Summary
The House and Senate are both in session this week as the first of the two “laddered” Continuing Resolutions (CR) is set to expire on Friday, along with the health care extenders that are keeping programs such as the Community Health Centers, the Teaching Health Center GME program, the National Health Service Corps, and the Special Diabetes Program in operation, as well as the continued delay of scheduled Disproportionate Share Hospital (DSH) reductions under Medicaid. On Sunday evening, House and Senate leadership agreed to another laddered CR that would extend the current CR’s and keep the government in operation until March 1 for the for the Agriculture, Energy and Water, MilCon-VA and Transportation-HUD spending bills and March 8 for the remaining federal agencies.
Senate Majority Leader Schumer will bring up the CR and will need bipartisan cooperation to pass the CR as quickly as possible before sending it to the House. Speaker Johnson’s tenuous hold over a fractured Republican party continues into the new year as he will need all Democrats and at least 77 Republicans to vote for passage. Members of the House Freedom Caucus have already come out in opposition to the topline spending deal Speaker Johnson and Senator Schumer made earlier this month and will likely vote against another the CR as well. As the Appropriations Committees struggle to finalize their bills in the coming six weeks, many House Republicans are pushing for immigration policy riders to be attached to the spending bill rather than a separate supplemental. However, Democrats have made clear they will not accept any poison pill policy riders in any appropriation bill put before the Congress.
2024 Presidential Election
This week is the official kickoff of the Presidential Primary season as Iowa held their Republican caucuses last night. Former President Donald Trump won the caucus handily with 51% of the vote, followed by Florida Governor Ron DeSantis with 21% and former South Carolina Governor with 19%.
Hearings
Senate HELP Committee: On Thursday the Senate Health, Education, Labor, and Pensions will hold a hearing to examine addressing long COVID, focusing on advancing research and improving patient care.
Regulatory Update
The Office of Management and Budget (OMB) completed reviewing a final rule that would place new prior authorization requirements on Medicare Advantage organizations, Medicaid managed care plans, CHIP managed care entities, state Medicaid and CHIP fee-for-service programs, and qualified health plan issuers on the federal Exchange. This rule also adds a new measure for eligible hospitals and critical access hospitals under the Medicare Promoting Interoperability Program and for Merit-based Incentive Payment System (MIPS) eligible clinicians under the Promoting Interoperability performance category of MIPS.
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.
- Medicare Advantage and Part D – The proposed rule would make changes for CY 2025 for MA capitation rates and Part C and Part payment policies. Additionally, the proposed rule would provide draft CY 2025 Part D redesign program instructions.
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.
- Eligibility and Enrollment – The final rule would implement changes to align enrollment and renewal requirements for most individuals in Medicaid and promote maintenance of coverage.
- Managed Care – The final rule is intended to improve access to care and quality outcomes for Medicaid and CHIP beneficiaries enrolled in managed care delivery systems.
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