September 28, 2018
Opiods, HRA and more
Opioid Bill The final opioid bill was unveiled this week. The 660-page bill contains numerous provisions designed to reduce illegal drug use, authorizes new grants and demonstrations, and includes a few provisions that effect Medicare and Medicaid.
- Medicaid – The bill partially repeals the IMD exclusion. This means that those with substance abuse disorders will be eligible for Medicaid coverage if they go to large treatment centers
- Medicare- The bill also expands reimbursement for substance abuse treatment using telemedicine. This change could be implemented as soon as July 2019.
The bill is expected to be voted on in the House in the next few days but unclear when the Senate would vote on it.
Immigration Rule – The Trump Administration released a new proposed regulation aimed at curtailing legal immigration usage of low income programs such as Medicaid or tax subsidies in the Exchanges. The crux of the proposal is that immigrants could be barred from green cards if they receive public benefits. The bill has the potential for affecting millions of current Medicaid/Individual market beneficiaries. As context--when a law passed in the mid-1990s, targeted at reducing food stamp access for non-citizens, use by non-citizens dropped 43% within a few years.
MA Quality Bonuses – Politico revealed that a bill in the Senate was introduced aimed to increase Quality bonuses to Medicare Advantage plans. Currently, MA plans have a cap on total payments. The legislation would remove the cap so MA issuers could receive additional funds. There is a parallel bill in the House.
Short Term Ban in California – Governor Jerry Brown signed into law a ban on short term plans for California. The ban continues a trend of blue states restricting the plans as a reaction to the recent Trump Administration rule that expanded access.