Washington Update: Monday, March 20, 2023
MedPAC makes annual payment recommendations to Congress.
MedPAC released its annual report to Congress and recommended a 1% increase in general hospital (IPPS) rates. For post-acute, MedPAC recommended a 3% cut in IRF rates, a 7% decrease for home health, and a 3% cut for SNFs. MedPAC also recommended Congress enact add-on reimbursements for physicians (particularly primary care) and for hospitals treating patients in underserved areas.
Congress doesn’t always implement MedPAC’s policy recommendations.
MedPAC will no longer cover LTCHs on a regular, recurring basis.
MedPAC didn’t recommend any specific payment adjustments for the LTCHs.
In fact, MedPAC announced it “will no longer provide an annual payment adequacy analysis for LTCHs but will continue to monitor that sector and provide periodic status reports.” This is a first since MedPAC was created in 1997. MedPAC said it was because LTCH cases have declined and “the small claims base and related data makes it difficult to assess payment adequacy for LTCHs.”
MA plans target Pennsylvania Members to fight Biden Administration rules.
The Biden Administration has proposed several new rules to increase regulatory supervision of “prior authorization” used by health plans. Even though these policies are fairly incremental, MA insurers have launched a number of advertising campaigns targeting Members of Congress who supported these and other policies. Two Pennsylvania House members have been targeted: Rep. Susan Wild (D-PA), of the Lehigh Valley and Rep. Matt Cartwright (D-PA), of Scranton.
CBO says prior-authorization legislation will cost Medicare.
The Congressional Budget Office recently reported to House members that their popular legislation to further change the way MA plans use prior authorization will raise costs in Medicare. CBO says the bill could increase Medicare spending by as must as $10 billion over ten years. This is lower than last year’s $16 billion estimate, but higher than expected. Advocates had expected a lower score this year since CMS has begun enacting some similar policies by rule. The high price tag makes it less likely that Congress will adopt the bill this year.
Senate Republican Leader Mitch McConnell (R-KY) admitted to IRF.
Sen. McConnell was discharged from a Washington hospital last week and admitted to a Washington IRF. The 81-year-old Senate leader has been hospitalized and receiving treatment for a concussion since March 8. He has held that post longer than anyone. The Senator has long been a supporter of post-acute care. His hometown of Louisville still hosts the corporate headquarters of Scion, formerly known as Kindred. McConnell began serving in the Senate in 1985.
Sen. John Fetterman (D-PA) also remains in the hospital.
Sen. McConnell is not the only senator in the hospital. Sen. Fetterman, still recovering from a stroke last summer, checked himself into Walter Reed Military Hospital several weeks ago to seek treatment for clinical depression. Fetterman, 53, is in his first weeks as a U.S. senator. A third Senator – Dianne Feinstein (D-CA) – has also been out of the Senate for healthcare reasons. The absence of three senators in a 51-49 Senate has complicated voting on recent legislation.
Pennsylvania city & state primary elections are coming on May 16.
The one open seat on the state supreme court is probably the most closely watched race. The court was called on to decide high-profile election-related lawsuits in the 2020 Biden-Trump race. Both Republicans and Democrats will compete in contested primaries for the open position. Democrats now hold a four-to-two majority on the high court after the death last year of Max Baer, a Democrat who was chief justice. Court justices are each elected to ten-year terms.
Pennsylvania county election boards will also be on the ballot.
This year’s local races will determine how Pennsylvania runs its 2024 presidential elections. Counties, not the state, run elections — and the county boards of elections that certify results are on the ballot this year for the first time since the 2020 presidential race. If county boards choose to contest election results, local officials can use their individual counties to hold the entire state’s results hostage. The act of certification was once a routine ministerial task.
Philadelphia primary election may choose next mayor.
Philly mayor Jim Kenney (D) is term-limited and 13 candidates will run in the May primary elections to succeed him. Philadelphia is heavily Democratic, and the May 16 primary will likely determine who will be the next mayor. The biggest issue is likely to be crime, an issue which last month brought the surprise defeat of Chicago’s incumbent mayor, Lori Lightfoot (D). Last October, Mayor Kenney’s attempted rule to restrict guns in the city was overturned by a state judge.