Policy Digest – January 26, 2026

Introduction

This week: House passes critical funding and skips town. All eyes on the Senate to hold off another shutdown.

OTHER REGULATORY NEWS

Centers for Medicare and Medicaid Services (CMS)

House Passes $1.2 Trillion Spending Package With 2-Year Telehealth Extension, PBM Reforms, and Hospital Payment Protections

The House voted 341-88 on January 22 to pass a government funding package through fiscal year 2026 that extends Medicare telehealth flexibilities through 2027 and the hospital-at-home waiver program through 2030. The legislation includes:

– One-year extensions for Medicare payment programs supporting rural hospitals
– A delay of Medicaid disproportionate share hospital cuts until fiscal 2028
– Pharmacy benefit manager reforms
– Increase in NIH funding
– An expansion of HHS authority to add items to the DME Master List for prior authorization to combat fraud, with Senate action is expected before the January 30 deadline.

However, the bipartisan path forward for a package of six appropriation bills, including funding for the Department of Homeland Security, quickly evaporated on Saturday after the shooting. Senate Minority Leader Charles E. Schumer, D-N.Y., said Sunday that Democrats would oppose the package unless the DHS bill is revamped.

Source(s):
House passes healthcare spending package (United States Department of Health and Human Services)
Extenders Bill Boosts DMEPOS Master List, Mandates Report On Lab Tests (United States Department of Health and Human Services)
Funding Deal Heads to the Senate (United States Congress x Health)
Congress’ health deal still has hurdles (Health Insurance)
Can a bipartisan health deal pass? (POLITICO Pulse)
STAT+: Congressional health care deal that funds NIH, cracks down on PBMs, expected to pass (United States Department of Health and Human Services)
House Passes HHS Funding Bill With 2-Year Telehealth, Other Extenders, PBM Reforms (United States Department of Health and Human Services)
House passes final government funding bills in milestone, overcoming Democratic DHS opposition (United States Congress x Health)
Pharmacy groups back PBM reforms in spending package (Becker’s Hospital Review)
Funding rescissions, re-staffing initiatives and other major takeaways from the final FY26 funding package (United States Department of Health and Human Services)
Congress clinches bipartisan health deal (Politico)
STAT+: What’s in Congress’ sweeping health care deal: PBM reform, telehealth, science funding (United States Congress x Health)
HHS Approps Bill Scraps House Cuts To HIV/AIDS Programs (United States Department of Health and Human Services)
Movement on a health plan, but not Trump’s (Huddle)
Shutdown odds plummet after House and Senate strike bipartisan deal on remaining funding bills (Government Executive)
Government shutdown looms: Congress unveils massive federal funding bill ahead of January 30 deadline (United States Congress x Health)
House Appropriations Committee releases health funding proposal (United States Department of Health and Human Services)
The health care debate is back in Washington. It never really went away (United States Congress x Health)
This week: Senate returns, staring at possible partial government shutdown
Tags: #HOSPITAL, #PROVIDER, #PAYER

Medicare Improper Payments Drop to $28.8B as MA Overpayments Continue at $76B Above Traditional Medicare

CMS reported Medicare fee-for-service improper payments totaled $28.83 billion in fiscal 2025, with the improper payment rate declining to 6.55% Medicare Advantage plans will receive $76 billion more than traditional Medicare in 2026, driven by aggressive risk score coding and healthier patient selection, despite CMS policy changes in 2024 aimed at limiting this practice. CMS also released quarterly Part B and Part D drug spending datasets for preliminary claims data, while proposed international reference pricing models (GLOBE and GUARD) are unlikely to pass savings to patients or health plans according to legal experts.

