HHS has a busy year of regulations planned

As Congress struggles to pass healthcare legislation this year, turn your attention down Independence Avenue to HHS. It is punctual to have a busy year.

why does it matter: Congress and HHS often act in response to each other. And when Congress falters, HHS persists.

  • “Even if Congress does nothing, or little, in certain policy areas, that doesn’t mean there’s still a lot that can change,” Brian Miller, a nonresident fellow at the American Enterprise Institute, told Axios.

details: 182 policies On the agency’s latest regulatory agenda. Here’s a glimpse of what’s to come:

1) The inflation reduction law is in effect: The past year has seen sweeping changes in drug prices for healthcare beneficiaries. right Now Implementation Work begins.

  • CMS will announce First 10 drugs selected for Medicare drug price negotiation program by September 1.
  • Prior to that, the Agency will open public comment periods for comments on the Biotechnology Small Exemption to the Price Negotiation Program, negotiation data items, and negotiation offers and counter-offer exchanges.
  • “It is critical that the public know when and how they can make their voices heard in these important endeavours,” Meena Sechamani, director of the Medicare Center, said on a call with reporters last week.

2) 340B recovery: HHS should know How to pay Hospitals will receive up to $10 billion for drugs purchased through the Federal Discounted Drug Program from 2018 to 2022.

  • The agency expects to publish a proposed roadmap for compensation as early as April.

3) Medicare Advantage Audits: Regulators are set to publish a final rule by February 1 on audits that check data used to adjust for risk.

  • In 2018, CMS proposed an audit method that would enable the agency to recover Medicare Advantage payments from 2011, but the rule has been repeatedly delayed.
  • Tricia Newman, executive director of the Kaiser Family Foundation on Medicare Policy Program, said payers and policy watchers are anxiously awaiting to see whether regulators will finalize the plan as it was proposed several years ago.
  • CMS may also finalize recent proposals to tighten Medicare Advantage marketing practices and Simplified prior authorization.

4) Private Insurance: The debate over how to deal with sudden medical bills isn’t going away anytime soon.

  • More regulations implementing the no surprises rule, including an element of an advanced interpretation of benefits, may be released around August. CMS has released a file requiring information on politics in september.

  • A lawsuit pending in the Eastern District of Texas at Surprise billing arbitration process It could also mean new regulations, depending on their outcome, said Zachary Barron, associate director for health policy and law initiative at Georgetown University’s O’Neill Institute.
  • HHS is also expected to propose rules on Short term insurance plans and religious exemptions from coverage of preventive services. harder Non-discrimination protection For private insurance also soon.

5) Transitional coverage of emerging technologies: Look for the Biden administration’s proposed rule on short-term Medicare coverage for a breakthrough Medical devices about april.

  • The Trump administration ended its Medicare coverage policy for innovative technology just days before the Biden administration took over. Biden administration He later canceled itsaying that the administration will revisit the case after that.
  • Lawmakers on both sides of the aisle have it The Biden administration pushed To re-issue the policy. In October, Sens. Maggie Hassan and Todd Young led 14 colleagues to urge the agency to put forward a proposal by the end of 2022.

What we watch: Proposed changes to oversee hospital accreditation agencies, and a new alternative payment model from the Center for Medicare and Medicaid Innovation.

Leave a Reply

Your email address will not be published. Required fields are marked *