Senate GOP Still Hoping for Weekend Vote on Reconciliation Package. Senate Republicans are hoping to pass their reconciliation package over the weekend after up to 20 hours of debate and a lengthy amendment process known as “vote-a-rama.” Negotiations continue to secure enough support for passage, and it is possible there are further changes during the amendment process. Before they can begin debate, Senate GOP leaders will need to adjust the reconciliation package to fix any issues flagged as Byrd Rule violations by the Senate Parliamentarian. The Byrd Rule requires that reconciliation consist only of policies that are directly related to the budget. Some critical health care components of the reconciliation bill were ruled as violations of the rule, so the GOP leadership has some work to do to adjust the bill for compliance. Additionally, while the Senate initially removed a House physician payment policy, there continues to be discussion about adding in something on physician payment in the final Senate bill. A4H will be tracking the details of this back and forth closely and will keep members updated. If the Senate is successful in advancing their draft of the reconciliation bill the House will likely take action next week to pass the bill before the President’s stated July 4^th deadline. A4H will continue to monitor progress on the bill.

Secretary Kennedy Testifies Before House Energy and Commerce. On Tuesday, HHS Secretary Robert F. Kennedy, Jr. testified before the House Energy and Commerce Health Subcommittee on the fiscal year (FY) 2026 President’s Budget Request for the department. The discussion covered a range of topics, including the cost of health care, agency reorganization, health technology and wearables, vaccines, and key priority disease areas, among other topics. Secretary Kennedy did not discuss the HHS reorganization at length, but acknowledged the department must change so that it can help transform the health care system. Notably, Secretary Kennedy stated:

We need…to realign the incentives so that people are getting paid to actually make people better. So we want outcome-based medical care. We want value-based medical care, we’re going through the Center for Medicare and Medicaid Innovation to explore a number of pilot projects that will do just that.

A4H Responds to CMS Tech RFI.  A4H was pleased to provide comments to CMS’ request for information (RFI) on the Health Technology Ecosystem, which sought comment from providers, payers, patients and caregivers, and value-based care organizations on the market for digital health products for Medicare beneficiaries as well as the state of data interoperability and broader health technology infrastructure. Our comments focused on the importance of granting flexibility for accountable care entities to utilize technology that works best for them to achieve their clinical and financial goals, highlighting existing barriers and opportunities for burden reduction. A4H advocated that policies should incentivize accountable care adoption without being prescriptive, as risk-bearing entities have a built-in incentive to use high impact, low-cost tools where they are most useful.

HHS Celebrates Industry Pledge to Improve Prior Authorization. HHS Secretary Robert F. Kennedy, Jr. and CMS Administrator Dr. Mehmet Oz met with the leadership from major insurance providers to discuss a new industry-driven pledge to streamline the prior authorization process. Plans, including those serving Commercial, Medicare Advantage, and Medicaid managed care markets, set voluntary commitments to standardize electronic processes, reduce the number of medical services subject to prior authorization, create user-friendly explanations of decisions, increase real-time electronic prior authorization, and ensure that qualified medical professionals review clinical denials. The Pledge aims to improve patient access to care, reduce administrative burdens on providers, and increase system transparency.

Milliman Publishes White Paper on Effects of PY2026 ACO REACH Program Changes. In May, CMMII announced updates to the ACO REACH Model. Milliman issued a white paper describing how each of the changes CMS is pursuing and, using its ACO Builder tool, provides analysis and quantification of the impact of each change. Key highlights include that the modification to risk score growth constraints could lead to one in six Standard ACOs seeing a decline in projected savings, and that the narrowing of the risk corridor for Global track ACOs will impact approximately 7 percent of Standard ACOs in the Global track, meaning a slightly higher proportion of ACOs are estimated to have their savings, rather than losses, reduced as a result of the change.

Bipartisan Policy Center Releases Report on Physician Payment Reforms. The Bipartisan Policy Center (BPC) released a report focused on primary care physician payment reform. A4H was pleased to contribute to the report, which outlined several recommendations for policymakers to consider as they modernize Medicare’s physician payment system. The report suggests that lawmakers should consider restructuring and extending the advanced APM bonus, establishing an advisory body to enhance primary care evaluations, enable more comprehensive tracking and target setting to measure primary-care spending, and aligning quality measurements across payment models to reduce administrative burdens on physicians. A4H and its members were pleased to participate in the development of this report.

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