10/30/2020: This Need to Know provides an overview of the congressional agenda for lame duck 2020, including FY 2021 appropriations and potential COVID-19 relief.
10/2/2020: Challenges facing the Biden-Harris transition team…MACPAC’s examination of Provider Relief Fund recipients…A list of the Administration’s health care executive orders.
9/25/2020: Highlights of COVID Task Force’s third appearance before HELP Committee…The HHS response to Azar’s new rulemaking authorities…The push to delay the Radiation Oncology Model.
9/18/2020: The latest EO on drug pricing…HELP Committee’s review of the COVID-19 response…Preview of “EUA-plus” for COVID-19 vaccine.
9/11/2020: New stakeholder reactions to drugmakers’ 340B policies…HELP Committee hearing on vaccines…MedPAC discussion on the future of telehealth.
8/14/2020: E&C inquiry into insurers’ profits…Pharma stakeholders’ reactions to Buy American EO…Challenges to boosting availability of antigen tests.
8/7/2020: Safety-net providers’ latest concerns over 340B…Current agreements between US government and COVID-19 vaccine developers…New EO to help rural health providers.
7/31/2020: Stakeholder reactions to EOs on drug pricing…Summary of the Healthcare Workforce Resilience Act…HHS report on surprise medical bills.
7/24/2020: Update on Provider Relief Fund…E&C Oversight Subcommittee hearing on vaccine development…DC federal appeals court rulings on short-term plans, site-neutral payment cuts.
7/17/2020: The Biden-Sanders proposal for universal coverage…Recommendations from Senate HELP Democrats on the COVID response…Proposal on more flexibility for grandfathered plans.
7/10/2020: On the possibility of mail-in voting in the fall…How pooled testing can help track COVID-19…Recent House activity on FY21 appropriations.
7/2/2020: ACA in focus amid COVID-19 pandemic…CMS proposal to permanently expand home health telehealth…Pending mental health legislation in the House.
6/26/2020: Lawmakers’ calls for transparency with Provider Relief Fund…Liability concerns for nursing homes with COVID-19 cases…Hospitals’ push for CMS to resume Advance Payment Program.
6/19/2020: Status of HHS Provider Relief Fund distributions…Calls for coronavirus liability protections in next relief bill…MedPAC’s calls to hasten transition to value-based payment.
6/12/2020: Senate Finance Committee’s hearing on unemployment insurance during COVID-19…Upcoming referendums in Oklahoma, Missouri on Medicaid expansion…The complicated summer 2020 calendar for Congress.
6/5/2020: The Administration’s new proposal to ban surprise medical bills…Newly announces changes to CMMI models due to COVID-19…Insurers’ waivers on out-of-pocket costs for virus-related treatments.
5/22/2020: COVID-19’s impact on 340B hospitals…The new vote by proxy rules in the House…Temperature check requirements in airports.
5/15/2020: The new push among lawmakers to raise budget caps…Highlights from final NBPP for 2021…BPC panel on how coronavirus will impact rural hospitals.
5/8/2020: Brookings webinar on telehealth after COVID-19…CMS interim final rule on helping ACOs during the pandemic, increasing access to testing…Stakeholder suggestions on the next COVID-19 relief bill.
3/27/2020: How Section 1135 waivers are helping states adapt to COVID-19…The latest hearing for the lawsuit on short-term plans…Status of pending proposed and final rules.
3/13/2020: AAF report on shortcomings of Maryland’s All-Payer Model…Overview of CMMI’s Part D Senior Savings Model.
3/6/2020: Supreme Court’s decision to review ACA for the third time…CAP report on gerrymandering’s impact on Medicaid expansion…CMMI’s selection of applicants to participate in ET3 model.
2/28/2020: The new HHS strategy to reduce EHR administrative burden…CMMI’s proposal to extend CJR model for three years…New research on role of private equity in medicine.
2/14/2020: Overview of proposed rule on MA and Part D…Highlights from BPC report on bipartisan approaches to health care reform…Possible next steps for surprise billing legislation.
2/7/2020: Highlights of proposed NBPP for 2021…Summary of providers’ criticism of proposed MFAR….Verma’s recent comments on HRAs, price transparency.
1/31/2020: The latest Medicaid waiver proposal from CMS…BCBSA’s new partnership with a nonprofit drug manufacturer…ACP’s recommendation for universal coverage.