Source(s):
Medicare Quarterly Part D Spending by Drug (Centers for Medicare & Medicaid Services Data)
Medicare Quarterly Part B Spending by Drug (Centers for Medicare & Medicaid Services Data)
Medicare fee-for-service improper payments hit $28.8B: CMS (Centers for Medicare & Medicaid Services)
Medicare Paying Billions More for Medicare Advantage vs Traditional Enrollees (Health Insurance)
Patients may not see savings from new Medicare drug programs (Centers for Medicare & Medicaid Services)
Tags: #PAYER, #PATIENT, #PROVIDER

CMS considers expanding TAVR coverage to asymptomatic patients, drawing mixed stakeholder response

CMS is weighing substantial policy changes for transcatheter aortic valve replacement (TAVR) that would expand coverage to include asymptomatic patients and reduce current restrictions. Medical societies, medical device companies, and clinicians have submitted feedback with divided opinionsâ€”some supporting the expanded indications while others express concern that the changes are premature or overly broad. The proposed updates represent a potential major shift in Medicare coverage criteria for the heart valve procedure.

Source(s):
Medical societies, medtech companies and clinicians weigh in as CMS considers sweeping TAVR changes (Centers for Medicare & Medicaid Services)
Tags: #DEVICE, #PROVIDER, #PATIENT

TEAM Success Depends on How Well a Hospital Ensures Medicare Patients Get the 30-Day Episode of Care They Need

Hospitals participating in CMS’s TEAM (Transforming Episode Accountability Model) must establish unified referral workflows that match Medicare patients to providers based on specialty, location, insurance, and real-time availability to successfully manage 30-day episodes of care. The model requires hospitals to ensure patients receive complete episode care within the 30-day window, with provider matching being critical to TEAM performance.

Source(s):
TEAM Success Depends on How Well a Hospital Ensures Medicare Patients Get the 30-Day Episode of Care They Need (Centers for Medicare & Medicaid Services)
TEAM is Here, and Hospitals Are Running Out of Time to Prepare (MedCity News)
Tags: #HOSPITAL, #PROVIDER, #PAYER

Maryland shifts Medicare cost burden onto commercial insurers under AHEAD model

Maryland will shift $435 million in hospital costs onto commercial insurers through annual $87 million rate increases from 2028-2032, while providing 11.55% rate relief to Medicare Advantage plans under the AHEAD model. The state must reduce Medicare fee-for-service spending growth by 2.66% compared to national trends by 2032, totaling $460 million in required savings with overall system impact reaching $870 million.

Source(s):
Maryland shifts Medicare cost burden onto commercial insurers under AHEAD model (Centers for Medicare & Medicaid Services)
Tags: #PAYER, #HOSPITAL, #PROVIDER

How CMS’ rural hospital program got providers out of the red

CMS’s rural emergency hospital program, launched in 2023, has converted 42 hospitals and reversed operating losses for many participants by allowing rural facilities to focus on emergency and outpatient services rather than maintaining inpatient beds.

Source(s):
How CMS’ rural hospital program got providers out of the red (Centers for Medicare & Medicaid Services)
Tags: #HOSPITAL, #PROVIDER

CMS wants to speed up tech innovation and AI for patients, setting major goalposts in 2026

Over 600 healthcare organizations have joined CMS’s Health Tech Ecosystem pledge since July 30, 2024, committing to accelerate technology and AI adoption. CMS official Amy Gleason announced a March 31, 2026 deadline for these organizations to deliver tangible, live results from their pledges.

Source(s):
CMS wants to speed up tech innovation and AI for patients, setting major goalposts in 2026 (Centers for Medicare & Medicaid Services)
Tags: #ALL

AARP Researchers: IRA Preservation Key As Top Medicare Drug Prices Soar

AARP analysis found 25 top Medicare drugs not yet selected for CMS drug price negotiation have increased prices an average of 67% since market entry. The research emphasizes the importance of preserving the Inflation Reduction Act’s drug pricing provisions amid ongoing price increases for high-utilization Medicare medications.

Source(s):
AARP Researchers: IRA Preservation Key As Top Medicare Drug Prices Soar (Centers for Medicare & Medicaid Services)
Tags: #DRUG, #PAYER, #PATIENT

Hospital readmission penalties shift based on Medicare Advantage penetration: Study

Hospitals with lower Medicare Advantage penetration (first quintile) were penalized $30,746 more on average under CMS’s Hospital Readmissions Reduction Program compared to high-MA hospitals (fifth quintile), which were penalized $26,915 less. The distortion may stem from unobserved severity factors, as MA beneficiaries are typically healthier than traditional Medicare patients, leaving hospitals with higher traditional Medicare populations facing penalties for sicker patients not fully captured in risk adjustment models. MA penetration increased from 25.3% to 29.9% during the study period.

