A Deloitte-Run System Denied Medicaid Benefits for Michigan’s Disabled. Now Trump’s Law Piles On.

By RACHANA PRADHAN, SAMANTHA LISS & KATE WELLS

Marie Noon takes eight medications a day. One keeps her heart rate from spiking to avoid a stroke. One prevents debilitating headaches. Another ensures she doesn’t retain excess fluid.

More than a decade ago, Noon said, she was diagnosed with adult-onset Still’s disease, a rare type of inflammatory arthritis that can cause rashes, debilitating pain, and fevers. The disease upended her life.

She had been living a typical suburban life in Michigan, shuttling her two kids to activities like cheerleading, choir practice, and track. She was active in the PTA. She managed a bank.

She went from that to crawling to the bathroom because she was in so much pain, “just crying all day long” from being so sick.

Noon, who is disabled, said she couldn’t work for eight years — a time marked by hospital stays that stretched for weeks.

“I honestly thought I was going to die,” Noon said.

So it was a shock when Michigan denied her application for Medicaid benefits last year after she lost private insurance. Worse yet, it came down to an IT error, according to an attorney who helped Noon overturn the denial.

“I can’t [Read More]

(LANSING) — Lansing-area healthcare advocates blasted U.S. Rep. Tom Barrett (R-Charlotte) in mid-July over his votes on Medicaid and Affordable Care Act subsidies as they announced they submitted enough signatures to place a local healthcare initiative before voters in November. Organizers said Lansing voters submitted 7,385 signatures to the city clerk last week, exceeding the 4,433 required to qualify for the ballot.

The proposals would establish citizen-led Healthcare Action Committees tasked with holding public hearings and developing recommendations to address healthcare costs and access at the local level. The committees would also examine how actions taken by state and federal officials affect residents’ healthcare.

Some folks are skeptical of the group behind the press conference, Community Action Michigan, which is a registered non-profit and state political action committee (PAC). Other than Lansing, they’re active in East Lansing, Kalamazoo, Portage, Benton Harbor and Battle Creek, who have all also sought to adopt this ballot initiative.

Bridge Michigan reported on the group writing that their registration resembles “hallmarks of so-called ‘dark money’ efforts,” though it’s largely centered on unanswered questions regarding their funding, origins and board members.

Jason Cabel Roe, Barrett’s campaign strategist and spokesperson, told MIRS that these organizations are “liberal advocacy groups funded by dark money,” describing the event as political theater.

The group seems [Read More]

By STEPHEN SHAVER
Wachler & Associates PC

As Medicare continues to expand its efforts to combat fraud, waste, and abuse, healthcare providers across the country are paying close attention to new audit and compliance initiatives. Hospice providers have experienced particularly intense scrutiny and one of Medicare’s preferred tools has increasingly become the Provisional Period of Enhanced Oversight (PPEO) program. While PPEO audits have thus far only been implemented in a few states, CMS has already expanded the program and further expansion or nation-wide implementation may not be far off. Understanding the purpose of the PPEO initiative and the broader direction of Medicare oversight can help healthcare organizations prepare for potential future changes.

In July 2023, CMS implemented the PPEO program for newly Medicare-enrolled hospices and hospices that underwent a change in ownership. Initially, PPEO only applied to hospices in Arizona, California, Nevada, and Texas. The initiative was developed as part of a broader effort to strengthen program integrity in response to growing concerns over fraudulent hospice billings. CMS has since expanded the program, first in September 2024 to include enhanced pre-payment review for existing Medicare-enrolled hospices in Arizona, California, Neveda, and Texas; and again in December 2025 to expand the program into Ohio and Georgia.

Under the PPEO program, [Read More]

By DANA ULRICH
Dickinson Wright 

LOI drift is one of the more underappreciated risks in healthcare transactions, and one of the more avoidable ones. It happens when the terms agreed to in a letter of intent, such as a co-branding commitment or a governance right, simply don’t make it into the definitive agreement. Whether by oversight or negotiating attrition, the result is the same: the deal you thought you closed isn’t the deal that governs the relationship. For healthcare organizations entering complex affiliations, joint ventures, or MSO arrangements, that gap can be costly.

