02 February 2026 This Week in Health Policy for February 2 House Energy & Commerce Oversight and Investigations Subcommittee will hold a hearing on Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid
Senate HELP Committee will hold a hearing on Modernizing the National Institutes of Health: Faster Discoveries, More Cures
Senate passes HHS appropriations and extenders. On Friday (January 30), the Senate approved by a 71-29 vote an appropriations "minibus" package consisting of five of the remaining House-passed bills — Defense, Labor-Health and Human Services-Education, Transportation-Housing and Urban Development, Financial Services and General Government, and National Security-State Department — plus a two-week extension of Homeland Security funding to provide time to address Democratic concerns related to the Department of Homeland Security (DHS). If the House passes the package early next week, as expected, it will minimize a partial government shutdown stemming from the Senate passing a different measure than the House. Current funding ends on January 30. The package largely funds HHS at FY 2025 levels, with some agencies — such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health — seeing funding increases. The package also extends funding for several expiring health care programs including community health centers , continues Medicare telehealth flexibilities through 2027, delays Medicaid disproportionate share hospital (DSH) cuts until FY 2028, extends alternative payment model (APMs) bonus payments for the 2026 performance year at 3.1%, delays the 15% reduction in Medicare clinical laboratory payments for 2026, and more. The package does not include funding to revive the Affordable Care Act's (ACA) enhanced premium tax credits that expired on December 31. It also does not include policies in President Trump's "Great Healthcare Plan" to expand tax-preferred accounts and codify the Most Favored Nations deals, however it does include additional transparency provisions for pharmacy benefit managers (PBMs) and hospital billing. Click here for WCEY's detailed alert on the health care provisions included in the package. Democrat senators raise concerns about TrumpRx, OIG guidance. On Thursday (January 29), Sens. Dick Durbin (D-I:), Elizabeth Warren (D-MA), and Peter Welch (D-VT) sent a letter to HHS' Office of Inspector General raising that raises concerns about TrumpRx, including the potential for "inappropriate prescribing, conflicts of interest, and inadequate care." The letter came in response to OIG guidance released on Tuesday (January 27) that clarifies financial arrangements between drug manufacturers and cash-paying patients who are enrolled in a federal health care program and the application of the Federal anti-kickback statute. OIG also issued a request for information on modifications to the Federal anti-kickback statute related to direct-to-consumer programs. Senate HELP Committee Republicans launch fraud taskforce. On Monday (January 26), Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Bill Cassidy (R-LA) announced the creation of a Republican task force to eliminate fraud in federal health care spending. As part of the initiative, the taskforce created an online portal for individuals to report fraud involving taxpayer dollars. CMS seeks input on hospital payment for domestic PPE, drug purchases. On Thursday (January 29), The Centers for Medicare and Medicaid Services (CMS) published an advance notice of proposed rulemaking requesting feedback on potential ways to pay hospitals that prioritize buying personal protective equipment (PPE) and essential medicines manufactured in the US. In the notice, CMS proposes establishing a "Secure American Medical Supplies" friendly designation for eligible hospitals, as well as potential ways to create a separate payment for US-manufactured PPE and essential medicines. CMS is accepting comment through March 30, 2026. President Trump signs EO on addiction. On Thursday (January 29), President Trump signed an executive order to coordinate the administration's response to drug addiction and to prevent fatal overdoses. The EO establishes the White House Great American Recovery Initiative, which will advise agency leaders on grants and federal programs to support substance use disorder treatment and prevention. Medicaid tech companies pledge to support Medicaid enrollment changes. On Thursday (January 29), CMS announced 10 health technology companies voluntarily committed to offer state Medicaid programs more than $600 million in no-cost and significantly discounted technology products and services to support states with Medicaid work requirements. The companies all have existing Medicaid eligibility and enrollment contracts with state Medicaid programs. Click here for a fact sheet. CMS issues provider tax final rule. On Thursday (January 29), CMS published a final rule that codifies statutory changes included in the One big Beautiful Bill Act (OBBBA), including prohibiting health care-related taxes on Medicaid providers that exceed those for non-Medicaid providers or taxes on high-volume Medicaid providers that differ from low-volume Medicaid providers. The rule, which takes effect April 3, finalizes transition deadlines. For example, states that have received waiver approvals for managed care organization (MCO) taxes within two years of April 3 must comply by January 1, 2027. Other MCO tax waivers approved more than two years ago have until state fiscal year 2028 to comply. All other provider taxes must meet compliance requirements by the state fiscal year 2029. CMS in the rule estimated