Health Care Policy Update – Weekly Wrap-up and What’s Ahead – April 1, 2024


When is Congress in session? House 2024 Calendar Senate 2024 Calendar

What’s Ahead: This Week
Hearings and Markups – 
  • Wednesday, April 3
    • Senate HELP Committee, Subcommittee on Primary Health and Retirement Security, “Field Hearing: When Health Care Becomes Wealth Care: How Corporate Greed Puts Patient Care and Health Workers at Risk.” Additional Information
Notable Policy Events – 
  • Tuesday, April 2
    • Health Information Technology Advisory Committee (HITAC), “Interoperability Standards Workgroup.” Free, Virtual. Additional Information
  • Wednesday, April 3
    • KFF, “Primary Care Check Up: Why It Can Be Hard to Get an Appointment and How to Fix It.” Free, Virtual. Additional Information
    • Health Affairs, “Briefing: Perinatal Mental Health & Well-Being.” Free, Virtual. Additional Information
    • Civitas Networks for Health, Gravity Project, & HealthBegins, “Coding and Co-design: Social Care and Health Care Lessons.” Free, Virtual. Additional Information
    • Healthcare Information and Management Systems Society (HIMSS), “Healthcare Special Topics: Generative AI in Healthcare.” Paid, Virtual. Additional Information
    • Partnership to Align Social Care, “New Resource and Webinar on Community Health Integration and Principal Illness Navigation Medicare Codes.” Free, Virtual. Additional Information
  • Thursday, April 4 to Friday, April 5
    • National Academies of Sciences, Engineering, and Medicine (NASEM), “Health Disparities in the Medical Record and Disability Determinations: A Workshop.” Free, Virtual/In-Person. Additional Information
    • NASEM, “Blueprint for a National Prevention Infrastructure for Behavioral Health Disorders: Meeting 3.” Free, Virtual/In-Person. Additional Information
  • Thursday, April 4
    • Association of State and Territorial Health Officials (ASTHO), “TEFCA Overview and Perspectives from the Field.” Free, Virtual. Additional Information
    • The Atlantic, “The Atlantic’s Health Summit.” Free, In-Person/Virtual. Additional Information
    • CMS, “Accountable Care Organization Primary Care Flex Model (ACO PC Flex Model) Overview Webinar.” Free, Virtual. Additional Information
    • CMS, “Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model Office Hour Webinar for Calendar Year (CY) 2025.” Free, Virtual. Additional Information
    • Duke-Margolis Health Policy Center, “Strengthening Whole-Person Specialty Care Through Accountable Care Innovation.” Free, Virtual. Additional Information
    • National Association of County and City Health Officials (NACCHO), “ICI: Setting the (Public Health) World on FHIR.” Free, Virtual. Additional Information
  • Friday, April 5
Weekly Wrap-Up: Notable Health Care Developments from Last Week
Medicare –
  • On March 25, Rep. Langworthy (R-NY) led nine House Republicans in a letter to CMS Administrator Brooks-LaSure urging the Administrator to ensure the 2025 Medicare Advantage (MA) Final Rate Notice accurately reflects increase in health care utilization and costs. Letter Press Release
  • On March 26, Rep. Buchanan (R-FL) led 19 Representatives in a bipartisan letter to HHS Secretary Becerra and CMS Administrator Brooks-LaSure urging them to ensure the 2025 MA Final Rate Notice accurately reflects growth rates and health care cost increases. Letter Press Release
  • Also on March 26, HHS announced 41 drugs available through Medicare Part B will have a lowered Part B coinsurance rate from April 1 to June 30, 2024, if the companies comply with the Inflation Reduction Act. Medicare Prescription Drug Inflation Rebate Program Press Release
  • On March 27, CMS issued the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) proposed rule, which would update the prospective payment rates for IRFs for fiscal year (FY) 2025. Comments are due May 28. Fact Sheet Proposed Rule
  • On March 28, CMS issued the FY 2025 Skilled Nursing Facility (SNF) PPS proposed rule, which proposes changes and updates to the policies and payment rates used under the SNF PPS for FY 2025, including several technical revisions to the code mappings used to classify patients under the Patient Driven Payment Model (PDPM) to improve payment and coding accuracy. Comments are due May 28. Fact Sheet Proposed Rule
  • Also on March 28, CMS issued the FY 2025 Inpatient Psychiatric Facilities (IPF) PPS proposed rule, which proposes annual updates to the prospective payment rates, including an update to the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPF), which include psychiatric hospitals and excluded psychiatric units of an acute care hospital or critical access hospital. Comments are due May 28. Fact Sheet Proposed Rule
  • Also on March 28, CMS issued the FY 2025 Hospice Payment Rate Update proposed rule, which would update Medicare hospice payments and the aggregate cap amount for FY 2025 in accordance with existing statutory and regulatory requirements. Comments are due May 28. Fact Sheet Proposed Rule
Medicaid –
  • On March 26, CMS approved an extension to the Alaska section 1115 demonstration, which allow Alaska to receive federal financial participation for providing clinically appropriate substance use disorder treatment services for short-term residents in residential and inpatient treatment settings that qualify as an institution for mental diseases. Application  Announcement
  • On March 27, CMS issued the Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes final rule, which would simplify the eligibility and enrollment processes for Medicaid, CHIP, and the Basic Health Program (BHP). Fact Sheet Final Rule Press Release
  • Also on March 27, HHS released an issue brief estimating children’s average monthly gains in Medicaid and CHIP eligibility under a federal 12-month continuous eligibility (CE) requirement. Issue Brief Press Release
  • Also on March 27, CMS announced that Georgia submitted an amendment to provide the state with authority to permit legally responsible individuals (including legally responsible family caregivers) to be reimbursed for the provision of medically necessary personal care services to medically fragile children under age 21 enrolled in the Georgia Pediatric Program (GAPP). The federal comment period is open through April 26, 2024. Comments  Pending Application
  • On March 28, CMS released the latest enrollment figures for Medicare, Medicaid and CHIP. As of December 2023, 66,874,253 people are enrolled in Medicare and 85,094,448 people are enrolled in Medicaid and CHIP. Enrollment Figures
  • Also on March 28, CMS announced an extension of the temporary special enrollment period (SEP) to help people who are no longer eligible for Medicaid or CHIP transition to Marketplace coverage in states using HealthCare.gov. CMS also released guidance and other resources. Guidance on Unwinding Process Guidance to Medicaid Managed Care Plans Press Release Resources for Partners Tools for States
  • Also on March 28, the HHS Office of Inspector General (OIG) released a report, which found that selected state contracts with Medicaid MCOs did not contain required parity provisions by the compliance date. Report
  • On March 29, CMS announced Florida submitted a request for a new demonstration, which would increase access to KidCare, the state’s CHIP, by raising the income eligibility threshold from 200 percent to 300 percent of the federal poverty level. The federal public comment period is open through April 28, 2024. Comments Pending Application
  • Also on March 29, CMS approved Idaho’s behavioral health amendment to reimburse legally responsible individuals (LRIs) for providing personal care services (PCS), typically provided by direct care workers in the home. Amendment
Marketplaces – 
  • On March 28, HHS, the Internal Revenue Service (IRS), and the Employee Benefits Security Administration (EBSA) released the Short-Term, Limited-Duration Insurance (STLDI) and Independent, Noncoordinated Excepted Benefits Coverage final rule, which amends the definition of STLDI and regulations regarding the requirements for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit in the group and individual health insurance markets. Final Rule Press Release STLDI Fact Sheet
  • Also on March 28, Senate HELP Committee Ranking Member Cassidy (R-LA) issued a statement rebuking the STLDI final rule. Press Release

