Health Care Checkup
October 1, 2021
|
|
On Thursday, the Senate passed a government funding bill that will fund federal agencies through December 3, 2021. Additionally, the bill will provide emergency funding for Afghan refugees resettling in America, and funding for natural disaster recovery. The funding bill does not address the looming October deadline to raise the debt ceiling. On Tuesday, Treasury Secretary Janet Yellen sent a letter to Congress that said, “We now estimate that Treasury is likely to exhaust its extraordinary measures if Congress has not acted to raise or suspend the debt limit by October 18.” If Senate Republicans maintain their current opposition to voting for a debt limit increase, Democrats would have few options, other than to add the change on their own to the budget reconciliation bill they hope to pass this year.
The House did not vote on the bipartisan infrastructure bill on Thursday, and, with disagreement between Progressives and Moderate members, President Biden is headed to the Hill on Friday to meet with House Democrats at 3:30PM. Progressive Democrats are still publicly opposed to the bipartisan infrastructure bill until their moderate colleagues Kyrsten Sinema (D-AZ) and Joe Manchin (D-WV) agree to the outlines of a larger economic relief and social programs bill that they hope to pass through budget reconciliation this fall. Progressive Democrats in the House have said that they will not vote for the bill until the broader “human” infrastructure bill is secured for passage. As a reminder, the bipartisan infrastructure bill, the Infrastructure Investment and Jobs Act (H.R. 3684) passed in the Senate on August 10 in a vote of 69-30. This legislation would invest billions of dollars into the nation’s infrastructure, including roadways, bridges, public transit, and clean energy.
On Thursday, the Departments of Health and Human Services (HHS), Labor (DOL), Treasury and the Office of Personnel Management (OPM) released a highly anticipated interim final rule to further implement the No Surprises Act on surprise medical billing. The new regulations create a process by which providers, health plans, and issuers can settle payment rate disputes. Specifically, under the new regulations, providers and insurers who have a dispute over the payment rate of certain procedures must participate in a 30-day “open negotiation period” to try to come to an agreement. If the negotiations fail, then either party can begin the “federal independent dispute resolution process” to rectify the payment rate disagreement. The rule is slated to take effect on January 1, 2022. The press release can be found here, and the fact sheet can be found here.
On Wednesday, the Bipartisan Addiction and Mental Health Task Force released its 2021 legislative agenda. The agenda outlines steps Congress should take to address the nation’s mental health and substance use crisis. These steps include the following: increasing access to recovery resources, putting an end to the stigma surrounding addiction and mental health, building a stronger public health infrastructure, and creating safeguards to prevent the circulation of drugs within communities.
Ahead of the Medicare open enrollment period, CMS has released the 2022 premium and deductible rates for Medicare beneficiaries. On average, the cost of premiums for Medicare Advantage (MA) plans will be $19.00 per month, which is less than in the $21.22 per-month premiums offered in 2021. However, for Part D prescription drug coverage, the average premium will increase to $33.00 per month, as opposed to $31.47 per month in 2021. It is projected that enrollment in Medicare Advantage will increase to 29.5 million people, up from 26.9 million in 2021. The Medicare open enrollment period begins on October 15, 2021 and ends on December 7, 2021. More information can be found here.
|
What to Expect Next Week: Negotiations will likely continue on the bipartisan infrastructure bill and the budget reconciliation bill. On Wednesday, the House Transportation and Infrastructure Subcommittee on Water Resources and Environment Hearing will hold a hearing titled, "Emerging Contaminants, Forever Chemicals, and More: Challenges to Water Quality, Public Health, and Communities." On Thursday, the House Veterans' Affairs Subcommittee on Technology Modernization will hold a hearing titled, “The VA Electronic Health Record Transparency Act of 2021 and IT Reform and Data Collection Bills.”
|
|
Senate Passes Stopgap Funding Bill to Avert Government Shutdown
The Senate passed a government funding bill on Thursday that will fund federal agencies through December 3, 2021. Additionally, the bill will provide emergency funding for Afghan refugees resettling in America, and funding for natural disaster recovery. However, the funding bill does not address the looming October deadline to raise the debt ceiling. On Tuesday, Treasury Secretary Janet Yellen sent a letter to Congress that said, “We now estimate that Treasury is likely to exhaust its extraordinary measures if Congress has not acted to raise or suspend the debt limit by October 18.” If Senate Republicans maintain their current opposition to voting for a debt limit increase, Democrats would have few options, other than to add the change on their own to the budget reconciliation bill they hope to pass this year. Additionally, if Congress does not meet the October debt ceiling deadline, the United States wouldn’t be able to pay its obligations and could default.
House Hopes to Pass Bipartisan Infrastructure Bill this Week
House Speaker Nancy Pelosi still hopes to bring up and pass the bipartisan infrastructure bill in the House on Friday. However, progressive Democrats are still publicly opposed to the bill, until their moderate colleagues Kyrsten Sinema (D-AZ) and Joe Manchin (D-WV) agree to the outlines of a larger economic relief and social programs bill that they hope to pass through budget reconciliation this fall. Pelosi originally planned to bring the legislation to a floor vote on Thursday, however that effort did not come to fruition. Progressive Democrats in the House have said that they will not vote for the bill until the broader “human” infrastructure bill is secured for passage. As a reminder, the Infrastructure Investment and Jobs Act (H.R. 3684) passed in the Senate on August 10 in a vote of 69-30. This legislation would invest billions of dollars into the nation’s infrastructure, including roadways, bridges, public transit, and clean energy.
