Latest
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New CMS Guidance on H.R. 1’s Restrictions of State Directed Payments
On February 2, 2026, the Centers for Medicare & Medicaid Services (CMS) issued new guidance implementing section 71116 of H.R. 1 (the “One Big Beautiful Bill Act” or P.L. 119-21), which restricts state-directed payments (SDPs) to hospitals and other health care providers. Under SDPs, states may require Medicaid managed care plans to increase provider rates or…
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CMS Issues Final Rule Implementing H.R. 1’s Prohibition of Certain Uniformity Waiver Provider Taxes
On January 29, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing the H.R. 1 provision prohibiting certain “uniformity waiver” provider taxes that states use to support their Medicaid programs. (The rule is scheduled to be published in the Federal Register on February 2, 2026). Nearly all states use taxes…
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House Republican Study Committee Pushes for Second Budget Reconciliation Bill and More Damaging Medicaid Cuts
On January 13, the House Republican Study Committee (RSC) unveiled its plan for a second budget reconciliation bill for this Congress, in addition to H.R. 1 (the “One Big Beautiful Bill Act” or P.L. 119-21) which was enacted on July 4, 2025. The plan includes a number of proposals to cut Medicaid, on top of…
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CMS Issues New Guidance on H.R. 1’s Restrictions on State Use of Provider Taxes to Finance Medicaid
On November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) issued new guidance with some new detail about how it will implement provisions in H.R. 1 — the budget reconciliation law also known as the One Big Beautiful Bill Act — that restrict states’ use of provider taxes to finance their share of…
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Several Key Questions about Trump Administration’s Drug Pricing Deals and Their Impact on Medicaid Remain Unaddressed
[Editor’s Note: This blog was updated on November 21, 2025, to reflect changes to the Request for Applications.] On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a new Center for Medicare and Medicaid Innovation (CMMI) model to implement pricing agreements with two drug manufacturers — Pfizer and AstraZeneca — which…