Health IT, Privacy, & Digital Health – 

  • On March 25, Senate Homeland Security Committee Security Chair Peters (D-MI) sent a letter to HHS Secretary Becerra and Cybersecurity and Infrastructure Security Agency (CISA) Director Easterly urging the agencies to prioritize cybersecurity improvements and protect Americans from cyberattacks in the health care sector. Letter Press Release
  • Also on March 25, House Oversight and Accountability Committee Ranking Member Raskin (D-MD) sent a letter to UnitedHealth Group requesting a briefing and information on the Change Healthcare cyberattack and subsequent system outages starting in February 2024. Letter Press Release
  • On March 26 New Democrat Coalition Artificial Intelligence Working Group Vice Chair Stevens (D-MI) and Chair Kilmer (D-WA) led 38 members in a letter to the White House Office of Science and Technology Policy (OSTP) in support of President Biden’s Executive Order (EO) on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. The letter also requests more information on the progress of the priorities outlined in the EO. Executive Order Letter Press Release
  • Also on March 26, the HHS Office of Inspector General (OIG) published a Cybersecurity Toolkit, which provides guidance on how to improve or maintain effective cybersecurity posture of HHS IT systems. Cybersecurity Toolkit
  • On March 27, ONC released its draft 2024–2030 Federal Health IT Strategic Plan for public comment. The Strategic Plan guides federal government efforts toward electronic health information (EHI) access, exchange, and use. Comments are due May 28. Draft Strategy Plan Press Release
  • Also on March 27, the Department of Homeland Security released a proposed rule, which would require the Cybersecurity and Infrastructure Security Agency (CISA) to promulgate regulations implementing the statute’s covered cyber incident and ransom payment reporting requirements for covered entities. Comments are due June 3. Proposed Rule
  • On March 28, the Office of Management and Budget (OMB) released government-wide guidance to mitigate risks of artificial intelligence (AI). Additionally, OMB released a request for information (RFI) on responsible procurement of AI in government. Comments are due April 29, 2024. Notice Press Release

