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December 19, 2022

This Week in Health Policy for December 19

This week (Dec. 19-23)

Congress will work to finalize and pass the FY 2023 omnibus package ahead of the new continuing resolution's December 23 expiration date. While lawmakers have expressed optimism they will be able to pass a FY 2023 omnibus, it is still possible they could pass another short-term CR into 2023, which will have implications for the health policy provisions that can be included.

Last week (Dec. 12-16)

Health Care Highlights

Congress passes one-week continuing resolution. This week, the House and Senate passed a one-week continuing resolution (CR) to extend government funding through December 23, as Congress prepares to try to pass a FY 2023 omnibus appropriations bill next week before departing for the holidays. On Wednesday (Dec. 13), House and Senate Appropriations Committee leaders announced an agreement on a framework for the omnibus bill and text for the bill is expected early next week. It remains unclear what exactly will be included in the bill, though lawmakers have expressed optimism that a SECURE 2.0 retirement package would be included. Conversations on health care provisions have been ongoing, with some optimism that a final bill could include mental health, telehealth, Medicare physician reimbursement bumps, and more.

White House ramps up COVID response. On Thursday (Dec. 15), the Biden administration relaunched the free at-home COVID-19 test program, enabling U.S. households to order up to four rapid COVID-19 tests. The program has been suspended since September because Congress did not appropriate additional funding, but the White House decided to shift existing money to purchase additional tests as COVID-19 cases have begun to rise. The Biden administration also announced it will make federal medical teams and resources available to strained hospitals and is launching a campaign to encourage vaccination among nursing home residents.

CMS issues Medicare Advantage and Part D 2024 Proposed Rule. On Wednesday (Dec. 14), CMS released the Medicare Program: Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, etc., proposed rule. The proposed rule includes several policy changes intended to better align Medicare Advantage plans with Medicare fee-for-service, address concerns related to Medicare Advantage plans' marketing tactics, further streamline prior authorization requirements, address gaps in behavioral health care access, and create a new health equity index in the Star Ratings program. CMS is accepting public comment on the proposals until February 13, 2023.

Senate passes maternal health data mapping bill. On Wednesday (Dec. 14), the Senate passed the Data Mapping to Save Moms' Lives Act (H.R. 1218), which would require the FCC to create maps to show areas of overlap between poor maternal health outcomes and broadband service gaps. The bill now goes to President Biden for his signature.

HHS to issue plan to integrate primary and behavioral health. On Wednesday (Dec. 14), Admiral Rachel L. Levine, assistant secretary for health at the Department of Health and Human Services (HHS), said HHS officials in 2023 expect to release an action plan with ways to improve access to primary care and better integrate behavioral, environmental, oral, and reproductive services. "We're thinking about the whole of integration of public health, social services, etc. We need an HHS dashboard that measures health in that perspective. We are in the process of identifying measures for which data are already being collected and then identifying the gaps to make sure this is a robust dashboard," Levine said.

FDA approves biosimilar to compete with Humira. On Wednesday (Dec. 14), the global health care company Fresenius Kabi announced that the Food and Drug Administration has approved its biosimilar Idacio® to compete with the autoimmune disease drug Humira®. The biosimilar is expected to reach the U.S. market in July.

SAMHSA releases proposed rule on opioid use disorder treatments. On Tuesday (Dec. 13), SAMHSA issued a notice of proposed rulemaking for Opioid Treatment Programs. The proposed rule would make permanent several COVID-flexibilities regarding opioid prescribing, including those to facilitate telehealth prescribing without an initial in-person visit. SAMHSA will accept public comments until February 14, 2023.

CMS releases Notice of Benefit and Payment Parameters Proposed Rule. On Monday (Dec. 12), CMS released the Notice of Benefit and Payment Parameters Proposed Rule for 2024. The proposed rule, which applies to qualified health plans (QHPs) and Affordable Care Act exchange plans, includes design updates to standardized plan options and limits on the number of non-standardized plans insurers can offer in each tier. In addition, the proposed rule would add mental health facilities substance use disorder treatment centers to the list of essential community providers, make policy changes to help ensure people who lose Medicaid or CHIP coverage are aware of coverage options on the exchanges and have time to enroll, and lower the user fee rate for the 2024 benefit year from 2.75% to 2.5% of premiums for plans sold on the federally facilitated exchange, and from 2.25% to 2.0% of premiums for plans in states that use a hybrid state-federal exchange platform.

IRS issues final regulations on ACA insurance forms. On Monday (Dec. 12), the U.S. Treasury Department and Internal Revenue Service (IRS) issued final regulations that permanently extend reporting deadlines under the Affordable Care Act for certain health insurance forms that employers and insurers are required to send to employees and other covered individuals.

AHRQ issues requests for information on workforce safety. On Monday (Dec. 12), the Agency for Healthcare Research and Quality (AHRQ) released a request for information (RFI) on advancing patient and health care workforce safety through the development of a National Healthcare System Action Alliance to Advance Patient Safety. The RFI seeks feedback on how the Action Alliance can be most effective, along with input on innovative care models, approaches, strategies, and solutions for overcoming common impediments to health care workforce safety. AHRQ is accepting comments until January 26, 2023.

Reports, Studies, and Journals

Health Affairs: National Health Care Spending In 2021: Decline In Federal Spending Outweighs Greater Use Of Health Care. The annual report found national health care spending grew by 2.7% to $4.3 trillion in 2021, this is down from a 10.3% spike in 2020 when the federal government was responding to the COVID-19 pandemic. The share of the economy accounted for by the health sector fell from 19.7% in 2020 to 18.3% in 2021, but it was still higher than the 17.6% share in 2019.

The Center for Medicare and Medicaid Innovation: 2022 Report to Congress. The latest report from the Center for Medicare and Medicaid Innovation highlights activities from October 1, 2020, through September 30, 2022 — a period of time where CMMI operated 33 models. The Innovation Center is required by statue to report to Congress on its activities at least every other year.

Congressional Budget Office: Health Care Options for Reducing the Deficit. The report highlights several potential changes to the health care industry that could generate federal savings.


Contact Information
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Washington Council Ernst & Young
   • Heather Bell (