The rules to watch from Trump’s first health regulation agenda

Modern Healthcare – Monday, September 15, 2025
By Bridget Early

The Health and Human Services Department has a busy few months ahead under a master list of regulations the White House wants to finalize by the end of the year.

The Office of Management and Budget released the first Unified Agenda of President Donald Trump’s second term on Sept. 4. The document outlines the administration’s plan for HHS and the rest of the federal government.

Here are some major regulations that could affect the business of healthcare.

September

• The Centers for Medicare and Medicaid Services’ annual policy proposal for Medicare Advantage plans, Part D plans and the Program of All-Inclusive Care for the Elderly, or PACE, for 2027.
• A proposed rule to update a price transparency regulation from 2020. The original rule focused on clarifying insurer pricing data.
• A final regulation governing electronic transactions and file attachments for prior authorizations. Hospital, physician and insurance groups criticized the proposed rule.
• Notices announcing premiums, deductibles and coinsurance amounts for fee-for-service Medicare benefits.

October

• A proposed rule “potentially related to new Center for Medicare and Medicaid Innovation models and/or to make updates to existing models.”
• A proposed rule on Medicaid and the Children’s Health Insurance Plan that would modify the 1115 waiver process, revise state enrollment procedures and update Medicaid managed care state-directed payments.

November

• Final Medicare reimbursement rules for hospital outpatient services, physicians, home health providers and end-stage renal disease providers are expected by Nov. 1.
• A second CMS innovation center proposed rule that could establish new Medicare payment models or update existing ones.
• A policy and payment proposed rule for the health insurance exchanges.
• A rule finalizing updates to the independent dispute resolution process under the No Surprises Act, which allows out-of-network providers and insurers to resolve billing disagreements before third-party mediators.

December

• An interim final rule that would update operating rules for electronic health data exchanges under the Health Insurance Portability and Accountability Act of 1996.
• A final rule setting a special registration process for prescribing controlled substances via telehealth.

Other

• A proposed rule on state-directed Medicaid payments is pending at the OMB. The rule was slated to be published in July.
• A proposed rule that would allow states to use immigration data for residency determinations and Medicaid eligibility is pending. The rule was due in July.
• The final version of a draft regulation on Medicaid provider tax policies is pending at the OMB, but the Unified Agenda does not include a publication estimate.
• A second iteration of the 2026 Medicare Advantage final rule is slated for December 2027. The administration put off the most consequential proposals in the first final version of this rule. But regulators “do not intend to delay publishing a Medicare final regulation for three years if we are able to publish it sooner,” and the regulation is currently under OMB review, the Unified Agenda says.
• A pair of draft regulations that would condition Medicare and Medicaid participation on providers not offering gender-affirming care are both pending at the OMB, but are not listed in the Unified Agenda.

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