Issue #275

Sellers Dorsey Digest

February 26, 2026

RHT Forum Blog
NEW BLOG

Rural Health Transformation Forum: From Planning to Implementation —What's Happening Now Across the Country

Our latest blog breaks down how states, CMS, and rural stakeholders are progressing from planning to implementation under the Rural Health Transformation (RHT) Program. With funding beginning to flow, states are establishing governance structures, preparing procurements, and gearing up for significant reporting and compliance requirements. Learn what’s happening now across the country, and how providers and partners can prepare to engage in upcoming RHT opportunities.

Federal News

AHA Sends Letter to HHS on AI Considerations in Healthcare

On February 23, the American Hospital Association (AHA) sent a letter to the Department of Health and Human Services (HHS) requesting that federal officials reduce regulations and allow clinician oversight of artificial intelligence (AI) within healthcare. Though supportive of AI in clinical care, AHA requests that HHS consider several guardrails as usage expands. This includes integrating new AI policies within existing regulations, implementing stronger federal privacy requirements, and promoting transparency of AI prior authorization algorithms. Additionally, AHA noted that AI implementation and operation are costly and time-intensive and are not accounted for in Medicare payment rates. The association warned against prioritizing AI over medical services. Finally, the letter encouraged HHS to extend privacy and security standards to third-party vendors and establish “risk-based post-deployment monitoring standards” for devices that use AI (Becker’s Health IT, February 23).

HHS Launches Health IT Challenge

On February 17, the HHS’ Assistant Secretary for Technology Policy (ASTP) launched the EHIgnite Challenge, in which participating health IT developers are tasked with creating tools, workflows, or platforms with the capability to transform raw electronic health information (EHI) into readable and actionable data that can be used by clinicians to make informed decisions for their patients. The agency will hold an informational webinar on March 11 at 2:00 pm (ET). Winners of the challenge will award the first phase winners with $10,000 and second phase finalists with $250,000, $100,000, and $30,000, respectively, with an additional award of $20,000 for the Most Innovative Use of AI. Those interested in participating must enter by May 13, 2026 (Beckers Hospital Review, February 24).

Stakeholders Urge Changes to 2027 MA Rates

CMS’ January 26 advance notice for the 2027 Medicare Advantage (MA) rate sets a 0.9% average payment increase (about 2.54% after coding adjustments), below the 4%-6% increase many insurers had anticipated. In response, the Better Medicare Alliance is circulating a sign-on letter to CMS Administrator Mehmet Oz requesting that the agency consider a higher final rate and take a measured approach to future policy changes in consultation with stakeholders. The proposal also includes updates to the MA risk adjustment model, including the exclusion of certain chart-review diagnoses not linked to patient encounters. Policy analysts describe the notice as reflecting broader federal fiscal considerations and oversight priorities. Insurers and ratings analysts have noted potential implications for premiums, benefits, and plan participation depending on the final rate. Comments on the advance notice are due February 25, and CMS is expected to issue the final rule by April 6 (Inside Health Policy, February 20).

HHS Delays ACIP Session Scheduled to Address Vaccine Program Updates

Health and Human Services (HHS) has postponed the February 25–27 meeting of the Advisory Committee on Immunization Practices (ACIP) after failing to publish the required Federal Register notice and amid a Massachusetts court case challenging HHS Secretary Robert F. Kennedy Jr.’s recent appointments to the panel. The meeting was expected to include discussion of whether to align the Vaccines for Children (VFC) Program with CDC’s January revisions to the vaccine schedule, including vaccines moved to “shared clinical decision-making” recommendations. Pediatric organizations have raised concerns that removing such vaccines from VFC could lead to differences in access between privately insured and VFC-eligible children. The delay also comes amid scrutiny of FDA’s handling of Moderna’s investigational mRNA influenza vaccine and ongoing leadership transitions at CDC (Inside Health Policy, February 19).

Second CDC Official Steps Down

On February 23, the CDC announced that Ralph Abraham, who began as the agency’s Principal Deputy Director in January, stepped down from his position citing unforeseen family obligations. The announcement comes soon after former NIH director Jay Bhattacharya was temporarily appointed to lead the CDC. Abraham, who was formerly the Surgeon General of Louisiana, has previously expressed anti-vaccination sentiments. This move comes as recent White House statements may signal a shift in HHS focus away from vaccines and toward food safety and pharmaceutical price reductions (Inside Health Policy, February 23).

Hospital Price Transparency Data Underutilized by Patients

According to KFF Health News, price transparency efforts from the federal government in recent years have not achieved their intended consumer impact. The first and second Trump administrations have pushed price transparency requirements for hospitals with the goal of allowing consumers to shop for more affordable healthcare. However, research has shown that hospitals have been slow to comply with the transparency rules. Moreover, other researchers did not find evidence that patients are using the price transparency data to make healthcare decisions. Despite efforts by both President Trump and President Biden, the data that is published is often sparse, inconsistent, or difficult for consumers to interpret or compare. Rather, the public data is utilized by the industry itself. Insurers have found the data to be a useful tool in identifying rate discrepancies and strengthening contract negotiation positions (Fierce Healthcare, February 18; KFF Health News, February 17).

