Government Spending Bill Needed In Next Two Weeks
With the government running out of money as of December 20, Congress is back for a lame-duck session and needs to pass a permanent funding bill or stop-gap continuing resolution (CR) soon. The latest guess is that the parties will come together in each chamber to pass a stop-gap CR and boot major funding and policy decisions until the next Congress. But that certainly puts Democrats at a disadvantage as they become the minority in both chambers. But the sheer work to get a permanent bill passed is likely just too much right now for anyone.
There is wide speculation on what will happen with various healthcare policy proposals. Many hope for a great deal of healthcare bills to be rolled up into an end-of-year act. But that hope is dying given all that needs to be done.
More likely are some carefully crafted healthcare fixes to get into the new year. Top among them are rolling back the Medicare physician rate cut. It could be partially or fully rolled back. There is the possibility that it could turn into some hike right now. Certain programs face expiration and could be extended for some time, including telehealth and hospital-at-home. Community health centers are looking for an increase due to major patient load, but it is unclear if that will happen.
Some argue that payfors like site-neutral payments and pharmacy benefit manager (PBM) reform could be included in an end-of-year bill. These would likely face major opposition from lobbyists, but PBM reform could provide savings for some increases.
Look for a three-month CR and a narrow healthcare package.
(Article may require a subscription.)
#crs #governmentshutdown #congress
Industry Hopes Trump Will Rescind Nursing Home Staff Regulation
The nursing home industry says it is hopeful that the Trump administration will reverse an onerous staffing level mandate when he returns to office. The industry believes the standards are not achievable given staff shortages and could spell financial doom for the industry due to the cost. Others argue the changes are modest and that quality is suffering in the institutions due to a lack of staff.
I have argued that the staffing rule had little to do with quality but was a political sop to the nursing home unions. Such rules have not worked in states that have passed such requirements. What is certain is that the rule will lead to further consolidation in the industry as smaller mom and pops sell to big chains because they cannot survive financially. Further consolidation in healthcare is not in anyone’s interest.
So far, 40 states and nonprofits have sued the government over what may very well be a regulatory overreach, especially in light of the striking of Chevron deference.
Additional article: https://kffhealthnews.org/news/article/nursing-home-staffing-mandate-trump-administration-repeal/
#nursinghomes #longtermcare #staffing #medicare #medicaid
Moving Hospital Price Transparency Forward
A new analysis in Health Affairs Forefront blog suggests that hospital price transparency regulations have had a positive impact on costs, but more needs to be done on the compliance front by the Centers for Medicare and Medicaid Services (CMS). A recent report from Turquoise Health found that average commercial prices for common hospital services have dropped three years after the rules went into effect.
At the same time, the analysis finds that enforcement actions have been lax. Compliance went up after initial compliance actions but many hospitals still are not abiding by the rules. The authors say there are delays in assessing penalties as well. The authors have numerous recommendations to increase oversight activity and penalties.
(Article may require a subscription.)
#transparency #pricetransparency #hospitals
Advocates Now Look To States To Push Medical Debt Reform
Advocates are worried that President-elect Donald Trump will curtail federal efforts to reform the medical debt problem, so they are looking to states to pick up the potential slack. Many states have already passed medical debt reform initiatives.
#medicaldebt #healthcare #trump
https://kffhealthnews.org/news/article/medical-bills-debt-trump-states-consumer-credit-reports-cfpb
Bristol Myers Squibb Sues On 340B
Bristol Myers Squibb is the third large drugmaker to sue the federal government over how the Health Resources and Services Administration (HRSA) conducts the 340B safety net drug program. Johnson & Johnson and Eli Lilly both filed lawsuits last month. All three drug makers argue they should be able to convert to a retrospective rebate program (as opposed to upfront price reductions) given the need to bring better transparency and return the program to its original intent. Numerous analyses suggest hospitals get the benefit of the discounts but do little to reduce costs for low-income Americans and thus pocket the concessions as margin.
#340b #drugpricing #hospitals #branddrugmakers
— Marc S. Ryan
