{"id":2135,"date":"2023-01-09T21:12:00","date_gmt":"2023-01-09T21:12:00","guid":{"rendered":"https:\/\/thornrun.com\/health-policy-report-1-9\/"},"modified":"2023-08-08T21:25:47","modified_gmt":"2023-08-08T21:25:47","slug":"health-policy-report-1-9","status":"publish","type":"post","link":"https:\/\/thornrun.com\/health-policy-report-1-9\/","title":{"rendered":"Health Policy Report (1\/9)"},"content":{"rendered":"\n

House lawmakers were finally sworn-in early Saturday morning after House Republicans elected Leader Kevin McCarthy (R-CA) as Speaker during the 15th<\/sup> round of voting. Speaker McCarthy ultimately won the gavel after GOP dissidents \u2014 Reps. Andy Biggs (R-AZ), Lauren Boebert (R-CO), Matt Gaetz (R-FL), and Matt Rosendale (R-MT) \u2014 switched their votes to present, thus lowering the threshold needed to win a majority. House Republican leadership will now turn their attention to passing the rules package (text<\/a>; summary<\/a>) for the 118th<\/sup> Congress, as well as settling a series of undecided committee leadership posts. According to the latest intel, the House GOP Steering Committee will meet today to begin the process of deciding on contested gavels for the Committees on Ways and Means, Homeland, Education and Workforce, Budget, and Small Business. Other organizational activities \u2014 including decisions on contested subcommittee leadership posts and committee assignments for the rank-and-file at large \u2014 are expected in the coming days from leaders on both sides of the aisle. <\/p>\n\n\n\n\n\n\n\n

Biden Administration\nReleases Fall 2022 Unified Agenda<\/strong><\/p>\n\n\n\n

On Wednesday, the Office\nof Management and Budget (OMB) published its Fall 2022 Unified Agenda<\/a> outlining the forthcoming regulatory priorities\nof the Biden administration. As lawmakers are expected to pass fewer pieces of\nlegislation due to a divided 118th Congress, federal agencies are expected to\nsteer President Biden\u2019s policy agenda in 2023 and 2024. Federal agencies\noperating in the health care space have revised and added a myriad of\nregulatory priorities for 2023 through this Unified Agenda. Notably, the\nDepartment of Health and Human Services\u2019 (HHS) Office of the Secretary (OS)\nintends to propose a rule to standardize health information technology (HIT),\nand the Office of the National Coordinator (ONC) will also craft HIT-related\nrules pertaining to interoperability and information blocking.  <\/p>\n\n\n\n

Pursuant to federal law,\nthe Centers for Medicare and Medicaid Services (CMS) will continue promulgating\nyearly payment policies \u2014 which will include skilled nursing facility (SNF)\nminimum staffing requirements \u2014 and the agency notes that it will also address\n340B-acquired drugs in response to the American Hospital Association v.\nBecerra<\/em> case. Additionally, Disproportionate Share Hospital (DSH) payments,\nMedicare Part B rates, certain civil monetary penalties (CMP), and numerous\nother policy topics are on CMS\u2019 docket to address in the coming months. The\nFood and Drug Administration (FDA) added a slew of regulatory priorities to its\nplate in the Unified Agenda as well, with over 15 new regulatory items\nimplementing oversight and review boards, medical device classification, research\nand development flexibilities, and constricting tobacco marketing, among other\nFDA policy goals.  <\/p>\n\n\n\n

CMS Outlines Managed\nCare Waivers for Social Needs<\/strong><\/p>\n\n\n\n

Last week, the Centers\nfor Medicare and Medicaid Services (CMS) outlined<\/a> <\/a>states\u2019 requirements for\nmeeting 115 waiver thresholds addressing social determinants of health (SDOH).\nTechnically, CMS is not providing a new waiver option but is clarifying ways in\nwhich states can use Medicaid managed care organizations\u2019 \u201cin lieu of services\nand settings\u201d option to target SDOH-related projects. For SDOH waivers to be\napproved, states must prove that their proposals are medically appropriate,\ncover Medicaid objectives, protect enrollees, and are cost-effective with\nprogram costs capped at 15 percent. The cost percentage will generally dictate\nthe amount of paperwork that states will have to provide to CMS; lower-cost\npercentage programs will require less paperwork and vice versa. Notably, some\nstates already have 1115 waivers that clearly cover SDOH services in a managed\ncare contract. These states will have until January 1, 2024, to comply with the\nnew paperwork and review process. <\/p>\n\n\n\n

FTC Proposes to\nCurtail Noncompete Clauses<\/strong><\/p>\n\n\n\n

The Federal Trade\nCommission (FTC) released a proposed rule<\/a> that, if finalized, would ban noncompete\ncontract clauses. The proposed rule would have a multi-sector impact, and these\nagreements are often signed by health care employees, especially in the\ninsurance and pharmacy benefit manager (PBM) industries. Generally, non-compete\nlaws are crafted on a state-by-state basis and those who break their noncompete\ncontracts may be sued by a former employer. Most insurance executives sign\nnon-compete clauses.  <\/p>\n\n\n\n

