Week in Washington 05/02/24

HHS Rules

Another week, another spate of CMS rules that were released. On Friday HHS released the final rule under Section 1557 that focuses on protections against discrimination. The rule would prevent discrimination in programs or activities funded by the Federal government. In particular it reinstates protections that previously removed during the Trump Administration (especially around prohibitions against discrimination based on sex that includes LGTBQ patients). It also clarifies that the nondiscrimination provisions apply to telehealth care and artificial intelligence.

The Biden Administration also released a final rule which rescinds the 2018 Association Health Plan (AHP) rule. The rule, formalizes a current court order (i.e., does not just change the current legal environment). Under the Trump era rule AHPs had greater flexibility in their formation. 

Mississippi Medicaid Expansion

Mississippi lawmakers continued to debate a potential plan around Medicaid Expansion. As currently constructed, the bill would make contingent of Medicaid Expansion on implementing work requirements. One of the current roadblocks is a debate as to if the bill should be put forth to voters via a ballot referendum.  It should be noted even if the bill passes, the current Administration will not approve of the expansion plan since it includes work requirements.

Earnings Summary

CVS/Aetna announced this week lower earnings than expected due to higher medical costs, specifically associated with their Medicare Advantage line of business. CVS stated that new utilization pressures in inpatient and pharmacy were driving the higher medical loss ratios. Humana and UnitedHealth Group reported similar spikes in medical cost in their Medicare Advantage line of business.

Walmart Closes Retail Clinics

Walmart announced this week that they would be closing their health clinics and virtual services. The news follows several other retailers (Amazon/CVS) and telehealth providers (Optum) who also recently announced they’d be closing their clinics or services.

Sign up for the
Wakely Wire,

our industry newsletter.