1/17/2020: Findings from NEJM study that dispels effectiveness of hotspotting…Pending SCOTUS review of state PBM regulations…Hospital groups’ latest lawsuit against site-neutral payment cuts.
1/10/2020: Summary of providers’ comments on proposed reforms to Stark Law, Anti-Kickback Statute…Stakeholder responses to new drug importation proposals…Review of 2020 Open Enrollment Period
12/20/2019: Implications of the Fifth Circuit ruling for the ACA…Newly proposed rules on organ donation…Health care extenders in FY 2020 minibus.
12/13/2019: Highlights from MedPAC’s discussion on MA…The latest in the legal battle over the public charge rule…Key 2020 presidential election dates.
12/6/2019: Where things stand on unpopular ACA taxes…Stakeholder resistance to drug importation plan…Preview of Hahn’s FDA agenda.
11/22/2019: Providers’ reactions to new transparency rules…W&M’s RFI on rural health…New outlook for Medicaid expansion in KY, LA, and VA.
11/15/2019: Newly proposed CMS rule to address misuse of Medicaid supplemental payments…Status of drug pricing legislation…Overview of rulemaking and RFIs pending review at OMB.
11/1/2019: The latest on Texas v. Azar…Highlights from the Republican Study Committee’s new health care plan…CMMI’s requests for application for the Primary Care First and Kidney Care models.
10/25/2019: Status of the FY 2020 appropriations process…Pending action on health care legislation this year…Highlights from Kaiser Family Foundation’s annual report on Medicaid.
10/18/2019: Highlights from CBO’s report on the Lower Drug Costs Now Act…New executive orders on guidance documents…Suspension of public charge rule’s implementation.
9/27/2019: CMS’ final rules on discharge planning, burden reduction…Grassley’s quest for GOP support of bipartisan drug pricing bill.
9/20/2019: Pelosi’s new drug pricing plan…The status of legislation to address surprise medical bills…Highlights from hearing on prior authorization.
9/13/2019: New program integrity requirements for Medicare, Medicaid, and CHIP…update on who the White House will nominate to lead FDA and CMMI….overview of 2020 retirement announcements in Congress.
7/26/2019: The status of health care legislation as August recess begins…Seema Verma’s criticism of public option proposals…OIG’s findings on characteristics of high-performing ACOs.
7/19/2019: CMS’ reversal of Obama Administration ban on arbitration agreements for nursing home residents…Update on ACA taxes following Cadillac tax repeal…New proposal to reduce Medicaid access reporting requirements.
7/12/2019: The Administration’s plans to overhaul kidney care…Proposed CY 2020 payment rates for home health care providers…Paul Mango, the new deputy policy chief at CMS.
6/28/2019: The new EO on price transparency…Ways and Means advances bills to promote telehealth, expand GME…Health care highlights from first Democratic debates.
6/21/2019: Highlights from MedPAC’s June 2019 Report to Congress…CMS’ proposed rule to streamline prior authorization…Pharma’s lawsuit against Administration over new requirements on drug prices in TV ads.
6/14/2019: The latest RFI form CMS on Patients over Paperwork…Highlights from hearing on impact of student debt on medical professionals…The Administration’s final rule on health reimbursement arrangements.
6/7/2019: Overview of final rule on PACE…Initial resistance to forthcoming executive order on price transparency…New legislation to streamline prior authorization.
5/24/2019: CMS’ final rule on Medicare Advantage and Part D drug pricing…National coverage determination on CAR T-cell therapy delayed…Overview of Senate HELP Committee leaders’ bipartisan proposal to reduce health care costs.
5/17/2019: The recently-passed ACA, generic drug bill in the House…Overview of White House’s principles on legislation to address surprise medical bills…The Administration’s final rule on drug prices in TV ads.
5/10/2019: Senate Finance hearing on MACRA in its third year…Status of the FY 2020 appropriations process…Recently-passed House bills on drug pricing, pre-existing conditions.
5/3/2019: The latest plans from CMS to reform primary care…CBO weighs in on single-payer…House subcommittee passes FY2020 LHHS appropriations bill.
4/12/2019: Overview of CMS’ final rule to promote telehealth in MA…Ned Sharpless, the FDA’s new acting commissioner…E&C Oversight Subcommittee’s hearing on high insulin prices.
4/5/2019: President Trump’s decision to move forward on ACA replacement after 2020 elections…Federal judge says association health plans rule violates the ACA and ERISA…Azar’s third congressional appearance on HHS budget.
