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The Trump administration has revised the terms of a pilot effort that will allow some drugmakers to offer rebates to certain hospitals and clinics for purchased medicines, a controversial move that may transform a key tenet of a federal drug discount program. (Silverman, 7/31)

A divided Michigan Supreme Court ruled on Friday that the state’s attorney general may investigate Eli Lilly over its pricing practices for insulin. (Silverman, 8/2)

Hospitals are in line for a 2.3% Medicare reimbursement increase for inpatient care under a final rule the Centers for Medicare and Medicaid Services issued Friday. The regulation also features a revamped version of the decade-old Comprehensive Care for Joint Replacement Model that makes it Medicare’s first mandatory and nationwide bundled payment initiative. CMS is reviving the model, dubbed CJR-X, after the original version saved more than $100 million from 2016 through 2024, according to the agency. (Early, 7/31)

Medicare pay for specialist physicians would undergo steep cuts while primary care reimbursement would rise under a plan the Centers for Medicare and Medicaid Services unveiled this month. The agency proposed a slate of policies this month that would effectively reduce reimbursement for some specialty services and boost pay for certain routine primary care visits. CMS can only accomplish the latter goal by cutting expenditures in other areas under a legal standard known as “budget neutrality” that doesn’t allow the agency to add more than $20 million a year in new spending. (Early, 7/31)

Many seniors and disabled people in California who need long-term care will soon face a dramatic reduction in assets they can keep and still qualify for Medi-Cal. Starting in July 2027, the individual limit will fall from $130,000 to $21,000, while the limit for couples will drop from $195,000 to $31,000 when they apply for Medi-Cal — California’s Medicaid program — or renew their coverage. That’s an 84% decrease. (Roy, 8/1)

Missouri’s Medicaid program is heading into its hardest budget years in at least a decade. A federal law passed by Congress last year, the One Big Beautiful Bill Act, threatens more than $1 billion in penalties unless the state lowers its error rate below 3% starting in October 2029. It also imposes new mandates on the Department of Social Services. The state allotted $132 million to implement the law in its fiscal year 2026 supplemental budget alone. (Quinn, 8/1)

���ϳԹ��� News: People With Disabilities Fear Service Cuts As Trump’s DOJ Questions Legal Protections

Amanda DeSimone-Shabrack relies on a home healthcare aide to help her high-needs autistic 12-year-old son. Virginia’s Medicaid program covers the assistance, enabling her to work as both an education technology specialist and a professor, run errands, and keep Mason in the home. That could change. In June, the Department of Justice issued a legal opinion saying federal disability rights laws don’t require states to provide services that allow people with disabilities to remain in their homes rather than institutions. (Armour, 8/3)

Democrats are taking President Donald Trump’s administration to court again in another effort to fight back against a controversial health insurance exchange regulation. New Jersey Attorney General Jennifer Davenport and California Attorney General Rob Bonta led 22 Democrat-run states in the latest legal challenge against a payment and policy final rule that brings major changes to the health insurance exchanges created under the Affordable Care Act of 2010. The officials filed the case in the U.S. District Court for the Northern District of California. (Early, 7/31)

���ϳԹ��� News: Kennedy, Oz Contend Fraud Crackdown, Not Skyrocketing Prices, Led Millions To Leave Obamacare

The Trump administration credits its fraud control efforts for the disappearance of millions of people from Obamacare rolls rather than a sharp rise in premiums — a claim disputed by policy experts that glosses over the reality that many more Americans now find themselves without health insurance. Enrollment in Affordable Care Act plans fell by nearly 3 million this year to about 19.2 million, following steep premium increases by insurers and the Republican-led Congress’ unwillingness to extend more generous premium subsidies. (Appleby, 8/3)