Congressional:

House E&C Oversight and Investigations Subcommittee Holds Hearing on CMS Response to Medicare and Medicaid Fraud

On Tuesday, the House Energy and Commerce Oversight and Investigations Subcommittee held a hearing examining the role of the Centers for Medicare and Medicaid Services (CMS) in reducing Medicare and Medicaid fraud, with CMS Deputy Administrator Kim Brandt testifying. Brandt detailed the Centers for Medicare and Medicaid Services' (CMS) aggressive, data-driven approach to combatting fraud, waste, and abuse, emphasizing a shift to prevention and a "stop-and-cop" model. Republicans, led by Subcommittee Chair John Joyce (R-PA), emphasized that there is widespread fraud in Medicare and Medicaid, particularly in sectors like durable medical equipment (DME), hospice, genetic testing, and skin substitutes. Democrats argued that the administration is weaponizing fraud allegations, using them to target Democratic-led states with funding cuts that threaten services for vulnerable populations. Read Mehlman’s hearing summary here.

House E&C Health Subcommittee Holds Hearing on Providers and Lowering the Cost of Healthcare

On Wednesday, the House Energy and Commerce Health Subcommittee held its third hearing in the series on health care affordability, examining providers. During the hearing, Republicans focused on structural market failures, such as consolidation, lack of price transparency, and anti-competitive behavior, which they argued were exacerbated by the Affordable Care Act (ACA). Their proposed solutions centered on market-based reforms like increasing competition, enforcing transparency, and repealing regulations that favor large systems over independent providers. Democrats pointed to the One Big Beautiful Bill Act (H.R. 1) for cutting Medicaid and the failure to extend the ACA’s enhanced Premium Tax Credits (EPTCs), arguing that these actions increase the number of uninsured, strain hospitals, and raise costs for everyone. Witnesses included the American Hospital Association CEO Richard Pollack, American Medical Association Chair David Aizuss, American Academy of Family Physicians CEO R. Shawn Martin, Purchaser Business Group on Health CEO Elizabeth Mitchell, University of California San Francisco Health physician Anthony DiGiorgio, and American Network of Community Options and Resources Biography CEO Barbara Merrill. Read Mehlman’s hearing summary here.

House Ways & Means Health Subcommittee Holds Hearing on Improving Kidney Health Through Better Prevention and Innovative Treatment

On Wednesday, the House Ways and Means Health Subcommittee held a hearing to examine the challenges in kidney disease prevention, treatment, insurance choice and access, and care delivery, with a focus on access to care, innovation, and patient outcomes for individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD). During the hearing, members discussed barriers to early detection and prevention, limitations in Medicare payment policy, disparities in access to treatment, and opportunities to expand access to home dialysis and transplantation rates, and to improve support for innovation in kidney care. Read the witness testimonies here.

House Appropriations Labor-HHS-Education Appropriations Subcommittee Holds Oversight Hearing on the NIH

On Tuesday, the House Appropriations Labor-HHS-Education Subcommittee held an oversight hearing on the National Institutes of Health (NIH) with NIH Director Jay Bhattacharya testifying. During the hearing, Ranking Member Rosa DeLauro (D-CT) stated that the Office of Management and Budget (OMB) approved the NIH's apportionments on Monday night, allowing the agency to spend the fiscal 2026 funding Congress appropriated. Bhattacharya also told the subcommittee that the NIH would spend all appropriated grant funds this year, avoiding disruptions that occurred last year. Republicans focused much of their questioning on rebuilding trust with federal health agencies after the COVID-19 pandemic. Read Bhattacharya's testimony here.

Senator Wyden, Senate Democrats Unveil Plans to Lower Health Costs

On Thursday, Senate Finance Committee Ranking Member Ron Wyden (D-OR) and eleven Senate Democrats circulated a “dear colleague” letter to Senate colleagues announcing a new initiative to lower the cost of health care and improve health coverage. The letter outlines three goals that will be the focus of policy development within the group in the coming weeks and months: reverse Republican cost increases, simplify health care for families, and take on corporate greed. While several Finance Committee members have proposals and bills addressing these topics, the plan is to initiate a process rather than select specific legislation for the package, with the goal of producing legislative text in 2027. Read the press release here and the letter here. 

