Week In Washington: Regulations Are Coming

October 18, 2018

Regulations are Coming

The big news this week-- HHS announced its list of forthcoming regulations for Fall 2018. It’s possible that some of these regulations will not be released in fall but they are all in various stages of development so the expectation is that at some point they will be released. You can read the full list here…. It’s a LOT of proposed changes. Details are still scarce on what each regulation contains but take a perusal.

A few to flag (hat tip to Axios)

  • Limiting third party payments for dialysis patients
  • Changes to Health Reimbursement Arrangements


  • Increasing flexibility for states to charge premiums/cost-sharing in Medicaid
  • Expanding flexibility to states for non-emergency medical transportation
  • Supporting Value Based Payments for Drugs Covered in Medicaid
  • Changes to DSH Allotment Reductions


  • Payment Notice
  • Increased program integrity for APTC enrollees and state-based Exchanges
  • Increased flexibility for grandfather plans


  • Creation of new safe harbor protection for rebates to plans or PBMs involving prescription drugs
  • Increased drug transparency in Medicare (and Medicaid)

Legislative Watch:

The other big news was Senate Majority Leader Mitch McConnell announced that if Republicans win enough seats in the midterms they could try to repeal the ACA again in 2019. McConnell also hinted at potential changes to entitlement programs like Social Security and Medicare to combat the growing Federal deficit.