July 1, 2025

Senate Passes Omnibus Budget Reconciliation Bill

The U.S. Senate has passed President Trump's domestic policy bill, which cuts trillions of dollars in taxes and slashes funding for Medicaid, SNAP food assistance, and clean energy programs. The final vote was 51-50 with Vice president JD Vance breaking the tie.

The Senate measure largely mirrors the version of the bill that House Republicans passed in May. Both would spend trillions to extend tax cuts enacted in 2017 while increasing funding to the military and immigration enforcement. However, the nonpartisan Congressional Budget Office (CBO) found that the Senate bill would add more than $3 trillion to the deficit over the next 10 years, with extension of the 2017 tax cuts making up the bulk of the cost. To offset these costs, the Senate bill cuts $930 billion from Medicaid and makes additional cuts to Medicare and the Affordable Care Act. The CBO estimates the measure will cause 11.8 million Americans to become uninsured, almost a million more than would have lost health insurance under the House version.

The cuts to Medicaid would be accomplished by imposing work requirements on able-bodied people, including some parents and older Americans, making sign-up eligibility more stringent, and changing federal reimbursement to states. A $50 billion rural hospital relief fund is included in the package to help rural and smaller hospitals around the country that are at risk of bankruptcy due to the steep Medicaid cuts.

The package now goes back to the House, where Congressional Republicans are working toward a July 4 deadline to pass the bill.

Apply Now for "Future Physicians of Idaho" Grant Awards

The Idaho Medical Association Foundation is pleased to announce that applications are now being accepted for the 2025 Future Physicians of Idaho Awards.

This year, the foundation will grant $30,000 to support medical students and residents/fellows committed to serving Idaho's healthcare needs. At least three grants will be awarded to 4th-year medical students graduating this spring who have matched to an Idaho residency and plan to stay and work in a medically underserved Idaho community. Another three will go to residents or fellows finishing training this spring - either in Idaho or out of state in a specialty not offered in Idaho - who also plan to practice in an underserved Idaho area and can show proof of an employment offer.

The overarching goal of the IMA Foundation is to support efforts to improve Idaho's physician workforce shortages and to improve the quality and accessibility of healthcare in Idaho. The IMA Foundation is a 501(c)3 charitable arm of the Idaho Medical Association.

IMA members can support the continuation of these awards by donating to the Foundation by texting the word "Give" to (208) 996-8776.

Applications must be submitted no later than July 7, 2025.

To apply, click the appropriate link below:

• Medical Student Application
• Resident/Fellow Application

The IMA Foundation is excited to provide support to the next generation of Idaho physicians. Please email sara@idmed.org with questions or call the IMA at 208-344-7888.

"Building Medical Systems in Idaho"

IMA Past-President Mary Barinaga, MD, Featured on The Ranch Podcast

Dr. Mary Barinaga is the Assistant Dean for the Idaho WWAMI Medical Education Program. In this interview, Dr. Barinaga discusses challenges and opportunities for bolstering the physician workforce in Idaho. Notably, more than one-quarter of the physicians currently practicing in Idaho are over the age of 60, precipitating a "silver wave" of upcoming retirements. Dr. Barinaga highlights the importance of engaging kids from an early age in understanding the rewards of being a doctor and serving their communities, as well as understanding resources that can help provide a successful path forward through their academic careers to medical school and into active practice.

The Ranch Podcast, hosted by Eagle resident Matt Todd, is conversational and informative, encompassing a broad spectrum of topics in a non-confrontational format that invites viewers to hear from speakers with varying perspectives on issues impacting the daily lives of Idahoans. Audio-only episodes are available through Apple Podcast and Spotify.

CMS to Audit All Medicare Advantage Plans Annually in Major Oversight Expansion

In a significant shift aimed at strengthening oversight of Medicare Advantage (MA) plans, the Centers for Medicare & Medicaid Services (CMS) announced on May 21, 2025 that it will begin auditing every Medicare Advantage plan annually. This marks a dramatic expansion from the agency's current practice of auditing approximately 60 plans per year to over 500.

Describing the move as part of an "aggressive" strategy to combat overpayments, CMS Administrator Mehmet Oz, MD, emphasized the agency's responsibility to ensure accurate billing. "While the administration values the work that Medicare Advantage plans do, it is time CMS faithfully executes its duty to audit these plans and ensure they are billing the government accurately for the coverage they provide to Medicare patients," Dr. Oz said. MA plans receive federal funding based on enrollees' documented health conditions, with higher payments allocated for sicker patients. However, the Medicare Payment Advisory Commission has estimated that up to $43 billion in overpayments may be issued each year due to diagnoses not supported by medical records.

To enforce its oversight, CMS conducts risk-adjustment data validation (RADV) audits, reviewing whether the diagnoses MA plans submit to justify payments are backed by patient health records. The agency will increase its auditing capacity substantially, expanding its team of from 40 to approximately 2,000 by September 1. Enhanced technology will also be deployed to support the medical record review process. CMS also intends to recover payments from previous years. In addition to the new annual audit policy, the agency will finalize outstanding audits from 2018 through 2024 and pursue uncollected overpayments. The last major recovery effort involved audits of plan year 2007.

Physicians in Medicare Advantage plans may face increased scrutiny as CMS audits focus on whether reported diagnoses are fully supported by medical records. Accurate documentation is critical to avoid denials and ensure proper reimbursement. With CMS emphasizing data integrity and compliance, providers should consider internal/independent audits to assess coding accuracy and prepare for potential impacts.

Read the press release HERE.

Grant Applications Open: Rural Health Care Access & Rural Physician Incentive Program