RECENT UPDATES
SFC Considers Dr. Oz for CMS Administrator; Dr. Oz Avoids Taking a Stance on Medicaid Cuts and Pledges to Use Technology, Lifestyle Interventions, and MA Regulation to Make Health Care More Efficient
The Senate Finance Committee (SFC) convened a hearing to consider the nomination of Dr. Mehmet Oz to serve as Administrator of the Centers for Medicare and Medicaid Services (CMS). Democrats largely focused on the potential impact of Medicaid cuts through reconciliation. Dr. Oz admitted that he is not familiar with the details of the proposal and avoided taking a stance on Medicaid aside… (McClurg, March 17, 2025) #Drug Pricing, #Health Information Technology, #Medicare Advantage, #Program Integrity, #Rural Health, #Telehealth
Commission Releases March 2025 Report to Congress with Recommendations for Payment Adequacy Updates, Removal of Freestanding IPF Limits
The Medicare Payment Advisory Commission (MedPAC) released its March 2025 Report to Congress. The first nine chapters review Medicare payment policy, payment adequacy indicators, and the Commission’s recommendations for updating 2026 payments across sectors of fee-for-service (FFS) Medicare. MedPAC recommends higher-than-current-law payment updates for acute care hospitals and physicians, and an update equal to current law for outpatient dialysis facilities…. (Testa, March 13, 2025) #Ambulatory Surgical Centers, #Cost-Sharing, #Costs, #Coverage Decisions, #Home Health, #Hospice, #Hospitals, #Inpatient Rehabilitation Facilities, #Medicare Advantage, #Medicare Part D, #Physicians, #Primary Care, #Quality, #Readmissions, #Risk Adjustment, #Skilled Nursing Facilities
MACPAC March 2025 Report to Congress Addresses External Quality Review in Managed Care Oversight and Improving Medicaid Home and Community-Based Services
The Medicaid and CHIP Payment and Access Commission (MACPAC) released its March 2025 Report to Congress, with (1) recommendations to improve the transparency and usability of external quality review findings in managed care oversight and accountability (2) using provisional plans of care in support of timely access to home and community-based services (HCBS); and (3) reducing administrative burden related to… (Marceno, March 13, 2025) #Coverage Decisions, #Home Health
Senate HELP Committee Advances FDA and NIH Nominees to Full Floor; White House Withdraws CDC Nomination
The Senate Health, Education, Labor & Pensions (HELP) Committee voted to advance Dr. Martin Makary for Commissioner of the Food and Drug Administration (FDA) and Dr. Jayanta Bhattacharya to serve as Director of the National Institutes of Health (NIH) sending their nominations to the full Senate for confirmation. Dr. Makary was approved in a 14-9 vote, with Democratic Senators Maggie… (Eisen, March 13, 2025) #COVID-19, #Food and Drug Administration, #National Institutes of Health, #Women’s Health, #Workforce
House Ways & Means Health Subcommittee Examines Challenges in Post-Acute Care; Highlights Bipartisan Concerns with Medicare Advantage
The House Ways & Means (W&M) Health Subcommittee convened a hearing to examine challenges in post-acute care access, particularly focusing on Medicare Advantage (MA) plans, Medicaid funding, and nursing home staffing standards. Lawmakers from both parties raised concerns about MA plans’ prior authorization practices and their impact on patient care. Democrats emphasized the risks of proposed Medicaid cuts and the importance… (Eisen, March 12, 2025) #Medicare Advantage, #Rural Health
CMS Innovation Center Cancels Eight Models Ahead of New Strategy Announcement
The Center for Medicare & Medicaid Innovation (CMMI) issued a statement announcing certain models will be canceled or end by December 31, 2025. The declaration was made after a review of the model portfolio by the Trump administration, which asserts that models must reduce spending in addition to maintaining or improving quality. The Biden administration sought to position improvements in quality… (Testa, March 12, 2025) #Care Coordination, #Costs, #Delivery Reform, #Demonstration Programs, #Generic Drugs, #Grants, #Primary Care, #Quality
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