The following is the latest health policy news from the federal government for the week of September 12-16.  Some of the language used below is taken directly from government documents.

No Surprises Act

• The Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration have issued a request for information (RFI) seeking stakeholder comment on how to implement the No Surprises Act’s requirement that health care providers and payers give explanations of benefits and good-faith estimates of costs for services and items that are scheduled at least three days in advance to individuals who have health insurance.  Previous regulations have focused on the delivery of this information to uninsured and self-pay patients and those obtaining services from out-of-network providers, but providers and payers asked regulators to delay implementation of the law’s requirements for the provision of such information to insured patients so they could address the technical infrastructure needed to transfer data effectively and in a timely manner between and among providers and payers.  Learn more this Federal Register notice.  Comments in response to the RFI are due

The following is the latest health policy news from the federal government for the week of September 5-12.  Some of the language used below is taken directly from government documents.

The White House

• The White House has published a fact sheet on the administration’s plan to get Americans an updated COVID-19 shot and to manage COVID-19 this fall.  The major components of the plan are providing access to free, updated vaccines; ensuring easy access to testing and treatment; encouraging safe practices; and preparing for potential surges and new variants.  Find that fact sheet here.
• The White House’s COVID-19 response team and other public officials have briefed the press on the federal government’s latest efforts in its response to the COVID-19 public health emergency.  Find a transcript of that briefing here.

Centers for Medicare & Medicaid Services

• CMS has issued a request for information “…seeking public input on accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency.”  The request for information also seeks feedback to inform CMS’s assessment of the impact of waivers and flexibilities provided in response to the

The Medicare Payment Advisory Commission held public meetings on September 1 and 2.  Among the subjects discussed during the meeting were:

• Reforming Medicare’s wage index system – “the commission remains concerned about Medicare’s current wage index policies, including the system’s inaccuracy, the circularity of hospital-reported data, the large volume of permitted exceptions, and administrative complexity and MedPAC commissioners discussed an alternative wage index methodology.”
• Context for Medicare payment policy – an annual discussion.
• Standardizing benefits in Medicare Advantage plans – cost sharing for Part A and Part B services
• Medicare Advantage encounter data – “MedPAC has been concerned about the accuracy of the encounter data Medicare Advantage plans submit because this data is used to calculate plans’ enrollee risk scores.”
• Addressing high prices of drugs covered under Medicare Part B – “in its report to Congress earlier this year MedPAC described alternative approaches for Medicare to address high prices for new Part B drugs, lack of price competition for drugs with similar health effects, and financial incentives associated with the percentage add-on to Medicare Part B payment rates.”

Go here to learn more about the issues MedPAC addressed and to find the presentations that were the basis of its discussions.…

The following is the latest health policy news from the federal government for the week of August 29 to September 2.  Some of the language used below is taken directly from government documents.

The White House

The White House has introduced a new “National HIV Strategy” for 2022-2025.  The new strategy updates the 2021 strategy and establishes targets for ending the HIV epidemic in the U.S. by 2030, including a 75 percent reduction in new HIV infections by 2025 and a 90 percent reduction by 2030.  Find the strategy here.

Proposed Changes in Medicaid, CHIP, and Basic Health Program Enrollment Processes

CMS and HHS have proposed a new rule to overhaul enrollment processes for Medicaid, the Children’s Health Insurance Program (CHIP), and basic health programs and to eliminate arbitrary coverage caps for children in CHIP.  The new rule seeks to simplify application and verification processes to make it easier for children, older adults, and people with lower incomes with Medicaid and CHIP coverage to enroll in and retain health insurance.  Highlights of the rule include:

• limiting eligibility checks to once every 12 months
• allowing applicants 30 days to respond to information requests
• giving applicants 90 days to apply for

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 23.  Some of the language used below is taken directly from government documents.

CMS “Roadmap for the End of the COVID-19 Public Health Emergency”

While the COVID-19 public health emergency (PHE) has not ended and HHS Secretary Becerra has committed to giving states and the health care community 60 days’ notice before formally ending it – notice he has not given – the federal government is already planning for life after the PHE and its latest step in this process is a new CMS “roadmap” for the end of the COVID-19 PHE.  As the agency notes, “Throughout the COVID-19 public health emergency (PHE), CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure access to care and give health care providers the flexibilities needed to respond to COVID-19 and help keep people safer.  Many of these waivers and broad flexibilities will terminate at the eventual end of the PHE, as they were intended to address the acute and extraordinary circumstances of a rapidly evolving pandemic and not replace existing requirements.”

CMS further explains that …