3/29/2019: House Democrats’ new bill to increase access to insurance coverage…The DOJ’s decision to affirm the district court ruling in Texas v. Azar…Highlights from Brookings discussion on solutions to surprise medical bills.
3/15/2019: President Trump’s FY 2020 budget request…RFI from CMS on selling insurance plans across state lines…New efforts to address concerns over hospital mergers and acquisitions.
3/8/2019: Republican Senators’ push to examine drug rebates…The latest Medicare-for-All proposal…A busy week of hearings on drug prices.
3/1/2019: Stakeholder feedback on proposed NBPP for 2020…New RFI on grandfathered group health plans…Recap of Azar’s State of the Department address.
2/22/2019: CMMI’s new model on emergency medical services…Overview of recently-introduced Medicare buy-in legislation…New projections on 2017-2028 health care spending.
2/15/2019: The newly proposed CMS rule to advance interoperability…Azar’s remarks on drug prices, value-based care…Summary of bipartisan bill to boost support for Medicare-funded GME.
2/8/2019: Reactions to the proposed changes to drug rebates…Health care highlights from the State of the Union…Azar’s remarks on drug prices at AcademyHealth conference.
2/1/2019: New efforts to address surprise medical bills…Senate Finance Committee’s first hearing this year on drug prices…Gottlieb’s remarks on using real world evidence in FDA clinical trials.
1/25/2019: Overview of new Part D, updated MA VBID models…The proposed Notice of Benefit and Payment Parameters for 2020…Health priorities of top E&C Democrats.
1/18/2019: Democrats’ concerns of shutdown’s effect on premium tax credits and marketplace enrollment…AG nominee William Barr’s health care positions…The Trump Administration’s new guidance on Medicaid.
1/11/2019: Status update on the partial government shutdown…overview of the new rules package for the 11th Congress…summary of PAHPA, Medicaid extenders.
12/20/2018: What the district court ruling in Texas means for the ACA…Recommendations for implementing Medicaid DSH cuts…The farm bill’s health care provisions.
12/14/2018: Overview of five Medicaid bills passed in the House on December 11…How the IMPROVE Act would penalize companies that misclassify drugs…The bipartisan maternity health bill headed to the White House.
12/7/2018: The Administration’s new Section 1332 waiver concepts for states…New recommendations on increasing competition and choice in health care…The collapse of bipartisan budget reform efforts.
11/30/2018: An overview of CMS’ proposed rule on Medicare Advantage and Part D drug pricing…Azar’s remarks on hospitals potentially using Medicaid dollars to pay for housing…An update on the CREATES Act.
11/16/2018: Where things stand on the makeup of the 116th Congress…An update on efforts to reform the budget and appropriations process…Key health care agenda items for Congressional Democrats next year.
10/19/2018: A recap of major 2018 health care legislation.
10/4/2018: The prospects for Tax Reform 2.0…Seema Verma’s comments on Medicare, Medicaid at the Atlantic Festival…Overview of stakeholder comments on proposed OPPS, ASC payment system changes.
9/27/2018: The conference agreement on opioids legislation…Summary of the Supporting Grandparents Raising Grandchildren Act…Health care reactions to proposed changes to public charge rule.
9/20/2018: A look at CMS’s proposed rule to reduce regulatory burdens on providers…An update on legislation to eliminate the gag clause….HELP Committee’s hearing on how improving transparency can address high health care costs.
9/13/2018: Status report on LHHS appropriations for FY 2019…An overview of Tax Reform 2.0…Summaries of four Medicare bills passed in the House.
8/2/2018: Highlights from CMS’ proposed rule on OPPS and ASC payment rates…Senate HELP Committee’s hearing on reducing administrative spending in health care…The return of risk adjustment payments.
7/26/2018: An overview of health care bills recently passed in the House…FDA’s new working group on drug importation…Details of drug manufacturers’ announcements on price reductions and price freezes.
7/19/2018: CMS’ latest cuts to the Navigator Program…Overview of HSA and insurance bills approved by House Ways and Means Committee…A brief look at proposed Physician Fee Schedule and Quality Payment Program changes for Contract Year 2019.
7/12/2018: A look at Brett Kavanaugh, Trump’s pick for SCOTUS…CMS’ proposed home health payment changes for 2019…Key points from the Administration’s plan to reorganize the federal government.
