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August 5, 2024
2024-1489

This Week in Health Policy for August 5

This Week (August 5 - 9)

The House and Senate are out of session until September 9.

Last Week (July 29 - August 2)

Health Care Highlights

Data privacy for kids. On Tuesday (July 30), the Senate passed, 91-3, a package (S. 2703) including two bipartisan bills that would boost privacy and safety features for children on social media sites. The Kids Online Safety Act, or KOSA (S. 1409) creates a legal "duty of care" for social media companies to prevent and mitigate harm, and violators would be subject to penalties enforced by the Federal Trade Commission (FTC). The other bill in the package, the Children and Teens' Online Privacy Protection Act (S. 1418) or COPPA 2.0, would update a 1998 law to prohibit online platforms from disseminating kids' personal information without obtaining a verifiable parental consent, effectively ending ads targeted at kids and teens. COPPA would raise the age of children protected to 17, up from 12 under current law. A substitute amendment from Majority Leader Schumer that combined the bills made some changes to the versions approved earlier by the Senate Commerce Committee. The KOSA text on tech companies' duty of care was narrowed to focus on product design features, with the FTC having sole authority to enforce the provisions. The measure also includes a preemption provision that would override state laws on children's online safety. The COPPA text was modified to give the FTC the authority to let educational institutions allow minors and children to access online content without requiring parental consent, and the measure would now permit tech companies to use identifying information solely for internal operations' purposes.

President Biden praised the Senate's action and called on "the House to send this bill to my desk for signature without delay." The House has already departed for the August recess, and it is not certain if the chamber will consider the package in September or in a lame-duck session after the election.

CMS issues FY 2025 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital payment final rule. On Thursday (August 1), the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2025 final rule for the Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System. The rule increases FY 2025 acute care hospital operating payments by about 2.9%, compared with FY 2024. CMS estimates the overall impact of the rule would result in an increase of about $2.9 billion in payments to acute care hospitals paid under the IPPS in FY 2025. In a change from the proposed rule, CMS estimated that Medicare uncompensated care payments to disproportionate share hospitals (DSH) would decrease by about $200 million in FY 2025, and additional payments for inpatient cases involving new medical technologies would increase by $300 million. In the rule, CMS noted that the Consolidated Appropriations Act of 2024 extended additional payments for Medicare-Dependent Hospitals (MDHs) and the temporary change in payments for low-volume hospitals through December 31, 2024. CMS estimated if Congress does not act and allows the funding to expire, payments to those hospitals would decline by $0.4 billion in FY 2025. CMS said the LTCH standard payment rate will increase by 3% and LTCH PPS payments for discharges paid the LTCH standard payment rate to increase by approximately 2% or $45 million.

Throughout the rule, CMS finalized several policies intended to increase health equity and improve maternal health, an ongoing priority for the Biden administration. CMS also finalized updates to hospital quality and value-based payment programs, among other changes. In addition, CMS finalized a new mandatory CMS Innovation Center model, the Transforming Episode Accountability Model (TEAM), that beginning January 2026 will test whether bundled payments for certain surgical procedures can improve or maintain care quality while reducing spending. Click here for a press release. Click here for a fact sheet. Click here for the final rule.

CMS issues FY 2025 Skilled Nursing Facility final payment rule. On Wednesday (July 31), CMS issued the FY 2025 Skilled Nursing Facility (SNF) Prospective Payment System Final Rule. CMS finalized a 4.2%, or about $1.4 billion, increase in Medicare Part A payments to SNFs for FY 2025, compared with FY 2024. CMS finalized its proposal to adopt the most recent Office of Management and Budget (OMB) statistical area delineations. SNFs impacted by the change can have payment cuts stemming from the wage index change limited to 5% from the previous year. CMS also proposed updates to the Patient Driven Payment Model ICD-10 code mappings, the SNF Quality Reporting Program, and the Value-based Purchasing Program. In addition, CMS finalized proposals to expand the type of civil monetary penalties it can impose and give CMS more flexibility to impose penalties in response to health and safety concerns. Click here for CMS' fact sheet and here for the final rule.

CMS issues FY 2025 Inpatient Psychiatric Facilities final payment rule. On Wednesday (July 31), CMS issued the FY 2025 Inpatient Psychiatric Facilities (IPF) Prospective Payment System Final Rule. In the rule, CMS finalized a net payment increase of 2.5%, or $65 million, for FY 2025, which includes the downward adjustment from CMS' updates to the outlier threshold. CMS also finalized updating the IPF patient-level adjustment factors used to set payment rates for psychiatric hospitals and psychiatric units to reflect cost and claims data from 2019 through 2021. CMS also finalized its proposal to make those changes in a budget neutral manner. In addition, CMS finalized its proposal to adopt the most recent OMB statistical area delineations, including a three-year transition for providers transitioning from rural to urban based on the updates. CMS also clarified eligibility criteria for filling all-inclusive cost reports and proposed new updates to the IPF Quality Reporting Program. Click here for CMS' fact sheet and here for the final rule.

