Consumers, Employers Make Joint Call For Price Transparency Reform
A coalition of consumer advocates, employers and health‑payer groups is urging Congress to pass a price‑transparency law that would require providers to disclose the true cost of treatments and prescription drugs at the point of care. The proposal also calls for uniform patient cost sharing and provider reimbursement across all outpatient settings, from hospitals to retail pharmacies. The National Alliance of Healthcare Purchaser Coalitions, Small Business Majority and Families USA argue that immediate cost visibility will curb surprise billing and help employers manage rising health‑care expenses. The initiative reflects growing pressure on policymakers to address escalating drug prices and out‑of‑pocket burdens.
White House Urges Mississippi To Reject Rx Fee Bill Over Drug Price Concerns
The White House is urging Mississippi legislators to reject a Senate‑amended bill that would impose a uniform $11.29 dispensing fee on every prescription. Federal officials argue the flat charge could raise out‑of‑pocket costs and undermine national drug‑price reduction efforts. The...
Medical Groups Press DHS To Prioritize Doctors In Immigration Processing
Leading medical societies have urged the Department of Homeland Security to create a national interest immigration category that would fast‑track physicians and medical trainees. The request follows the recent detention of two Venezuelan doctors in Texas, underscoring how immigration delays...
WV Legal Case Upholds Vaccine Mandates Without Religious Exemption
An appeals court in West Virginia upheld the state’s policy allowing school districts to impose vaccine mandates without offering religious exemptions. The ruling comes amid recent changes to the CDC’s Advisory Committee on Immunization Practices (ACIP) charter, which have intensified...
CMS Proposes To Scale Mandatory Joint Replacement Model Nationwide
The Centers for Medicare & Medicaid Services (CMS) announced a proposal to expand its Comprehensive Care for Joint Replacement (CJR) model nationwide, making it mandatory for all Medicare‑eligible hospitals. The model bundles payments for hip, knee and ankle replacements, covering...
CMS Showcases Progress Made On Four Medicare Tech Projects
The Centers for Medicare & Medicaid Services (CMS) showcased progress on four of its five Health Technology Ecosystem projects at an HHS event on April 9. The agency emphasized advancements in AI‑driven claims processing, data interoperability, telehealth integration, and cybersecurity...
AFGE: Plan To Access Fed Workers’ Health Data Likely Violates HIPAA
The White House Office of Management and Budget has unveiled a plan to obtain personally identifiable medical records from the insurers that cover federal employees and their families. The American Federation of Government Employees (AFGE), the nation’s largest federal‑worker union,...
AMA CEO Outlines Key Goals As New Digital Health/AI Center Staffs Up
American Medical Association CEO John Whyte announced the staffing of a new Center for Digital Health and AI, positioning it to shape policy as digital medicine expands. The center will convene a meeting next month with a leading digital‑medicine coalition...
Court Orders FDA To Provide Update On Mifepristone Review Before Midterms
A Louisiana district judge ordered the FDA to issue an update on its Risk Evaluation and Mitigation Strategy (REMS) review for the abortion medication mifepristone within six months. The mandate arrives as the Trump administration faces pressure to clarify its...
Nursing Homes, Providers Mixed Over Proposed 2.4% Bump In Fiscal 2027 Pay
The Centers for Medicare & Medicaid Services (CMS) has proposed a 2.4% increase in Medicare reimbursement rates for skilled nursing facilities (SNFs) for fiscal year 2027. The nursing‑home lobby praised the move as a practical boost to Medicare payments, while...
Judge Again Tells Trump Admin To Recognize VA Health Workers’ Union
A federal judge has again ordered the Trump administration to recognize the collective bargaining agreement for health‑care workers at the Department of Veterans Affairs. The ruling insists the government comply “in both form and substance,” effectively overturning prior attempts to...
Experts Warn MA Auto Enrollment Would Limit Choice, Raise Costs
Health policy experts are warning that the Centers for Medicare & Medicaid Services is exploring automatic enrollment of Medicare beneficiaries into Medicare Advantage (MA) plans. They argue the move could curtail seniors' ability to choose alternative coverage and drive up...
