Federal Health Policy Update for February 13

The following is the latest health policy news from the federal government for February 7 – 13.  Some of the language used below is taken directly from government documents.

Introduction

With the pause in external communication that the new administration imposed on HHS three weeks ago, including announcements, advisories, regular publications, and web site updates, there has been very little public communication from or activity involving HHS in the past week.  While an HHS spokesperson explained that the moratorium has been eased and agencies are now permitted to engage in some public communication, subject to review, such activity remains very limited.

The Administration

HHS Appointments and Nominations

• Robert F. Kennedy Jr. – confirmed by the Senate to serve as Secretary of the Department of Health and Human Services
• Michael Stuart – General Counsel – nominated (and subject to Senate confirmation)
• Gustav Chiarello III – Assistant Secretary for Financial Resources – nominated (and subject to Senate confirmation)
• Gary Andres – appointed Assistant Secretary for Legislation
• Tom Engels – appointed Administrator of HHS’s Health Resources and Services Administration (HRSA)
• Peter Nelson – head of the CMS office administering the Affordable Care Act marketplaces
• Rebekah Armstrong – head of CMS’s Office of Legislation

Congress

• The current continuing resolution funding the federal government expires on March 14 and 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.  It is yet unclear how Congress will meet either of those deadlines.
• The House Budget Committee has introduced a budget resolution for FY 2025 setting forth spending levels for FY 2026 through FY 2034.  Among other provisions, the resolution calls for the House Energy and Commerce Committee to cut spending by $880 billion over ten years.   Because that committee has primary jurisdiction over Medicaid, it would most likely be expected to find those reductions through Medicaid savings.  The resolution also calls for finding savings of $2 trillion from mandatory programs; while the resolution does not specify which mandatory programs, the largest such programs are Medicare, Medicaid, and Social Security.  Find the proposed House budget resolution here.  The resolution is being marked up on Thursday, February 13 and as of this writing it is not clear whether it will have enough support to pass.
• A Senate Budget Committee-proposed budget resolution released last week includes provisions directing both 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.  The proposed resolution was passed by the Budget Committee by an 11-10 vote along party lines.  Find that proposed budget resolution here.
• The House and Senate are taking different approaches to a budget resolution.  The House is pursuing a single, all-encompassing budget resolution while the Senate intends to adopt two resolutions: the first focused on border security, defense spending, and energy and a second that will address tax policy and other issues.  The chambers will need to work out the differences between the resolutions they have adopted.

Centers for Medicare & Medicaid Services

• According to a Politico report, CMS’s Center for Medicare and Medicaid Innovation (CMMI) will no longer collect data on race, ethnicity, preferred language, sexual orientation, and gender identity for participants in its various payment models.  Find that report here (a password is required).
• Late last month CMS held a support call for Medicare Shared Savings Program Accountable Care Organizations that are reporting quality data through the CMS web interface for the 2024 performance period.  The call highlighted information and updates about the reporting of quality data and included a question-and-answer session with CMS subject matter experts.  Now, CMS has posted two videos presenting that support call; find them here and here.
• CMS is seeking nominations of individuals to serve on its Medicare Evidence Development & Coverage Advisory Committee, which provides independent guidance and expert advice to CMS on specific clinical topics.  The committee is used to supplement CMS’s internal expertise and to facilitate an unbiased and current deliberation of state-of-the-art technology and science.  The committee reviews and evaluates medical literature, reviews technology assessments and public testimony, and examines data and information on the benefits, harms, and appropriateness of medical items and services that are covered under Medicare or that may be eligible for coverage under Medicare.  It also judges the strength of the available evidence and makes recommendations to CMS based on that evidence.  Learn more about the committee from its CMS web page and from this formal request for nominations, which also outlines the specific types of expertise the committee seeks and how to submit nominations.  The deadline for submitting nominations is February 17.

Department of Health and Human Services

• HHS has withdrawn its proposed regulatory agenda for the first part of 2025; that agenda was published in draft form last December by the Biden administration and was scheduled for final, official publication on February 12 but withdrawn before it could be published.
• HHS’s Office of the Inspector General (OIG) has modified a favorable opinion regarding the subsidization of enrollee cost-sharing obligations for Medicare-covered services provided as part of a clinical trial.  Find the revised opinion here.

HHS Newsletters and Reports

• AHRQ News Now – February 11
• HHS – Health Resources and Services Administration (HRSA) – Office for the Advancement of Telehealth – Announcements – February 11

Medicare Payment Advisory Commission (MedPAC)

MedPAC has submitted a formal comment letter to CMS in response to CMS’s advance notice of methodological changes for CY 2026 for Medicare Advantage capitation rates and Part C and D payment policies.  MedPAC’s letter addressed five issues:  the technical update to medical education payments in the non–end-stage renal disease per capita costs baseline; CMS’s hierarchical condition category risk-adjustment model for CY 2026; Medicare Advantage coding pattern difference adjustment; normalization factors for CMS – hierarchical condition category risk-adjustment models; and normalization factors for CMS’s prescription drug hierarchical condition category risk-adjustment model.  Find MedPAC’s letter here.

Medicaid and CHIP Payment and Access Commission (MACPAC)

Over the years, policymakers have introduced a number of programs that seek to better integrate care for beneficiaries dually eligible for Medicare and Medicaid; among those programs are the Program of All-Inclusive Care for the Elderly (PACE), the Financial Alignment Initiative, Medicare Advantage dual eligible special needs plans (D-SNPs), managed long-term services and supports (MLTSS) programs, and other demonstration programs.  MACPAC commissioned a systematic literature review and abstraction of studies that evaluate the impact of these programs.  Go here for a link to that report, which is presented in a downloadable Excel file.

Stakeholder Events

MACPAC – Commissioners Meeting – February 27-28

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, February 27 and Friday, February 28.  An agenda and registration information are not yet available but when they are they will be posted 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.