CEO Update 214
Second Trump Administration Health Policy Priorities Start to Take Shape
The newly installed Trump administration’s health policy priorities and the senior officials designated with implementing them are coming into focus.
Attorney Robert F. Kennedy, Jr. is making the rounds with senators before his confirmation process to lead HHS. Kennedy’s first nomination hearing is scheduled for Wednesday, Jan. 29 before the Senate Finance Committee, with the Senate Health, Education, Labor and Pensions (HELP) Committee scheduled to meet with him the next day. Sen. Mike Crapo (R-Idaho) chairs the Senate Finance Committee, which ultimately will vote whether to advance Kennedy’s nomination to the Senate floor.
Meanwhile, the administration has announced candidates for senior staff positions at HHS. These include: John Brooks, a first-term Trump health official who is running the transition’s HHS landing team, will return as chief operating officer at the Centers for Medicare & Medicaid Services (CMS); Drew Snyder is expected to run the CMS’ Medicaid program; Abe Sutton is in line to lead the CMS Innovation Center; Chris Klomp will helm the Medicare program; and Heather Flick, a former senior HHS official during the first Trump term, will return as chief of staff to Kennedy if his appointment is confirmed.
At the Office of Management and Budget (OMB), Don Dempsey is expected to return to the agency as associate director overseeing healthcare programs. Dempsey is currently vice president of policy and research at the Better Medicare Alliance.
Policy decisions and pronouncements are also moving swiftly. At HHS, a recent agency-wide memo directs officials to refrain from issuing any guidance, regulation, notice or grant announcement until it’s been approved by a presidential appointee. The freeze also applies to press releases, social media posts, website posts, communications via listservs and any speaking engagements.
President Trump’s first moves on Medicaid and the Affordable Care Act signal his administration’s willingness to make major changes to the government programs. Trump’s first administration approved several waivers to install Medicaid work requirements, which critics said would only lead to coverage losses. Executive orders for healthcare typically instruct agencies; to date, Trump’s orders only rescind the earlier Biden administration orders and don’t explain how policies should be addressed.
On Inauguration Day, Trump issued an Executive Order asking all agencies to refrain from issuing a rule until it has been reviewed and approved by a Trump administration department head, and to immediately withdraw rules that have been sent to the Office of the Federal Register (OFR) but have not been published. Department heads were also directed to postpone the effective data for any rules published in the Federal Register or that have been issued but have not taken effect so that they can be reviewed. Agencies might also consider reopening comment periods and potentially delaying the rules beyond 60 days.
That Executive Order presumably includes the 2026 Medicare Advantage and Part D rate notice and 2026 draft Part D redesign guidance released Jan. 10, and the 2026 Notice of Benefit and Payment Parameters finalized on Jan. 13 that became effective two days later.
Also unknown is if the Trump administration will choose to fund and implement the Biden Administration’s September 2024 updated parity rule, which established more stringent protocols, amended existing provisions, and added new ones to implement the Mental Health Parity and Addiction Equity Act (MHPAEA).
NABH is contacting new administration officials to support the rule and working with partners to continue supporting the landmark 2008 law’s implementation.
HHS, DOL, and Treasury Send 2024 MHPAEA Report to Congress
HHS, the U.S. Labor Department, and U.S. Treasury Department have released the 2024 MHPAEA Report to Congress, which highlights both progress and continued problems implementing the 2008 parity law.
A fact sheet from the three agencies noted that in fiscal year (FY) 2023, CMS received 43 MHPAEA-related complaints through the “No Surprises” Help Desk and investigated and closed 599 health plan investigations in FY 2023. Of those investigations, 457 involved issuers offering fully insured group or individual health insurance coverage and 142 involved self-funded non-federal governmental plans.
According to a report from Thomson Reuters’ Westlaw Today, a key announcement from the 2024 report is the three agencies’ indication they will release a comparative analysis (CA) with written explanations and supporting documents to show how a plan applied factors and standards in designing non-qualified treatment limitations (NQTLs) consistent with the 2024 final regulations.
“The sample CAs will assess various aspects of how NQTLs are designed and applied,” the Westlaw summary said. “In turn, this will help determine whether any processes, strategies, evidentiary standards, or other factors used in designing and applying the NQTL for MH/SUD benefits are comparable to—and not applied more stringently than—those for M/S benefits.”
ICYMI: NABH Analysis on How Medicaid Proposals Could Disrupt Behavioral Healthcare Access
Earlier this week NABH sent all members an analysis explaining how several proposals could lower federal financial participation (FFP) in Medicaid.
These proposals include changing the current formula for Federal Medical Assistance Percentages, instituting caps to FFP at the state- or enrollee-levels (such as by transitioning Medicaid to a block grant), or limiting the existing safe harbor preventing a portion of state taxes on providers’ net patient revenue from being considered when calculating FFP.
Other recommendations have been made to institute work requirements for Medicaid beneficiaries. Click here to read the NABH Analysis from Dan Schwartz, NABH’s director of quality and addiction services.
Safe Connections: Cyber-aggression Resources
NABH this week released and promoted two new resources about cyber-aggression as part of its Safe Connections campaign about healthy minds and social media habits for America’s youth.
Please visit our Youth Services page to access all of the Safe Connections resources and share our social media posts on LinkedIn and X.
NABH thanks Donald Grant, Ph.D., with Newport Healthcare, and the NABH Youth Services Committee for its work on this campaign.
Deadline is Today: CMS and Abt Seek Nominations for TEP to Design a Patient Assessment Instrument
CMS and its contractor Abt, a research and consulting firm, are assembling a TEP that will provide guidance on clinical and operational issues to design and implement a patient assessment instrument (PAI).
Abt seeks a mix of clinical and operational leaders, including participants with direct knowledge of the patient assessment process. Please refer to the TEP Charter for more information. The TEP will meet periodically for up to four years. All meetings will be held virtually, including the first meeting in February or March 2025.
Nomination packets must include a signed TEP nomination form, letter of interest, and CV, all of which must be e-mailed to IPF-PAI_testing@abtglobal.com with “Nomination” in the subject line. The deadline for applications is today, Jan. 24, 2025 at 5 p.m. ET.
Save the Date: Join Us in May for the 2025 NABH Annual Meeting!
Please plan to join your peers and the NABH team at the Salamander Washington, DC from May 12-14 for this year’s NABH Annual Meeting.
NABH will provide more details soon in future editions of CEO Update and in NABH Annual Meeting Alerts. We look forward to seeing you in Washington!
Fact of the Week
A new study published in JAMA Network found that interventions in young people (aged 10 to 24 years old) had a significant short-term association with improvements in stigma-related knowledge, attitudes, and behaviors and help-seeking attitudes and intentions.
For questions or comments about this CEO Update, please contact Jessica Zigmond.