This Week’s Dose: The House of Representatives voted to formally present the articles of impeachment against President Trump to the Senate, kicking off the trial phase of the impeachment process. The Senate trial is expected to tie-up and stall legislation in the upper chamber for several weeks, and perhaps longer. House lawmakers, meanwhile, continued to grapple with surprise billing.
Ways and Means Released Additional Details of Surprise Billing Plan. The one-page document released by House Ways and Means Committee Chairman Richard Neal (D-MA) and Ranking Republican Kevin Brady (R-TX) offers some additional insight into the Committee’s thinking on how to address surprise billing. The document released this week is light on details, similar to the outline released in December, but does say that the plan would allow insurers and providers to work out any payment disputes “without interference.” If they cannot do so, the proposal contains a “robust, impartial, and structured payment process to settle payments.” Exactly what that means is unclear. The document does not mention arbitration or a benchmark payment rate, which other committees have proposed to settle payment disputes. With that said, the committee seems to favor arbitration over a benchmark, and that may pull a compromise away from a pegged resolution mechanism. The Ways and Means summary also says it would not pre-empt state laws already enacted on surprise billing. Without legislative text, more details from lawmakers, or any cost or savings associated with the proposal, the path forward remains unclear. For more on what 2020 has in store for surprise billing policy, check out this week’s episode of the Health Policy Breakroom.
Lawmakers Urged Oversight of Tennessee Block Grant Request. House Energy and Commerce Committee Chairman Frank Pallone (D-NJ) and Senate Finance Committee Ranking Member Ron Wyden (D-OR) sent a letter to the Department of Health and Human Services (HHS) Office of Inspector General (OIG) calling on OIG to “exercise vigorous oversight” if the Centers for Medicare and Medicaid Services (CMS) approves Tennessee’s waiver request to turn its Medicaid program into a block grant system. If the waiver is approved, Tennessee will become the first state to establish a block grant for its Medicaid program, an idea that many conservatives have championed but Democrats fear could result in reduced access or benefits. In the letter, Wyden and Pallone warn that “the scheme promoted by the administration and embodied in the Tennessee waiver proposal would threaten beneficiary access to care in many ways, including all but ensuring Medicaid dollars are diverted by purposes not allowed under federal law.” OIG said that it received the letter, but has not otherwise responded. If CMS does approve Tennessee’s waiver, other Republican-led states may pursue similar plans. Many legal experts have questioned whether CMS has the authority to approve a block grant, and the waiver is sure to face legal challenges if granted.
ONC Released Draft Health IT Strategic Plan. The HHS Office for the National Coordinator for Health Information Technology (ONC) released its draft 2020-2025 Federal Health IT Strategic Plan, which offers a roadmap for health IT efforts by both government agencies and the private sector. The plan is in keeping with the Administration’s priorities of improving individual access to, and quality of, health information and promoting interoperability and data sharing. Key objectives of the plan include: advancing health IT safety practices; fostering competition, transparency, and affordability in healthcare; reducing regulatory and administrative burden on providers; and advancing individual- and population-level transfer of health data. CMS will accept comments on the proposal through March 18, 2020.
Court Battles over Various Administration Policies Continue.
States Continue to Seek Flexibilities Through Waivers.
Even with the fate of the Affordable Care Act (ACA) uncertain, states are continuing to request additional flexibilities in their Medicaid programs and insurance marketplaces through waiver authority provided under the ACA. For example:
Next Week’s Diagnosis: The House adjourns for a one-week recess and the Senate is expected to begin President Trump’s impeachment trial. The Medicaid and CHIP Payment and Access Commission will hold its January public meeting.
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