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January 17, 2023

This Week in Health Policy for January 16

This week (Jan. 16-20)

The House and the Senate are on recess this week and will return January 23.

Last week (Jan. 09-13)

Health Care Highlights

House leadership and chairmanships take shape. Early Saturday (Jan. 7), Rep. Kevin McCarthy (R-CA) gained the needed votes to be elected as House Speaker after making concessions to win support from conservative holdouts. Concessions include, but were not limited to, agreeing to not take up a debt limit increase without spending cuts, to bring up the 12 annual spending bills individually, not as an "omnibus" package, and to allow amendments. The concessions set up a potential future showdown over spending cuts to federal programs such as Medicare and Social Security.

On Monday (Jan. 9), the House Republican Steering Committee met to select committee chairmanships, including those with oversight of key health care programs. Rep. Jason Smith (R-MO) will chair the House Ways & Means Committee, Rep. Cathy McMorris Rodgers (R-WA) will chair the House Energy & Commerce Committee, Rep. Virginia Foxx (R-NC) will chair the House Education and Workforce Committee, Rep. Kay Granger (R-TX) will chair the Appropriations Committee, and Rep. James Corner (R-KY) will chair the Oversight and Government Reform Committee.

MedPAC recommends pay updates for Medicare providers. On Thursday (Jan. 12), the Medicare Payment Advisory Commission (MedPAC) held a virtual meeting during which the panel recommended 2024 pay updates that Congress should make for Medicare providers. The panel recommended a 1% pay increase for inpatient and outpatient hospitals, a 1.25% increase for physicians coupled with add-on payments for safety-net primary and specialty care providers, a 3% decrease for skilled nursing facilities, a 7% decrease for home health providers, and a 3% decrease for inpatient rehabilitation facilities. The panel recommended the statutory update for hospices, along with a reduction to the hospital aggregate cap. The panel's recommendations are not binding.

CMS releases timeline for drug price negotiation. On Wednesday (Jan. 11), the Centers for Medicare & Medicaid Services (CMS) released a memo and timeline detailing the agency's plans to implement the Inflation Reduction Act's Medicare drug price negotiation provisions over the next three years. CMS will announce the first 10 drugs to be part of negotiations on Sept. 1 and will have final prices in place by 2026. CMS noted they will seek feedback and insights from a "broad range of interested parties" throughout the implementation process, including through stakeholders calls and comment solicitation.

HHS extends PHE another 90 days. On Wednesday (Jan. 11), U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra renewed the COVID-19 public health emergency for another 90 days. Politico and other news outlets are reporting that Biden officials are targeting a spring end to the PHE, indicating this could be the final bump out.

2023 ACA exchange sign ups near 16 million. On Wednesday (Jan. 11), CMS said 15.9 million people selected a 2023 health plan through the federally facilitated or state-based marketplaces as of Jan. 7, marking a year-over-year increase of 13%.

House passes antiabortion measures. On Wednesday (Jan. 11), the House voted 222-209 to pass a resolution condemning violence against anti-abortion organizations and voted 220-210 to pass a bill that reaffirms the rights of infants born alive as a result of an abortion. The bills are not expected to be taken up in the Senate.

Court kicks 340B repayments to HHS. On Tuesday (Jan. 10), the U.S. District Court for the District of Columbia said HHS can propose an appropriate way to address underpayments between 2018 and 2021 to hospitals participating in the 340B drug pricing program. The case is in response to a June 2021 Supreme Court ruling that overturned a nearly 30% pay cut to 340B hospitals for certain Part B drugs because federal officials failed to collect acquisition costs from hospitals. HHS recently indicated that it expects to propose a remedy by April.

EPA announced $100 million grant opportunity. On Tuesday (Jan. 10), the Environmental Protection Agency (EPA) announced the availability of approximately $100 million for projects that support communities that face disproportionately high and adverse health and environmental impacts. The grants include opportunities for organizations working to address local environmental and public health issues.

HHS awards $245 million to support mental health. On Monday (Jan 9), the U.S. Department of Health and Human Services (HHS) awarded nearly $245 million in Bipartisan Safer Communities Act funding to support youth mental health and the health care workforce. The funding includes $185.7 million from the Substance Abuse and Mental Health Services Administration and nearly $60 million from the Health Resources and Services Administration.

CMS awards 200 Medicare residency slots. On Monday (Jan. 9), CMS awarded 200 Medicare-funded residency slots to 100 teaching hospitals across 30 states, Washington, D.C., and Puerto Rico, focusing on areas with the largest provider shortages. The slots, which will largely support primary care and mental health, were part of the 1,000 new slots included in Congress' 2021 Consolidated Appropriations Act. The application period for the second round of 200 residency positions will open later this month and close on March 31, 2023.

Reports, Studies, and Journals

CA: A Cancer Journal for Clinicians: Cancer statistics, 2023. The American Cancer Society report shows the U.S. cancer mortality rate has declined by 33% over three decades.The authors attribute the decline to improvements in cancer treatment and prevention, as well as declines in smoking.

Health Affairs: Workforce Composition In Private Equity-Acquired Versus Non-Private Equity-Acquired Physician Practices. The study — which compared changes in clinician workforce at private-equity acquired vs. non-private equity dermatology, ophthalmology, and gastroenterology practices between 2014 and 2019 — found no overall difference in the number of clinicians between private-equity acquired vs. non-private equity practices but larger numbers of advanced practice providers at private equity-owned practices.

Government Accountability Office: CMS Should Strengthen Reporting Requirements to Better Protect Individuals Receiving Hospice Care. The report found gaps in CMS' requirements for reporting and responding to abuse and neglect allegations and recommended actions the agency could take to better protect patients.


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Washington Council Ernst & Young
   • Heather Bell (