Health Care D.C. Download

Research evidence excerpt

Health Care D.C. Download

Industry Update Equity Research

House to Take Up Senate-Passed Reconciliation Bill… Continued from page 1. The House could vote

on the Senate-passed bill early this week and finally wrap up fiscal year (FY) 2026 appropriations. For

FY2027, the House passed the Agriculture-Food and Drug Administration (FDA) funding bill, and the

House Appropriations Committee plans to mark up the Labor-Health and Human Services (HHS) bill

this week, unless it is delayed by reconciliation activity.

Long-Awaited IDR Rule Met With Mixed Responses… Continued from page 1. Key changes include

lowering the per-party, per-dispute administrative fee from $115 to $15, laying the groundwork

for a modernized IDR portal called the IDR Gateway, formalizing the open negotiation process that

occurs before arbitration, revising batching rules, and increasing information and documentation

requirements that the Administration hopes will reduce the number of ineligible disputes and cut

down on systemic bottlenecks. Both payer and provider groups initially applauded the operational

changes, but some payer groups continue to call for reforms to the IDR system to address alleged

gaming or abuse by providers and private equity-backed organizations.

CMS Issues Medicaid Work Requirements Interim Final Rule With Controversial Medical Frailty

Provisions… Continued from page 1. Specifically, CMS will require beneficiaries to not only meet

the criteria outlined in OBBBA, such as having a substance use disorder or having a serious complex

medical condition, but to also justify how their condition prevents them from meeting the monthly

80-hour community engagement requirement. CMS is also preventing states from expanding the