Summary
Though Democrats and Republicans have not reached a deal on the FY 2023 omnibus appropriations package, “Chairman Leahy feels that sufficient progress in negotiations took place over the weekend to delay the introduction of the omnibus appropriations bill for the time being,” according to a statement from Leahy’s office. Still, we anticipate lawmakers will need to pass another continuing resolution in order to complete a deal on an end-of-year spending package. Questions remain on which policy provisions will be attached to the must-pass vehicle. At a minimum, we anticipate lawmakers will take steps to reduce the cuts to Medicare physicians in the upcoming spending bill. Whether the deal includes any investments to address mental health or bolster the public health system remain to be seen (details).
Committee Hearings: Nutrition, Gun Violence
Two Senate committees will hold hearings focused on nutrition as part of the groundwork for reauthorization of the Farm bill in 2023. Tomorrow, the Senate Agriculture Subcommittee on Food and Nutrition, Specialty Crops, Organics, and Research will discuss current efforts and potential opportunities for “food as medicine.” On Thursday, the Senate Special Committee on Aging will hear from state and local officials and advocates on ways to promote health and affordable food for older Americans. In the White House National Strategy on Hunger, Nutrition, and Health, the Biden-Harris Administration expressed support for legislation to create a pilot to test covering medically tailored meals for individuals in traditional Medicare who are experiencing diet-related health conditions.
On Thursday, the House Judiciary Subcommittee on Crime, Terrorism, and Homeland Security will hold a hearing intended to discuss bipartisan solutions to gun violence in the aftermath of Uvalde and other mass shootings in the U.S. Given the broad opposition among congressional Republicans for gun control reform, we do not anticipate the Republican-controlled House to prioritize the issue. The hearing appears to be an opportunity for Democrats, while they remain in control, to reiterate their policy priorities. The Bipartisan Safer Communities Act (P.L. 117-325) had omitted more sweeping gun control reforms, such as the Protecting Our Children Act (H.R. 7910) and Federal Extreme Risk Protection Order Act (H.R. 2377) passed by House Democrats.
Regulatory Update
Last week, the Office of Management and Budget (OMB) concluded its review of the Medicare Advantage (MA) and Part D programmatic changes for contract year (CY) 2024 proposed rule. It is not clear what the Centers for Medicare and Medicaid Services might propose in this rule, though the Administration states it intends to “strengthen and improve” the programs through this rulemaking. We expect its release imminently.
In addition, OMB recently began reviewing a proposed rule regarding how it counts disproportionate share hospital (DSH) days associated with section 1115 Medicaid demonstrations. As a reminder, CMS previously decided in its recent final rule for the fiscal year 2023 Inpatient Prospective Payment System (IPPS) not to finalize its proposal to revise its regulation pertaining to the calculation of the Medicaid fraction of the DSH calculation (WHG summary here). CMS stated it will review the issue of Section 1115 demonstration days for the purposes of DSH adjustment in future rulemaking.
As with previous years, we also expect OMB to release its next update to the Unified Regulatory Agenda, which will detail future rulemaking the Administration intends to undertake. When released, WHG will review the updated agenda and will highlight key upcoming rulemaking efforts the Administration is considering on the health care front.