Congress Passes Two-Tiered CR to Fund Government into Early 2024. In the absence of final passage of any of the 12 annual appropriations bills for FY 2024, Speaker Johnson (R-LA) unveiled a short-term CR, H.R. 6363, the...more
CONGRESS -
Senate Finance Committee Holds Markup on Better Mental Health Care, Lower-Cost Drugs, and Extenders Act. The bipartisan package includes Medicare and Medicaid extenders, provisions to expand the mental health...more
11/10/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Legislative Agendas ,
Medicare ,
Mental Health ,
National Institute of Health (NIH) ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Physician Fee Schedule ,
Prescription Drugs ,
Regulatory Agenda ,
Senate Committees ,
Telehealth ,
U.S. House
GOVERNMENT FUNDING EXPIRES SOON -
The government will run out of funding in 11 days, on November 17. The House will continue to work to advance annual appropriations bills this week. However, a continuing resolution (CR)...more
11/7/2023
/ Appropriations Bill ,
Centers for Medicare & Medicaid Services (CMS) ,
Federal Funding ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Section 340B ,
U.S. House
CONGRESS -
House Ways & Means Chair Smith, House Energy & Commerce Chair Rodgers and Senate Finance Ranking Member Crapo Call for Withdrawal of Nurse Staffing Mandate. Rep. Smith (R-MO), Rep. Rodgers (R-WA) and Sen. Crapo...more
11/6/2023
/ Artificial Intelligence ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
ESRD ,
Executive Orders ,
Final Rules ,
Hospitals ,
Medicaid ,
Medicare Advantage ,
OIG ,
Outpatient Prospective Payment System (OPPS)
On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) finalized the rule Medicare Program; Hospital Outpatient Prospective Payment System: Remedy for the Calendar Years 2018–2022 to addresses how the...more
11/6/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Final Rules ,
Healthcare ,
Healthcare Facilities ,
Healthcare Reform ,
Hospitals ,
Medical Reimbursement ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Prescription Drugs ,
Section 340B
CONGRESS -
House Republicans Elect New Speaker. After weeks of turmoil, the House elected Rep. Mike Johnson (R-LA) as the new Speaker of the House on Wednesday with 220 votes secured on the floor. The House is now able to...more
10/30/2023
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
HELP Act ,
Inflation Reduction Act (IRA) ,
Legislative Agendas ,
National Institute of Health (NIH) ,
Proposed Legislation ,
Senate Committees ,
U.S. House
THIS WEEK’S DOSE -
Uncharted Territory in the House: The House voted to remove Rep. McCarthy (R-CA) as Speaker of the House, then recessed until at least October 11, when the House is slated to reconvene to elect a new...more
10/9/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Extensions ,
Food and Drug Administration (FDA) ,
Healthcare ,
Healthcare Reform ,
Laboratory Developed Tests ,
Legislative Agendas ,
Medicare ,
New Legislation ,
Over The Counter Drugs (OTC) ,
Pharmaceutical Industry ,
Preventive Health Care ,
Proposed Legislation ,
Proposed Rules ,
Regulatory Requirements ,
Request For Information ,
Telehealth ,
Telemedicine ,
Temporary Regulations ,
U.S. Treasury
Do We End the Week with a Shutdown?
That is the question of the week. We’ll know the answer in five days, but right now, “yes” is a far more plausible answer than “no.”
On the House side, Speaker McCarthy will first...more
9/26/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Government Shutdown ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare ,
Proposed Legislation ,
Senate Committees ,
U.S. House
CONGRESS -
Senators Sanders and Marshall Release Bipartisan Primary Care and Health Workforce Act. Released on September 14, the legislation would reauthorize funding for a number of healthcare workforce programs that are...more
9/20/2023
/ Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Coronavirus/COVID-19 ,
DEA ,
Department of Health and Human Services (HHS) ,
Food and Drug Administration (FDA) ,
GAO ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicare ,
Pharmaceutical Industry ,
Proposed Legislation ,
U.S. House
CONGRESS -
House Republicans Release Healthcare Package. On September 6, House Republicans unveiled the Lower Costs, More Transparency Act, a draft package of healthcare transparency provisions, pharmacy benefit manager...more
9/11/2023
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Congressional Committees ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Disability Discrimination ,
Drug Pricing ,
Fair Labor Standards Act (FLSA) ,
Healthcare ,
Healthcare Reform ,
HELP ,
Legislative Agendas ,
Long Term Care Facilities ,
Long-Term Care ,
New Legislation ,
Over-Time ,
Pharmaceutical Industry ,
Prescription Drugs ,
Proposed Legislation ,
Proposed Rules ,
Request For Information ,
Rural Health Care Program ,
Transparency
Congress is officially in recess for the month of August and will return after Labor Day. On the regulatory front, the Centers for Medicare & Medicaid Services (CMS) released the final fiscal year (FY) 2024 Inpatient...more
8/4/2023
/ Acute Facilities ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Final Rules ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Long Term Care Facilities ,
Medicare ,
Medicare Part D ,
No Surprises Act (NSA) ,
Patient Prospective Payment System ,
Payment Systems
The House and Senate were both in session this week, with healthcare activity at the committee level. The House Ways and Means Committee held a markup focused on healthcare transparency and consolidation legislation. The...more
7/28/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Healthcare ,
Healthcare Reform ,
Inpatient Rehab Facilities ,
Legislative Agendas ,
