Congress Advances FY 2026 Funding Package with Major Health Policy Riders
In a welcome return to regular appropriations following the collapse of the December 2024 omnibus package, Congress passed the Consolidated Appropriations Act, 2026, clearing the decks of previously negotiated policies while responding to a series of major administrative actions taken over the past year. For organized neurosurgery and the broader physician and research communities, the legislation delivered several significant victories to protect biomedical research funding, preserve congressional oversight, and stabilize key federal health programs.
Signed into law on February 3, 2026, the legislation funded the Departments of Labor, Health and Human Services, and Education for fiscal year 2026 while advancing a broad set of health policy directives affecting the National Institutes of Health and the Centers for Disease Control and Prevention. NIH received $48.7 billion under the final package, an increase of $415 million above FY 2025 levels, while the National Institute of Neurological Disorders and Stroke received $2.804 billion to support neuroscience research and investigator-initiated funding. The National Cancer Institute received $7.352 billion, including expanded investments in childhood cancer research, prevention, and early detection initiatives. While the CDC did see a reduction in funding, Congress provided $761 million to support traumatic brain injury programs, including concussion surveillance, firearm injury prevention research, and more.
One of the most consequential provisions for academic medicine involved congressional intervention into NIH’s attempted overhaul of indirect cost reimbursement policy. Earlier in 2025, NIH proposed imposing a universal 15 percent cap on facilities and administrative (F&A) cost reimbursement rates, replacing longstanding negotiated agreements with academic institutions. The Washington Committee led national physician groups in opposition to the proposal and worked directly with House appropriators to preserve the protective language through final negotiations. The enacted bill reinforces that indirect cost structures must continue to be negotiated rather than imposed administratively across the board.
The legislation also included several significant Medicare Advantage (MA) and Medicare Part D policy riders affecting physician payment policy, pharmacy benefit manager transparency, telehealth services, rural health programs, and plan oversight. Among the most notable were new Medicare Part D reforms targeting pharmacy benefit manager compensation practices, including “delinking” provisions intended to reduce the financial incentive to favor higher-cost drugs by separating certain pharmacy benefit manager compensation from a drug’s list price or rebate value. The bill also establishes new statutory requirements governing
the accuracy of MA provider directories. Beginning in plan year 2028, MA plans must maintain publicly accessible, regularly updated, and standardized provider directories that contain specified information about participating providers, patient access, and covered services.
The package also reauthorized the Dr. Lorna Breen Health Care Provider Protection Act, extending federal support for physician mental health and burnout prevention programs.
Expanding Neurosurgery’s Influence in Washington
One of the most effective ways to strengthen neurosurgery’s voice in Washington is to ensure that neurosurgeons themselves serve in the rooms where federal policy decisions are made. While the Washington Committee continues to support advocacy through direct engagement with Congress and federal agencies, expanding neurosurgical representation across advisory bodies, commissions, and federal leadership positions remains a growing strategic priority.
In January, Quality Subcommittee Chair- Elect Anthony M. DiGiorgio, DO, MPH, was appointed to the National Committee on Vital and Health Statistics (NCVHS), the statutory public advisory body to HHS on health data, health information standards, privacy, interoperability, and modernization of federal health information systems. The appointment was facilitated through Washington Committee engagement and relationship development and represents a significant opportunity for neurosurgery to help shape ongoing federal discussions surrounding health data infrastructure and digital health policy.
That same month, Ricardo A. Hanel, MD, PhD, was appointed to the Advisory Council on Alzheimer’s Research, Care, and Services. Established under the National Alzheimer’s Project Act of 2011, the Advisory Council provides recommendations to HHS and federal partners on advancing dementia research, strengthening care delivery models, and improving long-term support for patients with Alzheimer’s disease. Dr. Hanel is believed to be the first neurosurgeon appointed to the Advisory Council, expanding neurosurgery’s presence in national conversations surrounding neurodegenerative disease policy, research, and patient care.
Physician-Owned Hospitals Take Center Stage in House Hearing
On March 18, 2026, as part of the House Energy and Commerce Committee’s ongoing health care affordability series following its January 22 hearing featuring health insurance CEOs, the Subcommittee on Health convened a hearing, Lowering Health Care Costs for All Americans: An Examination of the U.S. Provider Landscape. The hearing included representatives from the American Medical Association, American Hospital Association, American Academy of Family Physicians, and other national stakeholders. The Washington Committee helped secure Dr. DiGiorgio as a panelist.
