In this update:
- Trump Administration
- Trump Revokes Biden EO on Competition
- Federal Agencies
- HHS Launches MAHA in Action Tracker
- CBO Reports OBBBA Could Trigger $491 Billion Medicare Sequester
- CMS Seeks to Accelerate Disenrollment of Noncitizens from Medicaid
- HHS/CMS Establishing Healthcare Advisory Committee
- CMS Announces Crushing Fraud Chili Cook-Off Competition
- Other Updates
- AMA Publishes AI Governance Toolkit for Health Systems
- AAP Breaks from CDC in Vaccine Schedule Recommendations
- Federal Judge Vacates MA Marketing Rules
Trump Administration
Trump Revokes Biden EO on Competition
On August 15th, President Trump rescinded a Biden-era Executive Order (EO) – “Executive Order on Promoting Competition in the American Economy” – intended to promote market competition through antitrust enforcement. The Biden EO specifically expressed concern with hospital consolidation, especially in rural communities, and the rising cost of prescription drugs. The EO rescission was not accompanied by new policy, but the Department of Justice and the Federal Trade Commission expressed support for the move, noting that the original EO was based on “undue hostility towards mergers and acquisitions.”
President Biden’s original EO is available here.
Federal Agencies
HHS Launches MAHA in Action Tracker
On August 18th, HHS launched “MAHA in Action,” an interactive tool to communicate the Trump Administration’s initiatives regarding food, health, and public safety systems. The tracker includes information on Secretary Kennedy’s priority areas: removing petroleum-based food dyes, overhauling the Generally Recognized as Safe (GRAS) standard, launching Operation Stork Speed, autism, vaccine safety, and others. The site also includes a map following Secretary Kennedy’s MAHA tours, and a list of newly-enacted state policies aligned with MAHA priorities.
The tracker can be found here.
CBO Reports OBBBA Could Trigger $491 Billion Medicare Sequester
On August 15th, the Congressional Budget Office published an update on the sequestration process for 2025, specifically whether enacted legislation has exceeded established limits triggering a cancellation of budgetary resources. For 2025, CBO estimates that discretionary spending will not exceed the caps and that no sequestration will be required for this year.
Also on August 15th, CBO sent a letter to Senators Sheldon Whitehouse (D-RI), Ron Wyden (D-WA), Jeff Merkley (D-OR), and Representative Brendan Boyle (PA-02) on the effects of potential sequestration due to the One Big Beautiful Bill Act. CBO estimates that the bill will increase the deficit by $3.4 trillion over the 2025-2034 period relative to the January 2025 baseline, leading to a $45 billion Medicare sequester for fiscal year 2026, and a total $491 billion sequester over the 2027-2034 period. Congress has the power to reduce or reverse this sequester.
CBO’s sequestration update is available here. CBO’s letter to Democratic leaders is available here.
CMS Seeks to Accelerate Disenrollment of Noncitizens from Medicaid and CHIP
On August 19th, CMS announced the launch of an oversight initiative to ensure that Medicaid and Children’s Health Insurance Plan (CHIP) enrollees meet federal citizenship or immigration status requirements. Each month, CMS will provide states with reports identifying enrollees whose citizenship or immigration status could not be confirmed via federal sources. States must then review each case, verify the citizenship or immigration status of each identified enrollee, and, when necessary, disenroll ineligible individuals. CMS stated in its press release, “We expect states to take quick action and will monitor progress on a monthly basis.” The first reports were sent to states on August 19th and all states should receive a report over the course of the next month.
A press release is available here.
HHS/CMS Establishing Healthcare Advisory Committee
On August 21st, HHS and CMS jointly announced the creation of a Healthcare Advisory Committee to provide “strategic recommendations” to both Secretary Kennedy and CMS Administrator Dr. Mehmet Oz on “how care is financed and delivered across Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.” The Committee will specifically focus on:
- Actionable policy initiatives to promote chronic disease prevention and management;
- Opportunities for a regulatory framework of accountability for safety and outcomes that reduce unnecessary red tape and allow providers to focus on improving patient health;
- Levers to advance a real-time data system, enabling a new standard of excellence in care, rapid claims processing, rapid quality measurement, and rewards;
- Structural opportunities to improve quality for the most vulnerable in the Medicaid program; and
- Sustainability of the Medicare Advantage program, identifying opportunities to modernize risk adjustment and quality measures to assess and improve health outcomes.
CMS is currently accepting nominations for members, particularly seeking individuals with expertise in chronic disease prevention and management, federally-administered health care financing, and delivery system reform.
More information on submitting nominations is available here. Nominations will be accepted for 30 days.
CMS Announces Crushing Fraud Chili Cook-Off Competition
On August 19th, CMS announced the Crushing Fraud Chili Cook-Off Competition. The Chili Cook-Off is a market research-based challenge focused on using machine learning (ML) artificial intelligence (AI) models to identify trends in Medicare fee for service claims data that can be translated into novel indicators of fraud. The Chili Cook-Off will involve two phases. In Phase 1, CMS invites research proposals which are due September 19th. On October 20th, CMS will announce 10 teams selected to move into Phase 2. Selected teams will receive access to CMS’ Limited Data Sets claims data on October 30th and apply their proposed AI/ML techniques to the data. A summary of findings and recommended scalable analytic and policy solutions are due December 1st and the winner will be announced December 15th.
A press release is available here and more information is available here.
Other Updates
AMA Publishes AI Governance Toolkit for Health Systems
On August 18th, the American Medical Association published a toolkit – “Governance for Augmented Intelligence” – for health systems developing AI policies. The toolkit, developed in collaboration with Manatt Health, is an eight-step guide for health systems “to establish a governance framework to implement, manage, and scale AI solutions.” The eight foundational pillars of AI adoption include: establishing executive accountability and structure; forming a working group to detail priorities, process, and policies; assessing current policies; developing AI policies; defining project intake, vendor evaluation, and assessment processes; updating standard planning and implementation processes; establishing an oversight and monitoring process; and supporting AI organizational readiness.
The toolkit can be found here.
AAP Breaks From CDC in Vaccine Schedule Recommendations
On August 19th, the American Academy of Pediatrics (AAP) published its own vaccination schedule with updated guidance on influenza, RSV, and Covid-19 vaccinations, among others, for individuals from birth to age 18. In a break from tradition, the AAP’s recommendations differ from those of the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP). In a press release, AAP asserts that ACIP now includes individuals who have a history of spreading vaccine misinformation. Notably, the AAP schedule offers more explicit guidance on Covid-19 vaccination, while the CDC recommends “shared clinical decision-making in children’s Covid-19 vaccinations.
The AAP announcement is available here.
Federal Judge Vacates MA Marketing Rules, Citing End of Chevron Deference
On August 18th, Judge Reed O’Connor, of the U.S. District Court of the Northern District of Texas, vacated several provisions of an April 2024 final rule promulgated by CMS related to the marketing of Medicare Advantage (MA) plans. Judge O’Connor ruled that CMS exceeded its statutory authority, citing the Supreme Court’s elimination of the Chevron deference, and violated the Administrative Procedures Act when it tried to limit what Medicare Advantage plans can pay marketers. The rule had been under a stay since July of 2024 while legal proceedings were underway. The judge did uphold a provision of the rule that banned third-party marketing firms from sharing beneficiaries’ personal data with other firms.
Judge O’Connor’s ruling is available here.