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
Lobbying intensive this week, according to Politico, around the issue of looming Medicare cuts. There is still no agreement as to what changes will be enacted. Additionally, there is some discussion about including other health care items, such as mental health parity (for Medicare/Medicaid), telehealth, prior authorization changes, and other items in the end of year budget package. With only a few weeks left until the end of the year, there is growing pressure to come to agreement.
Prior Authorization Proposed Rule
CMS released a proposed rule yesterday that would change the prior authorization processes for Medicare Advantage plans, Medicaid MCOs, and QHP issuers on the FFE. The rule requires issues to implement electronic process for prior authorization. Most key provisions would go into effect Jan 1, 2026 if the rule is finalized as proposed. You can read the regulation here
ACA plan sign-ups during Open Enrollment continues to be going well. CMS announced that plan selections had hit at least 5.5 million as of the beginning of the month. Overall enrollment is up about 18% year over year.
Unfortunately, economic news was released last week that seemed to point to higher inflation continuing to occur in the economy. The higher inflation portends further federal reserve rates hikes and a greater likelihood of recession next year.
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