State News

Arkansas DHS to Test Work Requirements in the Summer

Arkansas plans to “soft launch” community engagement requirements in the summer of 2026 ahead of the January 2027 implementation date. The Department of Human Services (DHS) director of the Division of County Operations described how the agency intends to test its eligibility system by checking enrollees for compliance with the new community engagement requirements but will not require enrollees to submit any additional information. Importantly, no disenrollments will result from the test. Notices generated from the test would help enrollees understand their position and prepare for the new conditions ahead of the January 2027 go-live date. Like other states, Arkansas’ DHS is waiting for the interim final rule to be released to receive guidance on how to implement the new requirements. ARHOME, the state’s Medicaid expansion program, covers more than 220,000 residents. Previous efforts to implement work requirements in Arkansas resulted in nearly 20,000 enrollees losing coverage before being halted by a federal court in 2019. At the time of this publication, Nebraska remains the only state implementing community engagement requirements in 2026 (Arkansas Advocate, February 20).

Medical Debt Collection Reforms Advance in Multiple States

Efforts to restrict the use of wage garnishment for unpaid medical debt are advancing in eight states, including Colorado, Florida, Hawaii, Indiana, Maine, Michigan, Ohio, and Washington. The proposals range from full bans on medical debt garnishment, such as legislation under consideration in Colorado, to measures that would increase the portion of wages protected for lower-income workers. Some bills would also limit bank garnishments, cap payment plans as a percentage of income, and shorten collection timeframes. Supporters say the reforms address financial hardship linked to medical debt, while debt collection agencies and some healthcare providers argue additional limits could affect provider revenue and financial stability (Fierce Healthcare, February 23).

Mississippi Health System Closes Clinics Amidst Cyberattack

On February 19, the University of Mississippi Medical Center (UMMC) was hit by a cyber-attack that took down its access to their communication systems and Epic, which handles patients’ electronic health records. In response, UMMC quickly shut down all its clinics temporarily, but left several hospitals and emergency departments open. In the meantime, it continues to schedule patients who rely on time-sensitive care and are utilizing downtime procedures for its inpatient operations. The health system is actively working with federal authorities to respond to the attack. Regularly scheduled clinic appointments and elective procedures at UMMC are canceled through Friday (Healthcare Dive, February 23; Mississippi Today, February 25).

SPAs and Waivers

SPAs

  • Services
    • Montana (MT-25-0019, effective October 1, 2025): In alignment with 1905(a)(29) of the Social Security Act, ensures coverage of Medication-Assisted Treatment (MAT) for Opioid Use Disorder (OUD).
    • Tennessee (TN-25-0009, effective October 1, 2025): In alignment with 1915(I) of the Social Security Act, outlines the coverage of substance use disorder (SUD) treatment for individuals receiving care at eligible institutions that treat mental illnesses.
    • Wyoming (WY-26-0001, effective January 1, 2026): Confirms compliance with §5121 of the Consolidated Appropriations Act of 2023, which establishes targeted case management (TCM) services for eligible juveniles under 21 and former foster care individuals ages 18-26.
  • Payment
    • Arkansas (AR-25-0014, effective January 1, 2026): Carves out certain drugs, including Cell and Gene Therapy (CGT) from DRG reimbursement for hospitals and shits to actual acquisition cost.
    • Georgia (GA-25-0006, effective July 1, 2025): Implements add-on payments for the Rural Hospital Newborn Delivery Program from $1,000 to $3,000 per newborn delivery, depending on county population.
    • Hawaii (HI-25-0011, effective January 1, 2026): Aligns provide licensure and enrollment sections with current federal regulations at 42 CFR 455.
    • Maine (ME-25-0006, effective January 1, 2025): Amends nursing facility reimbursement through the implementation of a Quality Bonus Pool (QBP) and incorporation of Value-Based Payment (VBP).
    • New Jersey (NJ-25-0016, effective October 1, 2025): Increases transportation reimbursement rates for partial care services.
    • Ohio (OH-25-0029, effective January 1, 2026): Updates payment methodology for Ambulatory Surgical Centers (ASCs) by increasing the dental flat rate, decoupling ASC reimbursement from outpatient hospital rates, and implementing ASC-specific Enhanced Ambulatory Patient Group (EAPG) relative weights.

Sellers Dorsey Updates

Sellers Dorsey Welcomes New Director of Consulting, Kathy Moses

Sellers Dorsey is pleased to welcome Kathy Moses as Director of Consulting, bringing more than 25 years of Medicaid health policy and public health expertise. Kathy has worked extensively with states, managed care organizations, providers, and a wide range of Medicaid stakeholders to drive meaningful health system transformation. Her commitment to Medicaid innovation will help advance our mission to improve healthcare quality, access, and outcomes nationwide.

Leading the Nation's Child Welfare System: A Conversation with Children's Bureau Associate Commissioner

The national conversation around child welfare is evolving with a stronger emphasis on prevention and family stability. How will that vision translate into policy, funding, and expectations that make measurable improvements in child and family well-being? Join Sellers Dorsey for a candid, virtual discussion with newly appointed Children's Bureau Associate Commissioner Ryan Hanlon, Ph.D., MSW, on March 4 at 1 PM (ET) as we talk about the priorities, policies, and partnerships that will define the next era of child welfare.

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