CMS issues FY 2025 Inpatient Rehabilitation Facility final payment rule. On Wednesday (July 31), CMS issued the FY 2025 Inpatient Rehabilitation Facility (IRF) Prospective Payment System Final Rule. CMS finalized a payment increase of 3% for FY 2025, compared with FY 2024. CMS noted that total IRF payments should increase by $280 million, accounting for a $20 million decrease due to adjustments for higher outlier payments. CMS also finalized updates to improve collection of social determinants of health data in the IRF Quality Reporting Program. Click here for CMS' fact sheet and here for the final rule.

CMS issues FY 2025 hospice final payment rule. On Tuesday (July 30), CMS issued the FY 2025 Hospice Payment Rate Update Final Rule. Under the rule, Medicare payments to hospices will increase by 2.9%, or $790 million for FY 2025, up from the proposed $705 million payment bump. CMS also increased the hospice cap amount for FY 2025 by 2.9% to $34,465.34. CMS also finalized a proposal to adopt adopting the most recent OMB statistical area delineations, which would affect the geographic wage index for Medicare payments. Hospices impacted by the change can have payment cuts stemming from the wage index change limited to 5% from the previous year. The rule also proposes updates to the Hospice Quality Reporting Program and to implement the Hospice Outcome and Patient Evaluation (HOPE) tool to facilitate patient-level data collection and assessment, replacing the existing Hospice Item Set. Click here for CMS' fact sheet and here for the final rule.

HRSA unveils $68M to support HIV care for women and children. On Wednesday (July 31), the Health Resources and Services Administration (HRSA) announced more than $68 million in Ryan White HIV/AIDS Program funding to provide family-centered medical care and essential support services for women with low incomes, infants, children, and youth with HIV. Click here for the press release.

CMS releases 2025 Part D bid information and announced voluntary premium stabilization demonstration. On Monday (July 29), CMS released preliminary Medicare Part D bid information for CY 2025. CMS said the base beneficiary premium for 2025 will be $36.78, which is $2.08 more than 2024. CMS said preliminary average Part D premiums will be released later this summer, while the 2025 landscape will be published in mid-to-late September. CMS also announced a new voluntary nationwide demonstration program to test whether additional premium stabilization and revised risk corridors for stand-alone prescription drug plans can lead to benefit improvements for beneficiaries. Click here for a fact sheet.

Hearings, Markups, and Other Committee Activity

Senate Appropriations Committee held a markup of HHS and other FY 2025 appropriations. On Thursday (August 1), the Committee voted 25-3 to approve a bipartisan spending bill that would provide $122.8 billion in discretionary funding for HHS, including funding bumps for biomedical research, data modernization at the Centers for Disease Control and Prevention, cybersecurity efforts, and more. During the markup, senators spoke hopefully about reaching a bipartisan deal with the House on final HHS appropriations.

  • More information available here.

Senate Health, Education, Labor, and Pensions Committee advanced bills to reauthorize programs for older Americans, brain injury, and more. On Wednesday (July 31), the Committee voted 20-1 to advance three bills: the Older Americans Act Reauthorization Act of 2024 (S. 4776); the Autism Collaboration, Accountability, Research, Education, and Support Act of 2024 (S. 4762); and the Traumatic Brain Injury Program Reauthorization Act of 2024 (S. 4755).

  • More information available here.

Senate Committee on Commerce, Science, and Transportation advanced AI bills. On Wednesday (July 31), the Committee advanced eight bills related to AI as part of a broader mark up. While not health care specific, the AI bills include those to provide a framework for AI innovation and accountability, authorize the creation of a system to provide no or low-cost access to datasets and computing resources used in developing AI, establish AI standards, and more.

  • More information available here.

House Energy & Commerce Committee Democrats release report on access to reproductive health care. On Thursday (August 1), Ranking Member Frank Pallone (D-NJ) released a report with findings from a committee investigation into the impact of the Supreme Court's decision to overturn Roe v Wade on health care providers and patients. The report found the decision has had negative impacts on OB/GYN resident training, has been tied to care delays, and overall has led to disparate access to reproductive care in the US.

  • More information available here.

Reports, Studies, and Journals

Congressional Budget Office: Answers to Questions for the Record Following a Hearing on Hospital and Physician Consolidation and Its Impact on the Federal Budget. The report covered responses to questions for the record CBO Director of Health Analysis Chapin White received after testifying in May before the House Budget Committee, including potential impacts of site-neutral payment expansions, the impact of vertical integration on the drug supply chain, and the role of PBMs.

Substance Abuse & Mental Health Services Administration: 2023 NSDUH Annual National Report. The report, which highlights findings from the 2023 National Survey on Drug Use and Health, found that 22.8% of adults reported a mental illness in 2023, 3.1% of people misused opioids in 2023, and the number of adults receiving mental health treatment rose by 3.4 million from 2022 to 2023.

Health Affairs: Four Years And More Than 200,000 Deaths Later: Lessons Learned From The COVID-19 Pandemic In US Nursing Homes. The analysis focuses on policies and practices that evolved during the COVID-19 pandemic and recommends changes, including greater integration of long-term care into public health planning.

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Contact Information

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Washington Council Ernst & Young