|
Administration News
HHS
(9/2) Americans to Gain New Access to Real-Time Prescription Drug Price Information - HHS finalized a rule requiring certified health IT systems to support real-time prescription drug cost transparency, electronic prior authorization, and seamless data exchange between providers, payers, and pharmacies starting October 1. The reform, backed by CMS and health insurers, aims to reduce red tape, cut costs, and accelerate patient access to timely, physician-approved treatments.
CMS
(9/2) CMS Announces Changes to Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model to Improve Quality, Promote Transparency, and Decrease Costs - CMS announced policy and operational updates to the AHEAD Model, extending its end date to December 31, 2035, and giving states new tools to manage Medicare costs, strengthen prevention, and improve population health. The changes include a new Population Health Accountability Plan, expanded transparency requirements, and two-sided risk arrangements for geographically attributed Medicare beneficiaries, supporting CMS’s broader goals of choice, competition, and sustainable cost growth.
HHS
(9/3) HHS Announces Crackdown on Health Data Blocking - HHS announced it will increase enforcement against health care entities that engage in information blocking, reinforcing patient rights to access, exchange, and use their electronic health information under the 21st Century Cures Act. Led by ASTP/ONC and the HHS Office of Inspector General, the initiative includes potential penalties, program disincentives, and certification consequences for violators, while encouraging patients and providers to report suspected cases.
HHS
(9/9) MAHA Commission Unveils Sweeping Strategy to Make Our Children Healthy Again - The Make America Healthy Again Commission, chaired by HHS Secretary Robert F. Kennedy Jr., released a national strategy with more than 120 initiatives aimed at addressing childhood chronic disease. The plan outlines executive actions on food safety and labeling, reforms to Medicaid quality metrics, expanded research into prevention and nutrition, and new efforts to increase public awareness and strengthen collaboration across sectors.
CMS
(9/9) CMS Issues Guidance to Strengthen Oversight of Medicaid State Directed Payments - CMS issued preliminary guidance to states on new federal payment limits for Medicaid State Directed Payments (SDPs), required under the One Big Beautiful Bill Act, to strengthen program integrity and reduce fraud, waste, and abuse. Effective for rating periods beginning July 4, 2025, the limits will cap certain payments at Medicare-based rates, with a temporary grandfather period through 2028, while ensuring states can continue using SDPs as a tool to support access to care.
ASTP
(9/10) New Data on the Certified Health IT Market Now Available - – ASTP announced that new 2023 datasets link hospitals and clinicians in Medicare’s Promoting Interoperability programs with the specific certified EHR technologies they use. Hospital data is only for 2023 so far; clinician data spans 2019–2023.
HHS
(9/15) CMS Launches $50 Billion Rural Health Transformation Program - CMS released guidance for states to apply for the $50 billion Rural Health Transformation Program, created under the OBBA, to strengthen rural health systems by expanding access, improving quality, and supporting workforce development. In addition to infrastructure and technology investments, funds may be used to help rural providers, including independent practices, transition into value-based care arrangements such as alternative payment models and two-sided risk ACOs, supporting prevention, case management, and sustainable payment reforms that align with CMS Innovation Center models and Medicare Advantage.
|
