Week in Washington 041124

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

04/11/2024

CMS Rules

CMS released the proposed FY 2025 inpatient prospective payment system (IPPS) rule. The rule proposes updating hospital payments by 2.6%, which is lower than many hospitals expected. The rule also proposed paying hospitals an extra 75% of the estimated cost for treatment related to gene therapies for sickle cell disease.

Mississippi Medicaid Expansion

Axios reported that Mississippi continues to inch forward on a bill that would expand Medicaid in the state. Pressure is building on state lawmakers to expand Medicaid due to financial losses among its providers, especially rural hospitals. Approximately 200,000 people could gain coverage if Mississippi fully expands its Medicaid program. Mississippi is currently the state most likely to expand Medicaid in the near future.

Agent-Brokers and the ACA

KFF Health news reported last week that unauthorized enrollment or plan-switching is emerging as serious challenge for the ACA. Specifically in states operated by HHS (Healthcare.gov Exchanges) brokers and agents are signing up consumers for plans that they don’t want. CMS is currently investigating ways to reduce this issue.

Telehealth

Politico reported that Congress was working on extending the current temporary Medicare telehealth rules. The higher Medicare costs associated with the extension are the current sticking point.

Medicare Advantage Contracting

News reports circulated this week after a Wall Street insider predicted that health systems are likely to drop out of Medicare Advantage networks. The general disputes over MA plans and health systems about rates is expected to be particularly contentious this year. 

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