The U.S. Department of Health and Human Services (HHS) announced a complete overhaul in accordance with the president's recent executive order on government efficiency. The plan includes staff reductions and department consolidations for several public health and safety agencies. It also highlights the continued focus on health care fraud and abuse enforcement.
Key components of the HHS restructuring include reducing:
- 82,000 full-time employees to 62,000
- 28 divisions to 15
- 10 regional offices to 5
The HHS human resources, information technology, procurement, external affairs and policy departments will also be centralized.
The changes also impact key agencies under the purview of HHS. The Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH) and Centers for Medicare and Medicaid Services (CMS) will be impacted as follows:
- FDA: Workforce decrease of about 3,500 full-time employees, with a focus on streamlining operations and centralizing administrative functions. HHS clarified that the reduction will not affect drug, medical device or food reviewers, or inspectors.
- CDC: Workforce decrease of about 2,400 employees, with a focus on returning to its core mission of preparing for and responding to epidemics and outbreaks.
- NIH: Workforce decrease of about 1,200 employees by centralizing procurement, human resources and communications across its 27 institutes and centers.
- CMS: Workforce decrease of about 300 employees, with a focus on reducing minor duplication across the agency. This reorganization will not impact Medicare and Medicaid services.
HHS will also create a new assistant secretary for enforcement to oversee the Departmental Appeals Board (DAB), Office of Medicare Hearings and Appeals (OMHA), and Office for Civil Rights (OCR) to combat waste, fraud and abuse in federal health programs. This new position aligns with industry thinking that health care fraud and abuse will continue to be a priority under the Trump administration, as it was with the Biden administration. Typically, health care fraud and abuse enforcement has bipartisan support. The DOJ has already signaled its intent to pursue aggressive enforcement of the False Claims Act in health care.
According to the HHS press release, the restructure intends to create a more efficient HHS that is more responsive to Americans' needs and to implement the administration's goal of ending the chronic disease epidemic.
HHS also announced that it is not currently planning any additional cuts. Questions remain on more in-depth details regarding how the overhaul will be operationalized to achieve its intended goals and purpose.
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