In this update:
- Administration Updates
- President Trump Signs Executive Order on Eliminating Information Silos
- Acting CDC Director Susan Monarez Nominated as Full-Time Director
- President Trump Nominates March Bell for HHS Inspector General
- President Trump’s Health Nominees Advance in Senate
- Federal Agencies
- HHS Announces Department Restructuring
- HHS Announces AHEAD Hospital Global Budget Webinar
- DEA Again Delays Limits on Controlled Substance Prescribing Via Telehealth
- HHS Closes Office of Long Covid Research and Practice
- CDC Cancels $11.4 Billion in Covid-19 Grants
- HHS Publishes 2025 Updated Poverty Guidelines
- Other Updates
- Urban/RWJF Report Shows Potential Effects of Medicaid Work Requirements
- New York State Updates
- OASAS Adopts Final Rule that Sunsets Part 819 and Encourages Providers to Transition to Part 820
- CMS Approves NYS SPA Amending Pharmacy Reimbursement
Administration Updates
President Trump Signs Executive Order on Eliminating Information Silos
On March 20th, President Donald Trump signed an Executive Order (EO) entitled “Stopping Waste, Fraud, and Abuse by Eliminating Information Silos.” The principal objective of the EO is to promote “intra- and inter-agency sharing” of unclassified agency records.
Specifically, the EO orders the agencies to rescind or modify any guidance that may hinder access to unclassified records, data, software, and information systems. Agency heads must also ensure access to data from any state programs that receive federal funding. The Trump Administration believes that eliminating “information silos” will eliminate bureaucratic inefficiencies. The EO does not include any new cybersecurity provisions to protect against misuse or data breaches, the threat of which may increase with expanded access and users.
It is unclear how this EO will interplay with recent rulings by federal judges on DOGE’s attempts to access sensitive data from the Department of the Treasury and the Centers for Medicare & Medicaid Services (CMS).
The EO is available here.
Acting CDC Director Susan Monarez Nominated as Full-Time Director
On March 24th, President Donald Trump named Dr. Susan Monarez to serve as Director of the Centers for Disease Control and Prevention (CDC). Dr. Monarez is currently the Acting Director of the CDC, a role she assumed in January after serving as Deputy Director of the Advanced Research Projects Agency for Health (ARPA-H). Dr. Monarez, whose doctorate is in microbiology, is considered a leading infectious disease researcher and biosecurity expert by many in her field. Dr. Monarez has endorsed Covid-19 vaccines in the past. According to some report, Dr. Monarez has remained relatively quiet amid recent agency upheaval working with the Department of Government Efficiency (DOGE) to plan agency cuts. If confirmed by the Senate, Dr. Monarez will be the first nonphysician to lead the agency in over 50 years.
President Trump Nominates March Bell for HHS Inspector General
On March 24th, President Donald Trump nominated Thomas March Bell to lead the Department of Health and Human Services (HHS) Office of the Inspector General (OIG). Although the OIG is a traditionally non-partisan, watchdog role, March Bell currently serves as general counsel for House Republicans and has worked on Capitol Hill for decades. The Inspector General is charged with overseeing fraud, waste, and abuse audits across HHS. The previous HHS Inspector General was terminated along with a dozen other government watchdogs in January.
In 1997, March Bell was terminated from Virginia’s Department of Environmental Quality over improper use of funding. March Bell also spearheaded a 2016 House Republican investigation into Planned Parenthood’s use of fetal tissue for medical research. He previously worked in the Office of Civil Rights in the first Trump Administration.
President Trump’s Health Nominees Advance in Senate
On March 25th, the Senate confirmed Dr. Marty A. Makary (56-44) as Commissioner of the Food and Drug Administration (FDA) and Dr. Jay Bhattacharya (53-47) as Director of the National Institutes of Health (NIH).
Also on March 25th, the Senate Finance Committee voted to advance Dr. Mehmet Oz’s nomination as the Administrator of the Centers for Medicare & Medicaid Services (CMS) along party lines. The 14-13 party-line vote positions Dr. Oz to assume the position amid major debates over the future of Medicaid financing. A full Senate vote is expected in the coming days or weeks.
Federal Agencies
HHS Announces Department Restructuring
On March 27th, the Department of Health and Human Services (HHS) announced a department restructuring that involves eliminating 10,000 full-time employees. HHS estimates that this cut in workforce will save taxpayers $1.8 billion per year. Together with previous layoffs and voluntary departures, the total HHS workforce will drop from 82,000 to 62,000, over a 20% reduction. Specific details of the restructuring include:
- Agency Cuts: The Food and Drug Administration (FDA) will eliminate 3,500 employees (though HHS has stated these departures will not impact drug, device, or food reviews); the Centers for Disease Control and Prevention (CDC) and the Administration for Strategic Preparedness and Response (ASPR) will eliminate 2,400 employees; the National Institutes of Health (NIH) will eliminate 1,200 employees; and the Centers for Medicare & Medicaid Services (CMS) will eliminate 400 employees;
- Consolidating Agencies: HHS is planning to consolidate its current 28 divisions into 15, including:
- Creating the Administration for a Healthy America (AHA) through the combination of multiple agencies, including the Health Resources and Services Administration (HRSA) and Substance Abuse and Mental Health Services Administration (SAMHSA), among others;
- Absorbing ASPR into the CDC;
- Establishing a new Assistant Secretary for Enforcement to oversee the Office of Civil Rights, among others;
- Combining Assistant Secretary for Planning and Evaluation (ASPE) with the Agency for Healthcare Research and Quality (AHRQ) into an Office of Strategy; and
- Move programs within the Administration for Community Living (ACL) into other agencies.
