Summary
The House and Senate are both back in session this week, though just for a few days before many members join President Biden and foreign leaders in Normandy, France for a D-Day 80th Anniversary celebration. On Monday the House is scheduled to vote on multiple bills naming post offices before possibly taking up the first appropriations bill of the year, the fiscal year 2025 Military Construction and Veterans Affairs bill. The Senate also comes back into session on Monday with a nomination vote, which will be followed on Wednesday with a vote on the Right to Contraception Act, legislation introduced by Senators Ed Markey (D-MA) and Maize Hirono (D-HI) that will guarantee a woman’s access to contraception. In a letter to his Senate colleagues, Senate Majority Leader Chuck Schumer (D-NY) promised there would be “more to come” in terms of reproductive rights legislation this month.
On a Committee level this week, the Senate Health Education and Labor Committee will also be focusing on access to reproductive health with a hearing focused on women’s freedoms and access to abortions across America.
Meanwhile, the House Energy & Commerce Committee Oversight and Investigations Subcommittee will hold a hearing on Tuesday to explore recent trends and developments in the 340B drug pricing program. Last week Energy and Commerce Committee Republicans introduced the 340B Affording Care for Communities and Ensuring a Strong Safety-Net Act (340B ACCESS Act) that would establish additional oversight and transparency of the 340B program. A Senate bipartisan working group led by Senators John Thune (R-SD) and Debbie Stabenow (D-MI) has drafted their own legislation on the issue and is expected to officially introduce it in the coming weeks.
The House Appropriations Committee will continue their fast march towards completing all 12 Subcommittee bills by the August recess with the Subcommittee markups of the FY 2025 Homeland Security, DOD, State Department and Foreign Operations, and Financial Services bills.
Finally, the long-awaited Improving Seniors’ Timely Access to Care Act (the Seniors’ Act) is expected to be introduced in both the House and Senate this week. This bipartisan legislation seeks to address the overuse and abuse of prior authorization (PA) by Medicare Advantage (MA) plans. Introduced with great support in the past several Congresses, the bill was never enacted due to the bill’s high cost. However, this year’s bill has made changes to align with regulations finalized by CMS in 2023 and 2024 which should drastically reduce the score.
Regulatory Update
The Office of Management and Budget (OMB) is currently reviewing the following rules:
Medicare
- Calendar Year (CY) Payment Updates: The CY 2025 revisions to the Medicare Physician Fee Schedule proposed rule, the CY 2025 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates proposed rule, the CY 2025 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System and Quality Incentive Program proposed rule (June 2024), and the CY 2025 Home Health PPS Rate Update proposed rule (June 2024).
- Medicare Shared Savings Program: A proposed rule titled, “Mitigating the Impact of Anomalous Increases in Billing on Medicare Shared Savings Program Financial Calculations.”
Medicaid
- 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).
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).
- 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).