Week in Washington 04/25/24

CMS Finalizes Medicaid Rules

CMS published two final rules around payment and access. The rules establishes maximum appointment time standards, makes it easier for states to facilitate state-directed payments for value-based payment arrangements, set limits on state-directed payments in certain circumstances, made changes to MLR ratio reporting around state-directed payments, as well as other changes. You can read the CMS fact sheet here.

CMS is expected to release the final non-discrimination rule in the coming days/week. It’s unclear when the proposal mental health parity rule will be finalized.

California Approves Health Care Spending Target

The State of California approved a target health care spending target of 3%. The target would be phased in over time, starting at 3.5% for 2025 and 2026, 3.2% for 2027 and 2028, before reaching the ultimate target. The exact mechanisms for implementing this are still to be worked out.

On the Campaign

Axios reported that Republicans were planning on campaigning against the Biden Administration over the planned pay cuts to private Medicare insurance plans.

FTC Ruling

The FTC released a final rule banning non-compete clauses. The rule could have significant effects on the health care sector (the health care workers, especially doctors, often have non-compete clauses). The FTC estimates that the rule will lower health care costs by up to $194 billion over the next decade. The rule was immediately challenged in court and expected to eventually be brought before the Supreme Court.  

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