20 July 2026 This Week in Health Policy for July 20
House Committee on Oversight and Government Reform will hold a roundtable on "Medicare Fraud: Examining the Explosive Growth in Skin Substitute Spending."
Senate HELP Committee will hold an executive session to vote on nominations to lead the CDC, ASPR, and DOL.
Reconciliation 3.0. On Thursday (July 16), the House Budget Committee voted 20-14 to advance a budget resolution detailing reconciliation instructions for a $95 billion bill to the Agriculture, Armed Services, Intelligence, and House Administration committees. The blueprint would allocate $73 billion in defense and intelligence funds related to the Iran war; $12 billion in aid to farmers; and $10 billion for measures aimed at voter fraud. The resolution does not include offsets and it does not include reconciliation instructions for health committees. However, the bill includes a provision allowing the committee chairman to adjust the FY 2027 spending allocations for the Health Care Fraud and Abuse Control Program if appropriators provide additional funding — permitting up to $658 million above the $311 million base without violating House budget enforcement rules. The budget resolution passed after the committee rejected 14 Democratic amendments, including measures to reverse targeted cuts to nutrition assistance programs, student loan limitations, and changes to Affordable Care Act policies. Significant questions remain whether there is a path forward for both the budget resolution and any subsequent reconciliation legislation. House leadership is expected to bring the resolution to the floor next week — the chamber's final scheduled week in session before the August recess. While the Senate is scheduled to be in session longer, it remains unclear whether the chamber will embrace the House approach, with several Senators indicating the Senate will focus on other priorities. Funding bills. On Wednesday (July 15), the House voted 217 to 209, with all Democrats opposing, to pass a $47.3 billion bill funding the State Department for fiscal year 2027. Among other things, the bill includes nearly $8.9 billion in global health funding, which is about $532 million below the FY 2026 enacted level. That includes funding for the President's Emergency Plan for AIDS Relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria; Gavi, the Vaccine Alliance; as well as programs for maternal and child health, malaria, HIV/AIDS, tuberculosis and polio. The bill next goes to bicameral negotiations with the Senate. In addition, on Friday (July 17), House GOP leaders released text for a continuing resolution (CR) that would fund the federal government through December 4. With current funding set to expire September 30, the measure would push final bipartisan appropriations negotiations until after the midterm elections. The House is expected to vote on the measure next week. Senate rejects resolution to block WISeR. On Thursday (July 16), the Senate voted 46 to 50 to reject Democrats' Congressional Review Act resolution that sought to block further implementation of CMS' Wasteful and Inappropriate Service Reduction (WISeR) model, which tests AI-assisted prior authorization for certain services in traditional Medicare. CMS issues draft guidance for 2028 drug price negotiation. On Thursday (July 16), CMS issued draft guidance that details processes and requirements drug manufacturers will need to follow for Medicare Part B and Part D drugs selected for price negotiation in 2028. The draft guidance also includes processes that may apply to Medicare Part D plan sponsors, Medicare Advantage (MA) organizations, pharmacies, mail-order services, and other entities that dispense drugs covered under Medicare Part D, as well as hospitals, physicians, and other providers of services and suppliers that furnish or administer Part B drugs. Click here for a fact sheet. CMS updates nursing home oversight. On Thursday (July 16), CMS announced nationwide implementation of a new risk-based survey (RBS) process for nursing homes intended to streamline the review process for higher-performing nursing homes. The new process replaces or supplements traditional survey selection methods with a methodology that targets facilities based on risk indicators and enables higher-performing facilities to undergo a more "focused" survey protocol requiring less onsite time and a smaller survey team. DHS issues 'public charge' final rule. On Thursday (July 16), the Department of Homeland Security issued a final rule that rescinds a Biden-era 2022 final rule on the public charge standard and gives immigration officers greater discretion when considering statutory and case-specific factors for determining whether non-citizens are likely to become dependent on the federal government, including consideration of factors such as enrollment