This month's policy signals for health systems:
W&M Committee advances PFS stabilization, home health bills
House Ways and Means (W&M) Committee advances multiple health bills, including a proposal to stabilize physician pay: W&M Committee Chair Jason Smith (R-MO-08) says the legislative suite will “[deliver] more care to seniors in their homes and the communities where they live” if fully passed. The collection of bills includes the Provider Reimbursement Stability Act of 2026 (H.R. 8163), which would improve and modernize the Medicare Physician Fee Schedule (PFS) by increasing the budget-neutral payment threshold and indexing it to inflation. The bill would also bar the Centers for Medicare and Medicaid Services (CMS) from making changes to the PFS that would result in year-to-year changes greater than 2.5 percent and require the agency to compare policy change cost estimates with actual utilization data. Other bills advanced include the Main Street Pharmacy Access Act (H.R. 3164), the Improving Home Dialysis Act of 2026 (H.R. 8875), and the Removing Barriers to Work for Disabled Americans Act (H.R. 8884). Read the W&M Committee press release and more at the Committee for a Responsible Federal Budget and Inside Health Policy.
CMS trying to further restrict SDPs
CMS releases proposed rule to further restrict state-directed payments, codifying provisions of the One Big Beautiful Bill Act (OBBBA): The Medicaid Managed Care State Directed Payments (SDP) and Medicaid Fee-for-Service (FFS) Targeted Practitioner Payments Proposed Rule would cap SDP provider payment rates at 100% of Medicare payment rates for expansion states, and 110% for non-expansion states. Under the rule, similar limits would also be applied to certain targeted Medicaid fee-for-service payments and CMS would establish “consistent national standards to improve transparency and accountability.” CMS Administrator Mehmet Oz said the rule “restores balance” to Medicaid, and the agency predicts the rule would reduce Medicaid spending by $775 billion over the next decade—with most of the savings being realized by the federal government. Access the proposed rule’s Fact Sheet and read more at Modern Healthcare, Healthcare Dive, and Inside Health Policy.
RWJF launches healthcare affordability campaign
Robert Wood Johnson Foundation (RWJF) announces patient advocacy coalition campaign on healthcare affordability: “One Nation, Overcharged” will be led by 12 national partners and organizes more than 130 advocacy groups in health and civics communities, aiming to “surface people in America’s longstanding frustrations with unaffordable, inequitable health care in national and local conversations that demand a health care system that puts people over profits.” The group will host events across the country, including ‘creative installations’, with a corresponding digital communications and multi-channel advertising campaign that will leverage celebrities and other national spokespersons. Access the RWJF press release, the campaign website, and read more at Forbes and Inside Health Policy.