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
While there are a few outstanding races (including a runoff for a Senate seat in Georgia), the control of Congress is no longer in question. Starting in 2023, the Democrats will maintain control of the Senate, and the Republicans will gain control of the House. With the combination of a divided government and where both parties will operate with slim majorities; it generally points to a less legislative activity over the next two years than what has occurred in over the past two years. There is also an expectation for more investigations into the Biden Administration.
With the prospect of a divided government, there is increasing pressure and attention on the lame duck session. The current Congress has a number of items to potentially address before it closes up shop for the year. The top of the list is addressing potential provider payments cuts in Medicare. For example, Politico reported there is interest in muting the looming 4.5% physician fee cut, albeit not in totality (i.e., the reduction would be limited to a few percentage points). Finalization of an end of year budget bill is expected in early to mid-December.
CMS released its summary report of 2019 and 2020 benefit year RADV results. A total of 102 out of 145 state market risk pools will have their 2020 benefit year risk scores and transfers due to RADV adjustments. This is an increase from prior years, which is driven by both the averaging of multiple years and the change in methodology.
Cleveland Clinic New Fees
The Cleveland Clinic announced this week that it would be charging insurers $50 per message for e-mails received that take more than 5 minutes to answer. Several people from the Cleveland Clinic that have raised this new fee, said it could be adopted by other hospital systems.
There are a number of regulations currently at OMB that impact Medicare, ACA Exchanges, and Medicaid. Historically, Administrations have released regulations towards the end of the year. This has been on the lookout for a lot of news out of HHS this holiday season.
11/10/2022: Week in Washington
11/03/2022: Week in Washington
10/27/2022: Week in Washington
10/20/2022: Week in Washington