Potential New CMCS Director Emerges

Multiple outlets are reporting that Dan Brillman is expected to be the Trump Administration’s choice to fill the vacant spot of Director of the Centers for Medicaid and CHIP Services (CMCS) at CMS. Brillman is co-founder and CEO of Unite Us, a health tech company that facilitates social service referrals for patients. The company operates in 44 states, across a variety of nonprofits, providers, and payers. Earlier this summer, Drew Snyder stepped down as CMCS director, with Caprice Knapp stepping in as acting director in the interim (Fierce Healthcare, August 22).

HHS Forms New Healthcare Advisory Committee

The Department of Health and Human Services (HHS) is forming a new Healthcare Advisory Committee to provide strategic guidance on Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) exchanges. Announced by HHS Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz, the committee will focus on chronic disease prevention and management, reducing regulatory burdens, advancing real-time data systems for claims and quality measurement, strengthening Medicaid, and ensuring the sustainability of Medicare Advantage. CMS is accepting nominations from experts in relevant fields until 30 days after the August 22 Federal Register notice, with members to be announced later this year (Fierce Healthcare, August 21).

Federal Judge Blocks Major Provisions of CMS’ ACA Marketplace Final Rule

On Friday, August 22, the US District Court of Maryland blocked major provisions of the CMS regulation, “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability Final Rule,” from going into effect. While the Trump Administration contends that the final rule, which was set to become effective on August 25, is intended to reduce fraud and abuse in ACA Marketplace exchanges, many stakeholders argue that the rule would result in unnecessary loss of coverage. An estimated 1.8M individuals are expected to lose coverage as a result of the rule. The nonprofit Democracy Forward filed suit to block implementation of the rule in July on behalf of two advocacy groups and three large cities, arguing that the Trump Administration violated the Administrative Procedure Act, citing the potential for businesses to face higher costs if employees or members lose coverage. The District Court Judge blocked seven provisions, including the institution of a $5 premium for individuals who automatically re-enrolled in coverage and would otherwise have no premium costs; the prohibition of coverage for individuals who fail to reconcile tax credits with their income; the elimination of guaranteed coverage for people who are overdue on their premiums; the requirement for stricter eligibility verifications ahead of special enrollment periods; revisions to actuarial value requirements for plans; and the imposition of greater income verification standards if inconsistencies are found in tax data. The judge did not address the rule’s shortening of the ACA open enrollment window. Most provisions in the final rule impact plan year 2026, which insurers anticipate being challenging with the looming expiration of enhanced tax credits. It is unclear if the Administration will appeal the decision as the case continues (Healthcare Dive,  August 25; Inside Health Policy, August 22).

CHI Touts Idea for Rural Health Fund to be Used on Tech-Enabled Care

On August 21, the Connected Health Initiative (CHI), a coalition advocating for the use of technology to improve patient health outcomes, sent CMS a letter asking that part of the Rural Health Transformation Program (RHTP) fund be designated for AI, health information technology, wearable health devices, and telehealth services. CHI calls on CMS to clarify that telehealth services funded under the RHTP will not be held to pre-PHE Medicare telehealth standards and asks that the agency issue guidance regarding the adoption of cloud services and allow funds to be utilized to strengthen cybersecurity infrastructure and expand telehealth access (Inside Health Policy, August 21).