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Good morning from Washington where sunny skies and warm weather on the way signals positive vibes that a deal might be in the works for a temporary patch to fund the government. Reports over the weekend however made those of us following these developments believe a shutdown might still be in the works. If nothing is accomplished this week, a temporary shutdown would occur at midnight this Friday, followed by a full-scale shutdown on March 8. Procrastination is often a hallmark of Congress, much like my first-grade son getting dressed for school in the morning. Nothing like a good hurry up and wait heading into upcoming negotiations… Welcome to the Week Ahead!
The Administration
President Biden took the lead this weekend to bring House and Senate leaders together for discussions at the White House. The “big four” (Schumer, McConnell, Johnson, and Jeffries) will be meeting on Tuesday to discuss how to fund the government and delay a shutdown. With the State of the Union also on the horizon, it is important the President work with Congress to find a resolution. Concerns from agencies mount, as Congressional Republicans are looking to cut funding across the board like the National Institutes of Health which is looking to face a $3.8 billion cut to their $48 billion in funding the agency received last year. Meanwhile, House Republicans plan to continue to push for the impeachment of Homeland Security Secretary Mayorkas this week. It is very likely the impeachment proceeding goes nowhere in the Senate as many vulnerable Democrats and conservative senators signaled, as they do not have an appetite to move forward.
The Senate
Senator Schumer sent a Dear Colleague letter blasting House Republicans for not coming to the budget negotiations in earnest. The letter outlines concerns and ramifications as to what will occur if a deal is not struck this week. Concerns include cuts to programs which could impact vulnerable families through the Supplemental Nutrition Program for Women, Infant, and Children (WIC), potential shutdowns of veteran offices, as well as a potential FAA freeze which would negatively impact the hiring of air traffic controllers and cause delays in air travel across the country.
Health Care
Right now all eyes remain on whether or not the big four can come to an agreement on funding the government and what impact a partial or full shutdown will cause on a variety of health care programs.
The House
After a week-plus legislative break for the Presidents’ Day district work period, the House returns on Wednesday to consider a slew of bills under suspension of the rules. In a sign of the times, and the struggles facing both chambers, another short-term extension of reauthorization through May 10 was added to the legislative schedule, and arguably, the need for another short-term FAA extension points to the larger challenges facing House Speaker Mike Johnson (R-LA) and House Republicans in coming to an agreement both internally and ultimately with Senate negotiators on legislation to fund the government and on numerous policy provisions that have been connected to the government funding conversations as well.
With the first tranche of funding for four appropriations bills expiring this Friday, March 1, a partial government shutdown is now looking to be a very real possibility. Heading into the weekend, congressional leaders looked poised to release a bipartisan agreement on the first tranche of appropriations bills on Sunday, but ultimately, House and Senate leaders could not come to an agreement as Speaker Johnson continued to face pressures within his own conference—particularly from the Freedom Caucus—over the inclusion of certain policy riders. While this has impact on government appropriations, these struggles also raise questions about what agreement can be reached on various health measures, including several health programs that are set to expire on March 8. Among the expiring provisions are payments under the Medicaid Disproportionate Share Hospitals (DSH) Program, the Work Geographic Practice Cost Index (GPCI) Floor, and funding for Teaching Health Center Graduate Medical Education (THC GME), Community Health Centers (CHCs), and the National Health Service Corps (NHSC). In addition, the House Republican Doctors Caucus and physician organizations are continuing their push for relief from the 3.37% cut in Medicare payments that took effect on January 1.
Health Care
With the House not returning for legislative business until Wednesday afternoon, it will be a light week for health policy. Of note, though, the Energy & Commerce will continue to be active on the health care front with the Committee’s Health Subcommittee holding a legislative hearing on Thursday, February 29, titled “Legislative Proposals to Support Patients with Rare Diseases.” The hearing, which is set to set to coincide with the nationally recognized “Rare Disease Day 2024,” will examine 18 bills related to rare diseases and the challenges facing rare disease patients.
As always, we will be in touch with developments. Create a great week!
Medicare beneficiaries are often uninformed on prices, supplemental benefits, and the use of prior authorization in their Medicare Advantage (MA) plans. In a landscape where healthcare decisions can feel opaque, transparency could empower patients in navigating the Medicare Advantage program. New initiatives and regulations by HHS and CMS are working to enhance transparency within Medicare Advantage, creating more informed decision-making and ensuring equitable access.
The Administration’s goal is to provide tools so beneficiaries can make informed choices about their healthcare coverage. By bolstering transparency within the Medicare Advantage program, the Administration aims to address longstanding challenges and equip beneficiaries with the information needed to select plans that align with their healthcare needs and preferences.
At the core of this initiative lies a multifaceted approach designed to enhance transparency across various dimensions of the Medicare Advantage program. Key components of the Administration’s efforts include:
Enhanced Access to Plan Information
The initiative seeks to enable beneficiaries to compare coverage options with greater ease and clarity. By centralizing plan data and making it readily accessible to beneficiaries, the Administration aims to facilitate informed decision-making and empower individuals to select plans that best meet their healthcare needs.