6/28/2018: The latest plan by conservative organizations to repeal the ACA…The health care priorities of House Republicans’ FY19 budget resolution.
6/22/2018: How the ACA is factoring into the midterms…The DOL’s final rule on association health plans…House GOP proposals to expand health savings accounts.
6/18/2018: A look into DOJ’s decision to defend the ACA’s consumer protections…Alex Azar’s testimony before the Senate HELP Committee on the President’s drug pricing plan…Cuts to CHIP and CMMI in House-passed rescissions bill.
6/6/2018: A preview of the Congressional healthcare agenda for this summer…An update on projected premium increases and Medicaid expansion in the states…Key takeaways from the annual Medicare Trustees report.
5/18/2018: Status of efforts in the House and Senate to combat the opioid crisis…An overview of the Administration’s blueprint to lower drug prices…Update on states’ efforts to seek waivers for individual market and Medicaid programs.
5/10/2018: White House to unveil plan to reduce drug prices…HHS delay of 340B price ceiling rule…Significant increases in CY19 insurance premiums in early rate filings.
4/19/2018: Highlights from CBO’s Budget and Economic Outlook for 2018-2028…An executive order to explore expanding work requirements and direct reevaluation of safety net programs…New Jersey’s new law to reinstate the individual mandate penalty and fund a reinsurance pool.
4/12/2018: An overview of the final 2019 MA rule to increase plan payments by 3.4%…More state flexibility in plan year 2019 ACA benefits and payment final rule…The White House’s consideration of rescission process to roll back omnibus spending.
3/29/2018: Health provisions in the $1.3 trillion omnibus spending package…The White House plan to combat opioid addiction…FDA’s advance notice of proposed rulemaking regarding implementation of a product standard to lower nicotine in cigarettes to non-addictive levels.
3/15/2018: Highlights from speeches by HHS Secretary Azar, FDA Commissioner Gottlieb and CMS Administrator Verma.
3/8/2018: Individual insurance market stabilization measures and the omnibus…Congressional and DOJ action on opioids…Center for American Progress proposal called “Medicare Extra.”
2/28/2018: A blueprint for improving the nation’s health care system from a bipartisan group of governors… The House Energy and Commerce Health Subcommittee hearing on bipartisan legislative proposals to address the opioid epidemic… The President’s Council of Economic Advisors annual report on the administration’s domestic and international economic policy priorities.
2/22/2018: The House Energy and Commerce Subcommittee on Oversight and Investigations on the effects of consolidation within the health care industry…Our take on Idaho’s proposal to allow the sale of non-ACA compliant individual market plans and state action to expand their Medicaid programs.
2/14/2018: Trump administration’s Fiscal Year 2019 Department of Health and Human Services budget proposal…Insurance market stabilization efforts…A report on 2018 ACA enrollment.
2/7/2018: Highlights from Part II of the draft Medicare Advantage and Part D Call Letter Rate Notice… Congressional and FDA efforts to address the opioid crisis…The recent Amazon/Berkshire/JPM Healthcare partnership announcement.
2/1/2018: Health insurance market stabilization measures…340B Drug Pricing Program legislation…State Medicaid activity.
1/18/2018: CMS guidance on state Medicaid work requirement demonstrations…The House Energy and Commerce Committee Republicans’ release a report on the 340B Drug Pricing Program and 2018 FDA priorities.
1/10/2018: The Department of Labor regulations on association health plans…Hospitals’ lawsuit on 340B…Advance Notice of calendar year 2019 methodological changes for the Medicare Advantage Risk Adjustment Model.
12/20/2017: The Trump administration’s Fall 2017 Unified Agenda and federal agencies’ regulatory priorities for FY18…December’s Medicaid and CHIP Payment and Access Commission meeting…Newly-passed Republican tax legislation.
12/13/2017: Outstanding health care items on the congressional to-do list…MedPAC’s consideration of proposed changes to post-acute care payment systems…Preview of FDA’s public meeting in January on ways to better ensure the safe use of opioids.
12/6/2017: Senate HELP Committee hearing on Alex Azar’s nomination to serve as HHS secretary… CMS’ cancellation of the Episode Payment Models, Cardiac Rehabilitation Incentive Payment Model, plus changes to the Comprehensive Care for Joint Replacement Model…A look at end-of-year health care legislation.
