Summary
Happy 4th of July! Congress is on recess this week for Independence Day holiday and Capitol Hill is very quiet. We expect a flurry of activity next week when Congress returns for what is sure to be a busy three-week work period before the August recess. In the meantime, there has been a lot of activity on the regulatory front.
Rulemaking
We may soon see the short-term limited duration insurance proposed rule, which was cleared by the Office of Management and Budget (OMB) last week. The proposed rule is expected to reverse Trump-era policies that expanded the availability of short-term plans from three months to 36 months. Short-term plans are not required to comply with ACA protections, such as coverage for pre-existing conditions.
The Centers for Medicare and Medicaid Services (CMS) has begun releasing proposed updated to calendar year 2024 Medicare payment policies. So far, the agency has released proposed rules for home health agencies (client summary) and end-stage renal disease facilities (client summary). Proposed updates to the Physician Fee Schedule and hospital outpatient departments and ambulatory surgical centers are currently pending review at OMB.
A final rule intended to streamline the eligibility and enrollment process for Medicaid and CHIP recently arrived at OMB for review. In recent guidance on possible FMAP reductions for noncompliance with reporting requirements, CMS indicated that the agency would use timeliness standards established in forthcoming rulemaking to assess timeliness of monthly reports on activities related to eligibility redeterminations (client summary). The proposed rule seeks to revise timeliness standards to ensure applicants and beneficiaries have adequate time to furnish all requested information and states complete determinations and redeterminations within a reasonable timeframe at regular renewals and in response to a change in circumstances (client summary). CMS will review state-reported data on activities during the months that fall between July 1, 2023 and June 30, 2024 for purposes of the possible FMAP reduction for failure to comply with reporting requirements.
Additionally, OMB reviewing is the following:
- Minimum staffing standards for long-term care facilities – Proposed rule would address staffing requirements at long-term care facilities, including nursing homes.
- 340B Drug Pricing Program – Proposed rule regarding potential remedies for safety-net hospitals affecting cost years 2018-2022. In American Hospital Association v. Becerra, the Supreme Court ruled in favor of safety-net hospitals that challenged Medicare reimbursement cuts for prescription drugs provided in outpatient settings.