Source(s):
Hospital readmission penalties shift based on Medicare Advantage penetration: Study (Centers for Medicare & Medicaid Services)
Tags: #HOSPITAL, #PAYER

CY2026 Trends in Medicare Advantage Part D Plan Benefits

Wakely will host a webinar analyzing how Medicare Advantage Part D plan sponsors adjusted benefits and formulary tier placements for CY2026 following the Inflation Reduction Act’s Part D redesign that took effect January 1, 2025, and the introduction of Maximum Fair Price drugs a year later. The session will compare benefit and formulary decisions between Medicare Advantage Prescription Drug (MAPD) plans and standalone Prescription Drug Plans (PDPs) as benefit designs become more standardized.

Source(s):
CY2026 Trends in Medicare Advantage Part D Plan Benefits (Centers for Medicare & Medicaid Services)
Tags: #PAYER, #DRUG

Medicaid: What to Watch in 2026

The 2025 reconciliation law will require states to implement Medicaid work requirements for ACA expansion enrollees starting January 1, 2027, projected to increase the uninsured by 7.5 million people by 2034, with 5.3 million losing coverage due to work requirements alone. Nebraska announced it will begin enforcing work requirements early on May 1, 2026, while states face tight timelines to upgrade eligibility systems and processes before formal CMS guidance is available. The law also pauses Biden-era eligibility rules, restricts coverage for certain lawfully-present immigrants, and requires more frequent eligibility redeterminations for expansion adults.

Source(s):
Medicaid: What to Watch in 2026 (United States Department of Health and Human Services)
Tags: #ALL

Food and Drug Administration (FDA)

FDA relaxes medical device requirements for AI clinical decision support tools as ARPA-H seeks patient-facing cardiovascular AI agent

On January 6, FDA released updated guidance relaxing medical device requirements for clinical decision support tools, allowing many generative AI diagnostic and supportive tools to reach clinics without FDA vetting. The Advanced Research Projects Agency for Health is now soliciting proposals for researchers to build a patient-facing AI agent for cardiovascular health with a 3-year FDA approval timeline. Separately, concerns are mounting about AI “de-skilling” physicians, with a Lancet study showing gastroenterologists’ adenoma detection rates dropped from 28.4% to 22.4% when performing colonoscopies without AI assistance after becoming accustomed to AI-assisted detection.

Source(s):
The Trump administration is creating clinical AI agents with a 3-year FDA approval timeline (Fierce Healthcare)
How AI Is Actually Helping MedTech Teams Move Faster â€” Across Every Stage of Medical Device Development (MedCity News)
STAT+: He went from AMA to a loaded AI startup (STAT)
Does AI ‘De-skill’ Doctors? (MedPageToday.com)
Opinion: STAT+: After FDA’s pivot on clinical AI, we need AI safety research more than ever (Food and Drug Administration)
Tags: #PROVIDER, #DEVICE, #PATIENT

Health and Human Services

Trump administration’s year of funding cuts disrupts 74,000+ patients in NIH clinical trials, researchers consider career changes

After one year of Trump administration funding cuts and government layoffs, NIH canceled 383 clinical trials between February and August 2025, disrupting medical care for more than 74,000 patients according to JAMA Internal Medicine. Research in COVID-19, cancer, heart disease, brain disease prevention, and behavioral interventions was disproportionately affected, with HIV prevention and LGBTQ health studies completely defunded. Despite the disruption, a January 2025 Pew survey shows Americans’ trust in science remained stable at 77%, though partisan divisions emerged with Democrats concerned about U.S. scientific leadership slipping while Republicans remain unconcerned.

