In this update:
- Federal Agencies
- CDC Director Monarez Fired After One Month; Kennedy Revokes Covid Booster EUAs
- HHS Seeking Nutrition Education Requirements in Medical Training
- Other Updates
- SCOTUS Allows Trump Administration to Cancel Some NIH Grants
- Federal Judge Partially Blocks Marketplace Integrity and Affordability Rule
- ACOG Updates Vaccine Guidance, Departing from HHS Recommendations
- Study Shows Medical School Admissions Impacts from SCOTUS Ruling
- Study Shows Cost of Arbitration from No Surprises Act
- New York State Updates
- DOH Issues Notice of Expiration for PACE Licensure and Application Regulations
- OPWDD Adopts Final Regulations on Supported Decision-Making
Federal Agencies
CDC Director Monarez is Fired After One Month; Kennedy Revokes Covid Booster EUAs
On August 27th, the Washington Post reported that CDC Director Dr. Susan Monarez was fired from her job after disagreeing with HHS Secretary Robert F. Kennedy Jr. over his changes to vaccine policy and her refusal to fire senior CDC leaders. Monarez was confirmed by the Senate on July 31st but had been acting director since January. HHS confirmed the story, offering that Dr. Monarez is “no longer director of the Centers for Disease Control and Prevention” and that the Secretary has full confidence that the remaining team “will continue to be vigilant in protecting Americans against infectious diseases at home and abroad.” At least four other CDC officials resigned following Dr. Monarez’s firing: Dr. Debra Houry, CDC Chief Medical Officer; Dr. Demetre Daskalakis, Director of the National Center for Immunization and Respiratory Diseases; Dr. Daniel Jernigan, Director of the National Center for Emerging and Zoonotic Infectious Diseases; and Dr. Jen Layden, Director of the Office of Public Health Data, Surveillance and Technology.
The departures coincide with Secretary Kennedy’s announcement that the FDA had revoked emergency use authorizations for Covid-19 vaccines, replacing them with narrower approvals. Moderna, Novavax, and Pfizer shots are now available only to higher-risk individuals – such as those with asthma, cancer and other conditions – and individuals 65 and over. The change also limits the Pfizer booster to children five and older, though it had previously been available to children as young as six months.
The Washington Post story is available here. Secretary Kennedy’s Covid-19 booster announcement is available here.
HHS Seeking Nutrition Education Requirements in Medical Training
On August 27th, HHS and the Department of Education announced an initiative “urging America’s leading medical education organizations to immediately implement comprehensive nutrition education and training.” The Departments are calling for nutrition education requirements to be embedded across pre-medical standards, medical school curricula integration, medical licensing examination, residency requirements, board certification, and continuing education. The announcement requires U.S. medical education organizations to submit written plans “detailing the scope, timeline, standards alignment, measurable milestones, and accountability measures of their nutrition education commitment” by September 10th.
The announcement is available here.
Other Updates
SCOTUS Allows Trump Administration to Cancel Some NIH Grants
On August 21st, the Supreme Court voted 5 to 4 to allow the Trump Administration to cancel over $780 million in grants the NIH deemed related to DEI, gender ideology, and other topics. The decision lifted an order by U.S. District Judge William Young that previously restored funding for the roughly 1,200 NIH grants, noting in his decision that ending the grants represented “racial discrimination and discrimination against America’s LGBTQ community.” Justice Kentanji Brown Jackson wrote her own dissent, calling the ruling “bizarre” and saying that the current Supreme Court seems to have a rule that “this Administration always wins.”
The Court, however, also voted – in a different 5 to 4 majority – to maintain a lower court ruling that the Trump Administration’s overall policy allowing the cuts is likely unlawful and should be paused. The mixed ruling means that canceled grants will not be reinstated, but that further cancelations may be prohibited, and that recipients of canceled grants may be able to pursue recourse in certain courts.
Federal Judge Partially Blocks Marketplace Integrity and Affordability Rule
On August 22nd, U.S. District Court Judge Brendan Hurson temporarily stayed seven provisions of CMS’s Marketplace Integrity and Affordability Rule scheduled to go into effect on August 25th. The rule included a wide array of changes to health insurance marketplaces such as shortened open enrollment periods, stricter eligibility requirements for subsidy recipients, and a prohibition on year-round sign-ups for low-income enrollees. CMS argued that the regulation was intended to limit improper enrollments and misuse of federal funds. It was challenged by the cities of Chicago, Columbus, and Baltimore, Doctors for America, and the Main Street Alliance, who argued that the rule violated the Administrative Procedures Act and ran afoul of the Affordable Care Act.
