November 10 Health Law Updates: Essential Insights

Weekly Healthcare News Review

• Senate Discussions: Legislation that could affect Medicare payments, mental health services, pharmacy benefit managers and health extenders was forwarded by the Senate Finance Committee. A hearing on artificial intelligence (AI) in healthcare was also hosted by the Subcommittee on Primary Health and Retirement Security of the Senate Health, Education, Labor & Pensions (HELP).
• CMS Proposed Rule: A proposed rule for Medicare Advantage (MA) and prescription drug plan was issued by the Centers for Medicare & Medicaid Services (CMS).

Legislative Activities

Senate Finance Committee on Mental Health Care and Lower-Cost Drugs: A package that includes Medicare and Medicaid extenders, provisions for expanding the mental health care workforce and services, and further PBM reforms to reduce prescription drug costs was passed by the committee. The committee also reviewed amendments for the markup and considered the chairman’s mark. For more details on the bill, you can check here, here, and here.

The committee is moving towards a possible healthcare package if an end-of-year deal that includes healthcare is reached. The House has a package with similar provisions, H.R. 5378, the Lower Costs, More Transparency Act, and the PBM legislation passed by the Senate Finance Committee is also being considered. House and Senate committees, along with House and Senate leadership, will negotiate to determine the healthcare policies to be included in the end-of-year bill.

Senate HELP Committee on AI in Healthcare: A hearing was held to discuss the risks and benefits of AI in healthcare. For more details on the executive order, click here.

Administrative News

MA and Prescription Drug Plan Proposed Rule by CMS: A proposed rule was issued by CMS that would implement changes to the MA and Medicare Part D programs, most of which would be effective in plan year 2025. Notable provisions in the proposed rule include limiting plan payment to third-party agents and brokers, adding a new category under the MA plan network adequacy standard, and requiring MA plans to send personalized notices to enrollees about supplemental benefits. Public comments are due by January 5, 2024. For more details, click here and here.

Healthcare Quick Updates

• CMS AHEAD Model Webinar: A webinar providing an overview of the Notice of Funding Opportunity for the States Advancing All-Payer Health Equity and Development Model will be hosted by the CMS. To register for the webinar, click here.
• HHS Actions to Improve Rural Healthcare: Actions taken by the Administration to improve access to care in rural areas were outlined by the HHS. To learn more, click here.
• GAO Report on Public Health Preparedness: A report was released by the GAO describing the CDC’s awards to support jurisdictions’ public health infrastructure for preparedness.
• Senate Confirms NIH Director: Dr. Monica Bertagnolli was confirmed as the NIH Director.

Future Healthcare Plans

Next week, further healthcare activities at the committee level are expected, including a Senate Finance Health Subcommittee hearing on telehealth and a potential House Energy & Commerce Committee markup on healthcare legislation. The government shutdown needs to be avoided as the funding deadline of November 17 is approaching fast.

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