Source(s):
Researchers drop projects, consider switching fields after a year of Trump funding cuts and layoffs (United States Department of Health and Human Services)
Democrats say America’s role as a scientific leader is slipping, while Republicans remain unworried (STAT)
Tags: #PATIENT, #PROVIDER, #DRUG

Trump Administration Dietary Guidelines Double Protein Recommendations, Emphasize Red Meat and Whole Milk

The Trump administration’s 2025-2030 U.S. Dietary Guidelines recommend Americans double their daily protein intake, with Health Secretary Robert F. Kennedy Jr. declaring an end to “the war on protein.” The new guidance features a revised food pyramid emphasizing red meat, whole milk, and animal protein sources while de-emphasizing plant-based options. Leading nutrition experts from Tufts and Stanford challenge the recommendations, stating Americans already consume sufficient protein and warning that increased consumption could lead to higher fat intake and diabetes cases, while potentially spurring sales of protein-enriched processed foods.

Source(s):
Why nutrition experts are wary of Trump’s new protein guidelines (Health x Workforce)
Tags: #PATIENT, #PROVIDER

AAP Releases Alternative 2026 Vaccine Schedule, Breaks with CDC After Federal Downsizing

The American Academy of Pediatrics released its own 2026 childhood immunization schedule on January 26, maintaining recommendations for routine protection against 18 diseases and explicitly stating it no longer endorses the CDC’s version. The AAP schedule, backed by a dozen major medical organizations, differs significantly from the CDC’s recently downsized recommendations that moved six vaccines to “shared clinical decision-making” status under HHS Secretary Robert F. Kennedy Jr. Multiple states and doctors are now relying on the AAP guidelines instead of federal CDC recommendations, with medical groups also filing expanded lawsuits challenging the CDC changes amid a measles outbreak exceeding 600 cases in South Carolina.

Federal Union Files Complaint Over HHS Telework Policy Changes Affecting Disability Accommodations

The National Treasury Employees Union filed a complaint against HHS over a new policy requiring senior officials to approve telework and remote work requests for employees with disabilities, which the union argues will discourage workers from seeking reasonable accommodations. The complaint comes amid ongoing litigation where seven HHS employees won federal judge approval in January 2026 to pursue a class action lawsuit representing 10,000 laid-off workers over Privacy Act violations in April reduction-in-force notifications that contained errors about performance ratings, veteran status, and other personnel details. The Trump administration’s motion to dismiss the RIF lawsuit was rejected by U.S. District Judge Beryl Howell, who found sufficient evidence for the case to proceed.

Source(s):
Federal Workers Accuse Trump Administration of Breaking Labor Laws (United States Department of Health and Human Services)
Laid off HHS employees win judge approval to seek class action suit (United States Department of Health and Human Services)
Tags: #ALL

U.S. Completes WHO Withdrawal, Owing $130M and Losing Pandemic Surveillance Access

The United States formally completed its withdrawal from the World Health Organization on January 22, 2026, ending a 78-year relationship, with HHS Secretary Robert F. Kennedy Jr. and Secretary of State Marco Rubio citing mishandling of COVID-19 and failure to implement reforms. The U.S. owes WHO over $130 million and has not resolved issues including lost access to international disease surveillance data that provides early pandemic warnings. WHO rejected Kennedy’s accusations that it compromised independence and failed during COVID-19, stating the withdrawal “makes both the United States and the world less safe” and will address the matter at Executive Board meetings starting February 2, 2026.

Source(s):
The US withdrawal from the WHO and the assault on public health (United States Department of Health and Human Services)
WHO pushes back at HHS after US withdrawal (United States Department of Health and Human Services)
U.S. Completes Its WHO Withdrawal (United States Department of Health and Human Services)
U.S. makes exit from the WHO complete (STAT)
Tags: #ALL

340B program changes in 2026 test compliance, cash flow and margins

Eli Lilly expanded its claims-level data requirements on Jan. 15 to covered entities’ own pharmacies in addition to contract pharmacies, following a court’s temporary restraining order on HHS’ 340B rebate pilot program. CMS plans a drug cost survey to reinstate Medicare payment cuts for 340B drugs after the Supreme Court struck down a previous attempt, with non-response potentially treated as negligible costs leading to punitive 2027 rates. More state legislation in 2026 is expected to mandate covered entity reporting and either bolster or restrict contract pharmacies.

