Thursday, November 5, 2026
CMS to make drug price negotiation framework permanent
CMS has finalized a rule that sets ongoing policies for the Medicare Drug Price Negotiation Program, starting with negotiated prices that take effect in 2029.
The agency said the rule is designed to give drugmakers in the program a clearer, more predictable process going forward, according to a Nov. 5 news release.
CMS plans to pick up to 20 additional Part D or Part B drugs for the program’s fourth negotiation cycle by Feb. 1, 2027. It may also select previously negotiated drugs for renegotiation.
“This rule provides additional tools to help CMS negotiate better deals, achieve greater savings for taxpayers and beneficiaries, and improve health outcomes for seniors who rely on the Medicare Prescription Drug Program,” CMS Administrator Mehmet Oz, MD, said in the release.
The American Hospital Association urged CMS in Aug. 17 comments on the proposed rule to require drugmakers to provide the maximum fair price at the point of sale rather than through retrospective rebates. The group said a rebate approach would burden hospitals, especially rural, critical access and safety-net facilities, and could pave the way for a similar shift in the 340B program.
The final rule also includes these four provisions:
1. Fixed combination drugs: CMS finalized its proposed approach to certain fixed combination drugs that it considers new formulations of existing drugs. The agency said the policy is meant to keep manufacturers from moving patients to a new formulation to get around the maximum fair price.
2. Small biotech floor: As required by law, CMS cannot offer or accept a counteroffer below a specified price floor for certain eligible small biotech drugs in the 2029 and 2030 initial price applicability years.
3. Formulary requirements: Part D plans must cover selected drugs with a maximum fair price in effect on their formularies.
4. Pharmacy payment limits: The negotiated prices Part D plans pay pharmacies and other dispensing entities are capped at the maximum fair price plus any dispensing fees.
CMS finalizes 2.4% home health payment bump for 2027
CMS finalized its Home Health Prospective Payment System final rule Nov. 4, including a 2.4% home health payment boost for 2027.
The rule also includes stricter Medicare provider enrollment provisions as the federal government continues to target alleged fraud, waste and abuse in the healthcare system.
Here are eight things to know:
- CMS estimates that, in aggregate, Medicare payments to home health agencies will increase by 2.4% in 2027, up $415 million from 2026.
- CMS is continuing a 3% temporary adjustment to collect earlier overpayments. That 3% adjustment will allow the agency to recoup about $500 million of the $4.9 billion CMS said it is owed from 2020 through 2025. Other adjustments could come with future rulemaking.
- CMS is updating the payment weights for each of the 432 patient categories in Medicare’s Patient-Driven Groupings Model based on 2025 claims.
- In 2027, the fixed-dollar loss ratio, which is used to set the threshold for outlier payments for unusually high-cost care, will be 0.29. Outlier payments are made when the care’s estimated costs surpass that threshold. The ratio was previously set at 0.37.
- CMS is expanding how it can retroactively recoup payments to providers with revoked Medicare enrollment.
- CMS can deny or revoke Medicare enrollment for home health, hospice, and durable medical equipment, prosthetics, orthotics, and supplies businesses sold within 36 months if they do not enroll as a new provider and go through accreditation or a state survey.
- DMEPOS suppliers and independent diagnostic testing facilities are already required to install permanent visible signage showing their hours of operation. CMS is expanding that requirement to all Medicare providers and suppliers. CMS expects $15.6 million in annual compliance costs as this requirement kicks in.
- Beginning in April, Medicare Part B will cover certain infusion pumps and their paired home infusion drugs, allowing patients to access some drugs at home under certain circumstances. CMS is expecting about $800,000 in annual net savings.
CMS proposes broad rollback of conditions of participation
CMS proposed a sweeping deregulation rule Nov. 5 that would remove hospital staff training requirements tied to Biden-era obstetric standards. It would also roll back several nursing home requirements, rescind a Medicaid payment transparency rule and exempt certain critical access hospitals from distance requirements.
The proposed rule follows a CMS review of the conditions of participation for all 21 provider and supplier types. Providers must meet these baseline standards to bill Medicare and Medicaid.
CMS said the rule is meant to eliminate obsolete or excessively burdensome requirements so healthcare organizations can devote more time and resources to improving patient care.
The agency estimates the proposals would save $320 million a year and return more than 3.26 million hours of staff time to providers. Nursing homes would see the largest share at $142.6 million a year. Hospitals would save $123.2 million, CAHs $16.6 million and intermediate care facilities for individuals with intellectual disabilities $6.6 million. Rescinding a Medicaid payment reporting requirement accounts for another $30.4 million.
Eleven things to know:
Hospital obstetric and emergency standards
1. Hospitals would no longer have to train staff on transfer protocols and emergency services readiness. Both requirements have been in effect since July 1, 2025. The rule would also remove the OB care staff training requirement, set to take effect Jan. 1, 2027.
2. CMS said the ongoing burden of the training requirements outweighs their benefit. Other rules would still apply, including written transfer policies, EMTALA, accreditation standards and quality improvement requirements. The 2025 outpatient rule estimated that the emergency services readiness training alone would cost hospitals about $173 million and 1.6 million staff hours a year. CMS also cited financial pressure on rural hospitals.
