Senate And House Jockey On Budget Bill
Senate moderates and pragmatic conservatives are working on a rural hospital relief fund to offset the impact of numerous Medicaid and Exchange cuts in the budget reconciliation bill. Their chief complaint is that the $15 billion budget crafters are willing to put up is clearly inadequate. They believe a fund closer to $100 billion is needed to ensure the hospitals’ solvency. At least three senators are very vocal here, with others certainly sympathetic.
One pragmatic conservative up for re-election, Thom Tillis, R-NC, believes that the healthcare cuts being considered in budget reconciliation will mean the GOP losing control of Congress. His seat is especially vulnerable as a popular moderate Democratic former governor, Roy Cooper, could challenge Tillis in 2026.
Another major sticking point in discussions between the House and Senate is the status of the state and local taxes (SALT) deductions. Primarily to satisfy two dozen or so House moderates from Blue states, the House included a boost in the SALT allowance on federal income tax to $40,000 from $10,000. The Senate stripped the increase entirely. Negotiations continue.
As well, sixteen House members penned a letter to their party’s leadership warning that they cannot support the current Senate draft with the additional Medicaid cuts, including additional provider tax limits.
Additional articles: https://thehill.com/homenews/house/5370059-salt-negotiations-republicans-bessent/ and https://thehill.com/homenews/senate/5369675-senate-republicans-rural-hospital-relief-fund-medicaid/ and https://thehill.com/homenews/senate/5367877-tillis-republicans-mediticaid-cuts/
#budgetreconciliation #trump #congress #spending #coverage #medicaid #ruralhospitals
Oz Hints At Drug Price Transparency Changes
Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz hinted that the Trump administration could issue a rule that is focused on drug price transparency. This could be part of the administration’s overall drug price reform initiative. The rule might require healthcare companies such as health plans and pharmacy benefit managers to disclose the net prices of drugs.
Already this week, CMS has announced two other initiatives, eliminating rebates (which related to the above) and voluntary health plan reform of prior authorization processes.
#drugpricing #rebates #pricetransparency #priorauthorization #oz #cms
https://www.healthcaredive.com/news/drug-price-transparency-pending-cms-rule-oz/751488
CMS Projects Healthcare Spending Through 2033
The Centers for Medicare and Medicaid Services (CMS) Office of the Actuary issued its annual forecast for healthcare spending through the next decade, 2024 through 2033. The data with forecasts are collectively known as the National Healthcare Expenditure Data (NHED) and can be found here: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/projected .
The CMS actuaries say national health expenditures will increase 5.8% a year on average from 2024 to 2033, which outpaces economic growth of 4.3% annually. The spending jumps are attributed to a rapidly aging population and high demand for healthcare.
While the final 2024 expenditure level will be issued in December, the actuaries say 2024 expenditures are expected to have been $5.3 trillion last year, up 8.2%. Utilization spikes after the COVID pandemic were a significant contributor to the major growth. Spending grew 7.5% in 2023 and 6.4% in 2022. Healthcare as a percentage of gross domestic product (GDP) is slated to continue to increase.
I will have my traditional blog on the report next week.
(Article may require a subscription.)
#healthcare #expenditures
https://www.modernhealthcare.com/finance/mh-us-health-spending-2033
CVS Health Loses Drug Fraud Lawsuit
CVS Health must reimburse the federal government $95 million after a federal court ruled in a whistleblower lawsuit that CVS’ pharmacy benefits manager (PBM) overcharged Medicare for generic drugs. The complaint began in 2014. The suit said CVS inflated Medicare Part D drug prices to offset higher costs in other lines of business.
(Article may require a subscription.)
#drugpricing #fwa #cvshealth #pbms #partd #medicare
https://www.modernhealthcare.com/legal/mh-cvs-caremark-medicare-overbilling-lawsuit
— Marc S. Ryan
