President Trump Signs One Big Beautiful Bill into Law. The bill has wide-ranging health policy implications, which will impact the Medicaid program, provider payments, and health insurance coverage. The bill made significant changes to Medicaid, including work requirements, limitations on provider taxes and state-directed payments, and narrower eligibility rules with more frequent verification checks. The law includes a 2.5 percent increase to the Medicare Physician Fee Schedule for 2026. A4H was pleased to see this provision in place of one the House originally passed that would have removed incentives for advanced alternative payment model (APM) participants. A timeline with effective and implementation dates can be found here. Congress will now turn their attention to government funding and several health care extenders that will expire later this year such as Medicare telehealth flexibilities and the Hospital-at-Home program, a delay to Medicaid Disproportionate Share Hospital cuts, and reauthorizations for Community Health Centers. Other “leftover” health care policies could be in play including an extension of APM incentive payments.

Senate HELP Considers Health Cybersecurity and Privacy. The Senate Health, Education, Labor, and Pensions Committee held a hearing titled, “Securing the Future of Health Care: Enhancing Cybersecurity and Protecting Americans’ Privacy.” Discussion focused on the challenges providers face in trying to adhere to cybersecurity protocols, the need for modernized security and data privacy standards, and the impact of wearables and increasingly available health technology.

CMS Seeks Applicants for New Prior Authorization Model for Traditional Medicare. CMS’ new Wasteful and Inappropriate Service Reduction (WISeR) model seeks to use artificial intelligence (AI) and machine learning (ML) technologies to minimize waste in health care by identifying “low-value” medical services vulnerable to fraud, waste, and abuse. The six-year, voluntary model is slated to begin in 2026. Applications will be accepted until July 25 and the application portal is currently open. CMS is hosting “office hours” on WISeR on July 17 at 1pm eastern, registration is available here.

CMS Announces MSSP Trend Adjustment Change. CMS announced a partial reduction to the impact of the Accountable Care Prospective Trend (ACPT). In May, stakeholders urged CMS to zero out the impact of the ACPT due to concerns about timing and inaccuracy of the calculation, which dramatically underestimated Medicare cost growth. CMS reduced the ACPT’s weight in the MSSP benchmark calculation by half – from one-third of the benchmark calculation to one-sixth – for 2024. CMS stated that it will continue to monitor the performance of the ACPT and will communicate any future changes to the ACPT methodology through rulemaking. A4H looks forward to continuing to work with CMS to improve the accuracy and stability of ACO benchmarks across programs.

Housecall Providers Enables Patient to Receive Care at Home. After years of bouncing between doctors in a busy practice, Cathie longed for consistency, especially after developing encephalopathy, which caused symptoms that mimicked dementia. That’s when she met Dr. Jossi through Housecall Providers. Cathie was able to receive care from a provider who knew her full medical history, listened without rushing, and treated her like a person, all from the comfort of her senior living community. Learn more about how Housecall Providers is bringing healthcare home in our “Accountable Care in Action” case study.

Save the Dates for our Upcoming Double Click Meetings. Our in-person quarterly meetings are for policy-focused audiences in Washington, DC. Each meeting will be held at the Kaiser Center for Total Health (700 2nd St, NE, Washington, DC) from 11am to 2pm ET. Details to follow.

• Tuesday, September 30
• Tuesday, December 9