This Week’s Dose: Government funding negotiations continued against the backdrop of impeachment, and the Centers for Medicare and Medicaid Services (CMS) issued new rules on provider price transparency and Medicaid supplemental payments.
Congress Approaches Another Temporary Government Funding Deal. House lawmakers announced that they are nearing a final deal on a one-month continuing resolution (CR) to fund the government through December 20, 2019, while negotiations over a final spending package for fiscal year 2020 continue. The current CR expires on November 21, and with it, funding for several temporary healthcare programs (the so-called extenders). As negotiations continue on a longer-term funding agreement, policies that save money, such as addressing surprise billing and consensus drug pricing policies (e.g., the CREATES Act), could still move at the last minute to provide long-term funding for the extenders. Impeachment adds another layer of complexity to the end-of-year negotiations.
Trump Administration Announced New Price Transparency Rules. The two rules flow from President Trump’s June Executive Order on Improving Price and Quality Transparency in American Healthcare.
Both rules are likely to face pushback from providers and insurers. Hospital groups have already spoken out against publishing standard charge information, arguing that doing so will harm competition rather than reduce costs, and are planning to file a lawsuit challenging the rule.
CMS Issued Proposed Rule Aimed at Medicaid Financing Transparency. The Medicaid Fiscal Accountability proposed rule would increase reporting requirements for supplemental payments — those made to providers beyond the base Medicaid rate for a particular service — and make structural and definitional changes that could decrease states’ flexibility in financing the state share of the Medicaid program. The rule includes provisions that:
These changes affect states’ ability to finance the state share of the Medicaid program and alter state budgets. As a result, if the proposed rule is finalized as currently written, states will have to find other avenues to generate state share. If not, states may reduce Medicaid provider payments or services.
Court Battles Over Trump Administration Rules Continue.
Next Week’s Diagnosis: Government funding negotiations continue, and the HELP Committee holds its confirmation hearing for Stephen Hahn to be Commissioner of the Food and Drug Administration.
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