Improved Cost Transparency
By providing beneficiaries with clear and comprehensive information regarding plan costs, including premiums, deductibles, and copayments, the initiative aims to empower individuals to assess the financial implications of their healthcare choices and make informed decisions aligned with their budgetary constraints.
Increased Quality Reporting
Quality of care is a fundamental consideration for Medicare Advantage beneficiaries seeking to maximize the value of their healthcare coverage. By changing the way plans are rated and creating more transparency around key quality metrics, such as clinical outcomes and patient satisfaction ratings, the initiative aims to empower beneficiaries to make informed assessments of plan performance and quality of care delivery.
Accessible Tools and Resources
The Administration’s initiative prioritizes the development of accessible online tools and resources designed to support informed decision-making. From online comparison tools to personalized assistance through the Medicare Plan Finder, these resources are intended to empower beneficiaries with the information and support necessary to navigate the complexities of the Medicare Advantage program effectively.
Conclusion
The Administration’s push for increased transparency within the Medicare Advantage should foster transparency across various dimensions of the program. CMS is laying the groundwork for a more equitable, accessible, and patient-centered healthcare system that prioritizes the needs and preferences of Medicare Advantage beneficiaries. Major health plans and coalitions are objecting to many aspects of these proposals, so we will need to continue watching to see which of these proposals actually become finalized.
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On February 15, 2024, the House Veterans’ Affairs (VA) Health Oversight Committee held a hearing to discuss Artificial Intelligence at VA, reviewing what is currently happening and what could be implemented in the future.
In today’s digital age, the protection of sensitive health information has become a priority for Congress. The Health Insurance Portability and Accountability Act (HIPAA), a federal law enacted in 1996, has long been the cornerstone of health data privacy in the United States. HIPAA sets the national standards for health data privacy and security, ensuring your health information is kept confidential and secure. It’s like your personal gatekeeper for medical records. However, as online data collection has grown, cyberattacks are increasing. Lawmakers and officials at the Department of Health and Human Services (HHS) have recognized the need for more comprehensive safeguards to protect health data privacy.
HHS & FTC Enforcement
HHS Office for Civil Rights (OCR) plays a crucial role in enforcing HIPAA; this office ensures that covered entities, such as health plans, health care providers, and health care clearinghouses, comply with HIPAA Privacy and Security Rules.
Additionally, the Federal Trade Commission (FTC) enforces the FTC Act and the Health Breach Notification Rule. The Health Breach Notification Rule applies to vendors of personal health records (PHR), PHR-related entities, and third-party service providers. This rule covers businesses not covered by HIPAA. The FTC Act prohibits deceptive or unfair acts or practices in commerce, including misleading consumers about health information handling. It enforces the idea that companies must ensure their health data practices do not cause more harm than good.
Gaps
However, despite regulatory efforts, gaps remain in HIPAA that can only be addressed by Congress. The law does not cover data collected by wearable devices, smart devices, health and wellness apps, and other digital health technologies that fall outside traditional healthcare settings. (Xanax online) Companies may use this information for marketing purposes or share and sell your information to profit, depending on state law. In a House Energy and Commerce hearing in December of last year, witnesses discussed how Artificial Intelligence (AI) presents new challenges since AI models do not have HIPAA protection for the data they use, making it simple for an AI model to identify an individual patient
Congress is (kind of) Looking to Act
Congress has shown a growing interest in addressing health data privacy, particularly in the context of AI. President Biden issued an executive order on safe, secure, and trustworthy AI, emphasizing the need to protect Americans’ privacy, including from the risks posed by AI, and calling on Congress to pass bipartisan data privacy legislation. Yet, the urgency to tackle health data privacy has taken a backseat because of other congressional priorities and partisan disagreements on numerous matters.
Nevertheless, some Members of Congress, such as Senator Bill Cassidy (R-LA), are actively considering potential updates to HIPAA as evidenced by his request for input into potential updates to the legislation. As indicated by Sen. Cassidy’s persistence, ongoing consideration, and discussion regarding the expansion of health data privacy laws to encompass AI and other emerging technologies continues in earnest.
Advertisers’ Perspective
At least one group is happy Congress has not done anything to expand HIPAA – advertisers. The National Advertising Initiative (NAI) is an industry trade group that develops self-regulatory standards for online advertising for its members such as Google. The NAI states that Congress shouldn’t extend the federal health privacy law and that data-driven health advertising benefits consumers and health care professionals. They believe data-driven advertising serves to help consumers find the products they need, and it helps health care professionals optimize their products based on public needs.
Looking Ahead
As we have seen this year, Congress is struggling to pass anything right now. We will see if this year will be different, or if this becomes an issue for the next Congress to handle. Whatever happens, you can be sure we will be watching and providing in-depth analysis for our clients.
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