Source(s):
340B program changes in 2026 test compliance, cash flow and margins (United States Department of Health and Human Services)
Tags: #HOSPITAL, #DRUG, #PROVIDER

Federal health IT committee to resume after yearlong hiatus

The Health Information Technology Advisory Committee will reconvene February 19, 2025 after a year-plus hiatus that began in early 2024 during Trump administration changes at HHS. Both co-chairs Sarah DeSilvey and Dr. Medell Briggs resigned in January 2025, and the committee will restart without leadership while the Office of the National Coordinator for Health Information Technology eliminated over half of EHR vendor certification requirements in 2024.

Source(s):
Federal health IT committee to resume after yearlong hiatus (United States Department of Health and Human Services)
Tags: #PROVIDER, #HOSPITAL, #PATIENT

Organ Transplantation: HHS Action Needed to Improve Lifesaving Program

GAO found that HHS has contracted for assessments of organ allocation weaknesses including inequitable allocation and insufficient investigation of serious events like premature organ recovery, but has not developed detailed reform plans. The current contractor received $9.6 million in FY2024 from optional fees charged to transplant programs for supplementary analytics services, which HHS has not assessed for risks or conflicts. Over 100,000 individuals remain on the national waiting list as of May 2025.

Source(s):
Organ Transplantation: HHS Action Needed to Improve Lifesaving Program (United States Department of Health and Human Services)
Tags: #HOSPITAL, #PROVIDER, #PATIENT

HHS Increases Anti-Fraud Efforts With Another Former U.S. Attorney

The Trump administration appointed another former U.S. attorney to the HHS Office of the General Counsel, characterizing this as part of what it calls the largest and most aggressive anti-fraud effort in HHS history. The appointment strengthens the department’s legal team focused on pursuing healthcare fraud cases.

Source(s):
HHS Increases Anti-Fraud Efforts With Another Former U.S. Attorney (United States Department of Health and Human Services)
Tags: #ALL

Heard on the Hill

UnitedHealth CEO pledges to rebate ACA exchange profits to members in 2026

UnitedHealth Group CEO Stephen Hemsley announced during testimony before the House Energy and Commerce Health Subcommittee that the insurer will voluntarily eliminate and rebate all profits from its individual ACA marketplace plans to customers in 2026. UnitedHealth described itself as a relatively small participant in the individual ACA market and said it is still working out details on how to distribute the rebates as Congress works toward long-term solutions.

Source(s):
UnitedHealth promises to return ACA profits to members as CEO addresses Congress (Health Insurance)
UnitedHealth Group will rebate ACA profits, CEO says (Health Insurance)
UnitedHealth CEO Hemsley says insurer will rebate ACA profits to consumers (Fierce Healthcare)
UnitedHealth plans to rebate exchange profits to customers (Health Insurance)
Tags: #PAYER, #PATIENT

Insurance CEOs Face Congressional Scrutiny, Deflect Blame for Rising Healthcare Costs to Hospitals and Drugmakers

Five major health insurance CEOs testified before House Energy and Commerce and Ways and Means committees on January 22, 2026, defending their business models amid bipartisan criticism over a 6% increase in employer-sponsored family coverage costs. Executives from UnitedHealth, CVS, Cigna, Elevance, and Ascension argued that 85-90% of premiums go toward medical claims and blamed rising costs on hospital prices, pharmaceutical prices, and increased care utilization. Lawmakers harshly criticized the executives for care denials, market concentration, and multi-million dollar salaries, with Rep. Greg Murphy stating insurers have “put profits above patients,” while AHIP separately blamed hospital consolidation and private equity ownership of nearly 500 hospitals for driving 40% of premium costs.