 Apex Health, Inc. v. Atrium Health, Inc., 2026 NCBC 10 (N.C. Super. Ct. Feb. 11, 2026) is a notable example of the procedural consequences of LOI drift. Apex and Atrium executed an LOI for a Medicare Advantage plan that referenced marketing and co-branding, but when the definitive agreement was executed, those concepts had vanished. When the joint venture faltered, and Apex faced losses approaching $62 million, Apex sought to amend its complaint to add a UDTPA claim, attempting to resurrect the LOI’s business understandings as a basis for contractual interpretation. The court denied the motion to amend, citing the merger clause providing that it “contains the entire agreement between the Parties…” Apex Health, 2026 NCBC [Read More]

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Single-Payer, Universal Healthcare Gets 58% Support In MI Poll

A 58% majority of Michigan voters support a universal, single-payer health care system, according to polling released today by Progress Michigan.

The organization, in partnership with Public Policy Polling, surveyed 641 Michigan voters, asking whether they would “strongly support, somewhat support, somewhat oppose, or strongly oppose a single-payer, universal health care system in the United States, with the costs of healthcare for all residents being covered by a government-funded public system.”

According to the results, 47% of respondents said they strongly support a single-payer system, while 11% said they somewhat support it. Meanwhile, 31% strongly oppose the idea and 5% somewhat oppose it. The remaining 7% said they were unsure.

The poll comes as many Michiganders face uncertainty about their health care coverage following the passage of the federal budget legislation known as the One Big Beautiful Bill Act, which President Donald Trump signed into law on July 4 of last year. Health policy analysts estimate that changes could result in as many as 355,000 Michigan residents losing Medicaid coverage over the coming years due to enhanced work requirements and administrative policy changes.

In a press release from Progress [Read More]

By DARIUS TAHIR

Bill Curry, 65, raises cattle on the same land in rural Oklahoma once owned by his father and generations before him. Each quarter, for several years, he has made the 2½-hour drive to Oklahoma City for an epidural in his spine to treat his back pain.

But this year, because of a new Medicare program, Curry has traveled a little more often.

In February, during one trip, he was told unexpectedly that he needed preapproval for the procedure. Then he went again a month or so later to get the injection, for a total of 10 hours on the road. His clinic wanted him to come in a third time, which they had never asked of him before. That appointment was “just to fill out a piece of paper to tell them how you feel again,” Curry said, so he hasn’t gone.

In January, Oklahoma became one of six states to begin a pilot program testing the use of preapprovals in traditional Medicare, the federal health insurance program for people 65 and older or with disabilities. Medicare had previously eschewed the practice — also known as prior authorization — which requires patients or someone on their medical team to seek insurance approval before proceeding with certain procedures, [Read More]

By DUAA ELDEIB

They entered the world the way babies should, with piercing cries announcing their arrival. They passed their newborn screening tests. Some made it to their 2-week wellness visits without concern.

Then, without warning, their systems began to shut down. A 7-week-old boy in Maryland developed sudden seizures. An 11-pound girl in Alabama stopped breathing for 20 seconds at a time. A baby boy in Kentucky vomited before becoming lethargic. A brown-haired girl in Texas, not yet 2 weeks old, bled around her belly button.

Desperate to save them, records show, doctors inserted tubes into their airways and hooked them up to IVs. They ordered blood transfusions. They spent half an hour trying to resuscitate one boy until his parents told them they could stop. They shaved another boy’s soft locks to embed a needle directly into his skull to reduce the pressure in his brain.

None of it was enough.

At the morgue, the babies were brought in with their diapers and blankets and with their hospital ID bracelets still wrapped around their tiny ankles. The pathologists’ findings were like those you would typically see in ailing adults, not newborns — the kind of bleeding seen during strokes or brain tissue loss similar to what happens when radiation [Read More]

By ROLF LOWE
Wachler & Associates, P.C.

