1. insights
  2. the academy 360
  3. health policy and advocacy
  4. washington update september 2026
Report | the-executive-insights-hub

Washington Update - September 2026

Graphic with a blue background featuring the text “Washington Update 360°” alongside The Health Management Academy logo in the bottom left corner.
Related Topics:
Health Policy and Advocacy Payer StrategyPopulation Health
Relevant Roles:
Government Affairs/Policy Chief Executive Officers Chief Financial Officers

Washington Update - September 2026

OIG reports Medicare overspent on ineligible drugs

Department of Health and Human Services (HHS) Office of Inspector General (OIG) releases report on Medicare Part D payments for ineligible drugs: OIG estimates that the Centers for Medicare and Medicaid Services (CMS) has made $587.7 million in ineligible payments for over the counter (OTC) drugs that had been labeled prescription only. OIG’s audit investigated years 2021 to 2023 and said the spending was on five drugs that had been switched to OTC by the Food and Drug Administration more than a year prior. OIG blames CMS for the inaccurate payments and recommended the agency enhance its oversight on the issue. Access OIG’s report and read more at Healthcare Dive.

New CMS guidance updates oversight of CAH eligibility

CMS releases memo updating guidance for determining compliance with rural and distance requirements for critical access hospitals (CAHs): Beginning September 20, CMS will immediately review the distance criteria used to certify CAHs when a new hospital opens in the same area as an existing CAH and will require states to recertify eligibility at 10-year intervals. Previous guidance required eligibility reviews only after a complaint had been filed or at three-year intervals. Access the CMS memo and read more at Modern Healthcare.

Medicaid work requirements, spotty work hours may drive coverage loss

Researchers suggest as many as 10 million adult expansion population Medicaid enrollees could be at risk of losing coverage due to inconsistent work hours: Authors analyzed the working hour requirements set forth by CMS last year and the prevalence of being at risk of noncompliance to better understand how variable and/or part-time work hours may impact disenrollment from Medicaid. They estimate that 19.8% of those enrollees that are potentially subject to work reporting requirements and working are at risk of noncompliance, which could lead to disenrollment and loss of coverage. Access the study in JAMA Health Forum and read more at Fierce Healthcare.