Health Care Checkup
February 3, 2023
THE BIG PICTURE
The House and Senate finalized their committee assignments. The House committee rosters can be found here and the Senate committee rosters can be found here.
 
On Monday, the Biden Administration announced that it would end the COVID-19 public health emergency (PHE) on May 11. The PHE was originally put into place in January 2020 by former President Donald Trump and it has been renewed every 90 days since. Currently, the COVID-19 national emergency and the PHE are slated to expire on March 1 and April 11, respectively. However, the Administration is planning to extend both to May 11 and then end both on that date.
 
On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2024 Advance Notice for the Medicare Advantage (MA) and Part D Prescription Drug Programs, which would update payment policies for these programs. Under the proposal, MA plans are expected to see a 1.03% average change in revenue. As part of the Part C risk adjustment model revision, CMS proposes technical updates to the International Classification of Diseases (ICD)-10 classification system, which includes restructuring condition categories. The Notice can be found here and the fact sheet can be found here.
 
CMS released a final rule on the MA Risk Adjustment Data Validation (RADV) program. Under the program, CMS conducts audits to recover improper risk adjustment payments made to MA plans. As part of the final rule, CMS will extrapolate RADV audit findings beginning with payment year (PY) 2018.
 
On the one-year anniversary of President Joe Biden’s reignited Cancer Moonshot, his administration took various steps to combat the disease. HHS awarded $11 million to 22 Health Resources and Services Administration (HRSA) funded health centers to “improve access to life-saving cancer screenings and early detection services for underserved communities.” The press release with the list of awardees can be found here.

Additionally, the White House released several new actions the Cancer Cabinet is taking to prevent and treat cancer. The National Cancer Institute (NCI) will launch a public-private partnership to bring clinical and patient navigation support to families facing childhood cancer. Further, HHS is launching “CancerX,” which is a public-private partnership to promote innovation in the fight against cancer. More on these initiatives can be found here
What to Expect Next Week: Next week, the House Rules Committee will meet to consider, H.R. 185, which would terminate the requirement imposed by the Director of the Centers for Disease Control and Prevention for proof of COVID-19 vaccination for foreign travelers. On Tuesday, President Joe Biden will deliver the 2023 State of the Union Address. 
DEEP DIVE
Biden Administration to End Public Health Emergency May 11
On Monday, the Biden Administration announced that it would end the COVID-19 public health emergency (PHE) on May 11. The PHE was originally put into place in January 2020 by former President Donald Trump and it has been renewed every 90 days since. Currently, the COVID-19 national emergency and the PHE are slated to expire on March 1 and April 11, respectively. However, the Administration is planning to extend both to May 11 and then end both on that date. In its announcement, the Office of Management and Budget (OMB) stated that, “an abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system.” Additionally, OMB stated its strong opposition to enactment of H.R. 382, the Pandemic is Over Act, which would terminate the PHE and H.J. Res. 7, which would terminate the national emergency.

MA Plans Expected to Receive 1.03% Increase in Revenue in 2024
On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2024 Advance Notice for the Medicare Advantage (MA) and Part D Prescription Drug Programs, which would update payment policies for these programs. Under the proposal, MA plans are expected to see a 1.03% average change in revenue. As part of the Part C risk adjustment model revision, CMS proposes technical updates to the International Classification of Diseases (ICD)-10 classification system, which includes restructuring condition categories. Additionally, CMS’s proposal includes Part D benefit-related updates from the Inflation Reduction Act (IRA). Beginning in 2024, cost-sharing for Part D drugs will be eliminated for beneficiaries in the “catastrophic phase” of coverage. The Notice can be found here and the fact sheet can be found here.

CMS Issues Final Rule on MA RADV Audits
CMS released a final rule on the MA Risk Adjustment Data Validation (RADV) program. Under the program, CMS conducts audits to recover improper risk adjustment payments made to MA plans. As part of the final rule, CMS will extrapolate RADV audit findings beginning with payment year (PY) 2018. The rule also finalizes a policy in which CMS will not apply an adjustment factor, also known as the fee-for-service (FFS) adjuster, in RADV audits. The press release can be found here and the fact sheet can be found here.

HHS Proposes to Promote Greater Access to Birth Control Under the ACA
The Department of Health and Human Services (HHS) issued a proposed rule to improve access to birth control under the Affordable Care Act (ACA). The proposal would remove the moral exemption, which was enacted in 2018. This exemption allows for private health plans and insurers to exclude coverage of contraceptive services based on moral convictions. However, the rule would keep the religious exemption in place. The proposal would also create an “independent pathway” for individuals enrolled in plans “arranged or offered by objecting entities” to access contraceptive services directly through a provider without any cost. More can be found here.
 
Biden Administration Takes Actions to End Cancer on One Year Anniversary of Reignited Cancer Moonshot
On the one-year anniversary of President Joe Biden’s reignited Cancer Moonshot, his administration took various steps to combat the disease. HHS awarded $11 million to 22 Health Resources and Services Administration (HRSA) funded health centers to “improve access to life-saving cancer screenings and early detection services for underserved communities.” The press release with the list of awardees can be found here. Additionally, the White House released several new actions the Cancer Cabinet is taking to prevent and treat cancer. The National Cancer Institute (NCI) will launch a public-private partnership to bring clinical and patient navigation support to families facing childhood cancer. Further, HHS is launching “CancerX,” which is a public-private partnership to promote innovation in the fight against cancer. More on these initiatives can be found here.

House Energy and Commerce Subcommittee on Health Holds First Legislative Hearing of 118th Congress
On Wednesday, the House Energy and Commerce Subcommittee on Health held its first hearing of the new Congress. The hearing focused on four pieces of legislation: the HALT Fentanyl Act; the Block, Report, and Suspend Suspicious Shipments Act; the 9-8-8 Lifeline Cybersecurity Responsibility Act; and the Protecting Health Care for All Patients Act. There was great emphasis from the Committee on the importance of permanently scheduling all fentanyl-related substances as Schedule I drugs under the Controlled Services Act, which is what the HALT Fentanyl Act would do. Additionally, the Members discussed the importance of protecting the 9-8-8 suicide hotline from future cyberattacks and the need to permanently ban the use of quality-adjusted life years in all publicly funded health care programs. The hearing can be viewed here
ADMINISTRATION ANNOUNCEMENTS
Centers for Medicare & Medicaid Services
 
Food and Drug Administration
 
Guidance Documents from the Centers for Disease Control and Prevention

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