This Week’s Health and Insurance Law Update

This Week’s Dose

• House Energy and Commerce Oversight Subcommittee examines Medicare and Medicaid fraud. Centers for Medicare & Medicaid Services (CMS) Deputy Administrator Kim Brandt testified about CMS efforts to prevent and address fraud.
• House Energy and Commerce Health Subcommittee holds third affordability hearing. The hearing featured witnesses representing the hospital, physician, and home care industries.
• NIH Director Bhattacharya testifies at House Appropriations LHHS Subcommittee. The oversight hearing aimed to examine current National Institutes of Health (NIH) funding practices.
• House Ways and Means Committee discusses how to improve kidney health. Members presented various legislative proposals, including bills to prevent private health plans from discriminating against dialysis patients and to phase out waiting periods for certain individuals receiving disability insurance benefits.
• Senate Appropriations Committee releases FY 2027 guidance. The guidance outlines how senators can submit congressionally directed spending, programmatic, and report language requests.
• Senate Finance Committee Democrats pursue policies to improve health insurance coverage. Ranking Member Wyden (D-OR) and several other Democratic committee members released a letter outlining a new initiative to develop policy to improve private health insurance coverage.
• CMS requests program integrity information from Florida. This follows similar letters recently sent to Minnesota, New York, California, and Maine.
• President Trump establishes government-wide fraud task force. The task force formalizes the administration’s focus on combatting fraud across agencies.
• CMS Innovation Center releases notice of funding opportunity for MAHA ELEVATE. The Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA ELEVATE) model pilots whole-person functional and lifestyle medicine interventions.
• White House releases AI legislative framework. The framework includes policy proposals for Congress to consider to spur innovation and increase public trust in artificial intelligence (AI).
• Federal judge vacates HHS gender-affirming care declaration. The US Department of Health and Human Services (HHS) December 2025 declaration stated that gender-affirming care procedures were unsafe and ineffective for children.

Congress

House Energy and Commerce Oversight Subcommittee examines Medicare and Medicaid fraud. During the hearing, CMS Deputy Administrator Brandt highlighted CMS’s move away from a “pay and chase” system to a “stop and cop” approach by creating a high-risk watch list, entering into data-sharing agreements with other federal agencies, and using data analysis and algorithms. CMS is working to create a 50-state Medicaid program integrity playbook with best practices by the end of the year. Democrats emphasized that they believe CMS is weaponizing fraud to target states with Democratic governors, notably in Minnesota, California, Maine, and New York. Republicans expressed frustration that fraudsters may be taking advantage of vulnerable populations and voiced support for CMS’s initiatives. The day before the hearing, President Trump created a federal fraud task force, discussed below.

House Energy and Commerce Health Subcommittee holds third affordability hearing. The committee heard testimony from a panel of mostly healthcare providers. Democrats argued that the reductions in federal Medicaid funding passed last year in the One Big Beautiful Bill Act will result in significant levels of uncompensated care for hospitals, which will drive higher healthcare costs nationwide. Republicans emphasized the need for healthcare price transparency and wanted to find ways to encourage more physicians to practice independently. Both parties expressed concern about the impacts of healthcare consolidation and the physician workforce shortage. Witnesses recommended reforming physician payment to reflect the rate of inflation, increasing price transparency in hospitals, and repealing the ban on physician-owned hospitals.

NIH Director Bhattacharya testifies at House Appropriations LHHS Subcommittee. Members of the Labor, HHS, Education, and Related Agencies (LHHS) Subcommittee from both sides of the aisle discussed the importance of robust NIH funding and restoring and maintaining public trust in the NIH. Director Bhattacharya reiterated that trust can be restored through reproducible research. He highlighted the new NIH Unified Funding Strategy as a means of promoting more consistent, transparent, and science-driven funding decisions; reducing variability in grantmaking practices; and better aligning investments with urgent national health priorities.

Democrats raised concerns about the politicization of NIH funding decisions, canceled or delayed research funding, leadership vacancies, workforce disruptions, and declining opportunities for scientists, especially early-career researchers, while stressing that grants should be awarded based on scientific merit and backed by strong federal investment. Republicans emphasized the need to spread research funding beyond a small group of institutions, lower indirect costs, strengthen safeguards on foreign influence, and direct NIH support toward public health priorities such as chronic diseases. Director Bhattacharya reassured members that the NIH is distributing fiscal year (FY) 2026 grant funding and will spend its fully appropriated budget by the end of the FY.

House Ways and Means Committee discusses how to improve kidney health. Republicans noted that greater innovation in treatments and drugs for end-stage renal disease and kidney disease is needed, but argued that current Medicare payment structures discourage it. Democrats emphasized the impact that cuts to medical research and Medicaid would have on individuals with kidney disease. Witnesses spoke in support of more frequent screening options, innovation and reform in kidney treatment, and better patient and provider education on at-home dialysis options.

Senate Appropriations Committee releases FY 2027 guidance. Senators must submit LHHS congressionally directed spending (CDS) and programmatic/report language requests by April 21, 2026. The House Appropriations Committee released its guidance on February 25, 2026, and LHHS requests are due from representatives by March 27, 2026. Accounts eligible for LHHS CDS requests in the Senate are broader than in the House. In the House, CDS requests must be specific to the Health Resources and Services Administration (HRSA) health facilities construction and equipment account and contain additional restrictions on who can apply for those funds. In the Senate, requests can be directed to specified accounts at HRSA, the Substance Abuse and Mental Health Services Administration, the Administration for Children and Families, and the Administration for Community Living.

