Agency CBO Releases Preliminary Results on the Potential Impact of Climate Change on Medicare Beneficiaries

Agency CBO Releases Preliminary Results on the Potential Impact of Climate Change on Medicare Beneficiaries

The Congressional Budget Office (CBO) released preliminary results of the potential impact of climate change on health and federal health care expenditure, with a specific focus on Medicare beneficiaries. Climate change is anticipated to disrupt average temperatures, potentially leading to more frequent extreme hot and cold days. However, the precise effects of these temperature shifts on health outcomes and health… (Eisen, 1/1/70) #Costs, #Hospitals

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CMS Will Continue to Require Medicaid Unwinding Data Reports Until States Complete All Unwinding-Related Renewals

CMS Will Continue to Require Medicaid Unwinding Data Reports Until States Complete All Unwinding-Related Renewals

The Centers for Medicare and Medicaid Services (CMS) published a letter sent to state Medicaid agencies regarding the extension of state reporting requirements on the unwinding of the Medicaid continuous enrollment condition. CMS notes that to date, the information reported by states has aided the agency in understanding if individuals eligible for Medicaid have been able to retain coverage and… (Marceno, May 31, 2024) #COVID-19, #Health Equity, #Insurance Coverage, #Public Health

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Agency Issues ACO Primary Care Flex RFA; Application Questionnaire Due August 1

Agency Issues ACO Primary Care Flex RFA; Application Questionnaire Due August 1

The Center for Medicare & Medicaid (CMS) has released a Request for Application (RFA) detailing payment, care delivery, quality, and other policies for the ACO Primary Care Flex (ACO PC Flex) Model (IHPP summary). Interested applicants may apply through the application portal starting today, but must first apply as a new or renewing ACO to the Medicare Shared Savings Program (MSSP). The deadline to… (Testa, McClurg, May 30, 2024) #Accountable Care Organizations, #Care Coordination, #Delivery Reform, #Demonstration Programs, #Health Equity, #Physicians, #Primary Care, #Quality

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Agency Examines Variations and Oversight in Medicaid’s EPSDT Prior Authorization Process

Agency Examines Variations and Oversight in Medicaid’s EPSDT Prior Authorization Process

The Government Accountability Office (GAO) conducted a study on Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, examining how managed care plans authorize services for children and how states oversee this process. The EPSDT benefit, mandated by federal law, ensures eligible children receive a comprehensive array of medical, vision, dental, and hearing screenings, as well as necessary treatment… (Eisen, 1/1/70) #Care Coordination, #Pediatrics

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House Republicans Introduce 340B Legislation to Increase Transparency and Oversight of Program

House Republicans Introduce 340B Legislation to Increase Transparency and Oversight of Program

Reps. Larry Bucshon (R-IN), Buddy Carter (R-GA), and Diana Harshbarger (R-TN) introduced the 340B Affording Care for Communities and Ensuring a Strong Safety-Net (340B ACCESS) Act, which aims to increase oversight and transparency of the 340B program (press release). Additional details follow. Bill Components – While the legislative text has not been released, the bill features the following: Patient affordability… (Slifer, May 29, 2024) #340B

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House Agriculture Committee Passes Farm Bill Reauthorization After Lengthy Partisan Debate

House Agriculture Committee Passes Farm Bill Reauthorization After Lengthy Partisan Debate

The House Agriculture Committee convened a markup of the Farm, Food, and National Security Act (H.R. 8467), the House Republicans’ proposal to reauthorize the Farm Bill. There were several areas of disagreement, most notably the provision that would prevent a future Secretary from increasing the value of the Thrifty Food Plan (TFP), which is used to determine the benefit level of the… (McClurg, May 24, 2024) #Nutrition

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2024 Resources for Gag Clause Prohibition Compliance Attestation

2024 Resources for Gag Clause Prohibition Compliance Attestation

The Department of Labor’s Employee Benefits Security Administration (EBSA) released 2024 resources for the attestation of compliance with the prohibition on gag clauses on price and quality information in provider agreements (instructions; user manual, and template). Background. Under the Consolidated Appropriations Act, 2021, group health plans and health insurance issuers offering group or individual health insurance coverage are prohibited from… (Llamas, May 24, 2024) #Transparency

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Senate Finance Committee Members Debate Policies to Combat Illicit Fentanyl, Agree on the Benefits of Telehealth for Behavioral Health Services

Senate Finance Committee Members Debate Policies to Combat Illicit Fentanyl, Agree on the Benefits of Telehealth for Behavioral Health Services

The Senate Finance Committee convened a hearing to discuss opportunities in the health care system to improve addiction treatment, grow primary prevention, and combat the fentanyl public health crisis. Democrats used the hearing to ask questions about promising treatment approaches and criticize barriers to care such as prior authorization and funding challenges for Federally Qualified Health Centers (FQHCs). Republicans argued… (Marceno, May 23, 2024) #Mental and Behavioral Health, #Opioids, #Prevention, #Public Health

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House Budget Committee Discuss Addressing Consolidation in Health Care Markets, PBM Reform, Rising Costs, and Medicare Physician Fees

House Budget Committee Discuss Addressing Consolidation in Health Care Markets, PBM Reform, Rising Costs, and Medicare Physician Fees

EXECUTIVE SUMMARY The House Budget Committee convened a hearing to discuss the budgetary effects of increasing health care consolidation and explored policy solutions to enhance competition and reduce health care costs. With bipartisan consensus emerging on critical issues, such as the need to address rising costs and promote competition within the health care sector, Chairman Jodey Arrington (R-TX) and Ranking… (Eisen, May 23, 2024) #340B, #Costs, #Insurance Reform, #Medicare for All, #Pharmacy Benefit Managers, #Physicians

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USDA Announces Summer Nutrition Programs to Help Tackle Hunger and Improve Healthy Eating for Children

USDA Announces Summer Nutrition Programs to Help Tackle Hunger and Improve Healthy Eating for Children

The U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) announced the launch of SUN Programs: USDA’s Summer Nutrition Programs for Kids to address nutrition security during the summer months (press release). These programs offer families various options to ensure their children receive essential nutrition during the summer break from school. The SUN Programs include: SUN Bucks, a new… (Eisen, 1/1/70) #Nutrition, #Wellness

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