Summary
The House and Senate are on spring recess again this week. After finally passing the fiscal year 2024 bills prior to leaving town, action on an emergency spending package will await Congress upon their return. In addition to funding for war and humanitarian efforts in Ukraine, Israel, Gaza, and Taiwan, approximately $1 billion in emergency funding is needed to address the cleanup and rebuilding of the Francis Scott Key Bridge disaster in Baltimore. As one of the nation’s largest ports, it will be critical for Congress to address this disaster in order to maintain the flow of cars, appliances construction machinery, steel and aluminum, and many other critical imports and exports. Passing a package will not be easy as House Speaker Mike Johnson is at odds with the conservative faction of his party who are opposed to funding Ukraine efforts and are still upset with the Speaker over the FY 2024 spending bill. With just 1 vote margin, the Speaker finds himself once again needing Democrats to pass a bipartisan deal.
Hearings
Senate HELP Committee: Field Hearing: Corporate Impact on Health Care: On Wednesday the Senate Health, Education, Labor, and Pensions Committee will hold a field hearing in Boston, Massachusetts titled “When Health Care Becomes Wealth Care: How Corporate Greed Puts Patient Care and Health Workers at Risk.”
Regulatory Update
The Office of Management and Budget (OMB) completed reviewing two final rules related to Medicare Advantage and Part D: (1) a final rule for CY 2025 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies; and (2) a final rule for CY 2025 Policy and Technical Changes to MA, Medicare Part D, and Programs of All-Inclusive Care for the Elderly (PACE). OMB is also reviewing the following rules:
Medicare
- Alternative Payment Models – The proposed rule would implement a new Medicare payment model titled, Increasing Organ Transplant Access (IOTA) Model (was set for December 2023).
- Payment Update – The proposed rule would make policy payment updates for acute care hospitals inpatient and long-term care hospitals (April 2024).
- Nursing Homes – The final rule would establish minimum staffing standards for long-term care facilities and establish Medicaid institutional payment transparency reporting requirements (September 2026).
Medicaid
- Disproportionate Share Hospital Program – The final rule would implement requirements under section 203 of the Consolidated Appropriations Act, 2021 (CAA), which relate to Medicaid shortfall and third-party payments (February 2024).
- Access to Care – A pair of final rule intended to access to care and quality outcomes for Medicaid and CHIP beneficiaries enrolled in managed care delivery systems and fee-for-service Medicaid (April 2024).
- Drug Rebate Program – The final rule would establishes requirements related to manufacturers’ misclassification of covered outpatient drug products under the Medicaid Drug Rebate Program (MDRP). In addition, it finalizes beneficiary protections, as well as MDRP program integrity and administration changes (June 2024).
Commercial Insurance
- ACA Marketplace – The final rule would make changes to regulations governing Affordable Care Act (ACA) Marketplace plans, insurance standards, and the risk adjustment program for plan year 2025 (not specified but likely April 2024).
- Association Health Plans – The final rule would make changes the definition of employer under ERISA-Association Health Plans (April 2024)
Other Topics
- Healthcare System Resiliency and Modernization – The proposed rule would revise and update national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers (was set for December 2023).
- Reproductive Health Care Privacy – The final rule would modify the HIPAA Privacy Rule to support reproductive health care privacy (March 2024).
- Health IT – The proposed rule would advance interoperability through proposals for: standards adoption; public health IT certification; expanded uses of certified application programming interfaces (APIs), such as for electronic prior authorization, patient engagement, care management, and care coordination; and information sharing under the information blocking regulations (was set for November 2023).
- Disability – The final rule would revise regulations under section 504 of the Rehabilitation Act of 1973 to address discrimination on the basis of disability in HHS-funded programs and activities (April 2024)