Following the November 5th election, the Republicans are poised to have a “trifecta” and be in control of the White House, the Senate, and the House of Representatives.  When all votes are counted and certified the Republicans are expected to have a 53-47 majority in the Senate and a four seat or less majority in the House. This margin… (Lewis, November 18, 2024) #Affordable Care Act, #Budget, #Coverage Decisions, #Disproportionate Share Hospitals (DSH), #Food and Drug Administration, #Health Equity, #Health Insurance Exchanges, #Hospitals, #Medicare Advantage, #Mental and Behavioral Health, #Nutrition, #Pharmacy Benefit Managers, #Public Health, #Social Determinants of Health, #Tax, #Telehealth, #Transparency, #Workforce

Today, Chair of the Senate Committee on Agriculture, Nutrition & Forestry Debbie Stabenow (D-MI) introduced the Rural Prosperity and Food Security Act for Farm Bill reauthorization (press release; fact sheet; text). The legislation largely follows the framework Sen. Stabenow released in May (Impact summary), although the bill includes $39 billion in new funding. In addition to agricultural programs, the Farm Bill authorizes several important… (McClurg, November 18, 2024) #Nutrition, #Telehealth

The Drug Enforcement Agency (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) jointly issued a third temporary rule that extends the full set of COVID-19 telemedicine flexibilities for prescription of controlled medications through December 31, 2025. What is it. The agencies note that as the DEA and the Department of Health and Human Services (HHS) continue to… (Marceno, November 15, 2024) #Opioids, #Telehealth

The Congressional Research Service (CRS) released a detailed table on November 13 summarizing the expiring provisions of the Tax Cuts and Jobs Act of 2017 (TCJA). Many of these provisions, which impact individuals, families, and businesses, are scheduled to expire by the end of 2025. President-Elect Donald Trump has expressed support for extending all expiring provisions of the Tax Cuts and Jobs Act (TCJA),… (Joyce, Colocho, November 15, 2024) #Costs

The Medicare Payment Advisory Commission (MedPAC) held a meeting to discuss the participation bonus for clinicians in Advanced Alternative Payment Models (A-APMS). Clinicians who meet certain thresholds for payment and patients in an A-APM receive the bonus payment as an incentive for A-APM participation. The five percent bonus was originally intended to expire in performance year (PY) 2023, but was extended at 3.5 percent… (McClurg, November 8, 2024) #Demonstration Programs, #Insurance Reform, #Value-Based Insurance Design

The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss the issue of Medicare’s coverage limits for inpatient psychiatric care in freestanding inpatient psychiatric facilities (IPFs). MedPAC staff presented recent data that underscores the negative impact of these limits on Medicare beneficiaries, especially those with chronic and severe mental health conditions. Based on their analysis, MedPAC staff recommended eliminating… (Eisen, November 8, 2024) #Inpatient Rehabilitation Facilities, #Mental and Behavioral Health

The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss a policy option to update Medicare physician fee schedule (PFS) rates as well as an option to improve the accuracy of these rates. Principal Policy Analysts Brian O’Donnell and Geoff Gerhardt reviewed Commissioners’ primary concerns with the current fee schedule updates, specifically that Medicare Economic Index (MEI) growth is projected to exceed… (Testa, November 7, 2024) #Costs, #Physicians

The Medicare Payment Advisory Commission (MedPAC) convened a session on structural differences between the Part D standalone prescription drug plan (PDP) and the Medicare Advantage prescription drug plan (MA-PD) markets. In the presentation, Senior Analyst Tara Hayes and Principal Policy Analysts Shinobu Suzuki and Andy Johnson detailed how enrollment has shifted to MA-PDs and the stability of the PDP market… (Slifer, November 7, 2024) #Medicare Advantage, #Medicare Part D

The Centers for Medicare & Medicaid Services (CMS) released its calendar year (CY) 2025 end-stage renal disease (ESRD) prospective payment system (PPS) final rule (fact sheet). Details follow. What it is. This final rule outlines ESRD PPS payment policies applying to dialysis facilities beginning on or after Jan. 1, 2025. The rule also includes an update to acute kidney injury… (Marceno, November 5, 2024) #Coverage Decisions, #Drug Pricing, #End-Stage Renal Disease

The Medicaid and CHIP Payment and Access Commission (MACPAC) convened a session focused on the challenges of transitions of care for children and youth with special health care needs (CYSHCN) as they move from pediatric to adult health care services. The presentation included insights from a recent study involving stakeholder interviews and beneficiary focus groups, building on findings from earlier… (Colocho, November 4, 2024) #Care Coordination, #Insurance Coverage, #Pediatrics