In  2023, the Centers for Medicare and Medicaid Services introduced a new enforcement tool, Provisional Period of Enhanced Oversight (PPEO), specifically aimed at newly enrolled hospice providers. PPEO was implemented under the Social Security Act and is intended to apply enhanced oversight to new providers in high-risk categories. The PPEO program was developed due to CMS’ concerns about program integrity in the hospice program including potential fraud (criminal and civil), improper claim submissions and delivery of services that do not meet Medicare’s requirements for medically reasonable and necessary services.

The PPEO program was initially rolled out in Arizona, California, Nevada and Texas on September 17, 2024. Georgia and Ohio were added to the program beginning on December 30, 2025. Further expansion of the program into other states in the future is anticipated.

While the PPEO program is geared at newly enrolled providers, in some instances it may also apply to existing providers reporting a change of ownership as required by CMS’ conditions of participation. The PPEO process involves Pre-Payment Review (PPR) of selected providers, with the effective date of the PPEO beginning on the date a provider submits it first claim to Medicare Administrative Contractor (MAC). Providers selected for PPR will receive [Read More]

By RALPH LEVY
Dickinson Wright 

In a prior article in this publication, I provided guidance for physicians and other medical professionals on how to compare the taxes payable under competing offers to join practice groups.  I pointed out that these taxes will vary depending on several factors, including whether the offer includes equity ownership and whether the group is organized as a professional corporation (PC) or a professional limited liability company (PLLC).  Although it appears that a recent decision by the 5^th Circuit Court of Appeals on the self-employment taxes payable by a limited liability limited partnership could affect this guidance, on a closer look at this decision, it does not provide any tax relief to physicians and other medical professionals whose practice group is organized as a PLLC.

If the offer includes ownership in the practice entity that was organized as a PLLC and base compensation and contingent compensation based on the individual efforts of the physician or other medical provider (such as a percentage of billings collected by the PLLC from services provided by the physician or other provider), the cash compensation paid by the PLLC for services is treated as “guaranteed compensation” that is subject to Social Security taxes of 12.4% of the then [Read More]

Supremes Decline State’s Appeal In Benton Harbor Drinking Water Lawsuits

Lawsuits against the Department of Environment, Great Lakes & Energy (EGLE) arising out of elevated lead levels in Benton Harbor water stand after the Michigan Supreme Court declined to hear the state’s appeal.

Justice Brian Zahra would have granted the appeal, but he didn’t explain why in the court’s order.

In a January per curiam opinion, the Michigan Court of Appeals panel held the Court of Claims “properly concluded” that the state’s evidence didn’t eliminate factual questions arising from residents’ claims.

Separate lawsuits – led by Jennifer Janssen-Rogers, Daretha Braziel and Oliver Kavanaugh – argued, in part, that the city violated residents’ rights to bodily integrity by not doing enough to protect residents and failed to warn them about the toxicity of the drinking water.

The state has argued that area residents were aware of lead in the drinking water in October 2018 when the city distributed a public advisory letter with information, including advising users to “reduce your risk of lead exposure” by running the water to stable, cold temperatures and using bottled water to prepare baby formula.

“How can it be that the government deliberately hid lead contamination from the people of Benton Harbor if it spent three years repeatedly notifying the city’s residents [Read More]

By SAMANTHA LISS

Millions of people who apply for Medicaid in the coming years will have to prove they’ve been working, going to school, or volunteering for at least a month before they can gain or retain health insurance through the government program.

But Republican lawmakers in some states think the new rules — part of the GOP’s One Big Beautiful Bill Act, signed last July by President Donald Trump — don’t go far enough.

Indiana is leading that charge, with a new law that requires applicants to prove they’ve been working or participating in a similar activity for three consecutive months to get benefits.

Meanwhile, residents in many other states will have to show they’ve been working just one month, the least cumbersome option under Trump’s signature tax-and-domestic-spending law. It instructs states to decide whether to require one, two, or three months of work history.

As in Indiana, Republican Idaho lawmakers approved a three-month requirement, and the state’s governor signed the bill into law on April 10.

The efforts, along with similar moves in Arizona, Missouri, and Kentucky, are aimed at restricting flexibility to implement the federal law at the state level.

