THIS WEEK’S DOSE
- State Medicaid directors testify at House Energy and Commerce Oversight Subcommittee. The Medicaid directors from California, New York, Ohio, and Minnesota testified on their actions to ensure program integrity and prevent fraud, waste, and abuse.
- House Energy and Commerce Health Subcommittee advances 15 health bills. The transparency, prior authorization reform, and controlled substance bills move to the full committee, but it was noted they still require agency technical assistance before further consideration.
- Joint Economic Committee discusses healthcare fraud. The hearing centered on the impact of improper payments on healthcare spending and how to effectively address such payments.
- HHS OIG takes additional program integrity steps. The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a request for information and announced charges against medical professionals for fraud schemes.
- Federal judge temporarily blocks Department of Education definition of “professional degree” in student loan final rule. The judge ruled that the department cannot implement its narrow definition as litigation continues.
- Twenty states sue Trump administration over federal contractor DEI executive order. The executive order directs federal agencies to require that contractors not engage in “racially discriminatory diversity, equity, and inclusion” (DEI) practices as a condition of federal funding.
CONGRESS
State Medicaid directors testify at House Energy and Commerce Oversight Subcommittee. Republicans emphasized the need for stronger Medicaid fraud enforcement in all states to prevent the waste of taxpayer dollars, while Democrats expressed concern about Democrat-led states being unfairly targeted through deferral of federal funding. The Medicaid directors from California, New York, Ohio, and Minnesota stated that fraudulent actors exist within their Medicaid programs, but that combating fraud is a top priority for their states. During the hearing, Rep. Bilirakis (R-FL) introduced his bill, HR 9422, the Medicaid Recovery Audit Contractors Improvement Act of 2026, to strengthen Medicaid program integrity.
House Energy and Commerce Health Subcommittee advances 15 health bills. The Subcommittee advanced 15 health transparency, controlled substance, prior authorization reform, and nutrition education bills with voice votes. However, there was disagreement on some of the controlled substance bills, and there was an understanding that additional technical assistance was needed before the full committee votes on the bills. Democrats also continued to critique Republicans for passage of the One Big Beautiful Bill Act (OBBBA), which they said created an affordability crisis that the health transparency bills were aiming to address.
The fifteen bills that advanced are:
- H.R. 1266, Combatting Illicit Xylazine Act
- H.R. 2004, Tyler’s Law
- H.R. 7970, STOP Nitazenes Act
- H.R. 1561, ALERT Communities Act
- H.R. 7994, HERO Act
- H.R. 9389, Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026
- H.R. 8201, Expanding Community Access to Health Services Act
- H.R. 9393, Lower Costs, More Transparency Act of 2026
- H.R. 9397, Premium Transparency Act
- H.R. 9396, Prior Authorization Accountability Act
- H.R. 9390, Prices on the Wall Act of 2026
- H.R. 3514, Improving Seniors’ Timely Access to Care Act of 2025
- H.R. 9392, Medicare Advantage Cost Transparency Act
- H.R. 5243, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage
- H.R. 9395, Transparency in Medicare Advantage Steering Act
Joint Economic Committee discusses healthcare fraud. During the hearing, Democrats expressed an interest in combating fraud and improper payments without impacting access to healthcare services for vulnerable populations. Republicans discussed the fiscal implications of increasing healthcare expenditures and the role that improper payments play in driving up healthcare costs. Witnesses discussed challenges related to program integrity and enforcement activities in government-funded healthcare programs. Both Republicans and Democrats expressed support for reform efforts that would curb misaligned incentives and noted concerns about vertical integration.
ADMINISTRATION
HHS OIG takes additional program integrity steps. OIG announced a healthcare fraud takedown in which it charged 455 individuals, including 90 doctors and medical professionals, for alleged fraud schemes. OIG alleged the healthcare fraud and opioid abuse schemes involved a total of more than $6.5 billion across 45 states, with 50 state Medicaid fraud control units participating in the coordinated effort. OIG also issued a request for information (RFI) on fraud and abuse related to kickbacks and individuals’ participation in clinical trials. Comments on the RFI are due August 24, 2026.