Source(s):
Health insurers tell Congress their operations aren’t driving high healthcare costs (Health Insurance)
Insurance CEOs’ no good, very bad day on the Hill (Health Insurance)
AHIP lays blame for rising healthcare costs on hospitals, private equity (Health Insurance)
Health insurance CEOs to appear before House committees as premiums soar (Health Insurance)
Insurers point to providers, drugmakers for driving up health costs (Health Insurance)
Insurance CEOs set for back-to-back congressional hearings on affordability (Fierce Healthcare)
STAT+: Health insurance execs shift blame for costly, confusing health care system (Health Insurance)
Tags: #PAYER, #HOSPITAL, #PROVIDER

Bipartisan momentum builds in Congress to address healthcare consolidation, with GOP joining calls to break up industry giants

House Budget Committee Chairman Jodey Arrington, R-Texas, signaled Republican willingness to work with Democrats on addressing healthcare consolidation, calling for bipartisan action against “big medicine monopolies in pharma, hospital, insurance.” The shift comes as Senator Elizabeth Warren and Senator Josh Hawley have introduced legislation requiring insurers to divest their pharmacies, though the bill has attracted few co-sponsors. Mark Cuban publicly advocated for forcing large healthcare companies to divest all non-insurance assets, though policy experts note Congress has rarely intervened to break up major corporations.

Source(s):
Congress eyes tackling healthcare consolidation (United States Congress x Health)
Mark Cuban urges Congress to make healthcare companies divest (United States Congress x Health)
Tags: #ALL

Appropriators Ask HRSA To Brief Congress On 340B Rebate Pilot In Draft Minibus

Congressional appropriators included language in a draft HHS spending bill requiring HRSA to brief Congress if it plans to redraft a pilot program that would test replacing 340B’s upfront drug discounts with after-the-fact rebates. The provision gives Congress oversight over potential changes to the 340B drug pricing program structure before implementation.

Source(s):
Appropriators Ask HRSA To Brief Congress On 340B Rebate Pilot In Draft Minibus (United States Department of Health and Human Services)
Tags: #DRUG, #HOSPITAL, #PROVIDER

AHA pushes for value-based care as House seeks Medicare, CHIP updates

The American Hospital Association submitted a January 16 letter to the House requesting reforms to MACRA’s alternative payment models, citing member hospitals’ implementation struggles with CMMI initiatives and recommending 9 specific elements including voluntary participation, adequate risk adjustment, and upfront investment incentives. AHA advocated for consensus-based endorsement of all MIPS cost measures, conversion factor updates tied to inflation, and design changes to enable rural hospital participation in Advanced APMs. The organization also requested reforms to ACO risk transitions and attribution methodologies that account for upstream risk factors.

Source(s):
AHA pushes for value-based care as House seeks Medicare, CHIP updates (Cardiovascular)
Tags: #HOSPITAL, #PROVIDER, #PAYER

Health Groups Pleased With Proposed NIH Budget in Bipartisan Funding Bill

The bipartisan FY2026 funding bill provides HHS with $116.8 billion (up $210 million) and allocates $47.2 billion for NIH (up $415 million), including $7.35 billion for the National Cancer Institute, while rejecting Trump’s proposed $33 billion HHS cut. The bill blocks OMB’s controversial forward funding policy that resulted in 2,000 fewer NIH research grants in FY2025 and prohibits a 15% cap on indirect costs for grants. CDC receives $9.1 billion, rejecting the administration’s proposed 50% budget cut.

Source(s):
Health Groups Pleased With Proposed NIH Budget in Bipartisan Funding Bill (United States Department of Health and Human Services)
Tags: #ALL

Trump Is Barely Trying With His New Health-care Plan

Trump introduced a health-care plan proposing redirecting insurance subsidies into health-savings accounts, requiring insurers to disclose prices paid to providers and claim denial rates, and regulating pharmacy-benefit managers like Express Scripts and CVS Caremark. The proposal lacks detailed implementation plans and faces near-zero legislative prospects given Trump’s One Big Beautiful Bill Act already enacted severe Medicaid cuts and House Republicans’ razor-thin margins make passing health policy nearly impossible.

Source(s):
Trump Is Barely Trying With His New Health-care Plan (United States Congress x Health)
Tags: #ALL

Site-neutral payment emerges as Medicaid savings tool in GOP reconciliation plan

Congressional Republicans propose imposing site-neutral payment requirements on Medicaid hospital billing, projected to save $172 billion over 10 years, adding to $900 billion in federal Medicaid cuts from the One Big Beautiful Bill Act. The American Hospital Association estimates that banning facility fees for outpatient services would cut hospital revenue by $3 billion to $180 billion over 10 years depending on policy scope.

