CDC Announces Notice of Funding Opportunity
The Centers for Disease Control & Prevention (CDC) announced a Notice of Funding Opportunity (NOFO) on June 1 titled “Building National Partnerships for the Prevention of Emerging and Reemerging Infectious Diseases.” This cooperative agreement aims to strengthen the United States’ capacity to prevent, detect, and respond to infectious disease threats. The NOFO is open to state and local government, institutions of higher education, nonprofit and for-profit organizations, faith-based organizations, and more and includes four components: Programmatic Infrastructure and Capacity, Emerging and Re-emerging Pathogens, Antimicrobial Resistance and Healthcare-Associated Infections, and Outbreak and Emergency Response. Funded projects must align with CDC priorities and will seek to establish and strengthen a resilient public health infrastructure through national partnerships. More information is available here.
OIG to CMS: Improve Oversight of States Medicaid Expenditures
The Department of Health and Human Services Office of Inspector General (OIG) issued a report: CMS Should Improve Its Policies and Procedures for the Oversight of States’ Reported Medicaid Expenditures to Better Protect the Financial Integrity of the Medicaid Program. The OIG indicates that this audit was conducted because CMS may not consistently follow their own policies and procedures in review of state expenditures; this review is in support of the administration’s program integrity focus. The report finds that CMS didn’t’ follow their internal timelines in regulation, deferrals remained unresolved for extended periods of time, and tracking of disallowances was inadequate. From these findings, CMS concurred with all four of OIG’s recommendations to increase staff training to analysts conducting document review, revise policies to align with regulation on deferral resolution, change policies to specify responsibilities for tracking and resolving disallowances, and amend CMS’ internal document to help analysts determine disallowed payment status. Even if CMS were to expeditiously implement these changes, the effect on providers will be low. As more states, beyond California and Minnesota receive deferrals, more consistent administration from CMS will help states better understand the process and their recourse. A summary and the full report are available here.
Senators Call for Restart of Off-Cycle Revalidations
Senators Cory Booker (D-NJ), Ron Wyden (D-OR), and Elizabeth Warren (D-MA) sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz on June 3 urging CMS to immediately reinstate the skilled nursing facilities (SNFs) off-cycle revalidations. The off-cycle revalidations, which sought to provide greater transparency about the ownership, management, and financial ties of CMS-certified SNFs, were suspended indefinitely in December 2025 after multiple delays due to issues with the process. Issues included confusion among providers about what exactly to report, difficulty obtaining the required data from the entities to be reported, and a lack of clarity from CMS and consistency among the Medicare Administrative Contractors (MACs) responsible for processing the off-cycle revalidations. In the letter to CMS, the Senators contend “greater transparency into ownership and control is essential to protect residents, safeguard public funds, and enhance oversight of the nursing facility sector.” The Senators outline a troubling example of a complex network of related companies through which two nursing homes’ funds were tunneled while nursing home quality and staffing suffered. Cases like this highlight the need for improved transparency. However, the significant concerns identified with the CMS form and guidance by which nursing homes were required to report information on off-cycle revalidations underscore the need for CMS to re-evaluate this form and process. To improve nursing home ownership and management transparency in a meaningful way, CMS must develop a process that ensures the right information is acquired in the most efficient way.
LeadingAge Analysis: CMS Medicaid Interim Final Rule on Work Requirements
Late on June 1, the Centers for Medicare and Medicaid Services (CMS) released an interim final rule with comment (IFC) entitled Medicaid Program; Community Engagement Requirement for Certain Individuals. Community engagement requirements, more commonly called work requirements, were adopted as a mandatory eligibility qualification of Medicaid expansion enrollees in the congressionally enacted HR 1. The legislation, HR 1, commonly referred to as One Big Beautiful Bill, or the Working Families Tax Cut Act, required CMS to release rulemaking to establish eligibility and exemption criteria for states to deploy work requirements which need to be operational by January 1, 2027. The rule provides states with more details on establishing exemption criteria, timing for redeterminations, and steps beyond work requirements to align other related provisions from the law. Such provisions include the moratorium on enforcement of the 2024 Eligibility and Enrollment Rule, and changes to text from that rule to allow for increased frequencies of eligibility determinations, also mandated in the law for the Medicaid expansion population. Work requirements and increased frequencies of Medicaid renewals are new burdens on the expansion population- those 19-64 not enrolled via other eligibility pathways such as waiver or nursing home eligibility. A deeper dive into the rule is available here.
LeadingAge Submits Comments on Medicaid HCBS QMs
Following a 30-day comment period, LeadingAge submitted comments on a proposal from the Centers for Medicare and Medicaid Services (CMS) outlining quality measures for mandatory state reporting on home and community-based services programs in 2029. The measures include analysis of administrative data and adoption of survey tools and specific measures from the list provided by CMS. Participant outcome and satisfaction responses would require significant additional administrative burden on states. LeadingAge proposed that CMS should foot the bill and direct states to contract out directly for survey administration to ensure consistency in survey sampling, surveyor training, and not impose additional burden on providers. Our comments, along with access to others can be found here.
