Congress Watch
Congress has generally been on recess this summer but will reconvene next Monday and in session this month. The most pressing issue it will tackle this month is that it has until October 1 to pass an appropriation bill. The expectation is that there will likely be a temporary funding bill until after the election. More substantive potential changes (i.e., PBM regulations, changes to Medicare provider rates, sequestration) will not be handled until the lame duck session in late November or December.
CMS Rules
There are several CMS rules at OMB including the 2026 ACA Payment Notice, Enhancing preventative services regulation, and changes to the Medicare Shared Savings Program (over suspect billing activity). These regulations are likely to move sooner than later.
Medicare Advantage Exits
Humana announced it would be exiting some markets (13 counties) for its Medicare Advantage market. Centene also announced it would be exiting some markets as well. Other large national players like United and CVS are also considering shrinking their footprint. The reduction in plan offering is likely a result of recent cuts to base payments enacted by the Biden Administration.
Healthcare Worker Shortage
A new Mercer report noted that health care worker shortages are likely to increase over the next few years. Shortages are expected to be especially acute in the South.
Covid
Covid cases and emergency department visit appear to have peaked and are declining according to the latest CDC data.