- Regional Offices: Regional offices will be cut in half, from 10 to 5.
Secretary Kennedy claims that with the streamlining of duplicative functions and personnel across agencies, HHS will be better poised to execute their “priority of ending America’s epidemic of chronic illness.”
The announcement is available here, and the fact sheet is available here.
HHS Announces AHEAD Hospital Global Budget Webinar
On April 8th from 2:00 to 3:00pm ET, the Centers for Medicare & Medicaid Services (CMS) will host a webinar to review the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model CMS-designated Medicare fee-for-service hospital global budget methodology. The webinar will specifically review a new Version 3.0 of the financial specifications, including new enhancements, the “case for hospital participation,” and how CMS will calculate the payment amount for hospitals.
Registration is available here. Questions can be submitted in advance to AHEAD@cms.hhs.gov.
DEA Again Delays Limits on Controlled Substance Prescribing Via Telehealth
On March 2oth, the Drug Enforcement Administration (DEA) announced it would delay the effective dates of two rules that 1) expand prescribing of buprenorphine via telehealth and 2) allow controlled substance prescribing for patients at the Veterans Affairs (VA), until December 31st. The rules were set to take effect on March 21st. The buprenorphine rule would permanently allow providers to prescribe new patients a six-month supply of buprenorphine, a controlled substance to treat opioid use disorder (OUD), via telehealth. After that time, patients would need to see the provider in person. General telehealth prescribing flexibilities remain available through December 31st.
The announcement is available here.
HHS Closes Office of Long Covid Research and Practice
On March 24th, the Department of Health and Human Services (HHS) announced, via internal email, that it would be closing the Office of Long Covid Research and Practice as part of department-wide reorganization efforts. The Office was established in 2023 with the intention of supporting and improving care for individuals with Long Covid, while coordinating cross-government initiatives. According to the National Institutes of Health (NIH), as many as 23 million Americans have Long Covid. At his confirmation hearing, HHS Secretary Kennedy affirmed his commitment to ongoing investment in Long Covid research.
CDC Cancels $11.4 Billion in Covid-19 Grants
On March 24th, the Centers for Disease Control and Prevention (CDC) terminated $11.4 billion in funding to states, cities, and organizations for Covid-19 relief efforts. These funds were used for testing, vaccination, global projects, and community health worker (CHW) programs to address health disparities. States are still working to evaluate the impact of this rescission, but the affected states will likely shutter programming aimed at respiratory virus monitoring, public health lab operations, and immunization efforts.
Governor Hochul has stated that these cuts affect $300 million of funding across State agencies, while New York City’s Health Department is anticipating $100 million in cuts towards infectious disease prevention and surveillance. These cuts are separate from the Substance Abuse and Mental Health Services Administration (SAMHSA) cuts which affected about $90 million of supplemental block grant funding (SPG summary here).
HHS Publishes 2025 Updated Poverty Guidelines
The Department of Health and Human Services (HHS) has updated its poverty guidelines for 2025. The poverty guidelines are used as eligibility criteria for Medicaid and are adjusted annually based on the Consumer Price Index for all Urban Consumers (CPI-U). For 2025, the poverty guideline for an individual is $15,650 and $32,150 for a family of four.
More information on the poverty guidelines is available here.
Other Updates
Urban/RWJF Report Shows Potential Effects of Medicaid Work Requirements
On March 17th, the Urban Institute and Robert Wood Johnson Foundation (RWJF) released a report on the potential effects of Medicaid work requirements in expansion states. The authors found that:
- More than 5 million expansion adults could lose their Medicaid coverage under work requirements that require at least 80 hours of work per month (a policy set out in the Limit, Save, Grow Act);
- More than 9 in 10 expansion adults are already working, looking for a job, attending school, caring for family members or are in fair/poor health with reported disabilities (91% work some or part of the year); and
- If these requirements are extended beyond the expansion population, more than 30 million adults could be subject to them.
The report is available here.
New York State Updates
OASAS Adopts Final Rule that Sunsets Part 819 and Encourages Providers to Transition to Part 820
On March 26th, the New York State (NYS) Office of Addiction Services and Supports (OASAS) adopted a final rule that officially sunsets Part 819 “Substance Use Residential Services”, effective February 28, 2026. Providers authorized under Part 819 will need to obtain an operating certificate under other provisions prior to the sunset, such as Part 820 “Residential Services.” OASAS will provide a one-time payment of up to $205,000 to assist with program conversions (details here). The main difference in converting to Part 820 is that it enables providers to bill for their services.
The final rule is available here. Additional details are available on the OASAS website here and in the State Register here. Technical assistance may be addressed to PICIM@oasas.ny.gov.
CMS Approves NYS SPA Amending Pharmacy Reimbursement
On March 25th, CMS approved New York’s State Plan Amendment (SPA) that updates the reimbursement methodology of covered prescription and physician-administered drugs. Specifically, the SPA removes the 3.3% reduction from the Wholesale Acquisition Cost (WAC) for the reimbursement of brand name prescription drugs. Drugs administered or provided during a physician office visit will be reimbursed at the lesser of the National Average Drug Acquisition Cost (NADAC), WAC, federal/state limits, or the actual cost, without a dispensing fee. This change is effective retroactive to October 1, 2024.
The SPA is available here. The CMS approval letter is available here.