Navigating 2025 Healthcare Regulatory Changes

When I originally wrote this blog early in 2025, new rules, proposals, and enforcement priorities were already emerging. Since then, these changes have continued to reshape how healthcare organizations must approach compliance. I’ve refreshed the information here to help you stay informed, prepared, and equipped to navigate evolving requirements as they continue to unfold. 

Stay ahead of regulatory change and minimize disruptions with these tips.

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From the disbanding of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and substantial Medicaid changes to new regulations and clarifying court rulings, the following state, federal, and industry-specific rulings could be felt by healthcare organizations across the country. Awareness and preparedness are key! 

I anticipated changes with President Donald Trump’s return to office, and we’ve certainly seen that. There’s been a move to reduce federal oversight and regulatory burdens, with a goal of ultimately eliminating bureaucratic inefficiencies. While it can be beneficial for states to have more power, this approach also creates a more fragmented regulatory landscape, making meeting compliance standards state-by-state more challenging. 

In this article, I’ll share a high-level view of what you need to know, but remember that until laws are officially passed, there are currently as many predictions as facts regarding upcoming healthcare regulatory changes. 

MedTrainer is continuing to improve and update our platform and services to support organizations through these rapid changes. We have seen a steady increase in interest as healthcare teams seek effective solutions to manage complexity and maintain compliance.

One thing is for certain: there will be changes, particularly regarding federal oversight.

State-Level Regulations

Maintaining compliance amid new laws can be complex and confusing, especially as regulations vary from state to state. Understanding how a state ruling affects your healthcare organization is key.

OSHA Workplace Safety Regulations: Workplace safety remains a priority in 2025, and there is a potential for the Occupational Safety and Health Administration (OSHA) regulations to shift to improve state plan enforcement while reducing the impact of current federal rules. Regulations to watch under the new Trump administration include the Heat Injury and Illness Prevention Rule, Worker Walkaround Representative Designation Process, Emergency Response Standard, and new state health privacy laws.

It’s important to remember that with OSHA rules, just because it’s not a law doesn’t mean you’re not responsible per the General Duty clause. 

Paid Family and Medical Leave Expansions: Paid family leave policies continue to gain traction, with new programs in Minnesota, Delaware, and Maine beginning in 2025. These laws ensure employees can access wage replacement during serious illnesses or family-related events, such as the birth of a child. States like Connecticut, Washington, and Illinois have also expanded their programs. Employers must adjust payroll systems and educate staff to comply with these updates.

Federal-Level Changes

HICPAC Disbanding and Infection Prevention Impact: While HICPAC is only an advisory committee and CDC guidelines are not enforceable regulations, they provide the foundational framework for the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs). With HICPAC no longer in operation, healthcare organizations may face greater uncertainty in prevention practices. The absence of this key advisory committee risks creating gaps in the development and communication of clear, evidence-based guidelines. This could lead to inconsistent application of standards and ultimately increase the likelihood of related safety issues in healthcare settings.

DEA Telehealth Flexibility Extension: The DEA announced three proposed telehealth Final Rules designed to make permanent some of the flexibilities established during the pandemic. This extension would allow the prescription of Schedule III-IV controlled substances via telehealth, as well as expanding the medical specialists who could issue Schedule II medications. This policy supports accessibility but requires practitioners to complete an 8-hour training under the DEA MATE Act. 

HIPAA Security Rule Proposed Changes: The proposed changes impact 45 CFR 164.302-164.318 and would require training on the organization’s policies and procedures at least once every 12 months. The revision also includes a very specific list of safeguards that require annual maintenance or modification.

HIPAA Privacy Rule Changes: The revised 42 CFR Part 2 aligns confidentiality for substance use disorder (SUD) records with HIPAA standards, allowing patients to provide a single consent for future uses of their records. Compliance is required by February 16, 2026. New rules enhance reproductive health care privacy, protecting sensitive information from being used to investigate or penalize individuals for seeking or providing legal reproductive healthcare. Recent court notices clarify parts of the Final HIPAA Privacy Rule, including a June ruling from the U.S. District Court for the Northern District of Texas, which vacated certain provisions while leaving other modifications to the Notice of Privacy Practices (NPP) in effect. Healthcare organizations must be prepared to pivot as these court decisions and ongoing regulatory updates impact existing rules. Compliance with the remaining NPP modifications is required by February 16, 2026, and organizations should ensure their notices of privacy practices reflect these updates.

NCQA Credentialing Standard Changes: Effective July 1, 2025, NCQA standards around verification and exclusion monitoring will change. This will include expiration date tracking, shorter verification times, and expanded exclusions to include SAM.gov and are all required every 30 days.

