Health Care Policy Update – Weekly Wrap-up and What’s Ahead – August 5, 2024


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

New Client Resources – Sirona Strategies has uploaded a summary of the CY 2025 Medicare Physician Fee Schedule and the Health Data, Technology and Interoperability (HTI-2) proposed rule under Client Resources. Please visit our Sirona Strategies website and use the password Sirona2024Resources.

What’s Ahead: This Week

Hearings and Markups – No notable hearings this week. Congress is not in session.

Notable Policy Events –
  • Monday, August 5
    • ATI Advisory, “Advancing Nursing Facility Quality of Care through Medicare-Medicaid Integration: Starting the Conversation with Opportunities and Practical Considerations for CMS and States.” Free, Virtual. Additional Information
    • Office of the National Coordinator for Health Information Technology (ONC), “Annual Report Workgroup.” Free, Virtual. Additional Information
  • Tuesday, August 6
    • Health Equity Community Collaborative (HECC), “HECC Community Gathering: Building Upon Our Movement.” Free, Virtual. Additional Information
    • National Association of Counties (NACo), “Building a Behavioral Health Continuum of Care: The Role of Rural Leaders and Behavioral Health Directors.” Free, Virtual. Additional Information
    • Office of the National Coordinator for Health Information Technology (ONC), “HTI-2 Proposed Rule Task Force 2024 Meeting – Group 1.” Free, Virtual. Additional Information
  • Wednesday, August 7
    • National Institute for Health Care Management (NIHCM) Foundation, “Meeting the Health Care Needs of an Aging Population.” Free, Virtual. Additional Information
    • Office of the National Coordinator for Health Information Technology (ONC), “HTI-2 Proposed Rule Task Force 2024 Meeting – Group 2.” Free, Virtual. Additional Information
  • Thursday, August 8
    • National Academies of Sciences, Engineering, and Medicine (NASEM), “Expanding Behavioral Health Care Workforce Participation In Medicare, Medicaid, And Marketplace Plans: Public Report Release Webinar.” Free, Virtual. Additional Information
    • Office of the National Coordinator for Health Information Technology (ONC), “HTI-2 Proposed Rule Task Force 2024 Meeting – Group 3.” Free, Virtual. Additional Information

Weekly Wrap-Up: Notable Health Care Developments from Last Week

Medicare  –

  • On July 29, CMS released 2025 Medicare Part D bid information and announced a voluntary premium stabilization demonstration. Fact Sheet Press Release
  • On July 30, CMS issued the Fiscal Year (FY) 2025 Hospice Payment Rate Update final rule, which summarizes public comments received on the request for information regarding potential social determinants of health (SDOH) elements and provides updates on health equity, future quality measures (QMs), and public reporting requirements. Fact Sheet Final Rule
  • On July 31, CMS released the latest enrollment figures for Medicare. As of April 2024, 33,384,860 people are enrolled in Medicare FFS and 33,906,940 are enrolled in Medicare Advantage or other health plans. Medicare Enrollment Data
  • Also on July 31, CMS issued the FY 2025 Medicare Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Quality Reporting (IPFQR) Updates final rule. Policies included in this final rule support the provision of high-quality behavioral health treatment in inpatient psychiatric facilities. Fact Sheet Final Rule
  • Also on July 31, CMS issued the FY 2025 Inpatient Rehabilitation Facility Prospective Payment System final rule, which finalized the update to the IRF PPS payment rates by 3.0% based on the final IRF market basket update of 3.5%, less a 0.5 percentage point productivity adjustment. Fact Sheet Final Rule
  • Also on July 31, CMS issued the FY 2025 Skilled Nursing Facility Prospective Payment System final rule, which provides a net increase of 4.2%, or approximately $1.4 billion, in Medicare Part A payments to SNFs in FY 2025. Fact Sheet Final Rule
  • On August 1, Reps. Beatty (D-OH), Kelly (D-IL), and 28 Democrats sent a letter to CMS to designate self-measured blood pressure (SMBP) monitoring devices as durable medical equipment (DME) under Medicare. Letter Press Release
  • Also on August 1, CMS issued the fiscal year (FY) 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS)final rule. Fact Sheet Final Rule Press Release

Medicaid – 

  • On July 31, CMS released the latest enrollment figures for Medicaid. As of April 2024, 81,696,742 people are enrolled in Medicaid and CHIP. Medicaid Enrollment Data
  • On August 1, CMS announced that California submitted an addendum to its pending BH-CONNECT proposal to further expand the care continuum for Medi-Cal members with complex behavioral health issues and risk factors. The comment period is open through August 31. Pending Application Submit Comments

Payment & Delivery System Models – On August 1, the CMS Innovation Center finalized the Transforming Episode Accountability Model (TEAM) model, which would test a new mandatory episode-based model focused on coronary artery bypass graft (CABG), lower extremity joint replacement (LEJR), major bowel procedure, surgical hip/femur fracture treatment (SHFFT), and spinal fusion. Fact Sheet FAQs TEAM Webpage Press Release

