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Early this year, the FASD Respect Act was introduced in the Senate to authorize and modify programs administered by the Department of Health and Human Services to address fetal alcohol spectrum disorders (FASD), and became a provision of the SUPPORT for Patients and Communities Reauthorization Act. The bill sought to establish FASD Centers for Excellence to support FASD prevention through screenings, public awareness, and trainings at a local and state level. In September, Congress passed the SUPPORT Act, and last week the President signed it into law, which officially authorizes the FASD Respect Act.

The legislation will allow the US Department of Health and Human Services to promote and fund FASD education and awareness, as well as the promotion of FASD resources. Beyond funding and program expansion, the FASD Respect Act will task the federal government with addressing FASD through a realigned perspective that supports individuals and families and respects their lived experience.

Please contact Emma Sharp with any questions.

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From the Center for Connected Health Policy 11-18-25 Newsletter:

Last week, after agreeing to a deal to end the federal government shutdown, Congress passed a continuing resolution that would reopen the government, at least through January 30, 2026. Within the continuing resolution package was an extension of the Medicare telehealth waivers, which had previously expired on October 1, 2025 (NOTE: The package contained several divisions, however the link provided in this newsletter only goes to the section containing the telehealth items). In the passed legislation, the telehealth waivers that had expired will now be extended through January 30, 2026.

  TELEHEALTH WAIVER NEW EXPIRATION DATE
Waiving the location requirements (geographic and type of site) January 30, 2026
Expanded list of eligible telehealth providers January 30, 2026
Allowing federally qualified health centers (FQHCs) and rural health clinics (RHCs) to be eligible telehealth providers January 30, 2026
Delaying the prior in-person visit for mental health when certain permanent telehealth policy requirements are not met January 30, 2026
Delaying the prior in-person visit for mental health provided via telecommunications technology for FQHCs and RHCs January 30, 2026
Allowing of audio-only for telehealth services January 30, 2026
Extending the use of telehealth to conduct a face-to-face encounter for recertification of eligibility for hospice care January 30, 2026
Extending the Acute Hospital Care at Home Initiative January 30, 2026

In drafting the extension, Congress struck out the previous date in federal law of “September 30, 2025” (when the waivers previously ended) and placed the new expiration date of “January 30, 2026.” The extension of the waivers will be retroactive to September 30, 2025. Therefore, if a telehealth interaction took place starting October 1 through to the end of the shutdown, but was not eligible for coverage/payment under permanent telehealth policy, it would now be eligible under federal law.

What does this mean in light of the final rule for the 2026 Physician Fee Schedule (PFS)?

In the final rule for the 2026 PFS, the Centers for Medicare and Medicaid Services (CMS) aligned their policies on the prior in-person visit for mental health when an FQHC/RHC uses telecommunications technology with what Congress had put in place for other provider types (i.e. psychologists, counselors, etc.) delivering mental health services via telehealth when certain requirements (i.e., patient location) under permanent telehealth policy were not met. Prior to this continuing resolution being passed, CMS required that FQHCs and RHCs must meet the prior in-person visit requirements for all mental health visits that took place via telecommunications technology starting October 1, 2025. Due to the funding bill extensions, this requirement will no longer need to be met as the waiver’s expiration date is now January 30, 2026, with the in-person requirements now becoming effective on or after January 31, 2026. Even though CMS changed the federal regulations to reflect the need to have a prior in-person visit for mental health visits provided via telecommunications technology by an FQHC or RHC starting October 1, 2025, federal statute would take precedence over regulations. You can read more about the final rules for the 2026 PFS in CCHP’s fact sheet.

As for the effect this continuing resolution will have on other items in the 2026 PFS final rule, very little will change. CMS could not make changes to the telehealth policies in federal law as Congressional action would be required to do so, thus the 2026 PFS telehealth policies centered on issues that were not covered by the telehealth waivers. Readers may wonder about the policies regarding FQHCs and RHCs providing non-mental health services via telecommunications technology. With this new waiver expiration date of January 30, 2026, it simply means that those non-mental health services provided via telecommunications technology by an FQHC or RHC will again technically be regarded as “telehealth visits” and not “non-mental health services provided via telecommunications technology.” The reimbursement rate will not change nor how the entities bill for services since even during the shutdown, FQHCs and RHCs were instructed to continue to bill non-mental health services provided by telecommunications technology with G2025 and they were being paid the same rate they would have received had the service been labeled a “telehealth” service.

What’s Next?

It is important to highlight that this latest action has only extended the telehealth waivers an additional two and a half months, which is the same extension period as the funding for the federal government. This will mean that talks and negotiations will need to happen again in December and January and another bill will need to be passed if we are to avoid another shut down and expiration period.

Additionally, in early November, CMS announced that it would return all telehealth claims submitted between October 1 and November 10, 2025, that were not identified as definitively qualifying as mental health (as those were the primary telehealth services still covered during the waiver lapse period). Now that the waivers have been reinstated — and applied retroactively — providers may wish to resubmit any claims that were returned during that period, as well as submit all telehealth claims that may have been previously held.

