HealthCare Roundtable e-News – August 22, 2022

 

Top News

President Biden Signs Roundtable-Supported Inflation Reduction Act into Law

On Tuesday, President Biden signed the Inflation Reduction Act of 2022 into law. Before signing the law, President Biden said that the American people won. The package aims to make sweeping changes to major parts of the U.S. economy, investing about $300 billion in climate and energy priorities, limiting prescription drug prices, and imposing a new minimum tax on large corporations. The legislation is also projected to reduce the federal deficit. See the Roundtable’s response to the legislation here.

 

Labor, HHS, and Treasury Issue Final Rules to Clarify Federal Process for No Surprise Act (NSA)

The Departments of Labor, Health and Human Services (HHS), and the Treasury issued final rules concerning standards related to the arbitration process implementing the No Surprises Act (NSA). The bipartisan law, which went into effect this past January, protects consumers against surprise medical bills. The final rules will make certain medical claims payment processes more transparent for providers and clarify the process for providers and health insurances companies to resolve their disputes. The update addresses certain provisions of the July 2021 and October 2021 interim final rules that are relevant to the operation of the federal IDR process and revise certain provisions in light of two recent federal court cases. The departments are issuing Frequently Asked Questions Part 55 with guidance on implementing the requirements of the NSA. Click here to view a fact sheet of the final rule.

 

CMS Releases Guidance on Plan for Blanket Waivers Associated with COVID-19 PHE

CMS released guidance outlining their plan to terminate many of the blanket waivers associated with the COVID-19 Public Health Emergency (PHE). Excluding certain telehealth and Medicare appeals flexibilities, all other COVID-19 blanket waivers that were not previously made permanent will terminate at the end of the PHE. Providers will again be expected to follow existing regulatory requirements and processes. To help providers prepare for this transition, CMS has developed fact sheets noting previously ended waivers, those that have been made permanent, and those that will end with the PHE.

Administrative Action

  • CDC Director Rochelle Walensky announced that the agency is launching an overhaul of its structure and operations in an attempt to modernize the agency and rehabilitate its reputation follow the criticism from the COVID-19 pandemic. CDC Director Rochelle Walensky laid out a series of changes with CDC leadership and staff designed to transform the organization and its work culture by improving how the agency shares information, develops public health guidance, and communicates with the public.

  • CMS released guidance outlining their plan to terminate many of the blanket waivers associated with the COVID-19 Public Health Emergency (PHE). Excluding certain telehealth and Medicare appeals flexibilities, all other COVID-19 blanket waivers that were not previously made permanent will terminate at the end of the PHE. Providers will again be expected to follow existing regulatory requirements and processes. To help providers prepare for this transition, CMS has developed fact sheets noting previously ended waivers, those that have been made permanent, and those that will end with the PHE.

Congressional Action

Last week, Sen. Angus King (I-ME) and Rep. Mike Gallagher (R-WI) sent a letter to Secretary Becerra urging for stronger collective action against the increasing number of cyberattacks on the health sector. Sen. King and Rep. Gallagher are co-chairs of the Cyberspace Solarium Commission, and asked for a briefing on the status of the agency’s cybersecurity capabilities. Though pleased with recent administrative action to address the security threat, Sen. King and Rep. Gallagher noted the lack of robust and timely sharing of actionable threat information with industry partners and the need to dramatically scale up the Food and Drug Administration’s (FDA) Department of Critical Infrastructure Protection Division.

Regulatory Action

The Food and Drug Administration (FDA) issued a final rule to allow for a category of over-the-counter (OTC) hearing aids. The rule is expected to improve access to hearing aids for the nearly 30 million American adults with mild to moderate hearing impairment. Last month, President Biden issued an Executive Order on Promoting Competition in the American Economy, which called on the FDA to allow hearing aids to be sold OTC within 120 days. In 2017, Congress passed bipartisan legislation requiring the FDA to create a category for OTC hearing aids. The devices could hit shelves in retail and drug stores as soon as mid-October when the rule takes effect.

Medicaid

  • The U.S. Department of Health and Human Services (HHS), approved the extension of Medicaid and CHIP coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. This extension will allow for up to 34,000 individuals to qualify for Medicaid and CHIP coverage for a full year after pregnancy. In combination with previously approved waiver extensions, an estimated 318,000 Americans annually in 21 states and D.C. are now eligible for 12 months of postpartum coverage under Medicaid and CHIP.

  • A coalition of transgender-rights organizations is preparing to sue Florida to stop the state’s Medicaid regulator from banning coverage of gender-affirming treatments. Florida’s Medicaid regulator, the Agency for Health Care Administration, finalized rules last week and goes into effect on Sunday that prohibit Medicaid from covering treatments such as puberty blockers, hormone therapies, or surgical procedures for gender dysphoria. Experts say, the ban will affect up to 9,000 of the state’s Medicaid enrollees who are transgender. Currently nine other states ban Medicaid from covering gender-affirming care.

  • The Centers for Medicare and Medicaid Services (CMS) released a notice of proposed rulemaking (NPRM) to promote consistent use of nationally standardized quality measures in Medicaid and the Children’s Health Insurance Program (CHIP). The Core sets are designed to measure the overall national quality of care for beneficiaries, monitor performance at the state level, and improve the quality of health care. CMS is providing a 60-day comment period for the NPRM accepting comments no later than October 21, 2022.

  • The Kaiser Family Foundation (KFF) released an article on how the fate of Medicaid expansion and filling the coverage gap may depend on the outcome of state elections. The report notes that expansion is likely to be a major issue in several upcoming state elections. In the 12 states that have not adopted Medicaid expansion, all but two (NC and MS) have upcoming gubernatorial elections in November 2022. States where Medicaid expansion could be an issue in the election — and where the gubernatorial election is considered a toss-up — include Georgia, Kansas, and Wisconsin.

Marketplace

A health care company must pay $100 million to the Federal Trade Commission to refund consumers who were lured into a non-ACA compliant “sham” health care plans by agents and brokers who used deceptive marketing techniques. FTC’s action comes after numerous lawmakers, state regulators, and other stakeholders have been highlighting the proliferation of insurance products that are not required to adhere to the ACA’s consumer protections, like coverage of preexisting conditions, out-of-pocket spending caps, and annual limits, as well as marketing practices used by some agents and brokers to steer consumers into non-ACA compliant products like short-term plans, limited benefit plans or health sharing ministries.

Roundtable Reminders

SAVE THE DATE – November 9-11, 2022
Annual Conference Returns to Alexandria, VA

After two years of virtual meetings, the Roundtable is planning an in-person Annual Conference for this November. We will return to The Alexandrian Hotel in Old Town Alexandria, Virginia for our annual policy conference from Wednesday, November 9 to Friday, November 11, 2022.

Details will be released later this year. For now, save the dates!