“Normally, you would not see state legislators weighing in on these decisions,” said Lucy Dagneau, a senior official with [Read More]

By SAM WHITEHEAD

Katie Crouch says calling her state’s Medicaid agency to get information about her benefits can feel like a series of dead ends.

“The first time, it’ll ring interminably. Next time, it’ll go to a voicemail that just hangs up on you,” said the 48-year-old, who lives in Delaware. “Sometimes you’ll get a person who says they’re not the right one. They transfer you, and it hangs up. Sometimes, it picks up and there’s just nobody on the line.”

She spent months trying to figure out whether her Medicaid coverage had been renewed. As of late March, she hadn’t been reapproved for the year for the state-federal program, which provides health insurance for people with low incomes and disabilities.

Crouch, who suffered a debilitating brain aneurysm a decade ago, also has Medicare, which covers people who are 65 or older or have disabilities. Medicaid had been paying her monthly Medicare deductibles of $200, but she’d been on the hook for them for the past three months, straining her family’s fixed income, she said.

Crouch’s challenges with Delaware’s Medicaid call center aren’t unique. State Medicaid agencies can struggle to keep enough staff to help people sign up for benefits and field calls from enrollees with questions. A shortage of [Read More]

By SHANIYA RAHEJA
Wachler & Associates, P.C.

Over the past year, Medicare providers have increasingly felt the harsh effects of a shifting federal enforcement landscape. CMS has adopted a more assertive program‑integrity posture across all of its operations, signaling a renewed focus on payment accuracy and fraud‑prevention initiatives. This broader regulatory trend is reflected in the 2025 Marketplace Integrity and Affordability Final Rule, where CMS emphasized its intent to “strengthen program integrity standards,” “promote accurate eligibility determinations,” and “improve oversight and reduce vulnerabilities to fraud and abuse” across federally administered programs (CMS Marketplace Integrity and Affordability Final Rule Fact Sheet, 2025). Although the rule governs marketplace operations, it reflects the same enforcement philosophy now driving Medicare’s expanded audit activity in 2026. This context is essential to understanding why Medicare contractors have intensified their oversight efforts and why providers are experiencing a measurable increase in Medicare audits, particularly with respect to the growing reliance on statistical extrapolation.

Growing Reliance On Extrapolation In 2026 Audit Activity

One of the most consequential developments driving this increase in audit activity is the expanded use of statistical extrapolation in Medicare overpayment determinations. CMS revised the Program Integrity Manual in 2025 to expressly encourage contractors to apply extrapolation whenever data analysis suggests a “high level [Read More]

By LEE G. PETRO

As artificial intelligence (AI)‑driven tools proliferate across clinical care, diagnostics, and health insurance operations, the U.S. regulatory landscape is shifting rapidly in 2026. Absent a comprehensive federal AI statute, healthcare organizations face a patchwork of federal oversight (primarily through the FDA, CMS, and HHS) layered with a growing number of state AI health laws.

Federal Framework Shaping AI In Healthcare:

At the federal level, existing authorities and recent policy signals are converging to regulate AI in healthcare without yet creating a standalone “AI Act.” The most important federal AI actors are:

• FDA: The FDA continues to emphasize premarket review for higher-risk systems (e.g., AI‑assisted radiology tools, ECG or pathology interpreters), while allowing greater flexibility for lower‑risk administrative or workflow tools. January 2026 guidance on clinical decision support software clarified that AI products directly influencing clinical judgment or patient management will likely require FDA review or clearance.
• CMS and reimbursement: CMS continues to explore reimbursement pathways for AI‑augmented services through coding and coverage decisions in the 2026 Medicare Physician Fee Schedule, signaling that compliant, evidence‑based AI tools can be financially viable. CMS recognizes that many AI tools are iterative, continuously updated services rather than one‑time products, and is developing appropriate payment models.
• HHS and the [Read More]
  

By CELINE GOUNDER
Photos by ERIC HARKLEROAD

President Donald Trump will soon nominate a permanent director for the Centers for Disease Control and Prevention, its acting chief, National Institutes of Health Director Jay Bhattacharya, told agency employees at a Wednesday staff meeting.

