Top News
HHS Releases FY26 Budget in Brief
The Department of Health and Human Services (HHS) Released the Budget in Brief for Fiscal Year (FY) 2026. The budget includes an over $32 billion reduction in total discretionary funds from 2025 to 2026, with all departments experiencing budget cuts except for the Indian Health Service and General Departmental Management Budget Authority. The Make America Healthy Again (MAHA) initiative is a centerpiece of the budget, focusing on improving administrative efficiency, addressing chronic diseases, improving the food supply, promoting transparency and good science, and addressing adolescent and Tribal health. The Centers for Medicare and Medicaid Services (CMS) will prioritize reducing fraud, waste, and abuse in Medicare and Medicaid, promote Medicare beneficiary choice, invest in health care digital technologies, and explore initiatives to reduce the costs of medical equipment and pharmaceuticals.
Trump Administration Chooses Not to Enforce Biden-Era Parity Rule
The Trump administration gave notice via a court filing on Monday that it does not intend to enforce a Biden-era parity rule – one that would have strengthened the requirements of the 2008 Mental Health Parity and Addiction Equity Act. The Department of Justice (DOJ) asked the courts to place the case on a suspension while it determines next steps – to either modify the current rule or suspend it altogether. The Plaintiff ERIC, or the ERISA Industry Committee (ERIC), filed the lawsuit in January, just weeks before Trumps inauguration, and argued that the regulation overstepped its legal authority. Specifically, ERIC argued that the regulation violates due process, the Administrative Procedure Act, and the nondelegation doctrine. Advocates of parity noted that the actions of the Trump administration do not match its words, and that the administration should take into consideration opinions other than those of insurance companies. At this point, it is unclear whether the Trump administration will rescind or modify the regulation.
Telehealth Companies Use Regulatory Loophole to Circumvent FDA Ruling
High demand for weight-loss GLP-1 drugs has outpaced initial manufacturing capacity, and until recently the Food and Drug Administration (FDA) had placed tirzepatide and semaglutide on the shortage list. This allowed telehealth companies to develop their own, cheaper, non-FDA approved compounds of the drugs during the shortage but were ordered to stop sales of these compounds on Thursday, May 22. However, a regulatory loophole enables these companies to sell compounded drugs if they are tailored to individual patient needs without brokering a deal with brand-name manufacturers, even though this “tailoring” might entail making unnecessary changes and mass-producing “individualized” drugs.
How FDA will define the permissible scope of this “special needs” loophole has implications for the weight loss drug market and downstream impacts for telehealth providers. Cracking down on compounded drugs would be a victory for brand-name manufacturers such as Eli Lilly and Novo Nordisk and a loss for compounding pharmacies catering to the weight loss market such as the telehealth company Hims & Hers. Furthermore, other lucrative drugs, such as hormone replacement therapy, could become a target for other telehealth companies seeking to exploit this compounding model if the FDA continues to allow it.
GOP Doctors’ Caucus Advocates for Patient-Centered Healthcare Reforms
In an opinion piece, co-chairs of the GOP Doctors’ Caucus Representatives Greg Murphy, M.D. (R-NC) and John Joyce, M.D. (R-PA) identified several issues that they believe led to the “breakdown of our health care system”. The Caucus criticizes Medicare Advantage (MA) plans for prioritizing profits over patient care, engaging in practices like “upcoding” beneficiaries with irrelevant diagnoses, and delaying or denying necessary care. They call for reforms to eliminate these practices and ensure that MA plans focus on delivering quality care. Additionally, the Caucus highlights the negative impact of prior authorization requirements, which often delay necessary care and increase administrative costs. They support legislation that would require peer-to-peer reviews between physicians and insurance companies and streamline the prior authorization process to reduce unnecessary delays. The Caucus points to Pharmacy Benefit Managers (PBMs) as a significant factor driving up prescription drug costs, due to their role in negotiating with manufacturers and developing formularies. They advocate for establishing flat fees for PBM services and increasing transparency in drug pricing to protect patients and providers.
Save the Date
21st Annual Conference
Wednesday, November 5 – Friday, November 7, 2025
The Mayflower Hotel, Washington, D.C.