Medical Bills ,
Pharmacy Benefit Manager (PBM) ,
Senate Committees ,
Senate Finance Committee ,
Transparency ,
U.S. House
The House and Senate were both in session this week, with healthcare activity at the committee level. The House Energy and Commerce Committee held a hearing on innovation and a markup of 15 healthcare bills. The Senate...more
7/24/2023
/ Billing ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
HELP Act ,
Legislative Agendas ,
MCOs ,
Medicare ,
Proposed Legislation ,
SAMHSA ,
Senate Committees ,
Technology ,
Telehealth ,
U.S. House ,
Vaccinations
The House and Senate returned from recess, beginning a three-week sprint toward the August break. The House Education and the Workforce Committee held a markup of a bipartisan healthcare package of four bills. The House...more
7/14/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
New Legislation ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Proposed Legislation ,
Senate Committees ,
U.S. House
On July 7, 2023, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule Hospital Outpatient Prospective Payment System: Remedy for 340B-Acquired Drugs Purchased in Cost Years 2018-2022 to address how...more
We hope that you, like Congress, enjoyed some time off last week and are ready to dive in—for a few days at least. As we previously reminded you, the House is only in session 12 days in July, then away for August recess, and...more
7/11/2023
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Consumer Financial Protection Bureau (CFPB) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Hospitals ,
Medicare ,
MPFS ,
Notice of Proposed Rulemaking (NOPR) ,
Outpatient Prospective Payment System (OPPS) ,
Payment Systems ,
Physician Fee Schedule ,
Request For Information ,
Section 340B ,
U.S. Treasury
The House and Senate are in recess and will return next week to resume healthcare activity. The Senate Health, Education, Labor and Pensions (HELP) Committee is seeking feedback on a staff-level bipartisan discussion draft to...more
7/10/2023
/ Amended Rules ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Health Insurance ,
HELP ,
Information Blocking Rules ,
Legislative Agendas ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Proposed Legislation ,
Proposed Rules ,
Senate Committees
Congress was in session for a final week of legislative business before the two-week Independence Day recess. The House brought a small-business-focused healthcare bill to the floor, approving it along party lines....more
6/23/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Comment Period ,
Congressional Committees ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Health Information Technologies ,
Healthcare ,
Legislative Agendas ,
Legislative Committees ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
New Legislation ,
Proposed Legislation
The House and Senate were both in session this week, with healthcare activity continuing at the committee level. The House Energy and Commerce Committee held hearings on the Pandemic and All Hazards Preparedness Act (PAHPA)...more
6/16/2023
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Debt ,
Department of Health and Human Services (HHS) ,
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Healthcare ,
HELP ,
Hospitals ,
Legislative Agendas ,
Medicaid ,
Medicare ,
New Legislation ,
Pharmaceutical Industry ,
Proposed Legislation ,
Regulatory Agenda ,
Telehealth ,
Transgender
On June 3, President Biden signed the debt limit legislation into law, averting default and allowing Congress to return to regularly scheduled business. However, that return was short-lived in the House when a small group of...more
6/9/2023
/ Affordable Care Act ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Debt Ceiling ,
Department of Health and Human Services (HHS) ,
GAO ,
Health Insurance ,
Healthcare ,
HELP ,
Internal Revenue Code (IRC) ,
Investment ,
Mental Health ,
Opioid ,
Social Security ,
Telehealth
On April 26, 2023, the House Energy and Commerce Committee Health Subcommittee held a legislative hearing on 17 healthcare bills, including one that would direct the Centers for Medicare & Medicaid Services (CMS) to implement...more
THIS WEEK’S DOSE -
The House’s scheduled Memorial Day recess was cut short after President Biden and House Speaker McCarthy (R-CA) announced last weekend that they had reached a deal on raising the debt limit. The House...more
The House was in session this week, while the Senate was in recess. The House Energy & Commerce Committee continued its work on healthcare by advancing six bills that address competition, transparency and access to care. The...more
5/30/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Medicaid ,
New Legislation ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Proposed Legislation ,
Transparency
The House and Senate were both in session this week, with significant healthcare activity at the committee level. The House Ways & Means Committee met to discuss healthcare price transparency, and the Ways & Means Health...more
5/19/2023
/ Abortion ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Coronavirus/COVID-19 ,
Data Privacy ,
Data Protection ,
Federal Trade Commission (FTC) ,
Food and Drug Administration (FDA) ,
GAO ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicare Advantage ,
New Legislation ,
New Regulations ,
Non-Compete Agreements ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Price Transparency ,
Proposed Legislation ,
Proposed Regulation ,
Regulatory Agenda ,
Ways and Means Committee
The proposed rule would make transparency-related updates to state directed payments (SDPs). It would also require states to submit an annual payment analysis that compares managed care plans’ payment rates for routine...more