In Depth Analysis

Read our comprehensive summary of the final health-related provisions of the One Big Beautiful Bill Act, H.R. 1.

This +Insight reviews OIG’s findings and explores what they may signal for Medicare’s approach to global surgical payment, and why stakeholders may want to monitor developments and consider how best to engage as discussions around this topic continue.

Every year, the administration releases the president’s budget, which requests funding from Congress for the upcoming fiscal year (FY). The president’s budget is a nonbinding document and funding levels reflected in appropriations bills do not always align with funding levels in the president’s budget request. However, the president’s budget has traditionally been an opportunity for the administration to lay out its priorities and state publicly what programs and activities it wants to invest in, and which it wants to cut. Thus, it can be viewed as a guide map to how the administration wants departments, like the US Department of Health and Human Services (HHS), to be structured and funded.

On May 22, 2025, the US House of Representatives passed its reconciliation package, now known as H.R. 1, One Big Beautiful Bill Act, by a 215 – 214 – 1 vote, advancing an agenda that extends and builds on tax cuts enacted in President Trump’s first term.

The bill contains several policies including Medicaid provisions that would alter enrollee eligibility and how states finance their share of Medicaid funds, Medicare physician payment, Affordable Care Act Marketplace enrollee eligibility and benefits, and more. The bill now moves to the Senate, which is expected to make changes to key provisions.

Read on for a comprehensive summary of the health-related provisions in the reconciliation package.

This +Insight outlines key changes CMS is proposing, particularly related to episode pricing, quality measurement, and trend factor calculations.

On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2026 Inpatient Prospective Payment System (IPPS) proposed rule. The rule would update Medicare payment policies and quality reporting programs relevant for inpatient hospital services.