that the changes in the rule would save the federal government over $78 billion over the next 10 years. Click here for the fact sheet. DoEd proposes changes impacting medical degrees. On Thursday (January 29), the Department of Education published a notice of proposed rulemaking, Reimagining and Improving Student Education (RISE), implementing the OBBBA's provisions on federal unsubsidized loan caps. Among other changes, the rule includes a narrowing of degree programs that will qualify as "professional" that excludes numerous medical and health professions, including nursing, physician assistants/associates, occupational therapy, physical therapy and more. Professions that do not qualify as "professional" under the rule would have lower borrowing caps for federal student aid. The Department is accepting comments on the rule until March 2. DOL proposes PBM updates. On Thursday (January 29), the Department of Labor issued a proposed rule that would require PBMs to report on certain transparency measures to plan fiduciaries of self-insured group health plans subject to the Employee Retirement Income Security Act (ERISA). Specifically, PBMs would be required to provide information on rebates and other payments from drug manufacturers, direct compensation, spread compensation for each pharmacy channel, pharmacy co-pay clawbacks, compensation from the termination of a contract or arrangement, and other compensation that the covered service provider, affiliate(s), agent(s), or subcontractor(s) reasonably expects to receive. Comments are due on March 31, 2026. ASTP/ONC releases RFI on diagnostic interoperability standards and certification. On Thursday (January 29), the HHS Assistance Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP/ONC) released a request for information on ways to improve the electronic exchange of diagnostic imaging. CMS publishes ACA enrollment snapshot. On Wednesday (January 28), CMS reported that 23 million people signed up for an ACA exchange plan during open enrollment, which ended on January 15. The signup number is down from 24.2 million people who enrolled during the same period in 2025. The final number reflects signups, not a final enrollment tally of individuals who paid their first month's premium. CMS also published a list of program integrity and consumer protection actions the agency took over the past year. CMS proposes changes to OPO rules. On Wednesday (January 28), CMS issued a proposed rule intended to strengthen federal oversight of Organ Procurement Organizations (OPOs). The rule proposes changes to the conditions for coverage for OPOs, including changes to OPO certification, donation service area designation, and a new competitive process for OPO designation. The rule is open for comment for 60 days. Click here for a fact sheet. CMS unveils latest drugs selected for drug price negotiation. On Tuesday (January 27), CMS announced the next 15 Medicare Part D and Part B drugs that have been selected for the third cycle of the Medicare Drug Price Negotiation Program. CMS also selected one previously negotiated drug for the program's first renegotiation. Manufacturers of selected drugs have until February 28 to alert CMS if it will participate in negotiations. The negotiation period for this round will end on November 1, with CMS publishing final maximum fair prices by November 30. Those prices would take effect January 1, 2028. Click here for a fact sheet on the selected drugs. CMS also released a fact sheet on the top 50 negotiation-eligible drugs based on their combined expenditures in Parts B and D. CMS issues MA, Part D Advance Notice for CY 2027. On Monday (January 26), CMS issued the Calendar Year (CY) 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and MA and Part D Payment Policies. In the Advance Notice, CMS proposes a net average payment increase of 0.09% for MA plans, updates to MA and Part D risk adjustment models, and updates to MA star ratings measures and calculations. Click here for a fact sheet. Click here for the Advance Notice. Click here for WCEY's full alert on the Advance Notice. DOL's EBSA unveils FY 2026 enforcement priorities. This month, the DOL's Employee Benefits Security Administration (EBSA) announced its enforcement priorities for FY 2026, with key areas of focus including cybersecurity, mental health and substance use disorder benefits, benefit distributions, retirement asset management, and surprise billing under the No Surprises Act. Senate Veterans' Affairs Committee held a hearing on "Building a 21st Century VA Health Care System: Assessing Efforts to Restructure the Veterans Health Administration." On Wednesday (January 28), the Committee held a hearing during which they heard from VA Secretary Douglas Collins who shared his plans to reorganize the VA and address a backlog of veterans waiting for VA benefits and care. Secretary Collins fielded questions on his plans for the agency and the impact on veteran health.
Senate Special Committee on Aging held a hearing on "Truth in Labeling: Americans Deserve to Know Where Their Drugs Come From." On Thursday (January 29), the Committee held a hearing during which members heard from a panel of witnesses representing advocacy groups, think tanks and academics. Republicans on the committee raised national security concerns related to generic drug manufacturing and spoke in favor of policies to require disclosure of a drug's country of origin. Democrats also spoke in favor of increased transparency into the drug lifecycle and spoke of the need to address drug shortages, quality, and supply chain resiliency.
Document ID: 2026-0330 | |||