According to a recording obtained by KFF Health News, Bhattacharya at one point suggested to CDC staff that Trump could name a new leader for the agency as soon as Thursday. “But if not, I don’t think much will change,” he said.

Though his official position as acting director was set to expire Wednesday, Bhattacharya will continue to lead the agency until the top spot is filled. Meanwhile, news outlets including Axios and The Washington Post reported that the administration was postponing filling the permanent director job amid the challenges of gaining Senate confirmation and other political pressures.

Bhattacharya opened the meeting by acknowledging the struggles the beleaguered agency has gone through over the past year. Workers faced waves of job losses, and a gunman attacked the CDC’s Atlanta campus in August, killing a police officer and causing significant property damage. “I want to acknowledge very honestly that I know that it has been such a difficult year for the CDC and for every single one of you here,” Bhattacharya said.

He [Read More]

By JULIE APPLEBY

Complaints about enrollment fraud in Affordable Care Act health insurance coverage have bedeviled the federal marketplace for years.

Now, the Trump administration is claiming wins in reducing the problem while simultaneously saying more controls are needed.

It has proposed a sweeping set of ACA regulations for next year, including stepped-up requirements for some applicants to prove eligibility for subsidies or enrollment and new scrutiny of sales agents and marketing practices.

While there is a general acknowledgment that there is fraud in the ACA marketplace, some health policy analysts say these new requirements miss that mark and instead will make it harder for people who are eligible to enroll.

“There is a trade-off, particularly with the provisions focused on consumers, that maybe it will prevent some fraudulent enrollment, but also potentially a large number of valid applicants,” said Matthew Fiedler, a senior fellow with the Center on Health Policy at the Brookings Institution.

In its proposal, though, the administration expresses optimism that efforts already in place will continue to pay off, despite the fact that the number of complaints about unauthorized enrollment or switching rose to 341,906 in 2025, compared with 229,734 the year before Donald Trump took office. Still, according to the rule, “program integrity measures implemented during the past [Read More]

By ALLAN DOBZYNIAK, MD
R.F.K. Jr. is mandating nutrition education for medical students. Certainly nutrition is an important part of health. But is teaching it as a course devoted to nutrition in medical school the best way to influence a general appreciation of good nutrition for our citizens?

In medical school and post doctoral training nutrition is generally taught related to illness. For example, a patient who has had a cardiac bypass needs a diet designed to achieve an ideal weight and decrease the LDL cholesterol to the data driven optimal range, likewise for diabetes. A risk factor analysis for heart disease would include cholesterol testing, perhaps coronary artery calcium scoring and diet adjusted appropriately. Dietary instruction would be done by referral to a nutritionist. It is not possible for a busy physician to sit down with every patient to discuss general nutritional guidelines. We already have an increasing scarcity of physicians with one of their most important and precious commodities being time.

To impact the population of the United States effectively regarding nutrition cannot be done by a limited number of doctors; it is impossible. Perhaps this public health goal of nutrition education is more appropriately a role for the government. Schools, parents and teachers are logical sources [Read More]

By ROLF LOWE
Wachler & Associates, P.C.

In 2018 the Michigan Legislature introduced and passed Public Act 463 of 2018 providing a pathway for licensure as a dental therapist, with the legislation becoming effective in March of 2019. Nearly seven years later the Michigan Department of Health and Human Services (MDHHS) and Michigan Department of Licensing and Regulatory Affairs (LARA) are finally seeing the fruits of their labor to increase access to dental care to Michigan residents begin to blossom, with the state’s first dental therapist becoming licensed and starting to practice in the Upper Peninsula in early 2026. Michigan is one of fourteen states that currently authorizes the practice of dental therapy.

Dental therapists are licensed providers under Michigan’s Public Health Code, Public Act 368 of 1978, and are regulated by LARA’s Bureau of Professional Licensing (BPL) and the Michigan Board of Dentistry, with pathway to licensure coming to fruition in 2021. Dental therapists are trained and licensed to provide routine dental care, which includes patient examinations, the development of an individual treatment plan cleanings and filings.