FTC Lauds PBM, Insulin Efforts As Triumphs To Justify 2027 Budget Request
The Federal Trade Commission has submitted a FY2027 budget request of $426.7 million and 1,183 full‑time positions. The request emphasizes continuing its consumer‑protection agenda, notably the 2024 administrative complaint accusing pharmacy‑benefit managers (PBMs) of inflating insulin prices. It also funds an...
ONC To Issue Payment Rules, Work With OCR During Fiscal 2027
The Trump administration’s FY 2027 budget request outlines that the Office of the National Coordinator for Health Information Technology (ONC) will issue new rules updating payment policy and will collaborate with the HHS Office for Civil Rights (OCR) to strengthen patient...
EPA’s Draft CCL6 Adds Microplastics, Drugs In MAHA Alignment
The Environmental Protection Agency released a draft of its sixth Contaminant Candidate List (CCL6) that formally includes microplastics and pharmaceutical residues as chemical groups for possible future drinking‑water regulation. The move mirrors demands from the Make America Healthy Again (MAHA)...
Lilly Weight-Loss Pill First Novel Drug Approved Under CNPRV
Eli Lilly’s anti‑obesity pill Foundayo (orforglipron) became the first new molecular entity approved under the FDA Commissioner’s National Priority Voucher (CNPRV) pilot. The FDA granted approval just 50 days after Lilly filed the NDA, well ahead of its 294‑day target deadline. Foundayo’s...
CDC Not Testing For Pox Viruses Amid Mpox Outbreaks, Treatment Concerns
The Centers for Disease Control and Prevention has removed smallpox, mpox and rabies from its routine testing portfolio, even as mpox outbreaks flare in several nations. The agency’s website update confirms the suspension, raising alarms among clinicians who rely on...
Digital Rights Advocates Sue CMS Over WISeR, Dems Urge House Approps To Repeal Model
Digital rights group Electronic Frontier Foundation has filed a lawsuit against the Centers for Medicare & Medicaid Services demanding transparency for the Wasteful and Inappropriate Service Reduction (WISeR) model, which automates Medicare prior‑authorization decisions. The suit argues the model violates...
CMS LEAD Model Incorporates Telehealth, AI, Wearables, Interoperability
The Centers for Medicare & Medicaid Services (CMS) unveiled its Long‑term Enhanced ACO Design (LEAD) model, expanding accountable care organization (ACO) benefits to a larger share of Medicare beneficiaries. The model embeds new interoperability mandates and makes technology adoption—such as...
FDA Open To More Data On Rare Disease Drug Ersodetug Despite Missed Phase 3 Endpoint
Rezolute announced that the FDA remains open to reviewing additional data from its Phase 3 trial of the rare‑disease hypoglycemia drug ersodetug, despite the study missing its primary efficacy endpoint. The agency’s willingness suggests the experimental therapy could still move toward...
Bipartisan Bill Would Set Up Permanent Full-Risk ACO Program In Traditional Medicare
Lawmakers introduced a bipartisan bill on March 26 to establish a permanent, full‑risk accountable care organization (ACO) program within traditional Medicare. The legislation seeks to transition successful CMS Innovation Center pilots into a lasting model that places financial risk on...
Proposed FTC, CVS Agreement Underway To Settle Inflated Insulin Costs Allegations
The Federal Trade Commission and CVS Caremark have reached a settlement that resolves all claims alleging the pharmacy‑benefit manager inflated insulin prices through anticompetitive rebate practices. Court filings on March 23 indicate the agreement ends the FTC’s lawsuit in its...
Hawley Seeks Internal Data From Danco As Telehealth Abortions Rise
Sen. Josh Hawley (R-MO) has demanded that Danco Labs, the maker of mifepristone and misoprostol, turn over any internal communications it has had with the FDA, telehealth providers, pharmacists, patients, state medical boards, and attorneys general concerning the safety of...
CMMI AI Lead Bullish On Future Of ACCESS Model, Downplays Tech Focus
CMS Innovation Center’s AI and technology chief expressed strong confidence that the upcoming ACCESS payment model, built around outcome‑aligned payments (OAPs), will quickly gain traction in Medicare, Medicaid, and private insurers. He emphasized that the model’s focus on aligning payments...
