The House Budget Committee today passed a budget resolution by a 20-14 vote along party lines during a markup, paving the way for a new reconciliation bill that is narrowly focused on providing additional funding for defense, farm aid and election-related provisions. The budget resolution instructs the House Committees on Administration, Agriculture, Armed Services, and Intelligence to draft legislation by Sept. 11 that provides up to $95 billion in funding. The resolution does not include a request for committees to offset the increase in spending, and no committees with a healthcare jurisdiction received instructions. The budget resolution could be considered by the full House next week. The House and Senate must pass an identical budget resolution before moving forward with a reconciliation bill.

The AHA will continue to monitor the situation for any potential impacts on hospitals and health systems. An AHA webpage and fact sheet provide additional information on the budget reconciliation process.

The Department of Homeland Security today finalized a rule replacing “duration of status” admission for certain nonimmigrant visa classifications, including physicians on J-1 visas participating in residency and fellowship programs, with a fixed admission period.

Under the final rule, J-1 visa holders may remain in the U.S. for the length of their approved academic or training program, not to exceed four years. Individuals whose program length exceeds their initial period of admission may apply for an extension of stay. DHS may grant an EOS for up to four additional years plus 30 days, provided the total EOS does not exceed the original length of the approved program. In the final rule, DHS encouraged individuals to apply for an EOS during the six months before their current period of stay expires.

For individuals already in the U.S. on J-1 visas and admitted under the prior duration-of-status framework, DHS will allow them to remain in status through the program end date listed on their immigration documents, for up to four years from the rule's effective date, without filing an EOS request. The final rule also allows individuals who file a timely EOS application to continue working or participating in authorized program activities for up to 240 days after their J-1 status expires while their EOS application remains pending. The AHA previously submitted comments on the proposed rule, expressing concerns about the potential impact on physician residency and fellowship training programs. The final rule will take effect on Sept. 15, 2026.

The Department of Homeland Security today finalized its proposal to rescind the public charge ground of inadmissibility regulations issued in 2022. Among other changes, the final rule clarifies that receipt of means-tested public benefits (e.g., Medicaid, Children’s Health Insurance Program) would result in the breach of public charge bonds, rescinds all definitions associated with the 2022 Public Charge Inadmissibility Framework, and removes the previous list of exemptions and waivers for public charge ground of inadmissibility. The final rule will be effective 60 days after publication in the Federal Register. AHA members will receive a Regulatory Advisory with more details.

The Centers for Medicare & Medicaid Services today announced nationwide implementation of a new risk-based survey review process for high-performing nursing homes. CMS pilot tested the RBS process in more than 100 facilities in 22 states beginning in 2023. The initiative includes the addition of an icon on higher performing facilities in CMS’ Care Compare tool. CMS said the approach would reduce time required and staff members needed to conduct standard recertification surveys at higher performing facilities. All nursing homes will continue being surveyed at least every 15 months. While the RBS process would be available to all qualifying nursing homes, state agencies and CMS may still opt to use the traditional long-term care survey process based on concerns regarding residents’ health and safety, such as complaint reports, CMS said.

Approximately 12% of all nursing facilities will initially qualify for the new risk-based survey. To qualify, a nursing home must meet criteria quarterly, including a five-star overall rating on the Care Compare website, accurate data submission to CMS, zero citations indicating harm or substandard care quality in the previous survey cycle, and no recent ownership changes. CMS said that survey implementation is scheduled to begin in September following state agency training. Designations for high-performing facilities in the Care Compare tool are also expected to begin in September.

The AHA supports a number of steps to make healthcare more affordable for patients. A blog by Molly Smith, AHA group vice president of public policy, highlights how the healthcare system can better help patients reduce their need for complex, costly care and lower their direct costs. “Our recommendations recognize that affordability cannot be about cutting benefits or simply sifting costs from premiums into cost-sharing,” Smith writes. “The best approach to affordability is helping people stay healthy, eliminating unnecessary costs, simplifying the billing experience and preserving access to essential services.” READ MORE