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Healthcare Today - April 12, 2024


Senate Finance Committee Holds Hearing on Physician Fee Schedule: On Thursday, the Senate Finance Committee held a hearing with multiple providers discussing options to revise the Physician Fee Schedule to better address chronic condition care. Both panelists and Sens. Debbie Stabenow (D-MI) and Ron Wyden (D-OR) voiced support for raising the CMS reimbursement budget neutrality trigger cap, which panelists said forces cuts to one program when improvements are made on another. Panelists Steven Furr from the American Academy of Family Physicians and Patricia Turner from American College of Surgeons voiced clinicians’ frustrations with prior authorization rules, which the Committee also said it must revisit.

Sen. Sanders Releases Long Covid Discussion Draft: On Tuesday, Senate HELP Committee Chair Bernie Sanders (I-VT) released a discussion draft proposal that would spend $10 billion for Long Covid research and treatments. Sanders' draft would create a centralized entity at NIH for Long Covid research, implement grants for clinical trials, establish a research advisory board, develop a Long Covid patient database, and require federal health agencies to offer ongoing education and support for patients, providers, and the public regarding Long COVID. As of March 2024, an estimated 17 million Americans currently have Long Covid, and the HELP Committee previously focused on the issue during a January hearing.  

FDA Commissioner Califf Testifies Before House Oversight Committee: On Thursday, FDA Commissioner Robert Califf was questioned for over four hours by members of the House Oversight Committee. Republican members continued to criticize the FDA’s COVID-19 response, and Committee Chair James Comer (R-KY) singled out FDA inspections, which he noted have not returned to pre-pandemic levels overseas. Commissioner Califf called for more resources for FDA to establish consistent access to supply chain data to quickly respond to drug shortages.

House Energy and Commerce Committee Weighs Telehealth Extension Policies: On Wednesday, the House Energy and Commerce Subcommittee on Health held a legislative hearing considering 15 legislative proposals, largely focused on telehealth. Committee Ranking Member Frank Pallone (D-NJ) said he is still undecided on whether to push for a permanent or temporary extension of telehealth waivers, first established by CMS during the pandemic. In reauthorization discussions, legislators also discussed the need for an interstate licensing network for providers to serve patients across state lines.

CMS Releases FY2025 IPPS Rate Proposals: On Wednesday, CMS issued their inpatient prospective payment system rate proposals for FY2025, seeking to raise inpatient hospital payments by 2.6% beginning October 1. CMS will accept public comments on the rule until June 10, and hospital systems, led by the American Hospital Association, are already calling the proposed hikes “woefully inadequate.” Also, Medicare proposed add-on payments to incentivize small, independent hospitals to create buffer stocks of essential medicines to avert shortages.

CMS Finalizes 2025 Medicare Advantage and Medicare Part D Rules: Last Thursday, CMS released their final rules on Medicare Advantage and Medicare Part D programs. CMS estimates changes will increase Medicare Advantage plan revenues by an average 3.7%. Major changes include fixed compensation amounts plan agents can receive for enrolling patients, requiring patient consent for third-party sharing of their health data, and capping annual out-of-pocket costs for people with Medicare Part D at $2,000 in 2025.

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