The following is the latest health policy news from the federal government for March February 28 – March 6.  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.  Leaders intend to propose a long-term continuing resolution through the end of the current federal fiscal year in September.  The likelihood of success of that approach is uncertain.
  • 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 Senate and House have passed separate budget resolutions to initiate the reconciliation process but the chambers’ bills differ widely, so they 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.  Senate majority leader Thune has said the Senate will not take up the House measure until the end of March.
  • The House Ways and Means Committee next week will begin work on the tax portions of the House’s proposed reconciliation bill while majority members of the House Energy and Commerce Committee look for options to produce $880 billion in spending reductions.  Last week, Speaker Johnson ruled out changes to the formulas for the federal medical assistance percentage (FMAP, the rate at which the federal government matches state Medicaid spending) or implementing per capita caps for Medicaid as sources of savings.  There has been a good deal of discussion about introducing a Medicaid work requirement.  Yesterday, the Congressional Budget Office (CBO) confirmed that Medicaid cuts will be necessary if the Energy and Commerce Committee is to find $880 billion in savings.  Find the CBO’s letter here.
Centers for Medicare & Medicaid Services
  • CMS has released an informational bulletin rescinding past guidance on health-related social needs (HRSNs).  Specifically, it has rescinded the 2023 bulletin “Coverage of Services and Supports to Address Health-Related Social Needs in Medicaid and the Children’s Health Insurance Program,” which the agency explains “… discusses opportunities available under Medicaid and CHIP to cover certain services and supports that purport to address HRSN” and the 2024 bulletin “Framework of Coverage of HRSN Services in Medicaid and CHIP” or the “HRSN Framework.”  Rescinding this guidance does not negate existing approvals, which generally involve section 1115 waivers, CMS notes in its introduction to the informational bulletin.  Learn more from the new CMS informational bulletin.
  • CMS has issued an alert to providers reminding them of “…their obligation to protect American children from often irreversible chemical and surgical mutilation, including interventions that cause sterilization.  Hospital providers were alerted of serious quality and safety concerns associated with harmful, medical interventions for gender dysphoria.”  In addition, the agency announced that “… it may begin taking steps to align its policies and regulations with medical evidence and to safeguard children from often irreversible experiments.”  Learn more from this CMS statement.
  • CMS has announced that the ICD-10 MS-DRG V42.1 Grouper Software, Definitions Manual File (text version) and the Definitions of Medicare Code Edits V42.1 file, effective for discharges on or after April 1, 2025, are now publicly available.  Find them here.  The ICD-10 MS-DRG V42.1 Definitions Manual File (HTML version) will be available soon.
Department of Health and Human Services
  • HHS has rescinded its current practice for public participation in rulemaking, under what is known as the Richardson waiver, and realigned its rulemaking procedures with the Administrative Procedure Act.  Generally, agencies are required to publish a notice of proposed rulemaking in the Federal Register giving interested parties an opportunity to participate in the rulemaking through the submission of written data, views, or arguments, and then to publish a final rule that is accompanied by a statement of the rule’s basis and purpose.  The Administrative Procedure Act exempts from these requirements “…matter(s) relating to agency management or personnel or to public property, loans, grants, benefits, or contracts.”  The Administrative Procedure Act also permits an agency to forgo these requirements for “good cause” when the agency finds that the procedures are “…impracticable, unnecessary, or contrary to the public interest.”  The degree to which CMS’s transparency since 1971 has been related to the Richardson waiver, as opposed to the Administrative Procedure Act, is not entirely clear, but CMS can probably be expected to continue publishing its annual provider-specific Medicare payment proposals, such as for acute-care hospitals, long-term-care hospitals, outpatient services, physician services, and others, for public comment.  What is unknown, and difficult to predict, is how and when HHS and CMS might choose to exercise their authority to forgo the comment period and how this might affect the ability of stakeholders to comment on proposed Medicare and Medicaid policy changes.  Learn more about this change in HHS policy from this Federal Register notice, which takes effect immediately.
  • HHS Secretary Robert F. Kennedy, Jr. has issued a statement outlining his agency’s response to the measles outbreak in Texas, including working with state officials, the value of vaccines, and the CDC’s updated recommendation on the use of Vitamin A to treat the disease.  Go here to see the statement.  In addition, the CDC has issued its own statement about the Texas measles outbreak, which can be found here, and a separate statement, with some different information, on the “X” web site.
HHS Newsletters and Reports
Stakeholder Events

MedPAC – Commissioners Meeting – March 7

MedPAC’s commissioners are holding the second day of their two-day March public meeting virtually on Friday, March 7.  Go here to find the agenda and information about how to participate.

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.