Mental Health and Substance Use Disorder Policy – On March 26, Sen. Markey (D-MA) and Rep. Courtney (D-CT) sent a letter to HHS Secretary Becerra urging him to further strengthen disability nondiscrimination protections to ensure people with disabilities have equitable access to substance use disorder (SUD) and mental health treatment facilities. Letter Press Release Proposed Rule

Prescription Drugs & Health Innovation – On March 27, Senate HELP Committee Chair Sanders (I-VT) issued a statement, calling on Novo Nordisk to lower the list price of Ozempic following the release of a Yale study, which found that the diabetes and weight-loss drug could be profitably produced for less than $5 a month. Press Release Study

SDOH & Health Equity–
  • On March 27, GAO issued a report on strengthening HHS’ Healthy Start program, which aims to reduce infant death rates, improve maternal health, and reduce racial and ethnic disparities in health outcomes. The report recommends that HHS implement documented processes to 1.) review Healthy Start performance measures to ensure they are clear and allow for the collection of reliable data, and 2.) coordinate the selection of performance measures across Healthy Start and related programs. One-Pager Press Release Report
  • On March 28, OMB published a set of revisions to Statistical Policy Directive No. 15 (Directive No. 15): Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, which makes key revisions to questions used to collect information on race and ethnicity. ​​History of Statistical Policy Directive No. 15 Notice
  • On March 27, GAO issued a report on strengthening HHS’ Healthy Start program, which aims to reduce infant death rates, improve maternal health, and reduce racial and ethnic disparities in health outcomes. The report recommends that HHS implement documented processes to 1.) review Healthy Start performance measures to ensure they are clear and allow for the collection of reliable data, and 2.) coordinate the selection of performance measures across Healthy Start and related programs. One-Pager Press Release Report
  • On March 28, OMB published a set of revisions to Statistical Policy Directive No. 15 (Directive No. 15): Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, which makes key revisions to questions used to collect information on race and ethnicity. ​​History of Statistical Policy Directive No. 15 Notice

Health Systems & Health Care Workforce – 

  • On March 25, GAO released a report on its clinical research inspection workforce. GAO recommended that FDA evaluate its recruitment and retention efforts to determine their effectiveness and ensure it is using the most appropriate tools to maintain its investigator workforce. One-Pager Report Press Release
  • On March 26, Senate HELP Committee, Subcommittee on Primary Health and Retirement Security Chair Markey (D-MA) and Sen. Warren (D-MA) sent a letter to Steward Health CEO de la Torre urging him to testify at the April 3 subcommittee hearing, which will examine the impact of for-profit companies on health care access. Letter Press Release
  • On March 29, the Health Resources and Services Administration (HRSA) convened leaders from over 25 nursing and health care organizations for a roundtable discussion on the findings of the National Sample Survey of Registered Nurses, the first comprehensive federal survey of nurses since the onset of the COVID-19 pandemic in the United States. Survey Readout

Miscellaneous – On March 28, 258 members of Congress submitted an amicus brief to the U.S. Supreme Court, urging the Supreme Court to affirm that the Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospitals to provide emergency stabilizing care including abortion care. Amicus Brief Press Release

Legislative Activity –
Introduced Legislation –
  • On March 26, Reps. Crockett (D-TX) and Goldman (D-NY) introduced the Abortion Care Awareness Act of 2024 (H.R. 7820), which would direct the Secretary of Health and Human Services to conduct a public health education, awareness, and outreach campaign to enhance access to abortion and related health services. Bill Text Press Release
  • Also on March 26, Reps. Valadao (R-CA), Buschon (R-IN), Smith (R-NE), and Brownley (D-CA) introduced the Supplemental Oxygen Access Reform (SOAR) Act (H.R. 7829), which would improve the payment method for oxygen and oxygen related equipment, supplies, and services, to increase beneficiary access to oxygen and oxygen related equipment, supplies, and services. Sens. Cassidy (R-LA), Warner (D-VA), and Klobuchar (D-MN) introduced the companion legislation in the Senate (S. 3821) on February 28. Bill Text Press Release
  • On March 29, Reps. Lieu (D-CA), Jacobs (D-CA), Ross (D-NC), Scholten (D-MI), and Frost (D-FL) introduced the Reproductive Data Privacy and Protection Act (H.R. 7841), which would ensure requests for data on individuals do not pertain to reproductive services. Bill Text Press Release