The services of a dental therapist are provided under the supervision of licensed Michigan dentist. The supervision requires a written practice agreement between the dental therapist and the supervising dentist. The [Read More]

 By NICOLETTE TABOR
Dickinson Wright

 On Jan. 29, 2026, President Trump signed an executive order with the potential to significantly impact behavioral health and substance use disorder providers.

Executive Order 14379, titled “The Great American Recovery Initiative,” outlines the Trump Administration’s efforts to coordinate the federal government’s response to substance use disorders and the addiction crisis in the United States. Importantly, the executive order acknowledges that addiction “is a chronic, treatable disease” and that the framework for addiction treatment should parallel that of other chronic diseases – signaling a continued historical shift in the US healthcare framework. While this executive order does not immediately affect substance use disorder (SUD) providers, it does provide an important glimpse into how the Trump Administration plans to work with Congress to allocate funds to expand access to SUD treatment.

This executive order affects SUD providers in at least three ways:

1. Potential for increased federal and state funding opportunities. The executive order specifically directs the appropriation of grants to support addiction recovery, with a focus on prevention, treatment, and long-term resilience. Therefore, this means the Trump Administration expects increased funding to flow through federal and state programs addressing SUD treatment. Providers may be able to position themselves for federal and state funding opportunities – [Read More]
   

Lawmakers Still Chewing On Dental Compact Bill

Michigan would join an interstate compact allowing out-of-state dentists and dental hygienists to practice in Michigan under legislation still receiving work in a House committee.

Rep. Parker Fairbairn (R-Harbor Springs)‘s  HB 4935 would enter Michigan into the Council of State Governments (CSG) Dentist and Dental Hygienist Compact. If adopted, Michigan would join Wisconsin, Minnesota, Iowa, Nebraska, Kansas, Colorado, Washington, Arkansas, Tennessee, Ohio, Virginia and Maine in the agreement.

The bill moved out of the House Health Policy Committee without no votes and is now in the House Rules Committee, where it’s getting a second opinion.

Under the compact, dentists and dental hygienists would be able to streamline the process to practice in the state. Instead of applying for a full Michigan license, they would apply for a “compact privilege” to work in the state while maintaining their primary license elsewhere.

Bill Sullivan, the vice president of professional relations at the Michigan Dental Association in Okemos, said that entering the compact would allow more qualified professionals to practice in Michigan.

“This is to help those who want to move to Michigan without the bureaucratic process to get a license when they already have one,” Sullivan said.

Sullivan said that while the compact would not require taking additional [Read More]

By JULIE APPLEBY
Subsidies. Love ’em or hate them, they dominated the news during the Affordable Care Act’s sign-up season, and their reduction is now hitting many enrollees in the pocketbook.

While lawmakers continue to disagree on a way forward, and the politics of affordability keeps the issue front and center, it would be understandable to think these are the only taxpayer-funded health insurance subsidies in the U.S. system.

But that would be wrong.

“The vast majority of people with health insurance get some kind of federal subsidy for it, from Medicaid to Medicare to the ACA to employer-sponsored insurance,” said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes KFF Health News.

These broad taxpayer supports are rarely discussed, though, as they apply to work-based coverage. So, let’s take a look.

Adding Up the Tax Breaks

Nearly half of the more than $1.1 trillion in annual spending on Medicare, the second-largest program in the federal budget behind Social Security, comes from general federal funds. The rest comes from payroll taxes and the monthly premiums paid by enrollees, who number more than 66 million.

Medicaid — the nation’s largest health insurer, covering more than 70 million low-income people — costs more than $918 billion annually. It’s jointly financed by the [Read More]

Facing a $1.8 billion budget hole going into Fiscal Year 2027, Gov. Gretchen Whitmer proposed last month an $88.1 billion spending plan based on roughly $800 million in tax increases, $630 million in cuts and $400 million from the rainy day fund.

The plan puts a premium on preventing cuts to Medicaid, the health program that roughly 1 in 4 Michiganders count on to cover their care. The One Big Beautiful Bill Act (OBBBA) pushed new eligibility requirements and costs for Medicaid and Supplemental Nutrition Assistance Program (SNAP) recipients onto the states.

