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
CMS released the first of likely several regulations that will ban surprise bills. The new requirement takes effect on January 1, 2022. The regulation includes provisions regarding how mediators should consider provider/insurer disagreements, requirements for surprise billing notification, and requirements that would limit retroactively denying emergency department claims. You can read the rule here.
- Congress continues to consider a potential reconciliation package. At the moment, there seems to be some momentum for a return to cost-sharing reduction payments to help pay for the extension of ACA premium credits.
Unfortunately, a few states are starting to see some increases in cases, likely caused by the Delta variant taking hold. Nevada, Arkansas, and Missouri all saw significant increases in cases. Generally, the fear is that states with low vaccination rates (see below) have a higher susceptibility to case increases.
Odds and Ends
- CMS released its ACA Risk Adjustment report. You can read it here
- CMS released its (further) update to the 2022 Payment Notice. The proposed rule would increase user fees for issuers that operate in the Healthcare.gov states, have a permanent SEP for consumers that are eligible for APTCs and under 150% FPL, and put forth requirements around 1332 waivers. You can read the rule here
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