Judge Hurson’s ruling temporarily blocked a subset of the rule’s changes, including:
- $5 premium penalty on auto-enrollment;
- Disqualification for advance subsidy payment for consumers not filing income taxes and failing to reconcile taxes credits in a previous year;
- Elimination of guaranteed insurance coverage for individuals with past-due premiums;
- Verification of certain household income data;
- Pre-enrollment eligibility checks ahead of a special enrollment period; and
- Changes to the plan tier formula calculation.
A similar suit was filed by 20 state attorneys general in July, but no decision has been issued.
ACOG Updates Vaccine Guidance, Departing from HHS Recommendations
On August 22nd, the American College of Obstetricians and Gynecologists (ACOG) released updated clinical guidance regarding vaccination during pregnancy. The guidance supports and recommends Covid-19, flu, and RSV vaccines for all pregnant patients. It is a departure from HHS recommendations regarding Covid vaccination during pregnancy, which changed in May, when the federal government eliminated its recommendation for Covid vaccination during pregnancy. At the time, ACOG put out a statement criticizing the decision, noting that the organization was “extremely disappointed by the announcement” and that “despite the change in recommendations from HHS, the science has not changed.” The new guidance notes that Covid vaccines reduce morbidity from the virus’ complications in pregnant patients and their infants, and reduces pregnancy complications such as severe maternal morbidity, preterm birth, and stillbirth.
The ACOG guidance is available here.
Study Shows Medical School Admissions Impacts from SCOTUS Ruling
On August 26th, JAMA Network Open published a study, “Medical School Admissions After the Supreme Court’s 2023 Affirmative Action Ruling.” The authors studied 291,764 program applicants and matriculants to U.S. MD-granting medical schools from 2019 through 2023, and compared that data with applicants and matriculants in 2024, one year after the Supreme Court ruling in Students for Fair Admissions, Inc. v President and Fellows of Harvard College. Researchers found a 3.56 percentage point absolute decline in the share of matriculants from historically under-represented groups, a 1.94 percentage point decrease in white matriculants, and a 5.19 percentage point increase in Asian matriculants. The relative decrease in matriculants from groups underrepresented in medicine was 14.9%. The decline was concentrated in states without a preexisting state-level affirmative action ban.
The study is available here.
Study Shows Cost of Arbitration from No Surprises Act
On August 25th, Georgetown University researchers published a study in Health Affairs showing that the independent dispute resolution (IDR) process, established as part of the No Surprises Act, has generated at least $5 billion in total costs through the end of 2024. This figure includes roughly $2.24 billion in higher payments for services, $1.9 billion in plan and provider internal costs, $656 million in IDR entity fees, and $228 million in administrative fees. The cost estimate is based on roughly 3.3 million disputes filed from mid-2022 to May 2025, far higher than the 17,333 disputes estimated by federal agencies in the regulatory process. About 85% of these disputes had been closed by May 2025. The results run counter to original cost projections by the Congressional Budget Office, which assumed smaller awards and downward pressure on negotiations.
The full study is available here.
New York State Updates
DOH Issues Notice of Expiration for PACE Licensure and Application Regulations
On August 27th, the New York State (NYS) Department of Health (DOH) announced that the proposed Program for All-Inclusive Care for the Elderly (PACE) licensure and application regulations have expired. The change was authorized by legislation passed in 2022 and the regulations were initially proposed in August 2024 (see SPG summary here). The proposed regulations intended to consolidate the current requirements for PACE organizations under Article 28, Article 36, and Article 44 of New York’s Public Health Law into a single licensure under Article 29-EE.
The Notice of Expiration is available in the State Register here.
OPWDD Adopts Final Regulations on Supported Decision-Making
On August 20th, the NYS Office for People with Developmental Disabilities (OPWDD) adopted final regulations that facilitate the adoption of supported decision-making practices within the OPWDD service system. The regulations establish:
- New rules to implement provisions related to supported decision-making facilitation services;
- The duties, responsibilities, and eligibility of supporters under both formal and informal agreements;
- The differences between informal and formal agreements;
- The application of the presumption of capacity for individuals considering entering into such agreements;
- Notice requirements for eligible supporters; and
- The responsibilities of care management providers.
In response to public comment on the proposed rule, DOH made clarifying amendments and technical changes to the final regulations.
The Notice of Adoption, which includes a summary of public comments, is available in the State Register here.