3. Hospitals would no longer have to meet OB-specific quality assessment and performance improvement requirements, which were also set to take effect in 2027.
4. CMS created the obstetric conditions of participation in its 2025 outpatient payment rule to address potential gaps in training, staffing, transfer protocols and emergency readiness. The proposed cuts do not include the OB organization and staffing standards. Hospitals pushed back when CMS first proposed the standards in 2024. The American Hospital Association said it was “deeply concerned” that the agency was using the conditions of participation to advance its policy agenda.
5. The rule would also add a new OB requirement. Hospitals and CAHs that provide OB care would need informed consent standards for birth tissue collection, including the placenta and cord tissue. They would also need policies for families who request their birth tissue for cultural, religious or personal reasons. CMS cited an advocacy group estimate that birth tissue procurement organizations collect about 100,000 placentas a year. It also said these tissues are often marketed to the public in misleading ways.
Critical access hospitals
6. CAHs would no longer have to meet the emergency services readiness or OB staff training requirements, or the OB-specific quality improvement requirements.
7. The rule would implement Section 241 of the Consolidated Appropriations Act of 2026. That provision exempts certain CAHs from distance requirements: those designated as of Jan. 1, 2024, that received a CMS noncompliance notice between Dec. 1, 2024, and Jan. 1, 2026. CMS identified four facilities that qualify. The agency said the exemption is not time-limited. The rule would also make permanent CMS’ policy of measuring distance only to hospitals that provide acute inpatient care or to other CAHs.
Nursing homes
8. Nursing homes and ICFs/IID would no longer have to educate staff about the COVID-19 vaccine, offer it to them or document those actions. Nursing homes’ ongoing respiratory illness reporting would end, but reporting would still be required during a future public health emergency declared by the HHS secretary.
9. Existing facilities would be exempt from the standards that limit resident rooms to two residents and require each room to have its own bathroom. CMS said the renovations needed to meet these standards can discourage new operators from reopening older buildings.
10. CMS would rescind the requirement that states report the share of Medicaid nursing facility and ICF/IID payments spent on pay for direct care workers and support staff. The requirement came from the Biden administration’s 2024 nursing home staffing rule. When CMS repealed that rule’s minimum staffing standards in December 2025 it left the transparency requirement in place. CMS estimates that rescinding it would save providers $30.4 million a year.
Facility design
11. Hospitals, CAHs, nursing homes, hospice inpatient facilities and other providers would no longer need exterior windows or doors in patient care areas for natural light and ventilation. CMS would also adopt the 2024 editions of the National Fire Protection Association Life Safety Code and Health Care Facilities Code, along with the 2022 emergency and standby power systems codes.
Comment solicitations
CMS is accepting comments on the proposed rule through Jan. 9. The agency is also asking for comment on several topics it is not yet proposing changes on. These include:
- Loosening physician supervision of certified registered nurse anesthetists
- Expanding the scope of practice of nurse practitioners and physician assistants in nursing homes
- Lowering barriers to certifying new transplant programs
- Reducing the burden of respiratory illness reporting for hospitals and CAHs
- Future policies to address Medicaid institutional workforce shortages
See the full rule here.
Democrats looking to undo Trump's Canada tariffs: Wyden to WSJ
The Democratic Party is looking into ways to reverse tariffs that United States President Donald Trump imposed on Canadian goods. Senator Ron Wyden, who will become chair of the Finance Committee in January, told the Wall Street Journal that he is already discussing potential legislation with other lawmakers.
"There is overwhelming support for repealing the tariffs on products from Canada," Wyden said, adding that a bill to undo them could gather enough bipartisan support to stop Trump from vetoing it, or even to override a potential veto, which requires a two-thirds majority in both the House and the Senate. Wyden also insisted that Congress "must take away the president’s ability to unilaterally and arbitrarily impose tariffs."
https://breakingthenews.net/Article/Democrats-looking-to-undo-Trump's-Canada-tariffs/67500902
Pentagon Delivers 25,000+ Drones, Counter-Drone Systems To CENTCOM In "Massive Surge"
by Timothy Frudd via The Epoch Times,
The U.S. Department of War announced on Wednesday that a "massive surge" of over 25,000 drone and counter-drone systems were delivered to U.S. Central Command (CENTCOM) this year.
The drones and counter-drone systems were delivered by the Pentagon's Direct Reporting Portfolio Manager, a structure implemented by the U.S. military to accelerate the development, procurement, and fielding of unmanned technology. The Pentagon said delivery of the systems was part of an investment of roughly $782 million.
The announcement comes after Secretary of War Pete Hegseth directed the Pentagon in September to remove what he described as "unnecessary barriers" causing delays in counter-drone capabilities and to accelerate the use of capabilities designed to provide a defense against unmanned aircraft systems.
The deliveries announced on Wednesday included more than 24,000 counter-unmanned aerial systems, which the Pentagon said can be used to create a "multi-layered defensive shield" to protect U.S. forces against enemy drone attacks through Joint Interagency Task Force 401.