Health IT, Privacy, & Digital Health – 

  • On August 1, FDA announced the members of its Digital Health Advisory Committee. The Committee will focus on generative AI as its first topic. Digital Health Advisory Committee Roster
  • Also on August 1, GAO published a report on the Veterans Health Administration’s telehealth program. Report
  • Also on August 1, HHS announced a civil monetary penalty against a provider of emergency medical services’ failure to provide a patient with timely access to their medical records. Press Release Notice
  • On August 2, CDC released data on the percentage of adult day services centers that use telehealth. Data
Mental Health & Substance Use Disorder – 
  • On July 30, the Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of the 2023 National Survey on Drug Use and Health. Press Release Report
  • On August 1, House Education and the Workforce Committee Chairwoman Foxx (R-NC) sent a letter to the Departments of Health and Human Services, Labor, and Treasury around the Tri-Agencies’ mental health parity rule. Letter Mental Health Parity Proposed Rule Press Release

Prescription Drugs & Health Innovation – On August 1, FDA released online resource on information about reprocessing single-use medical devices for health care facilities. Online Resource FAQ

Health Systems & Health Care Workforce – On August 1, GAO issued a report on the expanded use of supplemental nurses during the COVID-19 pandemic. Report

Legislative Activity –

Votes and Committee Activity – 

  • On July 30, the Senate passed the National Alzheimer’s Project Act (NAPA) Reauthorization (S. 133), as amended, by voice vote. The bill would reauthorize NAPA through 2035 and modernize the legislation to reflect new understandings of the disease. The bill now heads to the House for consideration. Bill Text Press Release
  • Also on July 30, the Senate passed the Alzheimer’s Accountability and Investment Act (AAIA) (S. 134) by unanimous consent. The bill would require an annual budget estimate for the initiatives of the National Institutes of Health (NIH) pursuant to reports and recommendations made under the National Alzheimer’s Project Act. The bill now heads to the House for consideration. Bill Text Press Release
  • On August 1, the Senate Appropriations Committee advanced the Fiscal Year (FY) 2025 Labor, Health and Human Services, Education, and Related Agencies Appropriations Act by a vote of 25-3. The bill would make appropriations for the Departments of Labor, Health and Human Services, Education, and related agencies for FY 2025. Bill Report Bill Summary Bill Text Press Release

Introduced Legislation  –

  • On July 30, Reps. Jayapal (D-WA) and Larsen (D-WA) introduced the Workforce Opportunities for Communities in Recovery Act (H.R. 9209), which would expand workforce opportunities for communities facing substance use disorders. Sen. Markey (D-MA) introduced companion legislation (S. 4807) in the Senate. Bill Text Press Release
  • Also on July 30, Sen. King (I-ME) introduced the Primary and Behavioral Healthcare Access Act (S. 4835), which would require group health plans and health insurance issuers offering group or individual health insurance coverage to provide for three primary care visits and three behavioral health care visits without applying any cost-sharing requirements. Reps. Underwood (D-IL), Schrier (D-WA), and Porter (D-CA) introduced companion legislation in the House (H.R. 9133) on July 25. Press Release
  • Also on July 30, Sens. Booker (D-NJ) and Sanders (I-VT) introduced the Prescription Drug Affordability and Access Act (S. 4845), which would create an executive agency within HHS tasked with reviewing drug prices and determining appropriate list prices. Bill Text Press Release
  • On July 31, Sens. Durbin (D-IL) and Cassidy (R-LA) introduced the Reforming Evergreening and Manipulation that Extends Drug Years (REMEDY) Act (S. 4878), which would remove barriers to FDA approval for lower-cost generic drugs. Press Release
  • On August 1, Sens. Casey (D-PA) and Young (R-IN) introduced the Informing Grandfamilies Act (S. 4923), which would require states to provide information about available benefits and services to kinship caregivers. One-Pager Press Release
  • Also on August 1, Sens. Boozman (R-AR), Welch (D-VT), Tillis (R-NC), King (I-ME), Marshall (R-KS), and Shaheen (D-NH) introduced the Physician Fee Stabilization Act (S. 4935), which would update the budget neutrality threshold under the Medicare physician fee schedule. Press Release
  • Also on August 1, Sen. Blumenthal (D-CT) introduced the Compassionate Care Act (S. 4949), which would promote advanced care planning and end-of-life care. Rep. Barragán (D-CA) introduced companion legislation in the House (H.R. 9237) on August 2. Bill Text One-Pager Press Release
  • Also on August 1, Sens. Wyden (D-OR), Blackburn (R-TN), and Lujan (D-NM) introduced the Health Care Workforce Innovation Act (S. 4957), which would provide for a health care workforce innovation program. Bill Text One-Pager Press Release
  • Also on August 1, Sen. Wyden (D-OR) introduced the Restoring Congressional Authority Act (S.4987), which would codify Chevron deference. Press Release