The following is the latest health policy news from the federal government for February 21-27.  Some of the language used below is taken directly from government documents.

Congress
  • The current continuing resolution funding the federal government expires on March 14.
  • Separately, a number of health care extenders, including preventing cuts to Medicaid disproportionate share (Medicaid DSH), an extension of telehealth flexibilities, an extension of the Acute Hospital Care at Home program, and other rural programs, will expire on March 31.
  • Also, provisions that had been included in the bipartisan health care package proposed in December, including PBM reform, the package of health care extenders, and relief from Medicare physician payment cuts, remain a high priority for numerous members of Congress.
  • The House has passed a budget resolution for FY 2025 that initiates the budget reconciliation process.  The resolution does not include directives for specific cuts.  Instead, it instructs House committees to find targeted amounts of cuts, including calling for the House Energy and Commerce Committee to find $880 billion in cuts over the next ten years.  That committee has primary jurisdiction over Medicaid and parts of Medicare, so it would be expected to find most of that $880 billion in cuts from current Medicaid spending.
  • Passage of the House resolution is just one step in this process.  The Senate has already passed its own budget resolution, which directs both Senate committees with jurisdiction over health care – the Health, Education, Labor, and Pensions (HELP) Committee and the Senate Finance Committee – each to cut spending by $1 billion over ten years.
  • Now, the two chambers will need to negotiate the differences between their measures and come to an agreement on a single budget resolution before moving toward a single reconciliation bill.
Hospital Price Transparency

During his first term in office, President Trump signed an executive order requiring hospitals to post the prices they negotiate with health care payers.  While HHS has engaged in some compliance activities since then, critics have argued that those efforts have been insufficient.   Now, the President has issued an executive order calling for “radical transparency” of hospital prices, directing HHS and the departments of Treasury and Labor to update their guidance to reflect more rigorous compliance standards.  Find the executive order here and an accompanying administration fact sheet here.

The Administration
  • President Trump has issued an executive order titled “Commencing the Reduction of the Federal Bureaucracy.”  Among other matters the order addresses, it calls for the Secretary of HHS to terminate the Secretary’s Advisory Committee on Long COVID and for the CMS administrator to terminate the Health Equity Advisory Committee.  Learn more from this executive order.
  • President Trump has issued an executive order titled “Ending Taxpayer Subsidization of Open Borders” that calls for “…no taxpayer-funded benefits go to unqualified aliens.”  The order calls on federal agencies to “…identify all federally funded programs administered by the agency that currently permit illegal aliens to obtain any cash or non-cash public benefit, and, consistent with applicable law, take all appropriate actions to align such programs with the purposes of this order…” and to “… enhance eligibility verification systems, to the maximum extent possible, to ensure that taxpayer-funded benefits exclude any ineligible alien who entered the United States illegally or is otherwise unlawfully present in the United States.”  The order does not cite any specific federally funded benefits but could be interpreted as applying to Medicaid and other health care programs.  One action consistent with the executive order, and that President Trump pursued during his first term in office, could be reintroduction of a more expansive definition of what constitutes a “public charge” in considering citizenship applications.  Learn more from this executive order.
  • The White House Office of Management and Budget (OMB) has sent a memo to the heads of executive departments and agencies informing them that, in keeping with the President’s executive order on eliminating waste and inefficiency in the federal workforce, they must “…promptly undertake preparations to initiate large-scale reductions in force (RIFs), consistent with applicable law” and to submit their agency reorganization plans no later than March 13.  The memo also offers guidance on how to do this.  Learn more from the OMB memo.
Centers for Medicare & Medicaid Services
  • CMS has posted an updated list of billing and payment codes for orphan drugs that qualify for a 26 percent increased applicable percentage for calendar quarters in 2023.  The list also includes an explanation of when these billing codes are applicable.  Find the list here.
  • CMS has hired a contractor to help it with the development and evaluation of exchange health plan quality initiatives and that contractor will convene a technical advisory panel – groups of stakeholders and experts – to foster collaboration to provide strategic guidance and contributions that shape the star ratings and quality improvement efforts of Qualified Health Plans offered through the exchanges.  This technical advisory panel will advise on the continued implementation of the Quality Rating System (QRS) and Quality Improvement Strategy (QIS) by providing input on topics such as public engagement, guidance materials, data analysis and methodology, and measure set refinements.  Learn more about the panel’s work, the qualities it seeks from potential participants, the time commitment involved, and how to apply to participate from this CMS notice (click the link and then scroll down to “Development and Evaluation of Exchange Health Plan Quality Initiatives (QRS/QIS)”).  The deadline for applying is March 10.
  • CMS has published the electronic clinical quality measures (eCQMs) annual update pre-publication document, which provides the versions of the standards and code systems used within the updated eCQMs for potential use in CMS quality reporting programs for the 2026 reporting/performance period.  This pre-publication document is designed to prepare health IT/EHR developers, eligible clinicians, and hospitals for 2026 reporting/performance through the pre-release of the expected standards and code system versions.  Find a link to the pre-publication version of the document and learn more about it from this CMS notice.
HHS Newsletters and Reports
Centers for Disease Control and Prevention (CDC)
  • The CDC has issued a warning about a Listeria outbreak linked to supplement shakes distributed in long-term-care facilities.  According to the agency, 38 people from 21 states have been infected with this outbreak; 37 were hospitalized and 12 died.  Learn more about the shakes, where they originate, and how to identify Listeria and respond to possible cases from this CDC media alert.
  • New provisional data from the CDC’s National Vital Statistics System predict a nearly 24 percent decline in drug overdose deaths in the U.S. for the 12 months ending in September 2024 compared to the previous year.  Provisional data shows about 87,000 drug overdose deaths from October 2023 to September 2024, down from around 114,000 the previous year.  This is the fewest overdose deaths in any 12-month period since June 2020.  Learn more from this CDC announcement.
Stakeholder Events

MACPAC – Commissioners Meeting – February 27-28

MACPAC’s commissioners are holding their latest public meeting virtually on Thursday, February 27 and Friday, February 28.  Find the agenda and a registration link here.

MedPAC – Commissioners Meeting – March 6-7

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, March 6 and Friday, March.  An agenda and registration information are not yet available but when they are they will be posted here.

CMS – Hospital Open Door Forum – March 11

CMS will hold a hospital open-door forum on Tuesday, March 11 at 2:00 (eastern).  Go here to register to participate.

CMS – Physicians, Nurses, and Allied Health Open Door Forum – March 13

CMS will hold an open-door forum for physicians, nurses, and allied health professionals on Thursday, March 13 at 2:00 (eastern).  Go here to register to participate.

CMS – End-Stage Renal Disease Open Door Forum – March 18

CMS will hold an open-door forum for providers of end-stage renal disease services on Tuesday, March 18 at 2:00 (eastern).  Go here to register to participate.

CMS – Medicare Cost Report E-Filing System Webinar — March 19

CMS will hold a Medicare cost report e-filing system webinar on Wednesday, March 19 at 1:00 (eastern) during which participants can learn about new and upcoming functionality for Medicare Part A cost reports and hospice cap determinations in the Medicare Cost Report e-filing system.  The webinar will include a live Q&A session and an opportunity to provide feedback.  Learn more from this CMS notice (and scroll down to Medicare Cost Report E-Filing System Webinar – March 19) and go here to register to participate.

CMS – Skilled Nursing Facilities/Long-Term Care Open Door Forum – March 20

CMS will hold an open-door forum for skilled nursing facilities and long-term-care facilities on Thursday, March 20 at 2:00 (eastern).  Go here to register to participate.