Health Care Policy Update – Weekly Wrap-up and What’s Ahead – November 4, 2024

• Tuesday, November 5
  • HHS, “Food is Medicine (FIM) Webinar.” Free, Virtual. Additional Information
• Wednesday, November 6
  • HHS Assistant Secretary for Technology Policy (ASTP), “Health Equity by Design Task Force 2024.” Free, Virtual. Additional Information
• Thursday, November 7 to Friday, November 8
  • Medicare Payment Advisory Commission (MedPAC), “October Public Meeting.” Free, Virtual. Additional Information
• Thursday, November 7
  • Health Affairs, “Financial Integration of Medicare and Medicaid: Necessary But Not Sufficient.” Free, Virtual. Additional Information
  • HHS ASTP, “Health IT Advisory Committee.” Free, Virtual. Additional Information

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

Medicare & Medicaid –

• On October 29, CMS approved a five-year extension of Wisconsin’s “Wisconsin BadgerCare Reform” section 1115 demonstration, which covers out-of-state former foster care youth up to 26 years of age and non-pregnant, non-disabled, non-elderly childless adults with incomes of up to 100 percent of the federal poverty level (FPL). Announcement Approval Letter
• Also on October 29, Senate Finance Committee Chair Wyden (D-OR), House Ways & Means Committee Ranking Member Neal (D-MA) and House Energy & Commerce Committee Ranking Member Pallone (D-NJ) sent a letter to CMS expressing concerns about Medicare Advantage and prior authorization. Letter Press Release
• Also on October 29, CMS published an opinion piece in STAT News detailing the first round of Medicare drug price negotiations. Article
• On October 31, CMS released the latest enrollment figures for Medicare and Medicaid. As of July 2024, 33,507,888 people are enrolled in Medicare fee-for-service, 34,161,535 are enrolled in Medicare Advantage or other health plans, and 79,560,396 are enrolled in Medicaid and CHIP. Medicare Enrollment Data Medicaid Enrollment Data
• Also on October 31, CMS and the Consumer Financial Protection Bureau (CFPB) issued a joint statement detailing actions they are taking action to stop illegal billing of lowest-income Medicare recipients. Joint Statement Press Release
• On November 1, CMS published a notice, which would expedite review of Section 1115 Reentry Demonstration Opportunity applications and support state implementation planning. Notice
• Also on November 1, Sens. Hassan (D-NH) and Cassidy (R-LA) released a legislative framework to implement site-neutral Medicare payment policies in Medicare. Legislative Framework Press Release
• Also on November 1, CMS issued the Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Final Rule. The rule finalizes payment rates and policy changes effective January 1, 2025. Overall, the proposed CY 2025 PFS conversion factor is $32.35, a decrease of $0.94 (or 2.83 percent) from the current CY 2024 conversion factor of $33.29. Fact Sheet Final Rule Press Release
• Also on November 1, CMS issued the CY 2025 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center (ASC) Payment Systems Final Rule. The rule updates payment rates for hospital outpatient and ASC services for CY 2025 by 2.9 percent. Fact Sheet Press Release Final Rule
• Also on November 1, CMS released a public use file with Medicaid Medical Loss Ratio (MLR) data for CYs 2018 – 2020. Public Use FIle

Health IT, Privacy, & Digital Health – On October 29, ASTP issued a fact sheet on information blocking reminders related to application program interface (API) technology. Fact Sheet