On Friday, the Departments of Labor, Health and Human Services (HHS), and Treasury released Frequently Asked Questions (FAQ) announcing enforcement discretion, on a case-by-case basis, for the new cost-sharing disclosure requirements – applicable to most group health plans and issuers of group or individual health insurance – that went into effect on January 1, 2024.   Additional Details about Enforcement… (Llamas, February 5, 2024) #Transparency

The Department of Health and Human Services (HHS) Office of the National Coordinator for Health IT (ONC) announced a partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) to launch a new behavioral health information technology (IT) initiative. ONC and SAMHSA will work together to invest more than $20 million over three years to support the HHS Roadmap for Behavioral Health Integration to… (McClurg, February 5, 2024) #Health Information Technology, #Mental and Behavioral Health

The Department of Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) issued a final rule to modify regulations regarding medications for the treatment of opioid use disorder. The Administration also released a 2023 list of accomplishments highlighting HHS’ work to implement prevention, treatment, harm reduction, and recovery activity under the Overdose Prevention Strategy and combat… (Marceno, February 1, 2024) #Mental and Behavioral Health, #Opioids

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced a $28 million notice of funding opportunity for two grant programs aimed at expanding substance use disorder (SUD) treatment services among pregnant and postpartum women and through adult and family treatment drug courts. This funding supports the U.S. Department of Health and Human Services (HHS) efforts to advance its Overdose Prevention… (Marceno, February 2, 2024) #Mental and Behavioral Health, #Opioids, #Prevention

The House Energy & Commerce (E&C) Health Subcommittee convened a hearing to discuss additional solutions, beyond the House-passed Lower Costs, More Transparency (LCMT) Act (H.R. 5378), to constrain health care costs (hearing memo). Both parties touted the price transparency provisions of the LCMT Act, ramping up pressure on the Senate to consider the bipartisan bill. Members signaled a bipartisan appetite… (Llamas, Eisen, February 1, 2024) #Costs

The Biden-Harris Administration, through the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), announced it has initiated the first cycle of the Medicare Drug Price Negotiation Program. This program, established by the Inflation Reduction Act (IRA), empowers Medicare to directly negotiate prescription drug prices with pharmaceutical companies, similar to other federal agencies. The initial… (Colocho, February 1, 2024) #Costs, #Drug Pricing, #Public Health, #Transparency

The Centers for Medicare and Medicaid Services (CMS) announced the Advance Notice of Methodological Changes for Contract Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (press release, fact sheet and FAQs) What it is. The Advance Notice addresses a wide array of MA and Part D-related policies and includes the estimated… (Slifer, January 31, 2024) #Medicare Advantage, #Medicare Part D, #Prescription Drugs, #Quality, #Risk Adjustment, #Risk Corridors

The Department of Health and Human Services (HHS) announced a series of actions to address the surging syphilis epidemic, reaching its highest levels since the 1950s. With 207,255 reported cases in 2022, an 80 percent increase since 2018, and over 3,700 cases of congenital syphilis according to a new Centers for Disease Control and Prevention (CDC) report, HHS is focusing on targeted measures to… (Colocho, January 31, 2024) #Care Coordination, #Health Equity, #Prevention, #Public Health

On Monday, CMS released an FAQs regarding the implementation of 12-month postpartum Medicaid coverage.  The document includes details regarding what constitutes full benefits during the 12-month extended postpartum eligibility period, defines enhanced pregnancy-related services, outlines the mandatory tobacco cessation benefit for pregnant persons, and clarifies when a state plan amendment (SPA) is needed to amend coverage.   Of note, Texas… (Joyce, January 30, 2024) #Health Equity, #Prevention, #Primary Care, #Public Health, #Women’s Health

The Center for Medicare and Medicaid Innovation (CMMI) officially announced the Cell and Gene Therapy (CGT) Access Model, with sickle cell disease as the initial focus of the model (fact sheet, FAQs) The model is pursuant to President Biden’s executive order entitled “Lowering Prescription Drug Costs for Americans and, subsequently, CMMI’s February 2023 report detailing three potential models to be… (Slifer, January 30, 2024) #Demonstration Programs, #Drug Pricing, #Prescription Drugs