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March 26, 2026 – Last week, the Centers for Medicare & Medicaid Services (CMS) held its annual quality conference in Baltimore, Maryland. Beginning with the opening remarks from CMS Administrator Mehmet Oz, it was clear that the main theme of the conference was how CMS is working with federal partners and outside stakeholders to implement the Make America Healthy Again (MAHA) agenda. The MAHA-related initiatives that CMS highlighted during the conference went beyond “quality” and encompassed other major Trump administration priorities. To help dive into these, I’m bringing in my colleague Simeon Niles, who attended the conference in person (I listened to some sessions virtually).
HHS is operating with a whole-of-government approach to implementing MAHA. Right after Administrator Oz’s opening remarks, he shared the stage with Martin Makary, commissioner of the US Food and Drug Administration (FDA), and Jay Bhattacharya, director of the National Institutes of Health (NIH) and acting director of the Centers for Disease Control and Prevention (CDC). All three leaders talked about how they are working together and constantly sharing ideas, which is particularly meaningful because NIH and FDA decisions about evidence standards, trial design, and regulatory flexibility have downstream implications for what CMS can cover, how it pays, and which models it advances.
The conference included many sessions, and perhaps the most consistent throughline was the focus on prevention. Federal and private stakeholders repeatedly emphasized a move away from reactive episodic care toward longitudinal models that address chronic disease, particularly models that focus on nutrition and physical activity as key drivers of positive health outcomes. Administrator Oz framed this vision as a system oriented around “wellness instead of illness.” During the CMS directors panel, which hosted deputy administrators from across the agency, CMS leadership reiterated that prevention should begin not in the physician’s office, but in the home and the community.
This framing aligns with models such as the MAHA Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (ELEVATE) Model, which seeks to build an evidence base for lifestyle and functional medicine interventions, and Advancing Chronic Care with Effective, Scalable Solutions (ACCESS), which focuses on technology-enabled chronic disease care management. M+ recently wrote about ACCESS after payment rates were published.
This upstream orientation is not limited to traditional clinical interventions. CMS leaders discussed findings from the recently released final evaluation report for the Accountable Health Communities (AHC) model, in which patient navigation to address health-related social needs generated over $200 million in savings. This callout signals that CMS continues to view addressing social drivers of health as supportive of the agency’s cost containment strategies.
Another major conference theme was a focus on consumer-driven healthcare within public programs, with a strong emphasis on affordability and access. Peter Nelson, director of the Center for Consumer Information and Insurance Oversight (CCIIO) within CMS, discussed his priorities, including innovation in Marketplace plan options. CCIIO is considering proposals to allow greater regulatory flexibility in plan design, including removing barriers preventing insurers from offering multi-year or disease-specific plan options. He believes that these types of options allow for better alignment between insurers’ financial incentives and enrollees’ long-term health outcomes.
Director Nelson also highlighted how recent policy changes authorized under H.B. 1, the One Big Beautiful Bill Act, further expanded consumers’ choices and tools in managing healthcare costs. He noted that H.B. 1 expanded access to health savings accounts (HSAs) for individuals enrolled in certain bronze or catastrophic marketplace plans, and allows employers to contribute those HSAs to drive competition and innovation, which may bring prices down and create more options for consumers.
During the same panel, Abe Sutton, director of the Center for Medicare and Medicaid Innovation (CMMI) at CMS, discussed drug pricing models as a key lever to address drug affordability. M+ published a +Insight digging into these models, as well as other drug pricing strategies used by the Trump administration.
CMS has established a Fraud Detection Operations Center (internally known as the “war room”) to pursue more aggressive program integrity efforts using advanced technologies. Kim Brandt, CMS’s deputy administrator and chief operating officer, discussed how the agency is using advanced analytics, including pattern recognition algorithms, to identify high-risk providers in near real time. The agency reviews a subset of providers daily and reports that it has prevented up to $2.1 billion in fraudulent payments since these efforts began in 2025.
CMS also employs behavioral interventions, such as targeted letters to providers and suppliers suspected of fraudulent billing practices, which in some cases have led to immediate reductions in billing. These efforts are complemented by CMS Innovation Center models such as the Wasteful and Inappropriate Service Reduction (WISeR) model, which leverages artificial intelligence to streamline prior authorization. M+ wrote about WISeR when it was first announced last year.
Taken together, these efforts signal that CMS is moving away from a reactive audit-based approach to program integrity and toward a proactive intelligence-driven enforcement model.
If prevention, consumer choice, and program integrity are the goals of CMS’s strategy, technology shows us how the agency plans to achieve those goals. Across sessions, CMS pointed to technology infrastructure as a foundational requirement for the next generation of healthcare delivery and government oversight. Dan Brillman, director of the Center for Medicaid and CHIP Services (CMCS) in CMS, described how CMCS uses its levers to encourage states to adopt advanced technologies. He shared that his priorities include targeting Medicaid IT matching funds toward system changes that support the use of advanced analytics, such as artificial intelligence.
Speakers framed the transition to Fast Healthcare Interoperability Resources (FHIR)-based electronic clinical quality measures as critical to healthcare quality, and CMS signaled its intent to move all quality reporting to FHIR standards, with an initial optional reporting period before eventual mandatory adoption.
CMS is also integrating technology into care delivery itself via models such as ACCESS and the associated Technology-Enabled Meaningful Patient Outcomes (TEMPO) pilot. Developed in part through direct engagement with technology vendors, ACCESS is designed to support chronic disease management using digital tools and data-driven workflows. TEMPO, a collaboration between CMS and the FDA, enables the use of real-world evidence for eventual FDA marketing authorization of emerging technologies. This alignment between CMS and FDA is particularly notable. By coordinating on evidence standards and regulatory pathways, the agencies are working to accelerate the adoption of digital health solutions while ensuring they meet appropriate safety and effectiveness thresholds.
There were plenty of other sessions throughout the two-day conference, such as ones that discussed the future of the Merit-based Incentive Payment System, recent work to improve organ transplant processes and patient outcomes, best practices to address emergency department boarding, and updates on the acute hospital care at home waiver (the subject of this week’s breakroom podcast). All these sessions promoted the notion that HHS is advancing a coordinated strategy that aligns payment, regulation, evidence generation, and public health around a shared objective: MAHA.
Until next week, this is Jeffrey (and Simeon) saying, enjoy reading regs with your eggs.
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