The Pentagon created the task force in August 2025 to counter threats posed by drones. U.S. military bases have been repeatedly targeted by drones in recent years.
Other deliveries included more than 1,300 one-way attack unmanned aerial vehicles, more than 100 unmanned surface vessels, and unmanned underwater vessels.
"Under Secretary Hegseth's direction, we are moving at the speed of modern combat to equip our forces with decisive, affordable mass," Owen West, CEO of Project Agincourt and Direct Reporting Portfolio Manager for Unmanned Systems, said in a statement on Wednesday.
"DRPM-UxS (Direct Reporting Portfolio Manager for Unmanned Systems) was established to cut through red tape and put lethal technology directly into the hands of our frontline troops."
Hegseth announced Project Agincourt in a speech on Sept. 30 as a Pentagon effort to accelerate the adoption of autonomous systems.
The Pentagon said the delivery of over 25,000 drone and counter-drone systems to CENTCOM demonstrates the department's shift from multiyear development to what it described as a "Warfighting Acquisition" model and a restructuring of its defense procurement.
The effort also supports the development of the Autonomous Warfare Command, which was announced by Hegseth in September. The command, which the Pentagon aims to have established by October 2027, will be tasked with scaling both autonomous and robotic capabilities across the U.S. military.
In addition to delivering additional autonomous systems to CENTCOM, the Pentagon said it will expand fielding pipelines for the technology to Pacific Command, European Command, and the broader military force.
"The thousands of systems operating across CENTCOM this year are just the beginning," West said. "We will out-innovate, out-build, and out-adapt any adversary on the battlefield. The goal is to scale these capabilities across the Joint Force."
The Pentagon also announced on Wednesday that it awarded a contract of over $6.9 million to CHAOS 1, Inc., for Vanquish Prime advanced radar systems aimed at strengthening counter-drone protection for U.S. military forces and critical assets in the CENTCOM region.
The Pentagon said the advanced radar systems will improve situational awareness by helping U.S. forces identify and track potential aerial threats.
The radar systems will be delivered to designated locations in CENTCOM's area of responsibility as part of the contract, which also includes training and technology for the integration and operational use of the systems.
"This acquisition is a testament to our commitment to providing the warfighter with the most advanced capabilities available," said Lt. Col. Matthew Strohman, Joint Interagency Task Force 401's capability manager for mobile counter-unmanned aircraft Systems.
"The threat from unmanned systems is real and constantly evolving. By equipping our forces in CENTCOM with state-of-the-art technology, we are ensuring they have the decisive edge needed to protect our personnel and secure our strategic interests. This is about delivering the right tools at the speed of relevance."
Last month, the Pentagon also signed a framework agreement with BAE Systems to increase production of interceptor kits used to defend against drones and other aerial threats. Under the agreement, the Pentagon would purchase up to 25,000 interceptor kits each year for up to seven years.
Ryan Morgan contributed to this report.
Congress Demands Closed-Door Briefing With Nvidia CEO on Alleged Chinese Spy Contact
Three House Republican committee chairs have asked Nvidia CEO Jensen Huang to sit for a closed-door briefing on Nov. 18 about his dealings with Alice Huang, the Megaspeed executive they describe in a Nov. 5 release as a publicly reported Chinese intelligence asset.
Chairmen @RepBrianMast, @RepMoolenaar and @RepRickCrawford sent a letter to NVIDIA CEO @JensenHuang requesting that he appear before a joint, closed-door briefing on Huang's interactions with Megaspeed executive Alice Huang, a publicly reported People's Republic of China (PRC)...
— House Foreign Affairs Committee Majority (@HouseForeignGOP) November 5, 2026
Reps. Brian Mast (R-Fla.), John Moolenaar (R-Mich.) and Rick Crawford (R-Ark.), who chair the Foreign Affairs Committee, the Select Committee on the Chinese Communist Party and the Intelligence Committee, want Huang to speak to all three at once.
They also want to hear about Nvidia's security protocols against foreign espionage. They gave him until Nov. 11 to accept the date or propose another.
"Recent reports raise significant national security concerns regarding the PRC's access to sensitive U.S. technology," the chairmen wrote.
"It is vital that Congress determines the extent to which U.S. national security has been placed at risk."
As we first reported last week, according to people briefed on the surveillance who spoke anonymously to the New York Times, U.S. spy agencies concluded that Alice Huang was passing intelligence to Beijing and that surveillance of her showed contact with Huang.
They also say President Trump was briefed roughly a year ago and took no action. Officials reportedly did not believe at the time that Huang knew what she was doing, and no one has charged Alice Huang or Megaspeed with a crime.
Nvidia has said Huang's "interactions with Ms. Huang are not unusual or unexpected," and told CNBC that "meetings with customers are part of a CEO's job."
Alice Huang did not respond to the Times' requests for comment.
The date is no accident of the calendar: Nvidia reports earnings on Nov. 17, the day before the briefing.
As we noted on Nov. 1, and now even more so after the last couple of day, the market is already leaning hard on that report, and Huang now walks into it with a congressional invitation hanging over him.
Nvidia have not said yet whether Huang would attend.