These updates, as well as a full review of current State and Federal telehealth policies and practices, will be presented at the next RCPA Telehealth Work Group meeting on Tuesday, November 25, 2025, at 10:00 am. Register for the meeting here.

If you have any questions, please contact RCPA COO Jim Sharp.

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RCPA, in its partnership with the PA Health Access Network (PHAN), is asking organizations to consider signing on to their new letter, which opposes cuts to Medicaid and Pennie. The latest proposal in Congress would take healthcare away from 600,000 Pennsylvanians who receive their coverage through Medicaid or Pennie. This is a separate letter than was previously shared with members in February; we ask your organization to join PHAN and show your opposition to potential cuts. This new communication reflects some of the specific areas that will be impacted.

Enter your information to publicly sign on to the letter on behalf of your organization. Please note: this sign-on page is for organizations only. Please contact Bill England with any questions or if you do not want to be listed publicly.

RCPA continues its state and federal advocacy efforts for state mental health funding and preserving Medicaid funding. If you are interested in joining the Mental Health Safety Net Coalition, please contact RCPA Policy Associate Emma Sharp.

Thank you for all you do in working to preserve Pennsylvania’s healthcare.

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Capitol hill building in the morning with colorful cloud , Washington DC.

The Trump Administration’s “Big Beautiful Bill” was passed by House Republicans on May 22 and contains significant Medicaid cuts that could leave millions of Americans without coverage as well as severely reduce access to care. The proposed bill also includes cuts to Medicare funding, new restrictions on federal loans for medical students, and provisions to create a permanent, inflation-based mechanism for annual updates to Medicare physician payments. The legislation now heads to the Senate, where it will face further debate by lawmakers.

The proposed legislation seeks to accomplish the following:

Medicaid: 

  • The bill introduces a two-year acceleration of Medicaid work requirements for able-bodied adults ages 18 to 64, which is slated to take effect no later than December 31, 2026, instead of 2029. States have the ability to implement these requirements earlier to secure quicker savings.
  • Beginning October 21, 2027, states will be mandated to determine Medicaid eligibility every six months for people in the expansion population.
  • Medicaid and CHIP federal financial participation is prohibited under the bill revisions for people who fail to verify immigration status, citizenship, or nationality in the designated “reasonable opportunity” window.
  • States will also be required to cross-check their Death Master File quarterly to confirm deceased individuals are disenrolled. Should errors occur, there will be reinstatement provisions.
  • The Social Security Act is amended to cut retroactive Medicaid coverage from three months to one month before the application date.
  • Federal Medicaid and CHIP funding is prohibited for “specific gender transition procedures” provided to people under 18 years of age.
  • Eligibility for increased federal medical assistance percentage for states that are newly expanding Medicaid will be wound down. To qualify, states must start expansion by January 1, 2026, to restrict late expansion states from receiving an elevated match rate.
  • New rules for waiving the uniform tax requirement for Medicaid provider taxes will be imposed, which tightens conditions for states to use the financial tools.

Medicare:

  • A proposed staffing mandate is halted under the bill for long-term care facilities that receive Medicaid and Medicare funds.
  • The bill promotes the use of artificial intelligence to recover and reduce improper Medicare payments.
  • A May 20 report from the nonpartisan Congressional Budget Office found that the bill could cut nearly $500 billion over the next decade in Medicare funding.
  • The budget bill includes provisions to increase Medicare physician payments by an estimated 2.25% in 2026. This would be achieved by tying payments to 75% of the Medicare Economic Index. Starting in 2027, annual payments would be adjusted by 10% of the index, establishing a permanent, inflation-based update mechanism.
  • Under current law, physician pay is set to increase by just 0.25% in 2026 and 2.5% by 2035. The proposed changes would boost payments to 4.3% by 2035 instead. Physician groups, including the American Medical Association, strongly support the provision, calling it a critical step toward restoring stability after years of payment cuts.
  • The bill also adjusts the Medicare Physician Fee Schedule’s conversion factor, a key formula used to calculate final physician reimbursement. While the legislation introduces inflation-based updates, changes to the conversion factor could offset those increases and slow long-term payment growth. Physician groups have welcomed the update mechanism as a step in the right direction, though they say further reforms are needed to ensure physician payments fully reflect inflation and keep pace with rising practice costs over time.

CMS:

Outside of Congress, the Center for Medicaid Services (CMS) has also made announcements that could threaten access to healthcare:

  • On May 27, CMS announced increased federal oversight to prevent states from using federal Medicaid dollars to cover healthcare for undocumented immigrants for anything beyond emergency services, which violates federal law.
  • CMS outlined plans to increase audits of state Medicaid spending, eligibility systems, and financial controls, with recoupment of funds if misuse is found.

Please contact Emma Sharp with any questions.

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