This month, we delve into federal legislative activities and state policy updates that significantly impact the healthcare sector. Notable highlights include H.R. 1 and the establishment of the Rural Health Transformation Fund, the reintroduction of the Resident Physician Shortage Reduction Act, proposed telehealth flexibilities under the Medicare Physician Fee Schedule, and the Department of Justice (DOJ) launching a historic crackdown on healthcare fraud. We will explore how these changes shape the healthcare landscape and outline the necessary steps for compliance.
Federal Legislative Updates
The Rural Health Transformation Fund Under H.R. 1
Signed into law by the President on July 4, 2025, H.R. 1 aims to reform various aspects of the healthcare system, which presents opportunities and challenges for rural healthcare providers. One of its key provisions is the establishment of the Rural Health Transformation Fund, a substantial initiative designed to bolster healthcare infrastructure in underserved areas.
Key Details:
- Total Fund: $50 billion
- Annual Allocation: $10 billion from 2026 to 2030
- Administered by: Centers for Medicare & Medicaid Services (CMS)
- Eligibility: States must have CMS-approved Rural Health Transformation Plans
- Application Deadline: December 31, 2025
Implications for the Healthcare Industry:
States seeking funding must prepare robust Rural Health Transformation Plans that outline strategies for improving access and outcomes. This includes innovative approaches in leveraging technology—particularly artificial intelligence (AI)—and improving workforce recruitment and training initiatives. Compliance will require states to demonstrate:
- Comprehensive strategies to enhance health outcomes
- Strong partnerships among rural hospitals and healthcare providers
- Data-driven solutions to sustain rural healthcare facilities
Resident Physician Shortage Reduction Act (H.R. 3890)
The reintroduction of the Resident Physician Shortage Reduction Act aims to address the growing physician shortage by introducing 14,000 new Medicare Graduate Medical Education (GME) positions over seven years. This is particularly vital as healthcare facilities grapple with inadequate staffing levels.
Impact on Compliance:
Healthcare organizations should prepare for the onboarding of new residency positions and adapt their strategies to accommodate an influx of new physicians. This may involve reassessing mentoring programs and ensuring alignment with GME guidelines.
Telehealth & Medicare Physician Fee Schedule Enhancements
The proposed 2026 Medicare Physician Fee Schedule (MPFS) includes provisions to extend telehealth flexibilities through 2029, building on the rapid adoption of telemedicine during the COVID-19 pandemic.
Compliance Considerations:
Healthcare providers must stay abreast of the evolving regulations around telehealth practices, including reimbursement policies and documentation standards. Ensuring compliance will require:
- Updating telehealth protocols to meet new requirements
- Training for staff on any changes in billing processes
- Developing safeguards against fraud in telehealth service provision
DOJ Healthcare Fraud Crackdown
On June 30, 2025, the DOJ initiated a monumental healthcare fraud enforcement action, charging 324 defendants, including 96 licensed professionals, in schemes totaling over $14.6 billion in intended losses. This historic crackdown includes fraudulent activities across various healthcare sectors such as telemedicine and opioid prescriptions.
What This Means for Compliance:
Healthcare providers must enhance their compliance frameworks to mitigate risks of fraud.
This includes:
- Conducting regular audits of billing practices
- Providing comprehensive training on ethical practices and legal compliance
- Establishing whistleblower protections to encourage reporting of misconduct
State Policy Highlights
Transitioning to state-level developments, we focus on significant policy shifts influencing compliance and operational strategies.
Continuing Education Modernization in New Jersey
The New Jersey Senate’s passage of Bill S4387 requires a modernized approach to continuing education for licensed professionals. As the Assembly considers the bill upon reconvening, healthcare entities must prepare for potential changes in continuing education requirements.
Compliance Action Steps:
- Evaluate current continuing education offerings to align with new legislation.
- Prepare to integrate technology for training delivery.
- Ensure tracking and documentation processes meet new standards.
Interstate Medical Licensure Compact (IMLCC) Expansion
With North Carolina becoming the 44th IMLCC member, providers should note the potential for expanded licensure pathways across states.
Implications for Physicians:
Healthcare professionals should familiarize themselves with interstate compacts to streamline licensure processes, facilitating greater mobility and access to care.
Pharmacy Technician Registration Now Effective in Pennsylvania
The Pennsylvania Office of the Attorney General approved Regulation 16A-5433 – Pharmacy Technician Registration after a unanimous 5-0 vote by the Pennsylvania Independent Regulatory Review Commission. The regulation, now published in the Pennsylvania Bulletin, is effective June 28, 2025. It requires pharmacy technicians to complete background checks and three hours of child abuse education. Technicians have one year to register.
Conclusion
As the healthcare industry navigates these legislative changes, compliance will be paramount. Stakeholders must remain proactive in understanding the implications of new laws and policies while developing effective strategies to meet the evolving demands of the healthcare landscape. By prioritizing thoughtful planning and compliance, healthcare providers can enhance their operations and continue to deliver high-quality care.
To learn more about how Verisys helps make compliance easy, please contact us sales@verisys.com
