Archive for December, 2022

 

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22.  Some of the language used below is taken directly from government documents.

Congress

As of this writing, Congress continues to work on an FY 2023 omnibus spending bill:  the Senate has passed it but the House has not yet addressed it.  Highlights of what negotiators have agreed to – but that have not yet been adopted – include:

  • Preventing the additional four percent Medicare sequester for two years.
  • Reducing by more than half the 4.5 percent cut in Medicare payments to physicians that was scheduled to take effect on January 1.  The agreement calls for reducing that 4.5 percent cut to just two percent in 2023 and then imposing a 3.5 percent cut in 2024.
  • Extending COVID-19 public health emergency Medicare telehealth policies for two years, through 2024.
  • Ending the maintenance-of-effort requirement from the Families First Coronavirus Response Act that prohibited states from removing ineligible individuals from their Medicaid rolls.  Under that law, states were prohibited from reviewing the eligibility of Medicaid beneficiaries for the duration of the COVID-19 public health emergency in exchange for a 6.2 percentage point increase in FMAP. 

Paxlovid Will Soon Cost Patients

Free Paxlovid treatment for COVID-19 will soon be a thing of the past for many people because in the coming months the federal government plans to stop paying for the drug for everyone who needs it.

Nearly six million Americans so far have taken Paxlovid after being diagnosed with COVID, but by the middle of 2023 the federal government is expected to stop footing the bill.  Currently, it pays $530 a dose – a discounted price.

When that happens the drug may become far less accessible.  Because Paxlovid is only authorized under federal emergency use authorization, Medicare drug plans are prohibited by law for paying for it; Pfizer, the drug’s manufacturer, has applied for full FDA approval.  State Medicaid programs are expected to continue covering COVID care, including Paxlovid, into 2024.

Learn more about who is using Paxlovid now and the implications of federal withdrawal from paying for the drug for everyone who needs it in the Kaiser Health News article “Paxlovid Has Been Free So Far. Next Year, Sticker Shock Awaits.”…

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15.  Some of the language used below is taken directly from government documents.

White House

  • The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans.  Learn more about the plan from this White House fact sheet and go here for a transcript of the White House press briefing about the plan.

Congress

  • Yesterday the House passed a one-week continuing resolution (CR) that will prevent the federal government from shutting down when the current CR ends tomorrow, December 16; the Senate will take up that bill although some senators have expressed their objection to a short-term CR.  Appropriators have agreed on the spending limits for FY 2023 spending bills and hope to pass an omnibus spending bill encompassing all 12 appropriations bills before next Friday, December 23.  House minority leader Kevin McCarthy, backed by other House Republicans, objects to passing an omnibus spending bill before the end of

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The December 2022 MACPAC meeting began with a Commission discussion on two potential recommendations for improving Medicaid race and ethnicity data reporting. As part of its commitment to prioritizing health equity in all of its work, the Commission is focused on how to improve Medicaid race and ethnicity data collection and reporting. In October, staff presented findings from a literature review and key stakeholder interviews, as well as possible approaches for improving the collection and reporting of these data. In this presentation, staff reviewed the state data collection and reporting processes, data quality priorities, and barriers to improvement. Staff also presented two potential recommendations for the Commission’s consideration, with the goal of making recommendations in MACPAC’s March report to Congress. The Commission will vote on these recommendations in January 2023.

Next, the Commission discussed two potential recommendations to improve the transparency of nursing facility payment data. The Commission has undertaken long-term work to examine the extent to which Medicaid nursing facility payment policies are consistent with the statutory goals of efficiency, economy, quality,

COVID Flexibilities Apply to RSV, Flu, HHS Secretary Tells Governors

The same flexibilities that the federal government established to help states respond to the COVID-19 emergency can be used to respond to the current RSV and flu challenges, Health and Human Services Secretary Xavier Becerra has written to the nation’s governors.

According to the Becerra letter,

… the Administration has exercised regulatory flexibilities to help health care providers and suppliers continue to respond to COVID-19. These flexibilities – while critical in addressing the COVID-19 pandemic – can also help address many of the challenges you face during the spread of non-COVID-19 illnesses, including RSV and flu. They remain available to you and health care providers as you all make care available in response to flu, RSV, COVID-19, and other illnesses.

Among the available assistance cited in the letter are federal blanket waivers still in effect, expanded use of telehealth, access to equipment, supplies, and health care personnel, and possible federal financial assistance.

See the letter and more about the federal aid available in this HHS news release.…