in Medicaid or nutrition benefits . The final rule takes effect September 18. CMS issues RFI to update clinical lab rules. On Thursday (July 16), CMS published a request for information (RFI) to help update the Clinical Laboratory Improvement Amendments (CLIA) regulations from 1988. The RFI includes the following topics: 1) breath testing; 2) laboratory processes and procedures; 3) emergency preparedness, biosafety and biosecurity, and cybersecurity; and 4) specialty testing areas. Comments are due by September 14. Judge again blocks HHS exchange rule provisions. On Thursday (July 16), US District Judge Brendan Hurson granted a preliminary injunction blocking HHS from implementing several provisions of its 2027 Notice and Benefits Parameter final rule, including the expanded hardship exemption; revised network adequacy standards; updated bronze plan cost-sharing methodology and elimination of standardized plans. FDA shares new mission. On Wednesday (July 15), FDA Acting Commissioner Kyle Diamantas published updated FDA Public Health Pillars that outline agency priorities under his leadership. The four pillars: innovation and global leadership, advancing national health security, increasing access to affordable medicines and medical products, and preventing chronic disease and promoting wellness. The pillars outline the agency's focus on expanding access to rare disease treatments and continuing to expand the use of AI and digital tools in drug reviews and trials, among other priorities. CMS issues CY 2027 MPFS proposed rule. On Tuesday (July 14), the Centers for Medicare & Medicaid Services (CMS) issued its Calendar Year (CY) 2027 Medicare Physician Fee Schedule (MPFS) Proposed Rule, which includes updates to Medicare Part B payments and policies, the Medicare Shared Savings Program (MSSP), the Inflation Reduction Act (IRA) rebate program, and more. The rule also includes several updates to the methodology for determining the physician fee schedule aimed at improving reimbursement for primary and preventive care. For more information see our full WCEY Alert here. CMS issues CY 2027 OPPS proposed rule. On July 2, CMS issued their Calendar Year (CY) 2027 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center (OPPS/ASC) Payment Systems Proposed Rule. The rule includes a proposed 2.4% payment update for hospital outpatient departments, as well as proposals to reduce payments for 340B acquired drugs, expand site neutral payment policy to certain imaging without contrast services, continued phase out of the inpatient only (IPO) list, changes to hospital quality programs, and more. CMS is accepting comments on the proposed rule through August 31. For more information see our full WCEY Alert here. CMS issues CY 2027 Home Health Prospective Payment System proposed rule. On July 1, CMS issued the CY 2027 Home Health Prospective Payment System (PPS) proposed rule that would increase Medicare payments to home health facilities by 2.4%, or $420 million, compared to CY 2026. In addition to proposing home health payment updates and policy changes, the rule also includes proposals related to provider and supplier enrollment, requirements and benefits related to durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), and new disclosure requirements for private equity ownership. Click here for a fact sheet. FDA issues rule to streamline manufacturing registration. On July 10, the Food and Drug Administration issued a proposed rule that would enable drug manufacturing facilities in multiple locations to be registered as a single establishment using a "hub-and-spoke" model. The proposed rule also would clarify registration requirements for certain foreign companies that manufacture drugs, including APIs, that enter the US drug supply. HHS launches hospital nutrition pledge. On July 8, HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz launched a pledge that encourages hospitals to reduce highly processed foods and prioritize nutrient-dense food. The pledge aims to bring hospital food in line with the dietary guidelines the Health and Agriculture departments released in January. ACO REACH performance update. On July 10, the CMS Innovation Center released its third annual evaluation report for ACO REACH that shows the model improved health care quality and reduced gross spending during its first four performance years. The ACO REACH model is scheduled to end this year, with many participants transitioning to the Long-term Enhanced ACO Design (LEAD) Model, which launches in January 2027 and will run for 10 years. FDA selects PreCheck participants. On June 29, the FDA announced seven companies will participate in the FDA PreCheck Pilot Program: Amneal Pharmaceutical, Cellares Corp, Eli Lilly and Company, FUJIFILM Biotechnologies, Kriya Therapeutics, Kyowa Kirin, and Regeneron Pharmaceuticals. Selected