Doctors for America Raises PDUFA, CNPV, Bayesian, Supply Chain Concerns With Lawmakers
Doctors for America met with bipartisan lawmakers to flag several regulatory concerns at the FDA. The group warned that “America First” provisions in the upcoming PDUFA negotiations could increase user fees and hinder drug access, while the agency’s reliance on...
Confusion Swirls Over ACIP, Vaccine Policy Future After Court Ruling
A federal court has halted the CDC’s Advisory Committee on Immunization Practices (ACIP) recommendations, throwing the Trump administration’s vaccine policy into uncertainty. Officials are weighing whether to appeal the decision or dissolve the current panel and appoint new members. The...
TrumpRx List Grows To 54 Drugs, Many Nearing End Of Exclusivity
The TrumpRx website now lists 54 prescription drugs after adding seven products from GlaxoSmithKline and Amgen. The expansion pushes the total from 47 to 54, but health‑policy analysts note that the majority are older medicines nearing the end of their...
Advocates Press Agencies For Guidance On New Medicare Eligibility Restrictions For Certain Immigrants
Advocates have warned that the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) have not yet issued public guidance on new Medicare eligibility restrictions targeting certain immigrant groups. The restrictions, embedded in the Republican‑led reconciliation...
ACO Leaders Say Mandatory Models Could Expand Value-Based Care, But Incentives Must Be Right
CMS Innovation Center Director Abe Sutton signaled a push to enroll more providers in mandatory ACO payment models. In interviews, ACO executives said mandatory models could significantly expand the reach of value‑based care, but their success hinges on how CMS...
FDA Leucovorin Approval Raises Concerns About Reliance On Case Reports
The FDA granted approval for leucovorin calcium tablets to treat a rare genetic disorder that impairs folate transport to the brain. Unlike typical approvals, the agency relied primarily on a handful of patient case reports rather than a sponsor‑run clinical...
FDA Advisor Touts Approach Tailoring Regulation To Specific AI Use
The FDA’s artificial‑intelligence advisor announced a shift toward evaluating AI‑driven health technologies on a case‑by‑case basis, focusing on each tool’s specific function rather than applying a one‑size‑fits‑all rule set. This risk‑based approach will tailor regulatory requirements to the actual clinical...
Public Citizen To Push Compulsory Licensing If Pfizer Withholds Drugs From France
Public Citizen announced it will encourage compulsory licensing of generic drugs if Pfizer follows through on its January threat to withhold medicines from France unless the country raises drug prices. The consumer group’s stance turns a pricing dispute into a...
Senate Dems Ask How Trump’s MFN Deals Mesh With GENEROUS Model
Senate Democrats have pressed major pharmaceutical companies to clarify the secretive most‑favored‑nation (MFN) pricing agreements they struck with the Trump administration in December. Lawmakers are questioning how those deals align with the Centers for Medicare & Medicaid Services’ new GENEROUS...
ACOs Meet With Hill Staff On MACRA Reform
Accountable Care Organizations met with congressional staff last week to discuss reforms to the Medicare Access and CHIP Reauthorization Act (MACRA) after a bipartisan request for information was issued. The meeting aimed to explore long‑term solutions for physician payment that...
Prasad Out At FDA, Turning Critics’ Focus Back To Makary
Vinay Prasad, the FDA’s controversial biologics chief, has announced his departure, marking his second exit within a year. His resignation follows a public dispute over the agency’s handling of rare disease drug approvals, intensifying scrutiny of FDA decision‑making. Critics are...
CMS Gives States Two Options To Transition To Six-Month Medicaid Eligibility Checks
The Centers for Medicare & Medicaid Services (CMS) announced that beginning in 2027 states must move Medicaid eligibility checks from annual to six‑month intervals for the expansion population. States have two pathways: an immediate transition for all eligible beneficiaries or...
New Eli Lilly Platform To Expand Obesity Drug Options For Employers
Eli Lilly launched an Employer Connect platform on March 5, linking more than 15 independent program administrators with a nationwide pharmacy and telehealth network to broaden discounted access to its obesity drugs, notably the GLP‑1 Zepbound (tirzepatide) pen. The service targets employer‑sponsored...
Poll: Career Scientists, Outside Experts Trusted More Than HHS Leaders
A recent Annenberg Public Policy Center poll reveals that career scientists and independent experts enjoy higher public trust than leaders of the U.S. Department of Health and Human Services (HHS). Trust in federal public‑health agencies has declined steadily since the...