Senate Finance Committee Democrats pursue policies to improve health insurance coverage. Ranking Member Wyden and several other Democratic Finance Committee members released a letter outlining a new initiative to develop policies to improve private health insurance coverage. They are focused on policies that will “lower costs, make it simpler to get and use insurance, and rein in shameless profiteering by corporate insurance companies.” They invite stakeholders to provide input into such policies during weekly office hours. This is part of a planning effort for the possibility that Democrats gain control of the Senate, and it follows a similar effort related to drug pricing.

Administration

CMS requests program integrity information from Florida. An hour before the House Energy and Commerce Oversight Subcommittee hearing on March 17, 2026, CMS Administrator Oz announced that CMS had sent a letter to Florida seeking information about the state’s efforts to address Medicare and Medicaid fraud, waste, and abuse. The letter highlights concerns about certain high-risk services: durable medical equipment, applied behavioral analysis for children with autism, adult day center services, and personal care services. CMS asked for a response to more than 20 questions within 30 days.

President Trump establishes government-wide fraud task force. Following up on his announcement that Vice President Vance would lead the administration’s antifraud efforts, President Trump established the task force through an executive order that directs the task force to coordinate a comprehensive national strategy to stop fraud, waste, and abuse within federal benefit programs, including programs administered jointly with states. The task force will develop measures to improve eligibility verification processes; evaluate indicators of fraud; promote data sharing between states, the federal government, and law enforcement agencies; and investigate fraud.

Within 30 days, agencies must submit information to the task force on transactions and processes that are most susceptible to fraud. Within 60 days, agencies must work to adopt minimum antifraud requirements to combat identified fraud, including by working with state agencies. Within 90 days, all agencies must submit an implementation plan to the task force on these requirements.

CMS Innovation Center releases notice of funding opportunity for MAHA ELEVATE. CMS will select up to 30 cooperative agreement recipients to participate in MAHA ELEVATE, with three out of the 30 set aside specifically for programs focused on dementia and cognitive decline. Awards will be split across two cohorts (October 2026 and October 2027) with up to $3.3 million available to each selected recipient over a three-year performance period for a total of up to $100 million. Unlike traditional cooperative agreement awards, MAHA ELEVATE funding will be contingent upon meeting operational and enrollment milestones.

CMS will select recipients based on five criteria:

• Whole-person intervention design, including cost savings.
• Beneficiary recruitment and study design.
• Organizational and administrative capacity.
• Data management capabilities.
• Budget.

Letters of intent are due April 10, 2026, and applications for the first cohort are due May 15, 2026. Second cohort applications will be due at a later date. Applicants not selected for the first cohort will remain eligible for the second.

White House releases AI legislative framework. The broad framework outlines six objectives, each with legislative proposals, some of which could be applicable to healthcare. The objectives focus on protecting children and empowering parents; safeguarding and strengthening American communities; respecting intellectual property rights and supporting creators; preventing censorship and protecting free speech; enabling innovation and ensuring American AI dominance; educating Americans and developing an AI-ready workforce. The Trump Administration believes these policies should be applied uniformly across the US to avoid a patchwork of conflicting state laws, and the framework asks Congress to preempt state AI laws that impose undue burdens. After the framework’s release, House Republican leaders announced they would work with the White House to enact the national framework.

Courts

Federal judge vacates HHS gender-affirming care declaration. The judge in an Oregon District Court sided with the 21 plaintiff states by ruling that HHS Secretary Kennedy overstepped his authority when issuing a December 2025 declaration that gender-affirming care for children are unsafe and ineffective and do not meet professional recognized standards of healthcare. The declaration noted that HHS may exclude individuals or entities from participating in federal healthcare programs if they’re determined to be providing care that fails to meet professionally recognized standard of healthcare. It is unclear whether HHS will appeal this decision.

Bipartison Legislation Spotlight

Reps. Lawler (R-NY), Bishop (D-GA), Salazar (R-FL), and Clarke (D-NY) introduced the H-1Bs for Physicians and the Healthcare Workforce Act. The bill would exempt healthcare workers from new restrictions on H-1B visas enacted by President Trump in September 2025, including the $100,000 petition fee. After President Trump enacted this restriction, almost 100 bipartisan members of both the House and Senate wrote to the US Department of Homeland Security (DHS) urging the agency to exempt healthcare workers.

Quick Hits

• Senate HELP Committee holds member day hearing. Both on-committee and off-committee members discussed their priorities in relation to drug pricing, healthcare access, the healthcare workforce, and the pharmaceutical supply chain.
• House Select Committee examines US competition with China. There was bipartisan interest during the hearing in ensuring the United States remains the global hub for early-stage biopharmaceutical innovation. Witnesses, who included pharmaceutical executives and researchers, emphasized the importance of creating a policy framework that encourages domestic production of clinical medicines.
• CMS releases new data on AHCAH program. With this release, data is now available on the Acute Hospital Care at Home (AHCAH) program from November 2020 through September 30, 2025. Congress recently extended the program through September 30, 2030.
• HHS OCR opens federal conscience law investigation in thirteen states. The HHS Office for Civil Rights (OCR) is investigating claims that the states (California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont and Washington) are coercing healthcare entities to provide coverage of, or pay for, abortion contrary to a federal conscience law, the Weldon Amendment.

Next Week’s Diagnosis

Next week will be Congress’ last in-session week before the two-week spring recess, which begins March 30, 2026. We expect continued focus on healthcare fraud, Senate nominations, DHS funding, and FY 2027 appropriations. The House Energy and Commerce Health Subcommittee will meet on March 26 to discuss legislative solutions to protect against illicit drug threats. We also await the release of the president’s budget and the Medicare Advantage 2027 final rate notice and final technical rule, both of which are under Office of Management and Budget review. The final rate notice must be released by April 6.