MedTrainer Live: Upcoming NCQA Credentialing Changes

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DEA Registrant Validation: In 2024, the DEA changed registrant validation to avoid fraud. All validations must include the trusted URL, which requires Registrant Dataset Access (RDA) or multi-factor authentication token from the provider every time you need verification. With RDA access, MedTrainer is fully compliant — see how it works.

Healthcare Price Transparency: The executive order signed by President Trump directs the Departments of Health and Human Services (HHS), Labor, and Treasury to enforce price transparency rules introduced during his first term. This could lead to a shift in auditing and require closer attention to coding and billing compliance.

Industry-Level Updates

Quality Reporting for ASCs in 2025: ASC quality measures selected for use in the ASCQR Program evaluate the care in which ASCV provides treatment or adheres to processes expected to facilitate the best patient outcomes for the measured care. 

• 14 mandatory measures must be reported to avoid a reduction to future Medicare reimbursements
• 4 New voluntary measures (due May 15, 2026): 
  • Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery 
  • Risk-Standardized Patient Reported Outcome-Based Performance Measure (PRO-PM) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)
  • Screening for Social Drivers of Health (SDOH)
  • Screen Positive for Social Drivers of Health (SDOH)

CMS 2025 Physician Fee Schedule (PFS): Good news for rural health centers (RHCs) and federally qualified health centers (FQHCs)! The two will be required to bill individual service codes rather than G0511. CMS will also allow them to bill add-on codes for additional time spent. Other updates to PFS include:

• RHCs/FQHCs will include Advanced Primary Care Management Services (APCM), coordination services as well as Transitional care management (TCM), Chronic care management (CCM), Principal care management (PCM), and Chronic pain management (CPM)
• RHCs and FQHCs that provide dental services aligning with the requirements in the physician setting have an opportunity to bill separately for inextricably linked dental services provided on the same day as a medical visit
• RHCs and FQHCs can bill and be paid for Part B preventive vaccines (pneumococcal, flu, hepatitis B and COVID-19) and their administration at the time of service

Joint Commission Accreditation 360: The Joint Commission has introduced Accreditation 360, a new approach to healthcare accreditation designed to simplify the process, focus on outcomes, and align more closely with how care is delivered. Key updates and potential impacts for healthcare organizations include:

• Requirements have been reduced and reorganized to focus on critical areas, which may require reviewing and adjusting existing policies and procedures to ensure alignment with the new standards.
• Organizations now have options for continuous engagement to maintain safety and quality standards year-round, which may involve adopting new processes for ongoing monitoring and reporting.
• Accreditation requirements have been streamlined into 14 National Performance Goals (NPGs); organizations should review current safety practices to ensure they meet these updated priorities.
• Next-generation outcome-based certifications focus on areas such as maternity care, hip and knee procedures, spine procedures, and cardiovascular care, potentially requiring enhanced data tracking and documentation.

Strategies to Adapt 

Maintaining regulatory compliance can be challenging, especially when a wave of new regulations and standards hit. But with the right approach and technology in place, your organization and staff can understand new rules, creative effective policies, and ensure necessary training. Strategies to pivot amid regulatory changes might include:

• Stay Informed: Stay in the loop by checking out the latest news from federal and state agencies regularly.
• Utilize a System Approach: Even if something isn’t required anymore, it might still be worth doing. Take a step back and consider how it affects your team and organization.
• Simplify Policy Updates: Tools like MedTrainer’s AI Policy Guardian flag outdated compliance policies, suggest edits, and provide references — all within a comprehensive policy management platform. 
• Automate Compliance Processes: Automatically completing exclusions monitoring and license verification will keep you NCQA-compliant, while also saving time and hassle. 
• Leverage Technology:  Tools like MedTrainer’s all-in-one platform simplifies the process of updating policies (and securing acknowledgment), updating learning courses, and automatically completing exclusions monitoring and license verification – saving you time and hassle.    
• Implement Role-Based Training: Tailor training to specific staff roles and locations so that you don’t overload employees with training that isn’t required — but, those who need it are ready!
• Overcommunicate With Staff: Ensure updates come from trusted sources and are communicated clearly and consistently with providers and staff regarding any new information and their roles.

The regulatory landscape for healthcare in 2025 emphasizes safety, privacy, and accessibility with added governance from the states. Regardless of any changes that may occur, healthcare organizations must remain agile and informed. By proactively adapting to these changes, you can not only ensure compliance but also enhance the quality of care for patients and experience for staff.

How MedTrainer Can Help

Organizations must implement proactive measures to successfully meet these evolving requirements. MedTrainer’s all-in-one platform is designed specifically for healthcare and includes all of the automations, workflows, resources, and reminders to help your organization stay ahead of regulatory updates. 

Are you prepared for the potential changes ahead? See how MedTrainer’s comprehensive solution can alleviate and elevate your organization’s compliance process today – regardless of what new regulations and standards come their way.