Government Shutdown Could Occur
Senate Democrats came out today and said they do not plan to vote for the House GOP-passed continuing resolution (CR) to fund the rest of this federal fiscal year (through September), instead demanding a 30-day CR to allow for additional negotiations. But there is some buzz that many Democratic senators could change their minds if the Senate GOP majority calls for a cloture vote later this week. The GOP is very unlikely to opt for a 30-day option.
One GOP senator, Rand Paul of Kentucky, is against any CR. That means eight Democrats would be needed to invoke cloture to end debate and pass the bill. Several senators have commented they are worried about the political fallout if they vote no. Others feel a government shutdown further empowers Elon Musk and his cost-cutting commission and efforts. A CR must be passed by Friday or there would be a government shutdown.
Additional article: https://thehill.com/homenews/senate/5189724-senate-democrats-government-funding-shutdown/?tbref=hp
#governmentshutdown #cr #congress #trump
https://thehill.com/homenews/senate/5191508-senate-democrats-vote-government-funding-30-day-cr
Trump CMS Terminates Four Medicare Payment Models
The Centers for Medicare and Medicaid Services (CMS) announced that four experimental Medicare payment models will shut down by the end of 2025, at least a year earlier than anticipated. They are the following:
- Primary Care First
- Making Care Primary
- End-Stage Renal Disease Treatment Choices
- Maryland Total Cost of Care
The move is not unexpected. Even under the Biden administration, there was major criticism of the number of pilots and the fact that most were administratively expensive and had little or no savings.
Two pharmacy cost-sharing proposals were earlier struck by a Trump executive order.
CMS documents: https://www.cms.gov/newsroom/fact-sheets/cms-innovation-center-announces-model-portfolio-changes-better-protect-taxpayers-and-help-americans and https://www.cms.gov/newsroom/press-releases/statement-cms-innovation-center-aligning-portfolio-statutory-obligation
Additional article: https://www.modernhealthcare.com/policy/cms-terminates-medicare-payment-models
(Some articles may require a subscription.)
#medicare #vbc #pilots #cms
https://www.beckershospitalreview.com/finance/cms-to-end-4-medicare-payment-programs-early.html
BCBSA Antitrust Settlement Explained
A good article on the unraveling of two Blue Cross and Blue Shield Association antitrust settlements as more and more providers opt out of the most recent settlement. As I said at the time, the settlement was bad for employers as it did not go far enough to ensure true competition.
(Article may require a subscription.)
#bcbsa #antitrust #healthplans #providers
https://www.modernhealthcare.com/legal/bcbsa-antitrust-lawsuit-settlement
Health Equity Phrase Being Purged By Trump Administration
The Trump administration is busy purging policies and phrases from the federal government. Among the words is “health equity.” The Health Equity Index (HEI) is slated to replace the Reward Factor in Star Year 2027 in the Medicare Advantage (MA) Star program. Could this be a signal it is not long for the world despite the savings it delivers over the current Reward Factor.
#hei #medicareadvantage #star #quality
BSC CEO Lasts Two Months
Blue Shield of California CEO Lois Quam is stepping down after just two months. The nonprofit CA health plan will begin a search for a permanent CEO. CFO Mike Stuart has been appointed as interim president and CEO.
Additional article: https://www.beckerspayer.com/executive-moves/blue-shield-of-california-ceo-exits-after-2-months.html
(Some articles may require a subscription.)
#bsc #healthplans
https://www.modernhealthcare.com/people/blue-shield-ca-lois-quam-mike-stuart
— Marc S. Ryan
