Week in Washington 062223

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

06/22/2023

Drug Negotiation Lawsuits

The largest drug lobbying group, PhrMA, sued the Biden Administration over the Drug Negotiation provisions of the Inflation Reduction Act. This is the fourth major lawsuit brought against the provisions. Each of the lawsuits is happening in front of a different court which raises the likelihood that one of the judges will rule against the Administration and thereby delay implementation of the law. You can track all of the lawsuits here

On The Hill

A hearing this week will focus on MACRA (Medicare Access and CHIP Reauthorization Act of 2015) and if changes are needed. Several provider groups have argued that the MACRA provisions have meant that provider payments have not kept up with inflation and therefore changes are needed.

CMS Regulatory Agenda

OMB released the Administration proposed spring/summer regulatory calendar. The HHS’ calendar can be found here . A few non-annual forthcoming rules include changes to short-term duration plans, changes to the mental health parity requirements, updates to managed care requirements related to access, and simplifying Medicaid eligibility determinations/renewal requirements.

Medicaid

• Redetermination – Medicaid redetermination data continues to trickle in. Only about 22 states have reported data so far. Of those that are reporting the average renewal is about 65%.
• Georgia – Starting in a few weeks (July 1st) Georgia begins partial Medicaid expansion (up too 100% FPL). A further unique part of Georgia’s partial expansion is that work requirements will be part of the eligibility criteria. While Georgia estimates the program would enroll over 300,000, there is concern that operational systems may not be able to handle the end of continuous eligibility redeterminations and work requirements simultaneously.

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