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On March 5, 2026, the Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing on how to transform health care with data and improve patient outcomes. The Committee discussion focused on the topics of prior authorization, cybersecurity, interoperability of electronic health systems, and use of artificial intelligence.
OPENING STATEMENTS
WITNESSES
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Dr. Thomas Keane, MD, MBA, Assistant Secretary for Technology Policy and National Coordinator for Health Information Technology, US Department of Health and Human Services – Testimony
MEMBER DISCUSSION
Prior Authorization
Sen. Roger Marshall (R-KS) requested an update on how the office is improving the prior authorization process. Dr. Keane highlighted that they have finalized the HTI 4 rule, which sets standards that allow electronic prior authorization requests to be processed in real time by ensuring that electronic health records (EHRs) can be shared between insurance companies and providers. He also shared that ASTP is working with the Centers for Medicare and Medicaid Services (CMS) to meet the goal of 80% of prior authorizations processed in real-time by January 1, 2027. Sen. Marshall asked about current barriers to prior authorization reforms. Dr. Keane shared that the largest barrier is information sharing between insurance companies and providers, but insurance companies are working with him to identify the choke points and potential solutions. EHR companies have also committed to reducing barriers. Sen. Marshall also advocated for the Senate to advance the H.R. 3514, the Improving Seniors Timely Access to Care Act.
Cybersecurity
Senators also expressed concerns about cybersecurity in the health care space. For example, Sen. Josh Hawley (R-MO) expressed concerns about cybersecurity protections for rural hospitals. Dr. Keane acknowledged that cyber-attacks can be devastating for rural hospitals, and he is committed to ensuring patient data is protected and hospital systems are secure. Dr. Keane highlighted that the HTI 5 rule updates certification criteria to encourage systems to adopt the most modern standards for cybersecurity. Chairman Bill Cassidy (R-LA) questioned whether the new certifications and removal of ones previously in place would lead to lower security and fewer privacy protections. Dr. Keane said that the certifications removed were outdated, redundant, or not widely adopted by industry, and therefore the remove of the old standards had no impact on the market.
Interoperability
Senators on both sides of the aisle expressed interest in health care interoperability. For example, Sen. Tim Kaine (D-VA) focused his questioning on how to expand EHR use to other sectors of the health care system, like behavioral health and long-term care providers. Dr. Keane shared that they have been working with the Substance Abuse and Mental Health Services Administration (SAMHSA) on pilot programs that improve interoperability between providers and social service departments, as well as more generally looking for new, modernized solutions to improve interoperability for all providers, including long-term care. Sen. Marshall asked about the current barriers to interoperability, to which Dr. Keane responded that there need to be clear standards, tools to evaluate them, and ways to ensure that organizations are not willfully engaged in information blocking. Dr. Keane expanded that he works with the Health and Human Services Office of the Inspector General when allegations of information blocking are not addressed after warnings of non-conformity. Sen. Lisa Murkowski (R-AK) appreciated the conversation about interoperability but highlighted that many rural and tribal health systems lack the infrastructure and capacity to benefit from many technological advances in healthcare, including EHRs. Sen. Murkowski questioned if agencies such as the Department of Veterans Affairs (VA) and the Indian Health Service (IHS) have been engaged with the development of interoperability standards to ensure that they are not inadvertently creating barriers. Dr. Keane assured the Committee that he has been working with IHS, which was the first organization to join the Trusted Exchange Framework and Common Agreement (TEFCA), through monthly meetings and aiding in technology vendor and contract conversations.
Artificial Intelligence (AI)
Another bipartisan area of interest was AI in health care. For example, Sen. Angela Alsobrooks (D-MD) asked what the role ASTP should play in establishing guardrails on AI use. Dr. Keane responded that ASTP is committed to ensuring patient safety and privacy are protected, and through the recent Health and Human Services RFI on AI use in health care, ASTP can evaluate where gaps in the federal framework are. Chairman Cassidy asked how to best protect patients who upload their health information onto an AI platform, and how the Health Insurance Portability and Accountability Act (HIPAA) could be applied. Dr. Keane clarified that generally, if an individual chooses to download their health information and upload it to an AI tool, that is the individual’s choice and falls outside of the purview of HIPAA. Chairman Cassidy understood but suggested additional consumer safeguards, like a pop-up that would warn an individual that their health data is not protected once uploaded. Dr. Keane responded that any action that would improve security and patient privacy is worth considering.
The attack on Iran by U.S. and Israeli forces has brought foreign affairs back to the forefront of Washington’s attention. However, concerns about affordability continue to dominate domestic headlines, as Republicans and Democrats begin to refine their messaging for the November midterm elections. Health care is a critical part of that messaging, and both sides are trying to shape the narrative. How will they do it? Let’s get into it. Welcome to the Week Ahead!
