Health Care Checkup
January 13, 2023
THE BIG PICTURE
On Monday, the House convened with newly elected House Speaker Kevin McCarthy (R-CA) at the helm and took up a rules package for the 118th Congress. The House passed the package with opposition from only one Republican, Rep. Tony Gonzales (TX). The only substantive change to the package, from what was previously posted, was that the threshold for a motion to vacate to a single Member was lowered. After the House passed the rules package, it proceeded with committee assignments. The House Republican Steering Committee met on Monday to vote on contested committee chair positions. Rep. Jason Smith (R-MO) won the Ways and Means chairmanship, beating out Reps. Vern Buchanan (R-FL) and Adrian Smith (R-NE). The House also announced new committee assignments for the Appropriations Committee, Financial Services Committee, Energy and Commerce Committee, and Ways and Means Committee. The full list can be found here.

On Thursday, the Medicare Payment Advisory Commission (MedPAC) voted to recommend 2024 pay increases for hospitals and physicians and recommended that skilled nursing facilities (SNFs) and home health providers receive pay decreases. MedPAC voted for hospitals to receive a 1% payment increase over the current Medicare rates in 2024. Additionally, the commission voted for physicians to receive a 1.25% payment increase. Conversely, MedPAC recommended that the base payment rate for SNFs decrease by 3%, and that the base payment rate for home health facilities decrease by 7%.

On Friday, Speaker McCarthy invited President Joe Biden to speak before a Joint Session of Congress on February 7 to report on the state of the union. President Biden accepted the invitation.

The Department of Health and Human Services (HHS) announced key dates for the first year of the Inflation Reduction Act’s (IRA) Medicare Drug Price Negotiation Program. Due to the IRA, Medicare will be able to negotiate prescription drug prices. This process will begin this year, and the negotiated prices will go into effect in 2026. The full timeline for the Program can be found here.

The Congressional Budget Office (CBO) released the cost estimate of the Consolidated Appropriations Act of 2023, which became law at the end of 2022. The cost estimate can be found here.

Treasury Secretary Janet Yellen sent a letter to Congress on the debt limit. Secretary Yellen advised that, beginning on January 19, 2023, the “outstanding debt of the United States is projected to reach the statutory limit.” The full letter can be found here.

CMS awarded the first 200 of 1,000 Medicare-funded physician residency slots to improve the health care workforce and help hospitals serving underserved communities. According to the agency, approximately 75% of the new positions will be for primary care and mental health specialties.
What to Expect Next Week: Both the House and Senate will be out of session until the week of January 23. 
DEEP DIVE
House Republicans Assign Members to Congressional Committees, Pass Rules Package for 118th Congress
On Monday, the House convened with newly elected House Speaker Kevin McCarthy (R-CA) at the helm and took up a rules package for the 118th Congress. The House passed the package with opposition from only one Republican, Rep. Tony Gonzales (TX). The only substantive change to the package, from what was previously posted, was that the threshold for a motion to vacate to a single Member was lowered. After the House passed the rules package, it proceeded with committee assignments. The House Republican Steering Committee met on Monday to vote on contested committee chair positions. Rep. Jason Smith (R-MO) won the Ways and Means chairmanship, beating out Reps. Vern Buchanan (R-FL) and Adrian Smith (R-NE). Rep. Virginia Foxx (R-NC) beat challenger Rep. Tim Walberg (R-MI) for the position of Chair of the Education and Workforce Committee. Additionally, Rep. Jodey Arrington (R-TX) became Chair of the Budget Committee, beating opponents Rep. Lloyd Smucker (R-PA) and Buddy Carter (R-GA). The House also announced new committee assignments for the Appropriations Committee, Financial Services Committee, Energy and Commerce Committee, and Ways and Means Committee. The full list can be found here.

MedPAC Votes For 2024 Pay Increases for Acute Care Hospitals and Physicians, and Pay Decreases for Nursing Homes and Home Health Providers
On Thursday, the Medicare Payment Advisory Commission (MedPAC) voted to recommend 2024 pay increases for hospitals and physicians and recommended that skilled nursing facilities (SNFs) and home health providers receive pay decreases. MedPAC voted for hospitals to receive a 1% payment increase over the current Medicare rates in 2024. Additionally, the commission voted for physicians to receive a 1.25% payment increase. Conversely, MedPAC recommended that the base payment rate for SNFs decrease by 3%, and that the base payment rate for home health facilities decrease by 7%. MedPAC’s payment recommendations for 2024 will be included in its March 2023 report to Congress on Medicare.

HHS Announces Key Dates for the Medicare Drug Price Negotiation Program
The Department of Health and Human Services (HHS) announced key dates for the first year of the Inflation Reduction Act’s (IRA) Medicare Drug Price Negotiation Program. Due to the IRA, Medicare will be able to negotiate prescription drug prices. This process will begin this year, and the negotiated prices will go into effect in 2026. By September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) will publish the first 10 Medicare Part D drugs selected for the Program. The “negotiated maximum fair prices” for these drugs will be released by September 1, 2024 and prices will go into effect beginning January 1, 2026. The full timeline for the Program can be found here.

CMS Awards First 200 of 1,000 New Medicare-funded Residency Slots to Hospitals in Underserved Communities
CMS awarded the first 200 of 1,000 Medicare-funded physician residency slots to improve the health care workforce and help hospitals serving underserved communities. According to the agency, approximately 75% of the new positions will be for primary care and mental health specialties. The Fiscal Year (FY) 2022 Inpatient Prospective Payment System (IPPS) final rule established provisions to implement 1,000 new Medicare-funded physician residency slots to qualifying hospitals, phasing in 200 new slots every five years. The application period for the second round will open in January 2023 and close on March 31, 2023. Additional information can be found here.   

HHS Awards Nearly $245 Million to Programs Aimed at Supporting Youth Mental Health
HHS has awarded nearly $245 million in Bipartisan Safer Communities Act funding – $185.7 million from the Substance Abuse and Mental Health Services Administration (SAMHSA) and nearly $60 million from the Health Resources and Services Administration (HRSA) – to support youth mental health, help the health care workforce address mental health needs, and fund other critical mental health supports. A full breakdown of the awards can be found here.

ACA Marketplace Enrollment up 13% from Same Time Last Year
The Biden Administration announced that 1.8 million more people have signed up for Affordable Care Act (ACA) Marketplace health plans his open enrollment period, which is a 13% increase from the year prior. 20% of enrollees are new to the Marketplace for 2023, while 80% are returning. CMS said that four out of five HealthCare.gov enrollees will be able to find a plan for $10 or less after Inflation Reduction Act tax credits. Consumers can enroll in plans on the HealthCare.gov Marketplace until January 15, 2023. More can be found 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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