Weekly Roundup: December 22, 2022

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Senate Clears $1.7 Trillion Omnibus Spending Package, Sending Legislation to the House
This afternoon the Senate passed the $1.7 trillion omnibus spending package by a vote of 68-29. The package, which proposes to fund the government for fiscal year (FY) 2023, passed with six amendments added to the legislation. The amendments include policy provisions to expand federal protections for pregnant workers and nursing mothers, in addition to aid for 9/11 families. The House is expected to vote on the package either Thursday night or Friday morning before sending it to President Joe Biden’s desk ahead of the Friday night deadline. The Senate will also pass a stopgap patch to extend the continuing resolution through December 30th, which will allow ample time for the bill to become formally enrolled and reach President Biden’s desk. Click here to access Healthsperien’s summary of relevant provisions included in the package.
National Association of Medicaid Directors Supports Provisions in Omnibus Package
On Tuesday, the National Association of Medicaid Directors (NAMD) issued a letter in support of the Senate’s draft omnibus package. According to the letter, the legislation includes a critical policy that provides Medicaid agencies with certainty on the timing, resources, and rules for winding down the Medicaid continuous enrollment requirement and initiating redeterminations for millions of Americans. In what was thought to be a bridge too far only a few weeks ago, the package decouples the increased Federal Medical Assistance Percentage (FMAP) amounts and maintenance of effort requirements of the Family First Coronavirus Relief Act (FFCRA – passed in 2020). The net effect of this will be a phase-down of the longstanding 6.2 percent FMAP bump included in FFCRA and an allowance for states to begin the redetermination process – both set to begin in April 2023. NAMD also conveyed support for other Medicaid provisions in the package, including more stable funding for U.S. territories’ Medicaid programs, extending funding by two years for the Children’s Health Insurance Program, and making permanent the option for one year of postpartum coverage.
Rep. Guthrie Makes Price Transparency and Medical Innovation Priorities in Next Congress
Rep. Brett Guthrie (R-KY), Ranking Member of the House Energy & Commerce Subcommittee on Health, is expected to serve as the subcommittee’s chair when Republicans take control of the chamber in the next Congress. As chair, Rep. Guthrie (R-KY) would focus on medical product innovation, price transparency, and health agency oversight (subscription required). As a part of the work on price transparency, Rep. Guthrie wants to investigate how value-based agreements can spur innovation in pharmaceuticals and healthcare. In April, Reps. Guthrie (R-KY), Kurt Schrader (D-OR), and Markwayne Mullin (R-OK) introduced the Medicaid VBPs for Patients Act (H.R. 7389), which aims to decrease barriers to value-based purchasing arrangements in Medicaid to facilitate patient access to high-cost drugs. Rep. Guthrie (R-KY) mentioned that he’s also interested in how to use value-based models to pay for innovative treatments and diagnostics, including blood tests that help with the early detection of cancer. Additionally, he mentioned that he would like to look into the Food and Drug Administration’s use of emergency use authorizations and the agency’s response to the infant formula shortage.
Joint Commission to Launch Health Care Equity Certification Program in 2023
Next year the Joint Commission will launch a new voluntary certification program, Health Care Equity (HCE). The certification program will recognize hospitals and critical access hospitals that strive for excellence in their efforts to provide equitable care, treatment, and services. Beginning in early 2023, hospitals can pre-apply for the certification, but the application will not be available until July 1st, 2023. Both Joint Commission-accredited and non-accredited hospitals will be able to apply for the HCE certification if they comply will applicable federal laws, such as the Centers for Medicare and Medicaid Services’ Conditions of Participation.
Administration Action
  • This week, the Department of Health and Human Services’ (HHS) Secretary Xavier Becerra announced the annual release of HHS’ National Plan to Address Alzheimer’s Disease. Through the plan, HHS and its federal partners work to improve the trajectory of Alzheimer’s disease and related dementias (ADRD) research, support people living with dementia and their caregivers, and encourage action to reduce risk factors. The 2022 update includes several recent actions to address disparities in ADRD care and continues to advance actions to reduce risk factors for ADRD. Signed into law in 2011, the National Alzheimer’s Project Act charged the HHS Secretary with creating and annually updating a National Plan to Address Alzheimer’s Disease.
  • The Biden-Harris Administration released All In: The Federal Strategic Plan to Prevent and End Homelessness, which sets the goal of reducing homelessness by 25% by 2025 and aims to address racial and ethnic disparities in homelessness. According to the plan, individuals at increased risk of homelessness have fewer opportunities to access safe, affordable housing and health care and face more barriers to fulfilling these basic needs once they lose them. The United States Interagency Council on Homelessness (USICH) developed the plan as a blueprint for state and local governments to create their own plans to prevent and end homelessness. In 2023, USICH will develop implementation plans in collaboration with stakeholders and host public forums to help communities and partners use the roadmap.
Congressional Action
  • Late Monday evening (12/19/2022) the Senate released the anticipated omnibus spending package. The $1.7 trillion spending package proposes to fund the government for fiscal year 2023. It will first be considered in the Senate then in the House. The package represents the culmination of bipartisan negotiations and is thus expected to pass, despite vocal opposition from a small number of Republicans. Click here to access Healthsperien’s comprehensive summary of relevant provisions included in the package. Healthsperien will provide further updates as they become available.
  • Last week, the Medicare Payment Advisory Commission (MedPAC) held its December public meeting to discuss a number of issues related to Medicare payment policy. Healthsperien was there to cover the December MedPAC meetings. Click here to access Healthsperien’s comprehensive summary.
  • On Monday, 25 governors sent a letter to President Joe Biden asking for the end of the COVID-19 Public Health Emergency (PHE) in April. The letter claims the PHE negatively affects states, primarily by growing the Medicaid population, which costs states hundreds of millions of dollars. Under the Families First Coronavirus Response Act (FFCRA – passed in 2020), Congress authorized a 6.2% increase in the Federal Medical Assistance Percentage (FMAP) to state Medicaid programs in return for maintenance of effort (MOE) requirements that ensure continuous coverage for current enrollees through the end of the PHE. Late Monday evening, the Senate released the anticipated omnibus spending package, which includes a proposal to decouple the increased FMAP amounts and MOE requirements from the PHE. In the letter, the governors also ask President Biden to provide advanced notice of the Administration’s intentions to either end or extend the PHE to allow them to adequately plan for the future.
  • The Center for Medicaid and CHIP Services (CMCS) released a report summarizing the responses it received to this year’s Medicaid Access RFI. The RFI, which was released in February and had a comment period that closed in April, focused on three main areas: (1) coverage and access, (2) equity, and (3) innovation and whole person care. A short summary of the findings is included here. The report states that the Centers for Medicare and Medicaid Services (CMS) received approximately 7,125 comments from 796 individual respondents. The report analyzed 5,150 of those comments amounting to 615 of the respondents. CMCS is planning to use these responses in its subsequent regulatory and sub-regulatory efforts.
  • The Medicaid and CHIP Payment and Access Commission (MACPAC) held its December policy meeting. The Commissioners discussed a number of issues related to Medicaid payment policy. Healthsperien was there to cover the December MACPAC meetings. Click here to access Healthsperien’s comprehensive summary.
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