- Telehealth flexibilities for prescribing controlled substances extended
- 2025 CMS MIPS data submission window open
- ASTP/ONC releases deregulatory proposed rule focused on Health IT Certification Program
- CMS announces new drug pricing models
- Jan. 28 webinar: What will the health policy landscape look like this year, and how is AMA shaping it?
- More articles in this issue
Telehealth flexibilities for prescribing controlled substances extended
The U.S. Drug Enforcement Administration (DEA) has extended the COVID-era prescribing flexibilities for controlled substances through Dec. 31, 2026. This is the fourth extension and allows physicians to continue to prescribe controlled substances to patients who have not had an in-person evaluation and have had telehealth visits only.
Although the DEA has issued multiple notices of proposed rulemaking to establish permanent regulations for prescribing controlled substances when there has not been an in-person encounter and to create a special telemedicine registration for this purpose, to date it has not finalized these rules. The notice is available for review.
2025 CMS MIPS data submission window open
The Centers for Medicare & Medicaid Services (CMS) has opened data submission for the 2025 performance year of the Merit-Based Incentive Payment System (MIPS) program. Data can be submitted and updated until March 31, 2026, at 8:00 p.m. ET. Follow the steps outlined below to submit 2025 MIPS data.
Go to the QPP sign in page.
Sign in using your QPP access credentials.
Submit your data for the 2025 performance year or review the data reported on your behalf by a third party. (You can’t correct errors with your data after the submission period, so it is important to make sure the data submitted on your behalf is accurate.)
ASTP/ONC releases deregulatory proposed rule focused on Health IT Certification Program
The Department of Health and Human Services (HHS) Assistant Secretary for Technology Policy (ASTP)/Office of the National Coordinator for Health IT (ONC) released a proposed rule in late December 2025 that calls for dramatically scaling back the Health IT Certification Program and making changes to information blocking requirements. The proposed rule is known as HTI-5, the fifth piece in ASTP/ONC’s Health Data, Technology, and Interoperability rulemaking series.
As part of President Donald J. Trump's deregulatory initiatives, HTI-5 calls for eliminating 34 of the 60 health IT certification criteria and revising seven others. ASTP/ONC states that its proposal is reducing burden by eliminating redundant requirements and promoting innovation for health IT developers, providers, and other interested parties. The rule is intended to directly align with President Trump’s goals as outlined in the “Unleashing Prosperity Through Deregulation” Executive Order (EO 14192). In addition, the rule proposes removing one information blocking exception, revising the conditions of other exceptions, and revising definitions to better promote electronic health information access, exchange, and use.
The AMA is reviewing this proposed regulation. Many of the changes proposed by ASTP/ONC would be impactful for physician practices. Public comments are due by Feb. 27.
This rule was also accompanied by a separate proposed rule that calls for withdrawing several provisions from the HTI-2 Proposed Rule that had not previously been finalized.
CMS announces new drug pricing models
At the end of December 2025, CMS announced three new payment models aimed at reducing drug prices for Medicare and Medicaid beneficiaries.
BALANCE Model
The Better Approaches to Lifestyle and Nutrition for Comprehensive Health (BALANCE) model is a voluntary model promoting broader access to Glucagon-Like Peptide-1 agonists (GLP-1) for treatment of obesity for Medicare and Medicaid beneficiaries. The voluntary model would see CMS negotiate drug prices and coverage terms directly with GLP-1 manufacturers for state Medicaid and Medicare Part D plans. State Medicaid plans participating in the model can join beginning May 2026, while the model will begin for Part D plans in January 2027. The model will run through December 2031.
In addition to lower prices and coverage for GLP-1 medications, beneficiaries will have access to lifestyle support programs offered by manufacturers at no additional cost to beneficiaries. These programs will provide beneficiaries with education on maintaining weight loss and making positive health choices.
As a bridge until the model begins, CMS will run a demonstration project beginning in July 2026 that will allow beneficiaries that meet certain access criteria with access to GLP-1 medications for treatment of obesity with a $50 per month co-pay. AMA policy has long supported broader access to GLP-1 medications for the treatment of obesity. The AMA also supported earlier efforts by the Trump administration to negotiate down the prices of treatments.
GUARD, GLOBE Models
Alongside the BALANCE model expanding access and lowering costs for GLP-1 medications, CMS announced two proposed mandatory models that would assess rebates for certain drugs if the prices of those drugs exceed the prices paid by other economically comparable countries. The Guarding U.S. Medicare Against Rising Drug Costs (GUARD) model would apply to certain drugs within Part D, while the Global Benchmark for Efficient Drug Pricing (GLOBE) model would apply to drug administered in clinical settings and paid under Part B. CMS expects both models to help reduce out-of-pocket costs for beneficiaries.
CMS is accepting comments on the proposed GUARD and GLOBE models, with comments due by Feb. 23, 2026.
Jan. 28 webinar: What will the health policy landscape look like this year, and how is AMA shaping it?
This Advocacy Insights webinar on Jan. 28 at 4:30 p.m. Central Time, offers a timely and in-depth look into the complex health care issues facing the U.S. in the coming year and how the AMA is working to shape the landscape. Amid shifting priorities among policymakers, hear about the strategies organized medicine is using to meet the moment—advancing health policy to better meet the needs of patients and physicians.
Host:
David H. Aizuss, MD, chair, AMA Board of Trustees
Speakers:
Todd Askew, senior vice president, AMA Advocacy
Michaela Sternstein, vice president, Advocacy Resource Center, AMA
