On The Hill

Health Update (August 3rd)

Aug 7, 2018 | SHARE  
The House may be out of session this month, but that has not stopped the Senate from plowing forward with legislative activity this month. This week, the upper chamber passed a “minibus,” a four bill package that addressed funding for the Departments of the Interior, Agriculture, Transportation, and Housing and Urban Development. Senate Appropriations Chairman Richard Shelby (R-AL) said that a similar strategy may be employed to combine funding for the Departments of Defense and Labor, Health and Human Services, and Education. The Senate will be out of session next week, but a debate on the package could occur the week of August 13th. The Departments of Defense and Labor/HHS/Education represent the two largest of the 12 annual spending bills.

CMS News

Wisconsin became the first state to get a 1332 waiver approved this year. On Sunday, the Centers for Medicare and Medicaid Services approved Wisconsin’s request to create a reinsurance program, which will take effect in 2019 and is estimated to lower premiums over 10% from what they would have been otherwise. The federal government will redirect $166 million in insurance subsidies to fund the reinsurance program, while the state will likely cover the remaining $34 million. CMS approved a similar request from Maine on Monday. Maine had a reinsurance program in 2012 and 2013 but suspended it due to the Affordable Care Act (ACA) in 2014. Last year, CMS approved 1332 waivers from Alaska, Oregon, and Minnesota. New Jersey and Maryland currently have waiver requests pending.

CMS also released a final rule this week aimed at expanding the availability of short-term health plans. Critics of the plan say this is President Trump’s latest attempt at undermining the ACA. The rule will allow individuals to sign up for short-term plans lasting up to a year and renew coverage for up to 36 months. The full final rule from CMS can be read here.

Hearings

Last week, the House Energy and Commerce Health Subcommittee held a hearing to receive updates from physicians on the Merit-based Incentive Payment System (MIPS). As MIPS is set to go into full effect at the start of next year, members requested feedback from a panel of doctors and physicians on their experiences with MACRA and MIPS as our health care system transitions to a value-based system instead of a volume-based system. Generally, doctors believed that the system represents an improvement over the Sustainable Growth Rate, but offered suggestions on ways to further incentivize the model for doctors who are currently not participating.

On Tuesday, the Senate HELP committee held a full committee hearing to discuss approaches to reduce healthcare costs by decreasing administrative spending with President and CEO of Alaska State Hospital and Nursing Home Association Becky Hultberg, President and CEO of America’s Health Insurance Plans Matt Eyles, Harvard College Professor of Economics Dr. David M. Cutler, and Advisor to the American Action Forum Dr. Robert A. Book. The hearing focused on evaluating various methods to reduce administrative costs, specifically concentrating on expanding interoperability, simplifying operations, and standardizing pre-authorization requirements as potential solutions.

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