HHS Says About 50 Medical Schools Will Add Nutrition Training To Curricula
The U.S. Department of Health and Human Services announced that about 50 medical schools across 31 states will add at least 40 hours of nutrition training to their four‑year undergraduate curricula starting this fall. The initiative, driven by HHS Secretary...
CMS Eyes AI To Tackle Coding Under ‘CRUSH’ Anti-Fraud Plan
The Centers for Medicare & Medicaid Services (CMS) is evaluating artificial‑intelligence tools to improve the precision of Medicare Advantage coding and hospital billing. The initiative is part of the Trump administration’s proposed CRUSH (Combatting and Reducing Unnecessary Spending and Healthcare...
Johnson Floats ‘Right To Try 2.0’ As Makary Defends FDA’s Approval Standards
Senator Ron Johnson (R‑WI) is urging Congress to draft a “Right to Try 2.0” bill that would force the FDA to grant broader, faster access to experimental therapies for rare diseases. FDA Commissioner Martin Makary pushed back, defending the agency’s...
AHA Unveils ‘We Care, We Vote’ Campaign To Engage Candidates Ahead Of Midterms
The American Hospital Association (AHA) has launched the “We Care, We Vote” campaign to mobilize its member hospitals ahead of the 2026 midterm elections. The initiative offers a dedicated website featuring voter‑registration tools, turnout guides, and a questionnaire that helps...
Top HHS Officials Tout TEFCA Data-Sharing Framework As Central To MAHA
Top officials at the Department of Health and Human Services highlighted the Trusted Exchange Framework and Common Agreement (TEFCA) as a cornerstone of the "Make America Healthy Again" (MAHA) initiative. TEFCA, mandated by the 2016 bipartisan law, seeks to create...
CBO: Part D Contributed To Higher Medicare Spending Than Expected
The Congressional Budget Office’s latest 10‑year budget outlook reveals that Medicare spending will be higher than previously projected, largely due to the Part D prescription‑drug benefit. CBO estimates the drug benefit adds several hundred billion dollars to federal outlays over the...
Cassidy, GOP Colleagues File Brief In LA Case On Comstock Act
Senate health committee chair Bill Cassidy and 59 Republican lawmakers filed an amicus brief supporting Louisiana’s lawsuit that the FDA violated the 1870 Comstock Act by permitting telehealth prescribing of mifepristone. The brief argues the agency overstepped its authority, seeking...
Oz: Codifying MFN Deals Could Avert ‘Draconian’ Pricing Measures
Pfizer CEO Albert Bourla met with CMS Administrator Mehmet Oz to negotiate a "most‑favored‑nation" (MFN) drug pricing agreement, though the specific terms were not disclosed. Oz indicated that the Trump administration plans to codify such voluntary MFN deals into law...
Oz: Codifying MFN Deals Could Avert ‘Draconian’ Pricing Measures
Pfizer CEO Albert Bourla disclosed a direct collaboration with CMS Administrator Mehmet Oz on a "most favored nation" (MFN) drug pricing arrangement, though the specific terms remain undisclosed. Oz indicated that the Trump administration intends to codify such voluntary MFN...
Pediatric Myopia Drug Is Latest In String Of Unexpected FDA Rejections
The FDA has rejected a pediatric myopia drug, citing a lack of substantial evidence for its efficacy. Pediatric ophthalmologists argue the drug, already used in compounded form, effectively slows myopia progression in children. The decision follows a series of recent,...
FDA Backtracks On Moderna mRNA Flu Vaccine Refusal, Sets Aug. 5 Review Deadline
The U.S. Food and Drug Administration has reversed its earlier decision to decline a review of Moderna's mRNA influenza vaccine candidate. Following a Type A meeting with the company, the agency set an August 5, 2026 deadline for completing its evaluation. The...
Judge’s Ruling Expected On Whether To Block ACIP Meeting
A federal judge is set to rule this week on a lawsuit seeking to prevent the CDC’s Advisory Committee on Immunization Practices (ACIP) from convening. The plaintiffs argue the committee, whose members were appointed by HHS Secretary Robert F. Kennedy...