Source(s):
Site-neutral payment emerges as Medicaid savings tool in GOP reconciliation plan (Centers for Medicare & Medicaid Services)
Tags: #HOSPITAL, #PROVIDER, #PAYER

Notable Notes

J&J cardiovascular drives medtech growth, Boston Scientific to acquire Penumbra for $14.5B

Johnson & Johnson reported 2025 medtech sales of $33.79 billion with 6.1% growth, led by its cardiovascular segment which grew 15.8% year-over-year to $8.93 billion, while orthopedics grew only 1.1%. Boston Scientific announced plans to acquire Penumbra for $14.5 billion to enter new cardiovascular markets and accelerate growth. Abbott secured approval for its TactiFlex Duo catheter that switches between pulsed field ablation and radiofrequency ablation for AFib treatment.

Source(s):
Novo Nordisk offloads diabetes assets to Aspect amid cell therapy retreat (Fierce Biotech)
J&J’s cardiovascular business boosts medtech growth in 2025 (MedTech Dive)
Bariatric surgery outpaces GLP-1s for diabetes, SDOH: Study (Becker’s Hospital Review)
3 takeaways from Boston Scientific’s $14.5B Penumbra deal (MedTech Dive)
Abbott secures key approval for new catheter capable of PFA, radiofrequency ablation (Cardiovascular Business)
Pivotal trial highlights safety, effectiveness of FDA-approved carotid stent (Cardiovascular Business)
New-look heart failure treatment could loosen rigid cardiac muscles (Cardiovascular Business)
Tags: #DEVICE, #HOSPITAL, #PAYER

Medtronic to buy up to $90M stake in heart valve developer Anteris

Medtronic will purchase up to $90 million (16-19.99% stake) in Anteris Technologies, contingent on Anteris completing a $200 million public offering. Anteris is developing the DurAVR transcatheter aortic valve replacement device made from FDA-cleared ADAPT anti-calcification tissue, currently enrolling patients in the PARADIGM clinical trial in Denmark with first patients enrolled in Q4 2024.

Source(s):
Medtronic to buy up to $90M stake in heart valve developer Anteris (MedTech Dive)
Tags: #DEVICE, #PATIENT

AMA Survey: 89% of Physician Groups Identify Scope of Practice as Top State Policy Priority for 2026

Nearly nine in ten physician groups identified scope of practice as their top state health policy issue for 2026, with concerns focused on non-physician providers seeking independent practice authority, prescribing rights and unsupervised patient care. More than 70% of respondents also plan to engage on Medicaid-related issues in 2026. Additional priorities include workforce shortages, health technology oversight, and licensure issues including Interstate Medical Licensure Compact adoption, with over two-thirds of societies planning to work on licensure.

Source(s):
Physician groups said scope of practice will be the top state health policy issue in 2026 (Centers for Medicare & Medicaid Services)
Scope of practice is top of mind for physicians, says AMA survey (Healthcare Finance News)
Tags: #PROVIDER, #PATIENT

STAT+: Former AMA president says the U.S. health care system will implode without an overhaul

Jesse Ehrenfeld, 47, former AMA president and current anesthesiologist and dean at Medical College of Wisconsin, was recruited as chief medical officer by AI medical imaging company Aidoc. Ehrenfeld was the first openly gay person and first board-certified clinical informaticist to serve as AMA president three years ago.

Source(s):
STAT+: Former AMA president says the U.S. health care system will implode without an overhaul (STAT)
Tags: #PROVIDER, #DEVICE

America’s $38 trillion national debt is so big the nearly $1 trillion interest payment will be larger than Medicare soon

Net interest on the national debt exploded from $375 billion (1.7% of GDP) in FY 2019 to $952 billion (3.2% of GDP) in FY 2025, a 153% increase that outpaced Medicare’s 25% growth. Interest expense is projected to reach $1.6 trillion by 2034, surpassing Medicare as the second-largest budget item. In Q1 FY 2026, interest costs hit $179 billion, already exceeding both Medicare and defense spending for that period.

