Week in Washington 010622

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

1/06/2022

Happy 2022. A few notes from the week:

Legislation

While the House is technically still on recess this week, there does not appear to be a lot of momentum for the Build Back Better bill or other health care related legislation items. The Senate is expected to vote on voting rights issues in January, which is likely to push back voting on Build Back Better or its replacement plan into February.

Regulations

ACA Regulations

CMS released a series of regulations and guidance’s for the ACA markets. In particular, CMS released the 2023 ACA Payment Notice. This year’s Payment Notice proposes to make large changes for ACA plans network requirements, requires standard plans in Healthcare.gov states, changes the risk adjustment model, refine non-discrimination/EHB requirements, and make changes to Medical Loss Ratio submission guidance. CMS also released the proposed 2023 Actuarial Value Calculator as well as guidance on maximum out of pocket limits ($9,100 for self-only coverage).

Medicare rule

CMS also released the Contract Year 2023 Medicare Advantage and Part D Proposed Rule. The rule proposes to make changes to lower of pocket Medicare Part D prescription drug costs, revise rules on marketing and communications, quality ratings for MA and Part D plans, provider network adequacy requirements, MLR, and regulations for D-SNPs.

Coming Attractions

President Biden announced that the guidance that would require Commercial insurers to cover over the counter COVID tests would be released next week.

COVID

New COVID cases dramatically increased over the holidays, with the average number of COVID cases reaching nearly 600,000 day. Hospitalization numbers have also dramatically increased.

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