The FTC aims to ban\nthese clauses as a mechanism to limit anticompetitive practices across\nindustries and improve labor market conditions. However, proponents of\nnon-competes assert that such agreements encourage companies to pay their\nworkers more and invest in technologies due to assurances that the company is\nprotecting its investments for a certain period of time. Many policy experts\nbelieve that the FTC\u2019s rule should be more narrowly tailored instead of\nproposing a comprehensive ban. Notably, the U.S. Chamber of Congress voiced<\/a> <\/a>its intent to sue the\nFTC if the rule is finalized.  <\/p>\n\n\n\n

CMS Issues Medicaid,\nCHIP Unwinding Guidance <\/strong><\/p>\n\n\n\n

Medicaid stakeholders\nhave been anticipating an end to the COVID-19 public health emergency (PHE),\nwhich would signal when state maintenance of effort (MOE) requirements\ndissolve. However, the Consolidated Appropriations Act, 2023 (CAA, 2023)\ndecoupled MOE dates from the PHE, and now MOE requirements will end on March\n31, 2023. The Centers for Medicare and Medicaid Services (CMS) clarified<\/a> <\/a>last Thursday that\nstates can begin eligibility redeterminations in February, if they meet their\nregulatory deadlines. As such, states can initiate the renewal processes as\nsoon as February 1, 2023, and all renewals must be complete by May 31,\n2024.  <\/p>\n\n\n\n

States are required to\nsubmit their unwinding plans to CMS as a means to ensure that each state\u2019s\nunwinding blueprint minimizes beneficiaries\u2019 burden and promotes continuous\ncoverage. The Center for Medicaid and Children\u2019s Health Insurance Program\n(CHIP) Services (CMCS) intends to release additional guidance as states begin\nthe unwinding process, and additionally, CMCS will offer technical assistance\ndirectly to states. CMCS also plans to meet one-on-one with all state Medicaid\ndirectors throughout the unwinding period. <\/p>\n\n\n\n

2023 Appropriations\nBill Includes Medical Device Cybersecurity Policies<\/strong><\/p>\n\n\n\n

The fiscal year (FY)\n2023 spending package that President Biden signed into law in late December\nincluded a range of new requirements for medical device manufacturers. The $1.7\ntrillion bill directs manufacturers to submit plans to the Department of Health\nand Human Services (HHS) that monitor and address post-market device\ncybersecurity vulnerabilities, among other requirements. Manufactures will be\nrequired to address cybersecurity treats on a regular basis, subject to further\nagency regulation. Notably, the Secretary of HHS will have the discretion to\nidentify devices to be exempt from cybersecurity regulations, which will be\nposted in the Federal Register<\/em>. Many of these new provisions stem from\nthe Protecting and Transforming Cyber Health Care (PATCH) Act (S. 3983<\/a>) from the 117th<\/sup> Congress.  <\/p>\n\n\n\n

The Food and Drug\nAdministration (FDA) must also provide stakeholders with guidance related to\nimproving device cybersecurity, which is required to be updated every two\nyears. The first round of guidance is required to be uploaded to the FDA\u2019s\nwebsite within the first six months of 2023. FDA is also working on other\nmedical device cybersecurity guidance \u2014 which is expected to be released in the\nfall of 2023 \u2014 as well as guidance for hospital and health sector\ncybersecurity. The omnibus also included policy provisions related to a myriad\nof other cybersecurity provisions related to public health. <\/p>\n\n\n\n

CMS to Pay Medicaid, CHIP for Communication Between Primary and Specialty Care<\/strong> <\/p>\n\n\n\n

The Centers for Medicare and Medicaid Services (CMS) recently issued guidance <\/a>allowing states to reimburse a specialist when they consult with a beneficiary’s primary care provider. To implement this capability, a state would need to submit a state plan amendment providing this direct payment to specialists when they respond to a consultation request from an enrollee\u2019s primary care provider. The new allowance aligns Medicaid and Children\u2019s Health Insurance Program (CHIP) with Medicare, which has been paying for these interdisciplinary conferrals since 2019. Patients will not have to present for the communications to be reimbursable, though providers will need to submit applicable claims. While these reimbursement practices are available to all specialties, CMS is especially focused on leveraging the guidance to encourage discussions between primary care and behavioral health providers as a means to improve behavioral health care outcomes for beneficiaries.  <\/p>\n","protected":false},"excerpt":{"rendered":"

House lawmakers were finally sworn-in early Saturday morning after House Republicans elected Leader Kevin McCarthy (R-CA) as Speaker during the 15th round of voting. Speaker McCarthy ultimately won the gavel after GOP dissidents \u2014 Reps. Andy Biggs (R-AZ), Lauren Boebert (R-CO), Matt Gaetz (R-FL), and Matt Rosendale (R-MT) \u2014 switched their votes to present, thus lowering […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,7],"tags":[],"acf":[],"yoast_head":"\nHealth Policy Report (1\/9) - thornrun<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/thornrun.com\/health-policy-report-1-9\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Policy Report (1\/9) - thornrun\" \/>\n<meta property=\"og:description\" content=\"House lawmakers were finally sworn-in early Saturday morning after House Republicans elected Leader Kevin McCarthy (R-CA) as Speaker during the 15th round of voting. 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