Source(s):
America’s $38 trillion national debt is so big the nearly $1 trillion interest payment will be larger than Medicare soon (Centers for Medicare & Medicaid Services)
Tags: #ALL

Hospital use and service intensity helped fuel healthcare spending growth in 2024

U.S. healthcare spending reached $5.3 trillion in 2024, a 7.2% increase driven primarily by nonprice factors including increased demand and service intensity. Hospital care expenditures grew 8.4% to $1.6 trillion with hospital discharges up 3.2% and days up 1.5%, while Medicare retail prescription drug spending surged 12.9% partly due to Part D redesign under the Inflation Reduction Act.

Source(s):
Hospital use and service intensity helped fuel healthcare spending growth in 2024 (HFMA)
Tags: #ALL

The Success Triangle: What MedTech Startups Can’t Ignore

Article advises MedTech startups to holistically develop products, clinical studies, and payment strategies together to reduce risks, lower costs, and achieve profitability faster. The piece focuses on strategic business planning for medical device companies entering the market.

Source(s):
The Success Triangle: What MedTech Startups Can’t Ignore (MedCity News)
Tags: #DEVICE

New ABC campaign works to improve care in cardiology deserts

The Association of Black Cardiologists launched a patient education campaign targeting Louisiana, Arkansas, Georgia, and Mississippi to improve cardiovascular care access in underserved areas. ABC President Anthony Fletcher, MD, is leading the initiative to address cardiology care gaps in these four states.

Source(s):
New ABC campaign works to improve care in cardiology deserts (Cardiovascular Business)
Tags: #PATIENT, #PROVIDER

5 US payers make Fortune’s most admired companies 2026 ranking

Fortune’s 2026 World’s Most Admired Companies ranking included five U.S. health insurers, with UnitedHealth Group, Elevance Health, and Humana taking the top three spots. Medicare Advantage-focused Alignment Health made the list for the first time at #4, while Molina Healthcare dropped off after appearing in the 2025 ranking.

Source(s):
5 US payers make Fortune’s most admired companies 2026 ranking (Health Insurance)
Tags: #PAYER

American Psychiatric Association Sues Health Plan Over ‘Ghost Networks’

The American Psychiatric Association filed a December 30 class action lawsuit against EmblemHealth in federal court alleging the New York health plan maintains ghost networks that falsely list mental health providers who don’t accept their insurance or aren’t taking new patients, some without their consent. A 2023 Senate Finance Committee secret shopper study of 120 Medicare Advantage provider listings found 33% had inaccurate or non-working numbers and staff could only make appointments 18% of the time. The lawsuit seeks punitive damages and jury trial for deceptive practices, false advertising, and federal trademark violations.

Source(s):
American Psychiatric Association Sues Health Plan Over ‘Ghost Networks’ (United States Department of Health and Human Services)
Tags: #PROVIDER, #PAYER, #PATIENT

The EPA sets the value of human life and health at zero: A further comment

The EPA under the Trump administration plans to stop calculating monetary health benefits (premature deaths, heart attacks, asthma) when evaluating PM2.5 and ozone regulations while continuing to count industry compliance costs, and has moved to rescind the 2009 Endangerment Finding that provided legal basis for regulating greenhouse gases under the Clean Air Act. The EPA also proposes eliminating the Greenhouse Gas Reporting Program for most industrial sectors, with regulatory analyses previously showing stronger PM2.5 standards prevent tens of thousands of premature deaths annually. The policy changes are expected to reduce regulatory compliance expenses by billions of dollars annually for emissions-intensive sectors as the EU’s Carbon Border Adjustment Mechanism came into force in January 2026.

Source(s):
The EPA sets the value of human life and health at zero: A further comment (United States Congress x Health)
Tags: #ALL

AdvaMed’s top priorities and how it’ll work with the Trump administration

AdvaMed CEO Scott Whitaker and new board chair Mick Farrell (ResMed CEO) outlined five priorities including FDA performance improvements, CMS coverage policies, and ongoing MDUFA VI negotiations. The medical device industry association plans to engage with the Trump administration on these issues plus tariff concerns.

Source(s):
AdvaMed’s top priorities and how it’ll work with the Trump administration (Medical Design and Outsourcing)
Tags: #DEVICE