COURTS
Federal judge temporarily blocks Department of Education definition of “professional degree” in student loan final rule. The April 2026 US Department of Education final rule implemented the OBBBA provision capping aggregate graduate student loans at $100,000 and professional student loans at $200,000. The rule narrowed the definition of “professional degree” programs to exclude degrees in disciplines such as nursing, physical therapy, occupational therapy, and social work, thereby capping student loans for those degrees at $100,000. In response, associations representing the affected fields sued. The rule is set to be effective July 1, 2026, but the federal judge temporarily blocked implementation of the new regulatory definition as litigation continues.
Twenty states sue Trump administration over federal contractor DEI executive order. The lawsuit alleges that the March 2026 executive order (EO) “Addressing DEI Discrimination by Federal Contractors” is unlawful because its implementation violates federal statutes and regulations. In response to the EO, federal agencies have issued implementation guidance instructing contracting officers to update contract terms accordingly. The states allege that the EO is arbitrary and capricious due to its use of unclear terminology and point out that the agency guidance did not include a notice-and-comment period.
QUICK HITS
- House Democrats write to NIH on OMB proposed rule. House Energy and Commerce Democrats sent a letter noting that the Office of Management and Budget (OMB) proposed rule released in late May (summarized here) would politicize National Institutes of Health (NIH) grantmaking. The letter asks NIH Director Bhattacharya to ask OMB to rescind the proposed rule. Over 100 House Democrats also wrote to OMB expressing concern on the rule.
- CMS estimates annual health spending will increase to $9 trillion by 2034. The Centers for Medicare & Medicaid Services (CMS) analysis found that spending will increase from $5.3 trillion in 2024 to $9 trillion in 2034. The increase is mostly attributed to increased use of medical care, legislative changes from OBBBA and the Inflation Reduction Act, and demographic change in the Medicare population. The data to support the analysis can be found here.
- President Trump nominates Klomp as HHS deputy secretary. Chris Klomp is currently serving as director of the Center for Medicare at CMS and as HHS chief counselor. He will need to appear before the Senate Finance and Health, Education, Labor, and Pensions (HELP) Committees and be confirmed by the Senate before beginning this new role. Following the nomination, HELP Committee Chair Cassidy (R-LA), who is also a member of the Finance Committee, called Klomp “an encouraging pick”.
- Senate HELP Chair Cassidy releases 340B discussion draft. The draft follows Chair Cassidy’s (R-LA) focus on 340B, including a report, hearing, and investigation. The 340B for Patients Act aims to avoid duplicate 340B discounts, clarify definitions, and increase reporting requirements for 340B participants. Stakeholders can submit feedback through August 28, 2026.
- CMS proposes increase in ESRD Medicare payments for CY 2027. The proposed rule is the first of the calendar year (CY) 2027 Medicare payment regulations. The rule would increase Medicare end-stage renal disease (ESRD) facility payments by 1.1% and modify ESRD quality measures.
- HHS launches effort to strengthen clinical trials. The coordinated effort includes a US Food and Drug Administration RFI on an investigational new drug pilot program; National Cancer Institute work with cancer centers and researchers to streamline clinical trial activation; and Office of the National Coordinator for Health Information Technology exploration of ways to better connect patients with clinical trials through electronic health records.
- House Oversight Democrats release report on Trump administration health policies. The report describes the Trump administration’s policies on medical research, public health programs, and vaccines, noting that these policies are harming Americans’ health and failing to meet the Make America Healthy Again promise.
NEXT WEEK’S DIAGNOSIS
The Senate has begun its July 4 holiday recess and won’t return to Washington, DC, until the week of July 13, 2026. The House is scheduled to be in session next week through July 2, after which it will leave for the holiday. However, with disagreements among Republicans having caused the House to leave early this week because bills could not be advanced on the House floor, it is possible Speaker Johnson (R-LA) may be forced to cancel next week’s votes and start the House’s July 4 holiday recess early.
The House Education and Workforce, Health, Employment, Labor, and Pensions Subcommittee has scheduled a hearing on direct contracting as a way to lower healthcare costs on July 1, 2026.
Because of the July 4 holiday, the Check-Up will be on hiatus next week and will return on July 10, 2026.
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