New Administration Personnel
Several news outlets (notably the Washington Post and Politico) reported on expected key personnel at CMS. These individuals include:
- Chris Klomp, a healthcare entrepreneur, would lead Medicare (CM).
- Abe Sutton, a veteran of the first Trump administration, would oversee Medicare’s innovation center (CMMI). Sutton has previously written about shifting the Medicare Advantage risk adjustment model to an inferred risk system.
- Stephanie Carlton, a longtime McKinsey consultant, and former GOP Senate staffer, would serve as Oz’s chief of staff,
- Drew Snyder, longtime Mississippi Medicaid Director, would serve as director of the Center for Medicaid.
Last CMS Regulations from the Biden Administration
CMS released several key regulations. These included:
- The Advance Notice (for MA/Part D plans) – CMS published the proposed Advance Notice. It included an expected average change of 4.33%
- Notice of Benefit and Payment Parameters – CMS finalized the 2026 Payment Notice that affects ACA plans. Generally, it aligned with the proposed rule. It finalized the FFM user fee of 2.5% and the SBM-FP user fee rate to 2.0% (although that could change if enhanced subsidies are extended before July 31, 2025).
- Other proposed or finalized regulations will be handled by the incoming Administration.
Preventative Services at Supreme Court
The Supreme Court announced it will take up a case involving preventative services requirements. SCOTUS will consider whether some or all preventative service requirements are constitutional. SCOTUS is expected to hear the case in March/April and render a verdict in June.
Medicaid Updates
One of the key discussions going on in Washington is to what extent Medicaid cuts are included in a future reconciliation bill. Georgetown University has a summary of the potential changes and their implications here. Beyond potential cuts due to federal legislation, a number of states are facing extreme budget constraints and may be looking into ways of reducing costs. Axios reported Indiana is considering capping its Medicaid expansion enrollment and Idaho is considering a lifetime limit.