The Administration
In response to the Supreme Court decision striking down most of his 2025 tariffs, President Trump imposed a new 10% tariff for the next 150 days. While there were carve-outs for some products, such as pharmaceuticals and pharmaceutical ingredients, there are still implications for the wider health sector. The impacts are still to be felt, but concerns have been raised by groups such as the Healthcare Financial Management Association about supply chain delays impacting the availability of personal protective equipment (PPE) and other medical equipment and supplies.
Meanwhile, March marks the start of much of the annual payment rules season, so the Office of Management and Budget (OMB) is busy. OMB has already received the Inpatient Psychiatric Facilities and Hospice Prospective Payment System proposed rules, and more are on their way, including IPPS and OPPS for FY 2027. We expect these proposed rules in March or April.
The Senate
There were fireworks during the Senate HELP Committee hearing to consider the nomination of Dr. Casey Means to be the next United States Surgeon General. Chairman Bill Cassidy (R-LA) and Sen. Lisa Murkowski (R-AK), along with many Democrats, expressed concerns about Dr. Means’ views on vaccines. While these concerns are not the same as voting against the nomination, they could make Dr. Means’ road to the office a bit bumpier. At the time of publication, Sens. Murkowski and Susan Collins (R-ME) were still undecided on the nomination. Dr. Means can only afford one Republican defection in order to avoid being rejected by the Committee.
Will HHS Sec. Robert F. Kennedy, Jr. be heading to the Hill any time soon? During an executive session on February 26, Sen. Christopher Murphy (D-CT) urged the Committee to hold future hearings on the impact of last summer’s Reconciliation bill on health care. While Chairman Cassidy did not comment on that request, he did express support for bringing Kennedy, Jr. to testify before the committee again, where the department’s changes to the Childhood Vaccination Schedule and the Advisory Committee on Immunization Practices are likely to be a hot topic.
Health Care Hearings This Week
- March 5: Senate HELP Committee hearing on transforming health care with data and improving patient outcomes
The House
Whispers of Reconciliation 2.0 are making the rounds, and Rep. Richard Hudson, Chair of the National Republican Congressional Committee, told an audience at a BGov event that his members have begun discussing what could potentially be included. According to Rep. Hudson, any potential 2nd reconciliation package would be smaller in scope and would need alignment from all Republicans, likely making it more difficult to get off the ground.
The House Appropriations Committee is getting started on FY 2027 funding, holding a Member Day hearing for Labor-HHS on March 5. The deadline for programmatic language has been moved up several weeks (now March 20). The Labor-HHS bill will allow earmarks for the first time in 3 years, specifically for the Health Resources and Services Administration’s community project funding. This would see funds allocated to rural clinics, hospitals, and Federally Qualified Health Centers. March 20 is also the deadline for members to get these community project funding requests submitted.
Other Health Care Hearings This Week
- March 4: House Oversight Committee hearing on fraud and misuse of federal funds in Minnesota
- March 4: House Veterans’ Affairs Oversight Subcommittee hearing on oversight of Veterans’ health care and benefits legislation
- March 5: House Veterans’ Affairs Health Subcommittee hearing on supporting Veterans with traumatic brain injury
There You Have It
The newly renamed Actor Awards were last night, with many worthy nominations. Were you surprised by the winners? Let us know. Make it a great week!
Lawmakers are headed back to DC after a short break, without a clear path forward for funding the Department of Homeland Security (DHS) and foreign policy on their minds. It’s shaping up to be another big week so let’s get into it. Welcome to the Week Ahead!
The Administration
President Trump will be offering his State of the Union address on February 24. On health care, we expect the President to continue message on affordability. And we know why – the midterms are fast approaching!
A recent KFF poll found that 66% of US adults worry about being able to afford health care for them and their family, placing health care concerns above housing, utilities, and groceries. We expect the President to tout the launch of TrumpRx and recent efforts to reduce waste, fraud, and abuse as evidence of his success.
The Advisory Committee on Immunization Practices (ACIP) February meeting has been cancelled, following a legal challenge from the American Academy of Pediatrics over the committee members. Health and Human Services Secretary Kennedy removed all 17 ACIP members in June 2025 and selected replacements who are more skeptical about vaccines.
The Senate
While foreign policy is making the rounds on the news with the discussion of the War Powers Resolution, what is happening with health care?
Casey Means, nominated to be Surgeon General of the United States, will testify before the Senate Health, Education, Labor, and Pensions (HELP) committee on February 25. Her pick stirred up some controversy from within the Make America Health Again (MAHA) movement last year. One of Means’ most vocal critics was Laura Loomer, who raised concerns about her lack of an active medical license.
The Senate Aging Committee is holding a hearing on the regulatory process for rare diseases at the Food and Drug Administration (FDA) on February 26. This just one week after Senate HELP Chairman Bill Cassidy (R-LA) released a report on the FDA review process and reorganization. With closer looks from two Senate committees, Senate action on pushing FDA to approve treatments faster may be in the near future.
The House
Hospitals and providers will be in the spotlight in March as the House Ways and Means Committee continues looking at broad constituencies in the health care sector. As campaign season begins, both Republicans and Democrats will want to show their constituents that they are working on improving health care affordability.
