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Healthcare Today: July 14, 2023


CMS Issues CY 2024 Medicare Physician Fee Schedule Proposed Rule. The proposed rule includes updates to PFS payments for clinicians as required by law. Overall proposed payment amounts under the PFS would be reduced by 1.25% compared to CY 2023. The proposed CY 2024 PFS conversion factor is $32.75, a decrease of $1.14, or 3.34%, from CY 2023. The proposed policies work to advance health equity through expanding behavioral health services, supporting the President’s Cancer Moonshot, promoting innovation, and growing value-based care. The comment period ends on September 11, 2023.

CMS Proposes CY 2024 OPPS and ASC Rule. CMS announced the CY 2024 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. CMS proposes updating OPPS payment rates for hospitals that meet applicable quality reporting requirements by 2.8%. CMS proposed expanding access to behavioral health services through coverage of intensive outpatient services. CMS is also taking steps to increase hospital compliance with requirements, further strengthen enforcement, and improve the ability of the public to understand hospital charges for items and services. The comment period ends on September 11, 2023.

HHS Issues Proposed Rule To Advance Non-discrimination in Programming. The HHS Office of Civil Rights (OCR) released a proposed rule to affirm civil rights and equal opportunity for people nationwide in HHS-funded programs and services. The rule would clarify and reaffirm the prohibition of discrimination based on sexual orientation and gender identity in federal statutes administered by HHS. The comment period ends on September 11, 2023.

House Education and the Workforce Committee Passes Package of Four Healthcare Bills. Wednesday, the House Education and the Workforce Committee approved a package of four healthcare-related bills (H.R.4509 -Transparency in Billing Act, H.R.4507 -Transparency in Coverage Act of 2023, H.R.4527 - Health DATA Act, and H.R.4508 - Hidden Fee Disclosure Act). The legislation refines surprise medical billing laws to make them more effective and strengthens requirements that PBMs and Third-Party Administrators (TPAs) disclose compensation to plan fiduciaries.

House Energy and Commerce Health Subcommittee Holds Markup of Public Health Bills. The House Energy and Commerce Health Subcommittee held a markup of 17 healthcare bills on Thursday. The subcommittee passed two bills that help reauthorize the Pandemic All Hazards and Preparedness Act (PAHPA), H.R. 4421, the Preparing for All Hazards and Pathogens Reauthorization Act, and H.R. 4420, the Preparedness and Response Reauthorization Act.

Sanders’ Hold on Health Agency Nominees Continues. Delays continue in scheduling a confirmation hearing for President Biden’s pick to lead the NIH, Monica Bertagnolli. Sen. Bernie Sanders (I-VT) continues to block healthcare agency nominees until the Administration acts on lowering prescription drug prices. Additionally, Sen. Elizabeth Warren (D-MA) stated this week that she won’t back anyone who refuses to commit to not seeking employment in the industries related to their public services for at least four years after they leave the government. The NIH has been without a permanent leader for over a year.


In Case You Missed During Recess:

CMS Issues Proposed Rule on 340B Payments. On July 7, CMS issued a proposed rule outlining the proposed remedy for the 340B-acquired drug payment policy for CY 2018-2022. The proposal provides $9 billion for hospitals that received a cut in 340B payments during this time. The agency is proposing a one-time lump-sum payment to roughly 1,600 340B-covered entity hospitals in light of the 2022 Supreme Court decision in American Hospital Association v. Becerra. The comment period ends on September 5, 2023. 

HHS, DOL, and Treasury Release Proposed Rule on Short-Term, Limited Duration Insurance. On July 7, HHS, DOL, and the Treasury Departments released a proposed rule to modify the definition of short-term, limited-duration insurance (STLDI) and modify the conditions for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit. The comment period ends on September 11, 2023.

FDA Converts Alzheimer's Drug to Traditional Approval Pathway. On July 6, FDA announced that Alzheimer’s Disease treatment Leqembi will be converted from the Accelerated Approval pathway to traditional approval following a determination that a confirmatory trial verified clinical benefit. Following the FDA announcement, CMS released a registry open for clinicians to access.

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