| |  | The Lead Brief | It’s been a whirlwind of health care policy developments so far in 2026. In today’s edition, I’m taking a step back to explore the three major themes to watch for as the Trump administration makes its mark on health policy. 1. The “war on fraud” in health care President Donald Trump is making a crackdown on health care fraud a centerpiece of his agenda ahead of November’s midterm elections, announcing “the war on fraud” during his State of the Union address to Congress earlier this week. - Trump said during his speech on Tuesday that Vice President JD Vance would be leading the effort. The next day, Vance and Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, said that the administration would pause $259 million in Medicaid payments for Minnesota, a Democratic-led state the administration has had in its crosshairs.
What to watch: Vance said there could be similar crackdowns elsewhere in the country. During his State of the Union speech, Trump called out the alleged fraud in Minnesota and said that other Democratic-led states — including California, Massachusetts and Maine — “are even worse.” Minnesota Gov. Tim Walz (D) has called the move part of a “campaign of retribution.” - CMS is putting a six-month pause on new Medicare enrollment for certain companies that make durable medical equipment, prosthetics, orthotics and supplies — known as DMEPOS — in an effort to prevent fraudulent Medicare billing.
The moratorium is a notably blunt instrument by CMS: The agency isn’t imposing more screening requirements for companies; it’s blocking an entire category of medical suppliers from enrolling in the Medicare program. Fraud among DMEPOS suppliers has been on the government’s radar: The Office of Inspector General at the Department of Health and Human Services has found millions of dollars in alleged improper payments to these companies for years. Tom Ryan, who leads the advocacy group for the home medical equipment industry AAHomecare, said that suppliers and others in the industry “are 100% supportive of a comprehensive approach to keep criminal elements from abusing the Medicare program,” according to Medtrade. What to watch: The agency said the pause will allow it to figure out more preventative measures to “mitigate long-standing instances” of fraud among these companies. While the initial moratorium is set to last for six months, federal law allows CMS to impose additional six-month extensions. The American Academy of Sleep Medicine, which represents providers and accredited sleep centers, said that the move could have several implications for practices that rely on equipment suppliers for products including positive airway pressure (PAP) machines and masks. Cutting off new suppliers in Medicare has the potential to “reduce competition and slow the entry of new equipment providers, limiting access to care in underserved areas,” the group warned. - CMS is mulling whether to propose new rules around fraud prevention in public health programs — asking for input from states, providers, insurers and tech companies, among others — about “ways to strengthen its fraud-fighting toolbox,” according to a request for information.
Dubbed the Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH, initiative, CMS wants to know what’s working with the agency’s existing authorities to prevent, identify fraud, waste and abuse in Medicare, Medicaid, the Obamacare marketplace, and the Children’s Health Insurance Program, “as well as ideas for new regulatory approaches.” What to watch: Comments are due by March 30, and it’s worth watching to see what suggestions industry and others are able to come up with. Any new rules could shape future enforcement tools that could have significant impact on health care providers, laboratories, Medicare Advantage organizations and equipment suppliers. In a statement about the broader crackdown on fraud, Health Secretary Robert F. Kennedy Jr. said the department will be using “advanced AI tools to identify fraud instantly” to stop “improper payments” before they can occur. “CMS is done trying to catch fraudsters with their hands in the cookie jar — instead, we’re padlocking the jar and letting them starve,” Oz said in a statement. 2. Federal vaccine policy While Kennedy has been focusing publicly, as we’ve reported, on the administration’s healthy food initiatives, the administration has ushered in significant changes to vaccine policy with him at the helm. And more changes could be coming. The federal notice detailing plans for the Advisory Committee on Immunization Practices (ACIP) meeting next month indicates that those changes may not be slowing down despite immunization policy not being a focal point of the administration’s messaging. The panel is scheduled to discuss, among other topics, covid-19 vaccine injuries. ACIP, the influential federal vaccine panel that makes recommendations to the Centers for Disease Control and Prevention, has undergone a massive change since Kennedy became the nation’s top health official. He replaced the panel’s members with his own picks, many of whom have been skeptical of covid-19 vaccines or expressed anti-vaccine opinions. What to watch: It’s not clear that Kennedy is done reshaping ACIP, and he could add additional members before the set of meetings scheduled for March 18 and 19. The panel’s discussions about the risks of the covid shots could also change how Americans are able to get them. 3. The 340B drug discount program One of the next fronts in the health care cost war is likely to involve a discount drug program meant to help hospitals and clinics that serve a large number of low-income or uninsured patients, known as the 340B program. Congress created the program in 1992, compelling drugmakers to provide steep discounts on medication to so-called safety-net providers to help their budgets go further. Over time, it has exploded: Providers purchased $81.4 billion in discounted medications through the program in 2024, more than double the amount four years earlier. → The vast amount of money involved has the pharmaceutical industry declaring war, as drug companies claim that many hospitals are abusing the program. Hospital industry groups counter that the program helps facilities serve patients and keeps them afloat, while the pharmaceutical industry is only looking after its bottom line. - The Health Resources and Services Administration (HRSA), an agency within HHS, is going back to the drawing board on a pilot program meant to ensure that only eligible providers are getting the drug discounts.
A federal court paused the experimental initiative — which would have required facilities in the 340B program to pay full price for medicines and get a rebate later — arguing that the administration didn’t fully consider the negative impact it could have on providers. Hospitals and health clinics said that requiring full payment in advance could cause some cash-strapped facilities to close. What’s next: The Trump administration is soliciting public comments on its effort to retool the pilot program to comply with the federal court rulings. Earlier this week, HHS said it would extend the deadline for input to April 20, giving hospitals, providers, clinics, drugmakers and others more time to weigh in. - There’s also been congressional scrutiny of the 340B program. Sen. Bill Cassidy (R-Louisiana), who leads the Senate’s health panel, has been investigating hospitals’ use of the program. Last year, Cassidy released a report that alleged some facilities use the drug discounts to bolster profits or subsidize other operations without benefiting patients. House Ways and Means Committee Chair Jason T. Smith (R-Missouri) has also been critical of how some urban nonprofit hospitals gain rural classification, which allows them to gain easier access to the 340B program.
What to watch: In the Senate, there is a bipartisan working group developing legislation to overhaul the 340B program. In the House, hearings about health care affordability have yet to tackle hospitals. Lawmakers have heard from insurers, pharmacy benefit managers (PBMs) and the pharmaceutical industry — meaning hospitals could be up next. | 
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