Healthcare Harvest: New Medical Measures for October

Fall is a favorite time for most Americans as the last sweltering remnants of summer finally give way to October’s cool breezes.  It’s a time of new colors and brisk activity, and autumn harvest festivals are right around the corner.

This particular October is also significant for the new batch of healthcare laws that have become effective this month—from those affecting only certain states to those impacting the medical industry on a national scale.

The folks at Becker’s Hospital Review recently pulled together a collection seven federal and state-specific laws that became effective October 1.  The following is a summation of that information.

New Federal Laws

Medicaid Eligibility

Section 71109 of HR 1 limits federal funding for full Medicaid and Children’s Health Insurance Program (CHIP) benefits to U.S. citizens and nationals, lawful permanent residents, Cuban and Haitian entrants, as well as Compact of Free Association migrants.  This is pursuant to implementation guidance published by the Centers for Medicare & Medicaid Services (CMS) back in June.

Other noncitizens, including refugees and asylees, can still get emergency Medicaid.  States that selected the CHIPRA 214 option can also keep covering lawfully residing children and pregnant women.

As to hospitals, CMS said the above-referenced limits do not apply during presumptive eligibility periods.  As a result, healthcare services provided during those periods still qualify for federal funding.

Federal Match for Emergency Medicaid

Beginning this month, section 71110 of HR 1 caps the federal matching rate for emergency Medicaid services for noncitizens who are ineligible for full coverage because of immigration status at each state’s regular federal medical assistance percentage.  Prior to the passage of the law, “expansion states” received the enhanced 90% expansion match for these services, per the American Medical Association.  Now, these expansion states will receive their regular match rate, as “non-expansion states” already do. The law also gives CMS $1 million in fiscal 2026 to implement the change.

Medicaid Tax Limits

Section 71115 of HR 1 replaces the uniform 6% hold harmless threshold for healthcare-related taxes with limits tied to each state’s existing taxes.  In non-expansion states, thresholds are frozen at the level of taxes enacted and imposed as of July 4, 2025.  In expansion states, the threshold for most classes of services is the lower of that frozen level or a declining cap, which starts at 5.5% in fiscal 2028 and drops to 3.5% by fiscal 2032.

New State Laws

Certificate-of-need Program

Public Act 26-68 of the Connecticut legislature creates a new certificate-of-need (CON) framework within the Department of Public Health that takes effect October 1 (while most requirements do not apply until July 1, 2027).  A three-member panel will make all final CON decisions.  The law defines a change of ownership to include acquisitions of 25% or more of a healthcare facility’s assets, equity or voting shares, as well as real estate deals involving 20% or more of a hospital’s total assets.  It does not require a relocation review if the facility moves within the same town (or within 10 miles if the move will not substantially change the payer mix or patient population).

Financial Assistance Policy 

Public Act 26-68, as cited above, would also require hospitals to include a clear notice with each billing statement that financial assistance may be available and that patients can apply at no cost.  The notice must be in plain English and Spanish, and hospitals must also post it on their websites.  Each hospital must also have a written financial assistance policy that describes eligibility criteria, how patient charges are calculated and which providers in the hospital are covered.

Starting January 1, 2027, hospitals with financial assistance programs must treat patients enrolled in the Supplemental Nutrition Assistance Program, the Nutrition Program for Women, Infants and Children, or Temporary Assistance for Needy Families as meeting eligibility requirements.

Protected Areas

Sticking with Connecticut, their Public Act 26-14 (SB 397) bars federal law enforcement officers from detaining or arresting people for civil offenses in protected areas unless the person is the subject of a judicial warrant.  Protected areas include licensed medical facilities, along with their grounds, garages and parking lots.

Safe Staffing

In Maryland, the Safe Staffing Act of 2026 (SB 411) became effective on the first of this month.  The act requires hospitals to form clinical staffing committees by July 1, 2027.  For hospitals with 150 or fewer beds, committees must have three managers and two employees.  At larger hospitals, five managers and four employees must be part of the committee.

Hospitals must develop clinical staffing plans by July 1, 2027 and implement them by July 1, 2028.  Nurses and other frontline staff can bring complaints to the committee when unit assignments do not follow the plan.  Hospitals must post their plans and daily staffing data on patient units.  Starting July 1, 2030, the committees must report annually to the Maryland Health Care Commission.

So, while you’re raking up the leaves this month, don’t forget to glean what’s going on in terms of healthcare legislation.  Like the seasons, there are always changes.