Week in Washington 030724

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

03/07/2024

Congress

The House of Representatives passed a spending bill that would delay a government shutdown. The bill provides funding for parts of the government (Agriculture, Commerce, Transportation, Justice) until September. Other parts of the government (such as HHS) will require a funding bill by March 22. Within this funding bill include several health care related items. Notably:

• A 1.68% bump to the Medicare Physician Fee Schedule. Coupled with the increase from a prior budget bill, Congress blunted most (or a total of 2.93% payment increase), but not all, of the 3.37% decrease in the final rule.
• A one-year delay in the scheduled Medicaid DSH program cuts. The $8 billion-per-year cut to Medicaid is now scheduled to go into effect on Jan. 1, 2025.
• One-year extension to incentive payments for certain alternative payment models

State of the Union

President Biden is scheduled to speak on Thursday for his State of the Union speech. The President is expected to announce proposals that would serve as the cornerstone of the health policy that he will be campaigning on this fall. In particular, President Biden is expected to discuss proposals aimed at lowering prescription drug costs like expanding the number of drugs that Medicare can negotiate, introducing a cap on private insurance drug costs (a drug maximum out of pocket of $2,000). Finally, the President is expected to announce support for extending ACA enhanced subsidies and a program that covers individuals in the Medicaid coverage gap.

Courts

• Preventative Services – The Fifth Circuit Court heard arguments for the case Braidwood v. Becerra. The case surrounds whether issuers are required to cover in-network preventative services. The Fifth Circuit Court appeared to side against the government (i.e., preventative service requirements). A decision in either direction is expected to be appealed.
• A federal judge ruled against AstraZeneca in a case challenging CMS’ ability to implement the Medicare drug negotiation program. More cases are expected to be heard on this topic over the coming weeks.

Change Cyber Attack

Several insurers reported seeing a reduction in claims data as a result of the Change Healthcare cyberattack. Humana and Elevance both reported significant decreases in claims data which they attributed to the ongoing effects of the Change Healthcare breach.

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