THIS WEEK’S DOSE
- Senate Aging Committee holds hearing on drug supply chain. Members examined China’s influence on the US drug supply chain and strategies to encourage domestic drug production.
- CMS Innovation Center releases BALANCE model requests for applications. The Innovation Center invited state Medicaid agencies and Medicare Part D plans to apply for participation.
- CMS issues organ procurement guidance. The Centers for Medicare & Medicaid Services (CMS) guidance addresses the treatment of potential donors and their families.
- Labor organizations sue administration over CDC grant funding clawbacks. The terminated Centers for Disease Control and Prevention (CDC) grants relate to environmental public health, infectious disease prevention, and AIDS and HIV awareness.
CONGRESS
Senate Aging Committee holds hearing on drug supply chain. Republicans and Democrats expressed interest in policy proposals to promote domestic drug production. Chair Scott (R-FL) advocated for passage of S. 3788, the CLEAR LABELS Act, which would require prescription drug labeling to disclose the original manufacturers of generic drugs and active pharmaceutical ingredients, including the country of origin. Witnesses emphasized that favorable regulations for biotechnology innovation are necessary to incentivize US drug production.
ADMINISTRATION
CMS Innovation Center releases BALANCE model requests for applications. The voluntary model, announced in December 2025, aims to increase access to GLP-1 medications and healthy lifestyle interventions. Key takeaways from the state Medicaid agency and Medicare Part D plan requests for applications include the following:
- CMS outlined coverage criteria and specified that participating states and Part D plans must adopt the criteria without burdensome step therapy or prior authorization, as defined in the requests for applications.
- Participating states must cover all participating GLP-1 medications and must ensure that applicable Medicaid plan policies align with model requirements for both fee-for-service and managed care.
- CMS will only move forward with implementation of the model in Part D if a critical mass of Part D plan sponsors opt to participate. To incentivize participation, CMS is offering an optional narrowed first risk corridor threshold for certain Part D plans.
CMS issues organ procurement guidance. The changes within the quality, safety, and oversight memo and the updated state operations manual appendix seek to clarify and reinforce the responsibilities of organ procurement networks (OPOs) and donor hospitals. CMS states that OPOs and hospitals are required to approach potential donors and their families without coercion or pressure and clarifies that OPOs are prohibited from influencing the timing of life support withdrawal or death declarations. Failure to follow these requirements now constitutes noncompliance, which must be cited once identified, even if it was corrected.
COURTS
Labor organizations sue administration over CDC grant funding clawbacks. The American Federation of State, County, and Municipal Employees argued that the $600 million grant terminations targeted blue states and the administration used artificial intelligence to retroactively create other rationales. The impacted states (California, Colorado, Illinois, and Minnesota) have already pursued separate legal action, resulting in a temporary restraining order that blocked the grant terminations for 14 days.
QUICK HITS
- Joint Economic Committee releases issue brief on MA overpayments and Part B spending. The issue brief found that Medicare Part B premiums are higher because Medicare Advantage (MA) is overpaid. The committee also released a Medicare Affordability Tracker that reports estimates of excess Part B premiums attributable to MA overpayments by congressional district.
- GAO publishes study on private dental and vision insurance. The US Government Accountability Office (GAO) found that dental and vision insurance market concentration varied across states.
- CCSQ announces strategic roadmap. The CMS Center for Clinical Standards and Quality (CCSQ) will focus on five strategic goals: prevention, quality and safety, coverage innovation, data and technology, and burden reduction.
- FDA releases biosimilar development draft guidance. The US Food and Drug Administration (FDA) draft guidance recommends streamlining unnecessary clinical pharmacokinetic testing in an effort to bring more biosimilars to the market.
- FDA launches adverse event look-up tool. The new FDA Adverse Event Monitoring System consolidates the adverse event reporting systems under FDA’s purview, including the systems for drugs, biologics, and medical devices. The new system will display vaccine data but will not fully replace the Vaccine Adverse Event Reporting System (VAERS) because FDA and CDC co-manage VAERS.
- MedPAC and MACPAC release March 2026 reports. The Medicaid and CHIP Payment and Access Commission (MACPAC) report includes chapters on home- and community-based services, behavioral health services, justice-involved youth, and youth in foster care. The Medicare Payment Advisory Commission (MedPAC) report includes chapters on hospital inpatient, hospital outpatient, physician, outpatient dialysis, post-acute care, skilled nursing facility, home health care, inpatient rehabilitation, hospice, and ambulatory surgical center services. It also includes chapters on fee-for-service, MA, Part D, and dual-eligible special needs plans.
NEXT WEEK’S DIAGNOSIS
Congress will be in session next week. Notable hearings include:
- National Institutes of Health Director Bhattacharya will testify in front of the House Appropriations Labor, Health and Human Services, Education, and Related Agencies Subcommittee.
- CMS officials will testify about combatting Medicare and Medicaid fraud in front of the House Energy and Commerce Oversight and Investigations Subcommittee.
- The House Energy and Commerce Health Subcommittee will hold the third hearing in its affordability series, this time focused on providers.
CMS will also host its 2026 Quality Conference, and we continue to await the president’s budget request.
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