THIS WEEK’S DOSE
- House Energy and Commerce Committee advances health legislation. The bills, including an amended version of the Lower Costs, More Transparency Act, move to the House floor, potentially for advancement in preparation for an end-of-year package.
- Senate HELP Committee advances transparency, drug bills. The committee advanced its version of transparency legislation, the Patients Deserve Price Tags Act, following stakeholder feedback.
- House Oversight Health Subcommittee holds roundtable to discuss skin substitute fraud. The roundtable examined the growth in skin substitute spending.
- HHS announces additional Medicaid deferrals in California, Minnesota. The US Department of Health and Human Services (HHS) is deferring more than $1 billion in federal Medicaid funding, focused on home- and community-based services (HCBS).
- CMS issues Medicaid provider taxes proposed rule. The rule would implement section 71115 of the One Big Beautiful Bill Act (OBBBA) to cap provider taxes and reduce provider taxes in Medicaid expansion states over time.
CONGRESS
House Energy & Commerce Committee advances health legislation. The markup included consideration of 29 bills, including 20 healthcare bills. Ten of those were added to HR 9393, the Lower Costs, More Transparency Act, through an amendment in the nature of a substitute (AINS), and some were slightly modified compared to their original version. Those bills include:
- HR 5243, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.
- HR 9392, Medicare Advantage Cost Transparency Act.
- HR 9397, Premium Transparency Act.
- HR 5526, Biosimilar Red Tape Elimination Act.
- HR 9389, Nutrition Education and Chronic Disease Prevention Initiative.
- HR 9661, Expedited Access to Biosimilars Act.
- HR 8908, STOP Games Act of 2026.
- HR 9396, Prior Authorization Accountability Act.
- HR 3514, Improving Seniors’ Timely Access to Care Act of 2025.
- HR 8201, Expanding Community Access to Health Services Act.
Ultimately, the final, expanded version of the Lower Costs, More Transparency Act passed by a unanimous vote. The bill now moves to the House floor, where it could be advanced in lead up to a potential end-of-year package. However, the House Ways and Means Committee and Senate Health, Education, Labor, and Pensions (HELP) Committee have also advanced transparency bills (HELP consideration discussed below), which could potentially complicate efforts to reach consensus on comprehensive healthcare transparency reform.
The Energy and Commerce Committee also advanced legislation related to illicit drugs and a transparency bill that was not bipartisan:
- HR 8005, Stop Pills That Kill Act, passed by a 43 – 6 vote, with Reps. Ocasio-Cortez (D-NY), Tonko (D-NY), Clark (D-MA), Kelly (D-IL), Carter (D-LA), Schakowsky (D-IL) voting no.
- HR 1266, Combatting Illicit Xylazine Act, passed unanimously.
- HR 2004, Tylers Law, passed unanimously.
- HR 1561, ALERT Communities Act, passed unanimously.
- HR 7970, Strengthening Tools to Outlaw Poisonous (STOP) Nitazenes Act, passed mostly along party lines by a 28 – 21 vote, with Rep. Schrier (D-WA) voting yes.
- HR 7994, Helping Educators Respond to Overdoses (HERO) Act passed unanimously.
- HR 9390, Prices on the Wall Act, passed by a party line vote of 24 – 21.
Senate HELP Committee advances transparency, drug bills. The committee advanced 11 bills relating to price transparency, nursing workforce centers, insulin cost-sharing, and other topics.
- S. 2355, Patients Deserve Price Tags Act, passed by a 21 – 1 vote, with Sen. Paul (R-KY) as the sole no vote.
- S. 4189, INSULIN Act of 2026, passed by a 17 – 5 vote, with Sens. Paul, Scott (R-SC), Armstrong (R-OK), Husted (R-OH), and Chair Cassidy (R-LA) voting no.
- Baldwin Amendment was adopted by a 12 – 10 vote, with all Democrats and Sen. Collins (R-ME) in support.
- S. 4974, Making America’s Food Safer Act, passed unanimously.
- S. 5026, Childhood Diabetes Reduction Act, passed by a 12 – 10 vote, largely along party lines, with Chair Cassidy and Sen. Marshall (R-KS) joining the majority of Democrats in support, and Sen. Baldwin (D-WI) joining the majority of Republics in opposition.
- S. 1414, Expedited Access to Biosimilars Act, passed unanimously.
- S. 3788, CLEAR LABELS Act, passed by a 21 – 1 vote, with Sen. Paul as the sole no vote.
- S. 3794, SAFE Drugs Act of 2026, passed by a 17 – 5 vote, with Sens. Baldwin, Kaine (D-VA), Hassan (D-NH), Paul, and Scott voting no.
- S. 494, National Plan for Epilepsy Act, passed unanimously.
- S. 4110, EMPOWER for Health Act, passed 21 – 1, with Sen. Paul as the sole no vote.
- S. 1874, Title VIII Nursing Workforce Reauthorization Act of 2025, passed by a 21 – 1 vote, with Sen. Paul as the sole no vote.
- S. 380, Rural Obstetrics Readiness Act, passed by a 21 – 1 vote, with Sen. Paul as the sole no vote.
As noted above, S. 2355, the Patients Deserve Price Tags Act, is the Senate HELP Committee’s version of healthcare transparency legislation. The bill sponsors, Sens. Marshall and Hickenlooper (D-CO) previously sought stakeholder feedback on the bill, and the amended version of the bill received broad bipartisan support in the markup.
