CMS to End Several Payment Models
The CMS Innovation Center announced it will end several payment models to align with statutory obligations and strategic goals. CMS expects to end the Maryland Total Cost of Care Model, the Primary Care First Model, the End-Stage Renal Disease (“ESRD”) Treatment Choices Model, and the Making Care Primary Model by December 31, 2025. CMS expects to save $750 million by ending the models early. CMS will also consider reducing the size of the Integrated Care for Kids Model. Additionally, CMS will no longer pursue the previously announced, but not yet implemented, Medicare Two Dollar Drug List Model and the Accelerating Clinical Evidence Model.
MedPAC Issues 2025 Report to Congress on the Medicare Payment Policy
The Medicare Payment Advisory Commission (“MedPAC”) issued its report to Congress recommending changes to the Medicare fee-for-service (“FFS”) payment system. MedPAC recommended that for 2026, Congress update the 2025 Medicare base payment rates for general acute care hospitals by the amount specified in the current law plus 1%, redistribute existing disproportion-share-hospital and uncompensated-care payments through the Medicare Safety-Net Index (“MSNI”) using the mechanism described in the March 2023 report, and add $4 billion to the MSNI pool. MedPAC also recommended that Congress replace the current-law updates to the Medicare payment rates for physicians and other health professional services with a single update, equal to the projected increase in the Medicare Economic Index minus 1%, and enact the March 2023 recommendations to establish safety-net add-on payments under the physician fee schedule for services delivered to low-income Medicare beneficiaries. MedPAC also made recommendations pertaining to outpatient dialysis services, skilled nursing facility services, home health care services, inpatient rehabilitation facility services, and hospice services.
New Executive Order Rescinds Executive Order Addressing COVID-19
The President of the United States announced his administration will rescind several executive orders and former presidential actions, including Executive Order 13994 of January 21, 2021, titled “Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats” (“EO 13994”). EO 13994 directed the Secretary of HHS, alongside secretaries of other executive agencies, to designate a senior official to serve as an agency lead to work on COVID‑19 and pandemic-related data-related issues. Additionally, EO 13994 directed the designated agency official and a COVID-19 Response Coordinator to make data relevant to high-consequence public health threats, such as COVID-19, publicly available and accessible. Additionally, the COVID-19 Response Coordinator, alongside representatives from various executive agencies, were tasked to share the data they collected with State, local, tribal, and territorial authorities.
CMS Administrator Nominee Dr. Mehmet Oz Testifies at Senate Confirmation Hearing
Dr. Mehmet Oz, President Donald J. Trump’s nominee to serve as the next Administrator for the Centers for Medicare & Medicaid Services, testified at his confirmation hearing before the Senate Finance Committee. Lawmakers asked Dr. Oz about, among other issues, Medicaid, prescription drug costs, maternal health care, and rural health care. Dr. Oz obtained his M.D. from the University of Pennsylvania School of Medicine. Dr. Oz gained fame as a regular guest on the Oprah Winfrey Show and went on to be a prominent television host. If confirmed, Dr. Oz would oversee Medicare, Medicaid, and private insurance plans. Dr. Oz would also oversee CMS’s $1.2 trillion budget.
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