives as Schedule 1 substances as part of the Administration's efforts to address fatal drug overdoses. House Republicans show support for USTR actions on drug pricing. On July 14, Reps. Vern Buchanan (R-FL) and Jodey Arrington (R-TX) led a letter from 35 House Republicans that applauds US Trade Representative (USTR) Jamieson Greer's RFI on most-favored-nation drug pricing. CMS issues 2026 OPPS proposed rule. On July 15, CMS issued their Calendar Year (CY) 2026 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center (OPPS/ASC) Payment Systems Proposed Rule. The rule proposes to increase hospital outpatient department payment rates by 2.4%. The rule also includes proposals to advance site neutral payment for drug administration services, phase out the inpatient only list, update hospital price transparency requirements and changes to the hospital quality and star ratings program, among other updates. CMS is accepting comments on the proposed rule through September 15th. CMS issues 2026 MPFS proposed rule. On July 14, CMS issued their Calendar Year (CY) 2026 Medicare Physician Fee Schedule (MPFS) Proposed Rule. The rule proposes to increase the conversion factor by 3.62% in CY 2026 and 3.83% for providers in Advanced Alternative Payment Models. The rule also proposes several updates to the methodology for determining the physician fee schedule to improve reimbursement for primary and preventive care, as well as updates to Medicare Part B payments and policies, the Medicare Shared Savings Program (MSSP), the Inflation Reduction Act (IRA) rebate models, and more. The proposed rule will be open for comment until September 12. CMS cracks down on duplicate enrollment. On July 17, the Centers for Medicare & Medicaid Services (CMS) said it has identified 2.8 million Americans who were enrolled in two or more Medicaid or ACA exchange plans in 2024. CMS said it is taking steps to reduce duplicate enrollment that has the potential to save about $14 billion annually. CMS to halt continuous eligibility waivers. On July 17, CMS informed states that it will not extend existing or approve new Section 1115 waivers allowing states to provide continuous enrollment for Medicaid or CHIP beneficiaries longer than 12 months. Currently, some states have waiver allowing them to offer up to 24 months of continuous coverage for certain adults and children. CMS in a separate letter also said it does not plan to extend or issue new Section 1115 waivers to test workforce initiatives, such as workforce training or student loan repayment. Cell and Gene Therapy Access Model. On July 15, CMS announced 33 states, Washington, DC, and Puerto Rico will voluntarily participate in the Cell and Gene Therapy Access Model, which seeks to test outcomes-based payments for sickle cell disease treatments in Medicaid. FDA RIFs take effect. On July 14, up to 3,500 FDA workers who received RIF notices on April 1, were informed they were officially fired, a Department of Health and Human Services (HHS) spokesperson confirmed to Endpoints News. The move came in the wake of the Supreme Court's July 8 ruling halting a preliminary injunction issued by a California judge blocking the RIFs. The HHS spokesperson said workers impacted by a separate July 1 court injunction issued by a federal judge in Rhode Island were not part of the firings. FDA kicks off PDUFA reauthorization process. On July 14, the Food and Drug Administration (FDA) held its first meeting to begin the reauthorization process for the Prescription Drug User Fee Act (PDUFA VIII). During the meeting, FDA Commissioner Marty Makary said he'd like the next agreement to include lower user fees to reduce the barrier to entry for small companies and individual inventors. Monday's meeting was the first step of a lengthy negotiations process with industry to secure a commitment letter for the next PDUFA program. The commitment letter will provide the necessary information for Congress to pass legislation to reauthorize the program for another five years. CMS and ICE enter data sharing agreement. On July 14, CMS and the Immigration and Customs Enforcement (ICE) signed an agreement giving ICE access to Medicaid enrollee data to help find "the location of aliens" in the US, the Associated Press reported this week. While illegal immigrants are not eligible for Medicaid, federal law requires states to offer emergency Medicaid coverage to anyone, including illegal immigrants, for lifesaving care. Trump comments on pharma tariffs. On July 15, President Trump followed up last week's comments on forthcoming pharmaceutical tariffs by reiterating his expectation that the Sec. 232 investigation will conclude by the end of the month. Speaking with reporters he said, "Probably at the end of the month, and we're going to start off with a low tariff and give the pharmaceutical companies a year or so to build, and then we're going to make it a very high tariff." FTC commissioners. On July 17, D.C. District Court Judge Lori AliKhan ruled that President Trump must reinstate dismissed Democratic Federal Trade Commissioner Rebecca Kelly Slaughter to serve until her term ends in 2029. The judge dismissed a case brought by Alvaro Bedoya, another fired Democratic FTC Commissioner, because he has formally resigned from the position. The Trump Administration has not said whether it will appeal the ruling. Medical debt. On July 11, a US district judge ruled that the Consumer Financial Protection Bureau, under the Biden administration had exceeded its statutory authority and violated the law in issuing a rule to remove medical debt from credit reports. House Energy and Commerce Subcommittee on Health held a hearing on "Legislative Proposals to Maintain and Improve the Public Health Workforce, Rural Health, and Over-the-Counter Medicines." On July 16, the Subcommittee held a hearing during which they heard from a panel of witnesses representing HHS, FDA, and HRSA. During the hearing, witnesses and members discussed numerous bills including: H.R.4273; H.R.3686; H.R. 2821; Title VII Reauthorization; Title VIII Reauthorization; H.R.2493; H.R.3419; H.R. 3302; H.R.2846; and the Newborn Screening Reauthorization Act. There was a particular focus on reauthorization of several programs including the Over-the-Counter (OTC) Monograph Drug User Fee Amendments (OMUFA) program. During the hearing, there was bipartisan concern expressed at the primary physician and nursing workforce shortages expected over the next ten years. There was also bipartisan discussion of the need for a more efficient FDA approval process to allow for innovation in OTC drugs.
Senate HELP Committee held a hearing on "Freedom to Work: Unlocking Benefits for Independent Workers." On July 17, the Committee held a hearing during which lawmakers and witnesses discussed the barriers independent contractors face accessing affordable health benefits. Democrats on the committee spoke about the lack of access to affordable healthcare, social security, and retirement planning, while several Republicans spoke in favor of legislation to protect independent workers' benefits.
Senate HELP Committee held a nominations hearing on Brian Christine to be HHS Assistant Secretary for Health and others. On July 16, the Committee heard testimony from Brian Christine who President Trump nominated to be HHS Assistant Secretary for Health. During the hearing, Dr. Christine, a urologist, spoke of his commitment to the Make America Healthy Again initiative. Democrats during the hearing spoke critically of the reconciliation bill and HHS restructuring plans and questioned Dr. Christine about his positions on vaccines. Republicans largely focused on Dr. Christine's medical experience and ways to improve rural health.
Document ID: 2025-1536 | |||