House Oversight Health Subcommittee holds roundtable to discuss skin substitute fraud. Only Republicans attended the roundtable, where they argued that Medicare regulators failed in identifying and mitigating fraudulent activity related to skin substitutes in traditional Medicare. Some witnesses focused on the role that accountable care organizations can play in identifying potentially fraudulent services, while others talked about the important role that wound-care manufacturers and providers play in stabilizing the healthcare system. Witnesses also highlighted that reimbursement dynamics for skin substitutes may have created an environment for bad actors to perpetuate fraud.
ADMINISTRATION
HHS announces additional Medicaid deferrals in California, Minnesota. During a press conference, HHS leaders announced the deferral of $867.5 million in federal Medicaid payments for California’s in-home care programs due to concerns that spending on those services grew faster than national trends. HHS also reviewed claims in Minnesota for the previously identified 14 high-risk services and announced $199 million in federal payment deferrals while its review in Minnesota continues. Earlier this year, the Centers for Medicare and Medicaid Services (CMS) announced it was withholding $2 billion, deferring $259 million, and deferring $91 million from Minnesota due to fraud concerns with the 14 high-risk services, mostly HCBS programs. Minnesota sued CMS but the litigation is currently paused.
In addition, the HHS Office of Inspector General (OIG) announced it will delegate its exclusion authority to CMS to allow both CMS and OIG to remove bad actors from CMS programs. The same day, CMS announced a public data asset release under the Open, Public, Electronic, and Necessary Government Data Act, with the goal of supporting public engagement in identifying and preventing fraud, waste, and abuse. The release will include data on Medicaid provider spending by national drug code and Medicaid provider enrollment. The data will be available here.
CMS issues Medicaid provider taxes proposed rule. Under current federal regulations, states may use provider taxes to fund their share of Medicaid if they are broad based, uniform, and do not hold taxpayers “harmless” – meaning providers cannot be given a direct or indirect guarantee that they will be repaid for all or some of the taxes they contribute. “Hold harmless” arrangements are permissible if the taxes remain below 6% of net patient revenue. Section 71115 of OBBBA modified this and froze Medicaid provider taxes at the rate they existed at as of OBBBA’s passage on July 4, 2025, if the tax was “enacted and imposed” by that date. Starting in fiscal year (FY) 2028, expansion states must also reduce the hold-harmless threshold by 0.5% each year until it reaches 3.5% in FY 2032, effectively reducing provider tax revenue that can fund the state share of the Medicaid program.
On November 14, 2025, CMS issued preliminary guidance on Section 71115, specifically on the meaning of “enacted” and “imposed.” This proposed rule would codify the OBBBA changes to provider taxes and proposes a slightly broader interpretation of “imposed,” as compared to the November 2025 guidance, to address stakeholder concerns. The rule also proposes reporting requirements for states to support ongoing oversight of provider taxes. Read more in the fact sheet.
QUICK HITS
- HHS launches efforts to support Genesis Mission. The Genesis Mission, launched by President Trump in November 2025, aims to put the United States at the forefront of using artificial intelligence (AI) to solve society’s problems. HHS’s efforts will include a series of national science and technology challenges (that invite the public to solve health problems) and a focus on using AI to modernize the biomedical research ecosystem.
- GOP Doc Caucus, Democratic Doctors Caucus request information on Medicare physician payment reform. Following the release of their payment reform bill, HR 9693, the Patients First Act, the doctors’ caucuses released a request for information on physician reimbursement reform as they refine comprehensive legislation in this space. Feedback is due by August 21, 2026.
- House passes public health reauthorization, healthcare grant bills. The 12 bills advanced out of the House Energy and Commerce Committee earlier this year and passed the House under suspension, meaning they received bipartisan support.
- HHS OIG, GAO release reports on program integrity. The HHS OIG reports focus on state actions overseeing Medicaid managed care organizations’ referrals for provider fraud and concerns with the Colorado Medicaid program’s HCBS electronic visit verification program. The Government Accountability Office (GAO) similarly issued a report with recommendations for CMS and the Department of Veterans Affairs related to improper payments in the Medicare Advantage and community care programs.
- FDA announces first TEMPO pilot participant. The US Food and Drug Administration (FDA) Technology-Enabled Meaningful Patient Outcomes (TEMPO) for Digital Health Devices Pilot was announced in December 2025 in conjunction with the CMS Innovation Center Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model. The pilot and model aim to accelerate access to digital-health devices to improve patient outcomes. The first participant was announced, but the FDA continues to consider statements of interest for the pilot.
- CBO issues analysis on federal subsidies for health insurance. The Congressional Budget Office (CBO) estimates that federal subsidies for health programs, including Medicare, Medicaid, the Children’s Health Insurance Program, and Marketplace premium tax credits, total $33.6 trillion from 2026 – 2036. Almost half of all subsidies could be attributed to the Medicare program, at $16.1 trillion.
NEXT WEEK’S DIAGNOSIS
Following a busy week during which the House passed a preemptive stopgap continuing resolution to fund the government beyond the end of the current fiscal year on September 30, 2026, and the reconciliation 3.0 budget resolution, House members left town to begin their August recess. The House is currently scheduled to return August 31, 2026, although that may be subject to change. The Senate will be in session next week. The Senate HELP Committee will hold a markup to consider education legislation and a health information privacy bill, and to vote on nominations.
The Check-Up will publish a day early next week, on Thursday July 30, 2026.
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