Notable Bills:

Senator Cassidy Introduces Bill to Expand Mental Health Care for Seniors

On Wednesday, Senator Bill Cassidy, M.D. (R-LA), introduced the Removing Medicare Mental Health Inpatient Limitations Act to eliminate the Medicare 190-day lifetime cap on inpatient psychiatric care. Under Section 1812 of the Social Security Act, Medicare inpatient psychiatric care is limited to 190 days over a lifetime. Read the press release here and the bill here.

Representatives DelBene, Miller, & Schrier Introduce Bill to Remove Financial Barriers for Living Organ Donors

On Tuesday, Representatives Suzan DelBene (D-WA), Carol Miller (R-WV), and Kim Schrier, MD (D-WA) introduced legislation to provide greater support for living organ donors and address the rising costs of donation. The Expanding Support for Living Donors Act would increase the maximum reimbursement amount to $10,000 and tie it to inflation. The bill would also double the income eligibility to about $100,000 a year. Read the press release here and the bill here.

Senator Young and Warnock Introduce Bill to Increase Access to Medical Care for Americans with Diabetes

On Tuesday, Senators Todd Young (R-IN) and Raphael Warnock (D-GA) introduced the Diabetes Foot Health Access and Modernization Act, legislation that would increase access to diabetic shoes for more Americans. Read the press release here and the bill here.

Representative Allen Introduces the PBM Kickback Prohibition Act

Late last week, on Friday, Representative Rick Allen (R-GA), Chairman of the Health, Employment, Labor, and Pensions (HELP) Subcommittee, introduced the PBM Kickback Prohibition Act. This legislation would amend the Employee Retirement Income Security Act of 1974 (ERISA) to prohibit pharmacy benefit managers (PBMs) from paying kickbacks or referral fees to brokers, consultants, advisors, or similar intermediaries in exchange for directing employer health plan or insurer business to the PBM. Read the press release here and the bill here.

Executive Branch:

CMS Announces Manufacturer Participation in Third Cycle of Medicare Drug Price Negotiation

Late last week, on Friday, the Centers for Medicare & Medicaid Services (CMS) announced that the drug companies that manufacture the 15 drugs payable under Medicare Part B and/or covered under Medicare Part D selected for the third cycle of negotiations in the Medicare Drug Price Negotiation Program have chosen to participate. The press release and list of drugs can be found here.

Legal & Other:

Federal Judge Rules RFK Jr. Improperly Reshaped US Policy on Transgender Health Care

On Thursday, Judge Mustafa T. Kasubhai of the US District Court for the District of Oregon ruled that Health Secretary Robert F. Kennedy Jr. did not go through the proper administrative procedures in December when issuing a declaration, that called treatments like puberty blockers, hormone therapy and surgeries unsafe and ineffective for children and adolescents experiencing gender dysphoria, and warned doctors that they could be excluded from federal health programs like Medicare and Medicaid if they provide these treatments. The ruling grants preliminary relief to health professionals who provide the treatments. The judge also denied the government’s motion to dismiss the case. The case is Oregon et al. v. Kennedy et al.

Federal Judge Blocks ACIP's Changes to Vaccine Schedule

On Monday, Judge Brian Murphy of the US District Court for the District of Massachusetts issued a preliminary injunction, pausing the Advisory Committee on Immunization Practices’ (ACIP) decision to reduce the number of recommended childhood vaccines until Murphy can rule on the merits of a lawsuit brought forward by the American Academy of Pediatrics and other medical groups. The decision also pauses the appointments of 13 members Kennedy selected for the ACIP. “Plaintiffs have demonstrated that the harms described above will continue to arise out of further ACIP actions,” Murphy wrote. “While Defendants argue that it is merely ‘speculative’ that ACIP will take any votes at a future meeting, the Court finds the evidence both credible and compelling that a vote is likely at ACIP’s upcoming meeting.” A spokesperson for the US Department of Health and Human Services said the ACIP meeting is now postponed. The case is Am. Academy of Pediatrics v. Kennedy. Read the preliminary injunction here.