Summary
Congress is in session again this week after the House failed to pass a Continuing Resolution (CR) last week to keep the government in operation past September 30. The failed Republican proposal was a 6-month CR, that would have carried the government into March 2025. The bill also included the SAVE Act, legislation that would require proof of citizenship to vote to target non-citizen voting. Speaker Johnson failed to garner the votes of both the moderate faction of his party who disagreed with the time frame, as well as some of the more ultra-conservative members who fundamentally disagree with any funding bills that do not cut spending.
The Senate has not yet started on a CR of their own, instead waiting a bit longer for House leadership to find a way forward. If Congress fails to pass a CR in the next two weeks the government will run out of spending authority and will shut down. While a shutdown is unlikely, and most expect we will ultimately end up with a CR into mid-December, we can expect a messy two weeks before a CR is ultimately passed. In addition to the CR, Congress will also need to address parts of the farm bill that will expire in a few weeks, a potential $15 billion funding crisis for the Department of Veterans Affairs, disaster aid coffers that are running low, and funding for the Francis Scott Key Bridge disaster.
In the meantime, on Tuesday Senate Majority Leader Chuck Schumer (D-NY) is expected to bring up a political show vote with S. 4445, the Right to IVF Act this week. This is the same bill that failed earlier this summer. The House has put a host of bills on the suspension calendar for Tuesday, including:
- R. 3800, the Chronic Disease Flexible Coverage Act that will codify Internal Revenue Service guidance relating to treatment of certain services and items for chronic conditions as meeting the preventive care deductible safe harbor for purposes of high deductible health plans in connection with health savings accounts.
- R. 8111 , the Medicaid Program Improvement Act, to ensure the reliability of address information provided under the Medicaid program.
- R. 8089, the Medicare and Medicaid Fraud Prevention Act of 2024 that will require certain additional provider screening under the Medicaid program
- R. 6160, to reauthorize a lifespan respite care program.
- 4351 , the Poison Control Centers Reauthorization Act of 2024.
- R. 7218, the BOLD Infrastructure for Alzheimer’s Reauthorization Act of 2024 to extend the program for promotion of public health knowledge and awareness of Alzheimer’s disease and related dementias
- R. 7858, the TELEMH Act of 2024 that will establish a Medicare incident to modifier for mental health services furnished through telehealth
- R. 7208, the Dennis John Benigno Traumatic Brain Injury Program Reauthorization Act of 2024.
- R. 4758– Accelerating Kids’ Access to Care Act that will streamline enrollment under the Medicaid program of certain providers across State lines.
H.R. 7213 – Autism CARES Act of 2024, to enhance and reauthorize activities and programs relating to autism spectrum disorder,
Hearings: There are several hearings scheduled for this week, including:
- Senate Finance Committee: On Tuesday the Senate Finance Committee will hold a hearing to examine lowering health care costs for Americans, focusing on the Inflation Reduction Act (IRA).
- House Ways and Means Committee: On Wednesday, the House Ways and Means Health Subcommittee will hold a hearing to examine the prevalence of chronic disease in America and the value of investing in prevention and innovative treatment options.
- Senate Agriculture Committee: On Wednesday the Senate Agriculture, Nutrition, and Forestry Subcommittee on Food and Nutrition, Specialty Crops, Organics, and Research will hold a hearing to examine keeping kids learning in the National School Lunch Program and School Breakfast Program.
Regulatory Update
The Office of Management and Budget (OMB) completed reviewing the following rule:
- 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).
OMB is reviewing the following rules:
Medicare
- Payment – The final rule establishes Medicare hospital inpatient and long-term care hospital prospective payment system for fiscal year (FY) 2025.
- Fraud – The final rule would modify the Medicare Shared Savings Program (Shared Savings Program) regulations to address the impact of significant anomalous billing patterns on performance year (PY) 2023 Accountable Care Organization (ACO) financial reconciliation (no date).
Private Insurance
- ACA Marketplace – The proposed rule would set payment parameters and provisions related to the risk adjustment programs; cost-sharing parameters; and user fees for issuers offering plans on Federally-facilitated Exchanges and State-based Exchanges using the Federal platform. It would also provide additional standards for several other ACA programs (September 2024).
- Preventive Services – The proposed rule is titled, “Enhancing Coverage of Preventive Services under the Affordable Care Act.” It was not included in the latest Unified Agenda.
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).
- Retail Pharmacy Standards – The final rule would require pharmacies and vendors to modify the currently adopted National Council for Prescription Drug Programs (NCPDP) standards to the Telecommunications Standard Implementation Guide Version F6 (F6); Batch Standard Implementation Guide version 15; and Batch Standard Subrogation Implementation Guide version 10 (was set for February 2024).