THIS WEEK AT A GLANCE
CMS deferred $259.5 million in Minnesota Medicaid funding over suspected fraud and imposed a nationwide moratorium on new Medicare enrollment for certain medical equipment suppliers. The Minnesota action is a warning shot for every state and territory with Medicaid program integrity vulnerabilities — including Puerto Rico.
Separately, the FDA launched a new “Plausible Mechanism” framework to accelerate approvals of individualized therapies for ultra-rare diseases, and 15 states sued HHS over its decision to reduce the number of routine childhood immunizations from 17 to 11.
AGENCY WATCH: CMS / HHS
CMS Defers $259.5 Million in Minnesota Medicaid Funding
Date: February 25, 2026
The Trump Administration announced a major crackdown on healthcare fraud, with CMS deferring $259.5 million in quarterly Medicaid funding to Minnesota while an investigation into the state’s Medicaid fraud is completed.
Key Details:
Why This Matters for Puerto Rico: This is the clearest signal yet that CMS is willing to withhold significant Medicaid funding from jurisdictions with fraud vulnerabilities. Puerto Rico’s Medicaid program has historically faced scrutiny over program integrity. Coming on the heels of CMS’s proposed regulations from February 9 — which included tightened fraud verification measures — and the publication of the largest open-source Medicaid dataset the prior week, this action establishes a pattern. Puerto Rico should proactively examine its anti-fraud mechanisms and documentation practices to avoid a similar deferral. For healthcare providers and managed care organizations operating on the island, compliance posture has never been more critical.
FDA Launches “Plausible Mechanism” Framework for Ultra-Rare Diseases
Date: February 25, 2026
The FDA introduced a new framework designed to accelerate development and approval of individualized therapies for ultra-rare diseases. The “Plausible Mechanism” approach emphasizes targeting the root cause of disease, using well-characterized natural history data, confirming successful target engagement, and demonstrating clinical benefit through outcomes or validated biomarkers.
Key Details:
Puerto Rico Connection: The framework could benefit Puerto Rican patients with ultra-rare conditions by accelerating access to individualized therapies and reducing costs for treatments otherwise unavailable on the island.
OTHER DEVELOPMENTS
15 States Sue HHS Over Childhood Vaccine Schedule Changes
The attorneys general of 15 states — led by Arizona, California, and Colorado — along with the governor of Pennsylvania, filed suit against HHS to halt the agency’s decision to reduce the number of diseases children are routinely immunized against from 17 to 11. HHS has defended the new schedule as closely resembling Denmark’s model, while opponents argue that comparison is invalid given Denmark’s nationalized healthcare system and much smaller population.
HHS Restructuring Research Office
HHS plans to restructure the Office of Planning, Research and Evaluation (OPRE), reducing staff from 120 to approximately 20 and moving most work under political appointees. Over 130 organizations and research institutions criticized the plan, warning it would effectively dismantle OPRE’s independent evaluation work. OPRE manages over $150 million in grants and contracts providing evidence-based assessments of federal programs for low-income children and families.
Surgeon General Nomination Uncertain
Trump’s Surgeon General nominee, Casey Means, faces an uphill confirmation battle after declining to address questions about vaccine efficacy at her Senate confirmation hearing.
LOOKING AHEAD
No Health Subcommittee hearings or markups have been announced for the week of March 2.
On Our Radar:
NEED MORE DETAIL?
Maceira Zayas Law offers in-depth regulatory analysis, legislative tracking, and staff training on federal developments affecting Puerto Rico. For questions about any item in this briefing, or to schedule a consultation, contact:
Ginnell Torres, Health Attorney
gtorres@mzls.com
© 2026 Maceira Zayas Law. All rights reserved. This briefing is provided for informational purposes only and does not constitute legal advice.