“We can talk about efficiencies,” said Senate Appropriations Committee Chair Sarah Anthony (D-Lansing). “We can talk about tightening our belts and increasing revenues, but we also need to pause to think about the fact that there were decisions made at the federal level, and when I look at who is holding the bag, it’s people. Michigan families.”

Budget Director Jen Flood made it clear to a joint hearing of the House and Senate appropriations committees today that Whitmer is not going to throw people off their care, so a “responsible” funding plan was crafted to keep the program afloat amid an otherwise generally flat budget.

According to the Budget Office, Kentucky is proposing a $1 billion rainy-day fund withdrawal [Read More]

Nurses in Michigan would be guaranteed eight consecutive hours of time off after working a 12-hour shift, under legislation by Sens. Stephanie Chang (D-Detroit) and Ed McBroom (R-Waucedah Twp.).

“It pains me that after decades of nurses organizing and mobilizing for safer guardrails, so little has truly changed,” said Kimberly Rackley, a fourth-generation nurse working at Borgess Health in Kalamazoo.

Rackley testified in support of SB 296 and SB 297 in front of the Senate Regulatory Affairs Committee this morning, which heard testimony on the legislation. Rackley described working as part of an open-heart surgical team, and how the team must be available 24 hours daily in order for the hospital to maintain its Level II Trauma Center status.

“We are often scheduled long over our scheduled shifts, because we stack surgery after surgery, up to three, four or five surgeries a day sometimes,” Rackley said. “This will go on for days and weeks on end. This is not sustainable.”

She said that since joining her team in November 2023, it has lost nine nurses, while gaining one nurse and one surgical technician. She explained the reasons the nine left are consistent.

“We are overworked and exhausted, stretched beyond what is safe,” she said, adding that when she’s not on the clock, she’s caring [Read More]

By DANIEL AYYASH

Wachler & Associates, P.C.

On Dec. 31, 2025, the Drug Enforcement Administration (DEA) released a fourth temporary Rule extending certain controlled substance prescribing flexibilities through Dec. 31, 2026. The Rule maintains the DEA’s position on controlled substance prescribing via telehealth that has been in place since the beginning of the COVID-19 public health emergency (PHE). By extending these flexibilities, healthcare providers have extra time to make preparations in the event that pre-PHE telemedicine prescribing requirements are revived, and also gives the DEA time to evaluate whether a more permanent framework for telemedicine controlled substance prescribing can be implemented.

Background

Prior to the beginning of the COVID-19 PHE and the prescribing flexibilities that came with it, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (Ryan Haight Act) required a telemedicine provider to perform an in-person medical evaluation of a patient before a controlled substance could be prescribed, with certain limited exceptions. Once a provider had conducted at least one in-person medical evaluation of a particular patient, the specific requirements of the Ryan Haight Act related to remote prescribing of controlled substances no longer applied to that particular provider-patient relationship, and the provider could prescribe certain controlled substances via telemedicine indefinitely.

In response to the COVID-19 PHE, [Read More]

By DAVID J. DAVIDSON
Dickinson Wright

2025 was a busy year for federal health law, with several major laws, regulations, and policy changes. Many of these will still be relevant in 2026. The following is a brief overview of the most significant developments and what they may mean going forward.

1. The “One Big Beautiful Bill Act” (OBBBA)

The OBBBA was a comprehensive reconciliation bill enacted in mid-2025.  The law includes noteworthy changes to federal health policy, including changes to Medicaid, Medicare, and the Affordable Care Act (ACA). The law addresses health coverage and federal program integrity, along with new eligibility and verification requirements for ACA marketplace enrollment.  The phasing out of enhanced ACA premium tax credits could raise enrollees’ costs unless there is further legislative action.

2. Inflation Reduction Act

Pursuant to the Inflation Reduction Act of 2022, effective January 1, 2026, Medicare began implementing drug pricing negotiated between the government and drug manufacturers.  These “final maximum fair price” amounts can only be adjusted for inflation (tied to the CPI), or through subsequent negotiation. Under this program, in 2026, drug costs are capped for ten Medicare Part D drugs.  Up to fifteen more drugs will be added per year in 2027 and 2028, with up to [Read More]