participants will engage with FDA under the two-phase PreCheck model. Senate Health, Education, Labor and Pensions (HELP) Committee holds hearing on "Nominations of Sean Kaufman to be Assistant Secretary for Preparedness and Response for the HHS and Erica Schwartz to be Director of the CDC." On Wednesday (July 15), the Senate HELP Committee held a hearing to consider the nominations of Dr. Erica Schwartz to lead the Centers for Disease Control and Prevention (CDC) and Sean Kaufman to serve as Assistant Secretary for Preparedness and Response (ASPR). During the hearing, much of the discussion focused on vaccine policy. Members and nominees also spoke of the challenges the nominees would face, if confirmed, in restoring trust in CDC and public health agencies. Republican members largely focused their questioning on ways to rebuild that trust, individual liberty concerns related to mandates, nutrition/MAHA priorities, API reshoring, and more. Democrats focused their questioning on the nominees' willingness to resist political interference in decision-making related to vaccines, particularly from HHS Secretary Robert F. Kennedy Jr. Democrats also asked the nominees about their positions on specific vaccines and vaccine research, the elimination of the Office on Smoking and Health, data reporting cuts related to the cyclosporiasis outbreak, and more. Both witnesses affirmed that vaccines are safe and effective but noted there may be instances in which a vaccine should be more narrowly targeted to certain populations. The witnesses also both pledged to follow the science but repeatedly pushed back on statements that Secretary Kennedy or President Trump would ever direct them to violate scientific integrity. For more information see our full WCEY Alert here. House Ways and Means Committee held a markup of Legislation Expanding Access to Quality, More Affordable Health Care & Holding Health Care Empires Accountable. On Wednesday (July 15), the Committee advanced seven bills to the full House:
House Energy and Commerce Health Subcommittee held a markup of three bills. On Wednesday (July 15), the Subcommittee advanced to the full committee three bills via voice vote that aim to address existing and emerging drug threats and safeguarding public health:
House Energy and Commerce Health Subcommittee held a hearing on "Maintaining America's Leadership in Biomedical Innovation: FDA's Role in Advancing U.S. Drug Development." On Wednesday (July 15), the Subcommittee heard testimony from witnesses who spoke of the need to improve communication between the FDA and pharmaceutical industry and streamline FDA drug approval processes. Republicans on the Subcommittee raised concerns about the FDA's drug development process but showed support for increasing access to clinical trial participation through local providers and telehealth, while Democrats raised concerns about the impact FDA layoffs and funding cuts have had on innovation. Both Republicans and Democrats raised concerns about the growth of research conducted in foreign countries. House Education and Workforce Committee held a hearing on "Training Activists, Not Physicians: The Impact of DEI on Medical Schools." On Tuesday (July 14), the Committee held a hearing during which members heard testimony from representatives of the National Medical Association and three medical schools: University of California, Los Angeles, David Geffen School of Medicine; University of California San Francisco; and University of Illinois College of Medicine. During the hearing, Republicans focused their questions on the universities' responses to claims of alleged antisemitic conduct, inappropriate accreditation standards, medical school curriculum, social justice and advocacy in medical care, and campuswide initiatives related to related to racial equity. Democrats on the committee focused their questions on health equity, the need to address workforce shortages, and the importance of cultural competence in health care. Senate Judiciary Committee held hearing on "From Genes to Machines: the Patent Eligibility Debate." On Tuesday (July 14), the Committee heard from a panel of witnesses representing intellectual property experts, academics focused on laboratory medicine, and aging. Much of the hearing focused on the Patent Eligibility Restoration Act of 2025 (PERA) (S. 1546), which aims to clarify and expand what is considered patent-eligible. Members asked the witnesses how to strengthen the legislation, asking specific questions on unmodified human gene activity. Witnesses spoke of the importance of maintaining a strong patent system that supports innovation, but offered divided opinions on the bill with some witnesses raising concerns about the bill's impact on patient access to innovations and cost.
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