RISE summarizes recent regulatory-related headlines and reports.
Trump to nominate former deputy surgeon general as next CDC director
In a post on Truth Social, President Donald Trump announced he will nominate Erica Schwartz, M.D., JD, MPH, as the next director of the Centers for Disease Control and Prevention (CDC). Dr. Schwartz previously served as the deputy surgeon general during Trump’s first term.
If she is confirmed by the Senate, Dr. Schwartz will replace Dr. Jay Bhattacharya, director of the National Institutes of Health (NIH), who took over as acting CDC director in February. She is considered a qualified, traditional choice for the agency’s director, according to the New York Times as she supports vaccines as a cornerstone of prevention but also believes in healthy diet and exercise. In a post on X, Health and Human Services Secretary Robert F. Kennedy Jr. praised the nomination, as well as other nominations that Trump plans to make for senior leadership at the CDC, and said he is looking forward to working with them to “restore trust, accountability, and scientific integrity at the CDC so we can return it to its core mission and Make America Healthy Again.”
Wakely report: ACA enrollment drops as fewer consumers pay premiums in early 2026
Early evidence from the Affordable Care Act (ACA) individual market indicates that actual enrollment for 2026 is declining far more than initial sign‑up figures suggested, according to a new analysis by Wakely Consulting Group.
Using proprietary data that cover roughly 80 percen6 of the national individual market, Wakely estimates that total enrollment in 2026 is down between 17 percent and 26 percent compared with 2025. The decline is significantly steeper than the roughly 5 percent decrease seen in early Open Enrollment Period (OEP) plan selection data, revealing a widening gap between who selected coverage and who ultimately paid premiums.
Wakely found that 85.9 percent of enrollees paid their January 2026 premiums, meaning a substantial share of individuals counted in early enrollment figures never enacted coverage. Because subsidized enrollees may receive a 90‑day grace period, enrollment totals often continue to change through the spring, but early payment data suggest attrition will be materially higher than plan selections alone imply.
The enrollment losses follow a year of major disruption in the individual market. The expiration of enhanced premium tax credits, changes in subsidy eligibility under recent legislation, elevated medical trend and inflation, and premium increases tied to correcting prior underpricing combined to produce the largest net premium increases in years. These pressures raised concerns that healthier enrollees would be more likely to exit the market. Wakely’s analysis suggests those concerns are being realized.
In addition to shrinking enrollment, the firm estimates that market morbidity in 2026 could worsen by 2.9 percent to 6.5 percent on average, as remaining enrollees are disproportionately higher‑cost members.
Florida nursing assistant sentenced to prison for $11.4M DME fraud scheme
The Department of Justice announced that a Florida nursing assistant was sentenced to nine years in prison and two years of supervised release for his role in an $11.4 million health care fraud and wire fraud conspiracy in which hundreds of Medicare beneficiaries were sent thousands of orthotic braces they did not need. He was also ordered to pay $3.7 million in restitution and approximately $725,000 in forfeiture.
According to court documents and evidence presented at trial, Christian “Chris” Cruz, 45, of Pompano Beach, Fla., owned and operated a durable medical equipment (DME) supplier based in Florida through which he submitted millions of dollars in false claims to Medicare for medically unnecessary orthotic braces.
Cruz and his partner paid illegal kickbacks and bribes to obtain signed doctors’ orders. They used these orders to ship orthotic braces to Medicare beneficiaries nationwide and then claim payment from Medicare, including to beneficiaries who neither requested nor needed the braces. Cruz lied to Medicare, claiming that he was the sole owner and operator of the company, when in fact he shared ownership in the company with his co-conspirator, a convicted felon. Medicare would not have allowed the company to enroll with Medicare if it had known about Cruz’s partner. The co-conspirator has been charged but remains at large.
After a six-day trial in January 2026, a federal jury convicted Cruz of one count of conspiracy to commit health care fraud and wire fraud, four counts of health care fraud, one count of conspiracy to defraud the United States and to make false statements relating to health care matters and three counts of structuring.
CMS accepts 150 organizations into ACCESS model, extends deadline for new applications
More than 150 health care organizations have been accepted to participate in the launch of the Centers for Medicare & Medicaid Services’ (CMS) Advancing Chronic Care with Effective Scalable Solutions (ACCESS) Model. The 10-year voluntary model aims to provide original Medicare beneficiaries with new options to improve their health and prevent and manage chronic diseases with technology-supported care.
CMS said most of the accepted organizations have not previously served Medicare beneficiaries and will bring additional technology-supported care options to help people manage chronic conditions like high blood pressure, diabetes, chronic pain and depression.
The agency also announced it is extending the initial application deadline to May 15 so that more organizations can participate in ACCESS when it launches on July 5. Medicare enrollment is required for participation but not to apply. Interested participants should visit kidneyxempowerchallenge.org to apply for the 2026 EMPOWER Prize Challenge and receive updates, key dates, and reminders as they become available. Selected winners will receive monetary prizes and national recognition, helping accelerate the development and real-world adoption of their solutions.