11/30/2017: Health care provisions in the tax reform legislation…Overview of 2019 Medicare Advantage and Prescription Drug Benefit proposed rule…Preliminary 2018 ACA enrollment data.
11/7/2017: A look at final CMS rules on CY18 Hospital Outpatient and Ambulatory Surgical Center, Home Health, and Physician Fee Schedule.
10/31/2017: Proposed CMS rule on federally-facilitated and state-based exchange plan benefit and payment parameters for CY19…Senate Finance Committee’s draft proposal on Medicare Extenders…CMS’ End-Stage Renal Disease final CY18 payment rule.
10/25/2017: Congress’ and the Administration’s approach to the national opioid crisis…The White House’s health care priorities…Section 1332 waiver updates.
10/11/2017: A look at the CHRONIC Act…Overview of ACA market stabilization efforts…Recent efforts by states to impose transparency requirements on pharmaceutical pricing.
10/5/2017: The status of Medicare extenders…Proposed 340B reimbursement reductions…The search for a new HHS secretary.
9/27/2017: Recap of activity around Graham-Cassidy…RFI on changes to the Center for Medicare and Medicaid Innovation…A list of upcoming regulations from HHS.
9/20/2017: Update on Graham-Cassidy…A look at the President’s Opioid Commission report…Pending CHIP legislation.
9/13/2017: Senate HELP Committee’s bipartisan hearings on ACA stabilization…Overview of CR/debt limit extension…The status of Graham-Cassidy-Heller’s ACA replace legislation.
8/9/2017: Highlights of the recently-passed FDA User Fee legislation…Quick guide on pending legislative priorities for September…Appropriations tracker and chart on increases in the statutory debt ceiling since 1990.
5/17/2017: Recently-approved FDA user fee legislation by the Senate HELP Committee plus the drug pricing debate…The challenges of extending the CHIP in a bipartisan way…Insurer announcements that are driving the current debate over the ACA’s insurance exchanges.
5/4/2017: The FY2017 omnibus appropriations agreement so far…The CREATES Act and generic drug competition…The President’s tax reform proposal and its effects on health-related tax items.
4/6/2017: Roundup of ACA news stories…A look at Democratic drug pricing legislation…The impact of proposed budget cuts to the National Institutes of Health.
3/24/2017: Vote on the American Health Care Act suspended…Senate Finance Committee Ranking Member Ron Wyden’s legislation on pharmacy benefit managers…HHS Secretary Tom Price and CMS Administrator Seema Verma letter to governors on the Medicaid program.
3/16/2017: The President’s FY 2019 Budget Request, with a focus on HHS’ budget priorities.
3/15/2017: CBO score of the American Health Care Act…President Trump to nominate Steven Gottlieb for FDA Commissioner…State flexibility under Section 1132 waivers.
3/10/2017: Review of committee markups of the American Health Care Act…House Education and the Workforce Committee’s markup of health legislation.
3/1/2017: Budget outlook for Fiscal Years 2017 and 2018…Highlights of recently-introduced legislation to allow drug importation…The leaked House Republican draft of legislation to repeal and replace the ACA.
2/22/2017: Summary of the House Republican policy proposal on repealing and replacing the Affordable Care Act…CMS’ proposed rule on ACA market stabilization…CMS Actuary’s National Health Expenditure Report.
2/10/2017: House Energy and Commerce Committee’s legislation on generic drug pricing…Senate Finance Committee’s contentious nomination hearing on Rep. Tom Price for HHS Secretary…Recently-introduced legislation to stop the Independent Payment Advisory Board process.
1/26/2017: House Ways and Means Oversight Subcommittee’s hearing on the ACA’s individual mandate…President Trump’s recent Executive Order on the ACA…Republican plans for repealing and replacing the ACA.
1/20/2017: The recent focus on drug pricing in Congress…Senate Finance Committee Republicans’ roundtable with Republican Governors on Medicaid reform…The latest on efforts to repeal and replace the ACA in Congress.
1/11/2017: Divisions among Senate Republicans over timeline and strategy for ACA repeal and replacement…Summary of House Ways and Means Health Subcommittee’s draft legislation on value-based purchasing for post-acute care…Overview of changes in committee leadership in the 115th Congress.
1/5/2017: Senate Aging Committee’s bipartisan report on generic drug price increases…Highlights of legislation on Congress’ ability to block regulations…Overview of the confirmation process for President-elect Trump’s cabinet nominees.