In the meantime, the Health Subcommittee is holding a hearing on advancing the healthcare workforce on February 24. While not the committee that typically talks about workforce, we expect Republicans to take credit for pushing out key workforce dollars from the $50 billion Rural Health Transformation Program. Health care providers are up in arms about the concerns the Department of Education’s proposed rule on graduate and professional student loans, which would greatly limit the amount of funding for medical and nursing students. This on top of visa approvals and renewals being stalled, with the lapse in DHS funding, will certainly be hot topics.
Also, the House is buzzing with the release of the draft Farm Bill. Don’t forget the Farm Bill includes telemedicine loans and grants and rural broadband improvements.
There You Have It
The Winter Olympics have officially ended with the US walking away with 33 medals, including 2 impressive overtime gold medal wins from the men’s and women’s hockey teams. What was your favorite event? Let us know. Make it a great week!
On February 11, 2026, the Senate Special Committee on Aging held a hearing to examine how regulatory challenges for physicians can create undue burdens. There was bipartisan support about the need to address the issues of physician burnout, administrative burdens, and prior authorization reforms.
OPENING STATEMENTS
WITNESSES
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Alma Littles, MD, Dean and Chief Academic Officer, Florida State University College of Medicine – Testimony
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Lee Gross, MD, Founder, Epiphany Health Direct Primary Care – Testimony
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Jeffrey Smith, CPA, MBA, FACMPE, CGMA, Incoming Board Chair of Medical Group Management Association (MGMA) and Chief Executive Officer Piedmont HealthCare, PA – Testimony
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Corey Fiest, JD, MBA, Co-founder and Chief Executive Officer, Lorna Breen Heroes’ Foundation – Testimony
MEMBER DISCUSSION
Sen. Ashley Moody (R-FL) expressed concerns that the exodus of providers from traditional practices to direct primary care will lead to care not being accessible to all patients. Sen. Moody asked what Dr. Gross would recommend to ensure that patients served by traditional practices continue to have access to quality and affordable care. Dr. Gross responded that, in his view, a physician who leaves practice completely would be seeing zero patients, but a physician who moves to a direct primary care model is still seeing patients.
Ranking Member Gillibrand (D-NY) requested that Mr. Fiest explain how the wellbeing guide developed by his organization reduces physician burnout. Mr. Fiest shared that clinicians who practice in systems that have implemented the guide have experienced a decrease in time spent outside of direct patient care and increased levels of wellbeing, both of which have decreased burnout symptoms. Ranking Member Gillibrand also asked what the expected impact of the Wasteful and Inappropriate Service Reduction (WISeR) Model will be on administrative burden and burnout. Mr. Smith expressed concerns that the model will increase the need for prior authorizations and lead to more patients seeing delayed or denied care. Mr. Smith continued that these effects would lead to sicker patients and contribute to physician burnout. Ranking Member Gillibrand was also interested in how a mismatch in medical training and actual practice can drive burnout. Dr. Gross argued that current medical education does not teach practice management skills, which are crucial for physicians who want to practice outside of a large hospital system.
Sen. Raphael Warnock (D-GA) questioned what the effect of additional workforce shortages will have on health professionals. Mr. Fiest shared that reductions in staff will impact access, quality, and cost of health care as physicians need to take on greater amounts of administrative work. Sen. Warnock wondered if increasing the number of residency spots, through bills such as S.2439, could be part of a solution. Mr. Smith said that yes, any increase in slots would help, but they also need to incentivize residents to practice general primary care. Sen. Warnock questioned if the costs associated with medical school are dissuading students from entering the profession. Dr. Littles shared that costs are a large factor for students as they must support themselves through schooling. Dr. Littles also stated that students will make decisions on what type of medicine to practice based on salaries for different specialties.
Sen. Angela Alsobrooks (D-MD) asked what impactful, preventive system reforms could address the root causes of burn out. Mr. Fiest noted that reducing administrative burden, improving nursing safety, and preventing acts of violence would make the workload more manageable for providers. Sen. Alsobrooks then asked how the current prior authorization system contributes to physicians’ burdens and impacts the delivery of care. Mr. Smith explained that prior authorizations are delaying care, with more patients seeking care in urgent care or emergency rooms. Mr. Smith also highlighted that many administrative workers are experiencing high levels of burnout due to the workload and addressing administrative burdens would reduce turnover.
Chairman Rick Scott (R-FL) questioned how increased documentation requirements may reduce the desire to work in underserved areas. Dr. Littles shared that rural communities often do not have access to many electronic health record systems due to the high costs, and for systems that do have them, the complexity and lack of interoperability have a negative impact on the practice experience. Chairman Scott wanted to understand the general structure of Dr. Gross’s day. Dr. Gross shared that he has a greater capacity for same-day patients, which reduces his need to refer patients to the emergency room or specialists. Dr. Gross also has more time to manage his practice.