A central focus of the hearing was the role of physician-owned hospitals (POH) and independent physician practices in promoting competition, reducing consolidation, and improving patient access. During his testimony, Dr. DiGiorgio argued that federal policy has steadily weakened the independent physician sector through site-of-service payment disparities, restrictions on POH expansion, and increasing administrative burden.
Dr. DiGiorgio highlighted research showing that many physician-owned hospitals deliver high-quality care at lower or comparable costs while maintaining high patient satisfaction and lower complication and readmission rates.
Congressional Effort Emerges to Delay MPFS Efficiency Adjustment
The Washington Committee continues to make Medicare physician payment reform among its top federal advocacy priorities, with particular focus on CMS’s finalized “efficiency adjustment” under the CY 2026 Medicare Physician Fee Schedule (MPFS). Finalized in the CY 2026 rule, the policy imposes an across-the-board 2.5 percent reduction to work RVUs for nearly all non-time-based services based on assumed physician productivity gains over time.
In response, the Washington Committee advanced a multi-pronged advocacy strategy focused on both immediate relief and broader structural reform. Efforts included coalition engagement, direct outreach to CMS and congressional offices, and development of a revised framework for evaluating physician services and code valuation under the Medicare payment system.
Those efforts culminated in the introduction of the Efficiency Adjustment Delay Act (H.R. 7520), bipartisan legislation delaying implementation of the adjustment while Congress and stakeholders evaluate its long-term impact. The legislation and bipartisan lead sponsorship resulted directly from Washington Committee-led advocacy efforts. The Committee secured Representative Ron Estes (R-KS) as the Republican lead sponsor, with E. Sander Connolly, MD, helping to secure Representative Tom Suozzi (D-NY) as the Democratic co-lead. Dr. Khalessi was featured in the bill sponsors’ official press release supporting the legislation, with an accompanying coalition letter of support.
Medicare Fraud Prevention Request for Information
The Washington Committee, alongside fourteen specialty and subspecialty societies representing more than 100,000 physicians through the Alliance of Specialty Medicine, submitted formal comments in response to CMS’s representing more than 100,000 physicians through the Alliance of Specialty Medicine, submitted formal comments in response to CMS’ Comprehensive Regulations to Uncover Suspicious Healthcare Activity (CRUSH) initiative, aimed at strengthening Medicare’s ability to detect and prevent fraudulent billing.
While the Washington Committee strongly supports efforts to combat fraud, waste, and abuse in Medicare, its response raised significant concerns that poorly designed program integrity policies risk penalizing good-faith physicians while doing little to deter bad actors.
Billing Deadlines
CMS is considering shortening the window in which physicians must submit bills for services already provided. Many billing delays stem from Medicare’s own administrative processes, such as lengthy enrollment reviews for new physicians. The CNS made clear in its response that penalizing doctors for such delays serves no meaningful fraud-prevention purpose— the most effective tools are precise and targeted, not broad mandates that fall hardest on physicians who fully comply with Medicare rules.
Neurosurgery Applauds New Dietary Guidelines
In January, the Administration released the updated Dietary Guidelines for Americans, 2025-2030. The guidelines represent a return to whole foods, reduced reliance on ultra-processed products, and age-adjusted nutritional patterns across the lifespan. Dr. Khalessi, MD, MBA, commented on the guidelines, thanking Secretaries Robert F. Kennedy, Jr., and Brooke Rollins for their leadership in elevating nutrition as a national health priority and highlighted several important examples of how neurosurgical outcomes depend on proper nutrition.
From Advocacy to Action: A Year in Review
Over the past year, the stories featured throughout this section have reflected more than policy updates. They have documented tangible advocacy outcomes, from blocking NIH’s proposed 15 percent indirect cost cap to securing changes to CMMI’s WISeR Model. CNS’s 2025 Annual Report provides a year-in-review of the Washington Committee’s advocacy during Dr. Khalessi’s first year as chair. Click here to view the report.