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Week in Washington
A new resource by Georgetown’s Center for Children and Families that is very helpful tracking Medicaid terminations can be found here. The tracker includes state by state and month by month disenrollment data. About 2 million Medicaid enrollees have been disenrolled since redeterminations restarted. Overall, about 36% of people with a completed renewal were disenrolled even though the variation of state by state remains high (Idaho’s 76% termination rate relative to Michigan’s 10% termination rate).
- Leqembi Medicare Coverage – CMS announced that broader Medicare coverage is now available for Leqembi (the drug design to treat individuals with Alzheimer’s disease). There are a number of steps a person will need to do in order to receive coverage of this drug. CMS has not released any statements around the implications for Medicare Advantage as a result of this National Coverage Determination.
- OTC Birth Control – The FDA for the first time approved an over-the-counter birth control pill (Opill by Perrigo). It is expected to be widely available at pharmacies. Its costs and potential coverage by insurers/Medicaid are unclear at this time.
- Short-Term Limited Duration Insurance Proposed Rule – The Biden Administration released a proposed rule last week that would impose limitations on short-term limited duration insurance (STLDI). A good summary of the rule can be found here. Key details include shortening the period individuals can be enrolled in STLDIs to four months (currently can be up to 3 years). Those currently enrolled in STLDIs are grandfathered in, and the rules would not apply until the current regulation requirements expire.
- Enrollment – Mark Farrah released new data that ACA individual market enrollment has reached 19.5 million, which is near a record high that was achieved in 2015.
- June 30th Report – CMS released its annual June 30th report – which summarizes risk adjustment transfers for ACA plans.
- Site Neutral Payment Bill – CBO released their score on HR 3561 that would make changes to site-neutral payments. CBO estimates the bill would save about $10.8 billion over 10 years. The bill would apply site-neutral payments in Medicare to off-campus hospital outpatient department who were grandfathered out of the 2015 reforms.
06/29/2023: Week in Washington
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06/08/2023: Week in Washington