Biden Administration Releases Surprise Medical Billing Interim Final Rule
On Thursday, the Departments of Health and Human Services (HHS), Labor (DOL), Treasury and the Office of Personnel Management (OPM) released a highly anticipated interim final rule to further implement the No Surprises Act on surprise medical billing. The new regulations create a process by which providers, health plans, and issuers can settle payment rate disputes. Specifically, under the new regulations, providers and insurers who have a dispute over the payment rate of certain procedures must participate in a 30-day “open negotiation period” to try to come to an agreement. If the negotiations fail, then either party can begin the “federal independent dispute resolution process” to rectify the payment rate disagreement. In that process, both parties submit their offers to a third-party “certified independent dispute resolution entity,” who then decides the final payment rate. Generally, the rate chosen by the third-party entity will be the rate closest to the median in-network rate for the procedure. The rule is slated to take effect on January 1, 2022. The press release can be found here, and the fact sheet can be found here.
Bipartisan Addiction and Mental Health Task Force Announces 2021 Legislative Agenda
On Wednesday, the Bipartisan Addiction and Mental Health Task Force released its 2021 legislative agenda. The agenda outlines steps Congress should take to address the nation’s mental health and substance use crisis. These steps include the following: increasing access to recovery resources, putting an end to the stigma surrounding addiction and mental health, building a stronger public health infrastructure, and creating safeguards to prevent the circulation of drugs within communities. Representative Annie Kuster (D-NH) leads the Task Force along with Representatives Brian Fitzpatrick (R-PA), David Trone (D-MD), and Jaime Herrera Beutler (R-WA). Representative Kuster explained the Task Force’s agenda and said, “The public health and economic crisis brought on by the COVID-19 pandemic created new obstacles for those already struggling with addiction and mental health challenges, making the work of our Task Force all the more important.” Additional information can be found here.
CMS Announces Participants of 2022 Medicare Advantage Value-Based Insurance Design Model
On Wednesday, CMS announced the participants of the 2022 Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model. CMS reports that there is a “more than two-fold increase in the number of Model enrollees covered by participating MA plans in 2022 compared to 2021.” In the VBID Model, CMS tests a wide range of MA health plan innovations, which are designed to improve the quality of care for Medicare beneficiaries. As part of the Model, MA plans offer enhanced supplemental benefits, such as reduced co-payments, to improve health equity among Medicare beneficiaries. Plans may also offer their beneficiaries rewards and incentives, such as meals and transportation. The full list of Model participants can be found here.
CMS Releases 2022 Premiums and Deductible Rates Ahead of Medicare Open Enrollment
Ahead of the Medicare open enrollment period, CMS has released the 2022 premium and deductible rates for Medicare beneficiaries. On average, the cost of premiums for Medicare Advantage (MA) plans will be $19.00 per month, which is less than in the $21.22 per-month premiums offered in 2021. However, for Part D prescription drug coverage, the average premium will increase to $33.00 per month, as opposed to $31.47 per month in 2021. It is projected that enrollment in Medicare Advantage will increase to 29.5 million people, up from 26.9 million in 2021. MA plans will continue to offer a broad array of supplemental benefits in 2022, including but not limited to dental benefits, eyewear, hearing aids, and fitness benefits. CMS also reports that the percentage of plans offering special supplemental benefits for chronically ill beneficiaries will grow from 19% to 25%. The Medicare open enrollment period begins on October 15, 2021 and ends on December 7, 2021. More information can be found here.
SAMHSA Awards $825 Million in Grants to 231 Community Mental Health Centers
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it will distribute $825 million in funds to 231 Community Mental Health Centers (CMHCs) across the nation. The funding will come from both the Consolidated Appropriations Act of 2021 and the Coronavirus Response and Relief Supplement Act of 2021. CMHCs are facilities that provide a wide array of mental health services, including prevention, treatment, and rehabilitation. The funding from the grant program is expected to help CMHCs better address the needs of individuals with serious emotional disturbance (SED) or serious mental illness (SMI). The full list of grant recipients can be found here.
|
|
SENATE HEARINGS AND EXECUTIVE SESSIONS |
Senate Health, Education, Labor and Pensions Committee - Hearing
Full Committee Hearing: Nominations of Lisa Gomez to be the Assistant Secretary for Employee Benefits Security, Department of Labor, and Jose Javier Rodriguez to be the Assistant Secretary for Employment and Training, Department of Labor
Thursday, October 7 at 10:00 AM ET
|
|
HOUSE HEARINGS AND EXECUTIVE SESSIONS |
House Committee on Transportation and Infrastructure - Hearing
Subcommittee on Water Resources and Environment Hearing: "Emerging Contaminants, Forever Chemicals, and More: Challenges to Water Quality, Public Health, and Communities."
Wednesday, October 6 at 11:00 AM ET
House Committee on Veterans' Affairs - Hearing
Subcommittee on Technology Modernization Hearing: the VA Electronic Health Record Transparency Act of 2021 and IT Reform and Data Collection Bills
Thursday, October 7 at 10:00 AM ET
|
|
ADMINISTRATION ANNOUNCEMENTS |
Centers for Medicare & Medicaid Services
Food and Drug Administration
Guidance Documents from the Centers for Disease Control and Prevention
National Institutes of Health
|
|
1341 G Street NW
Washington, DC 20005
202-585-0258
|
|
|
|
|
|
|
