Week in Washington 010523

Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.

Week in Washington

01/05/2023

Congress

As of writing this, the House of Representatives have not yet selected a Speaker of the House. Until this is done, new members cannot be sworn in. In other words, no legislation can move until this happens. The difficulties in selecting a Speaker also portends substantial gridlock over the next two years.

Things You May Have Missed

A few things happened towards the end of the year that is worth repeating.

• Congress passed an omnibus budget bill. The bill included important provisions like:
  • Prevent the PAYGO sequestration from going into effect in 2024.
  • Reduces the physician fee schedule cut from 4.5% to 2% for 2023 and around 3% in 2024.
  • Extends rural Medicare programs, telehealth flexibilities, and Acute Hospital Care at Home programs.
  • Allows states to begin Medicaid redeterminations starting on April 1, 2023. The PHE enhanced FMAP will slowly decrease each quarter over the year.
• CMS released new enrollment figures on ACA Exchange enrollment. Overall, enrollment is up 18% year over year. Open Enrollment continues for most states until January 15th.
• CMS also released a summary of how dispute resolutions over surprise billing. Overall, there have been over 90,000 disputes in the first 6 months of the program, which far exceeds expectations.

Things to Watch this Month

• There are at least three major rules that would impact Medicare currently at OMB. The expectation is they will be released this month.
• States plans on Medicaid redetermination will start becoming clearer in the next month as the first round of notices to beneficiaries at risk of losing coverage could start arriving next month.

Final ACA Open Enrollment figures should arrive towards the end of the month also (at least for most states). It is looking like the extension of the enhanced subsidies may result in record high enrollment figures.

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