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Whitepapers, briefs, press releases and more

Week in Washington 07/18/24

Post-Chevron As discussed last week, the post-Chevron legal landscape would invite a litigation around HHS regulations. Three cases that have already opened up are around hospital payments (A New Jersey-based hospital is suing HHS over payments calculations to disproportionate share hospitals), non-discrimination requirements (enforcement of protections for LGBTQ= patients), and title X (withholding of federal ... Read more

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Events & More

Unlocking Solutions in Medicaid, Medicare, and Marketplace

Still on the fence about registering? We’d like to share a few reasons why you should register today for HMA’s 7th annual Fall Conference:
1. OUR EARLY BIRD DISCOUNT IS ENDING SOON!
2. Stellar speakers from state Medicaid, behavioral health, human services, and insurance agencies, health plans, healthcare providers, hospital systems, and more.
3. Exclusive access to HMA’s national experts at Pre-conference tactical workshops.
4. Mix, mingle, and re-engage with peers and make new contacts to build your network.
5. Ample opportunities to network with industry C-suite leaders.

We’re continually releasing details about our agenda. Click here to see what’s new and register. Early bird registration ends July 31, 2024.

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Newsworthy Findings

House Committee Tells FDA to Suspend Lab Developed Test Rule

Lawmakers said the final rule carries “the risk of greatly altering the United States’ laboratory testing infrastructure.”

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Editor's Note
The House Appropriations Committee made this request amongst conversations about funding and recommended a partnership between the FDA and Congress to revise the regulation of laboratory developed tests.

GenAI-Enabled EHRs Match Human Clinicians in Messaging, New Study Shows

When able to access patient-specific medical data, an integrated chatbot was accurate, complete and as empathetic as human providers in its message replies – but also long-winded and more complex, according to research from NYU Langone.

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Editor's Note
The purpose of this study was to find ways to lessen documentation burdens and their role in physician burnout.

The Biden-Harris Administration Releases Final Part Two Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs

The final part two guidance on the Medicare Prescription Payment Plan was released on July 16th, 2024 and updates and finalizes requirements proposed in the draft part two guidance released in February 2024. This new payment option provides people with high Rx spending the option to spread out the costs of their prescription drugs over the calendar year and eliminate the burden of paying the total out-of-pocket cost upfront

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Editor's Note
This final part two guidance complements CMS’ forthcoming national education and outreach efforts to engage interested parties, including Part D plans, pharmacies, providers, drug manufacturers, and beneficiary advocates, on program implementation.

Fact Sheet: Calendar Year (CY) 2025 Medicare Physician Fee Schedule Proposed Rule (CMS-1807-P)-Medicare Shared Savings Program Proposals

On July 10, 2024, CMS issued the calendar year 2025 Medicare Physician Fee Schedule (PFS) proposed rule (CMS-1807-P) that includes changes to the Shared Savings Program to further advance Medicare’s value-based care strategy of growth, alignment, and equity.

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Editor's Note
ACOs (Affordable Care Organizations) are now delivering care to nearly 50% of people with Traditional Medicare. The policy changes to the Shared Savings Program are expected to grow participation in the program and increase the number of beneficiaries assigned to ACOs by up to four million over the next several years. These policies are expected to drive growth in participation, particularly in rural and underserved areas, promote equity, and advance alignment across accountable care initiatives.

CMS proposes 2.9% cut to physician pay for 2025

Regulators said Medicare’s budget neutrality requirement is to blame for the reduction, which was quickly decried by provider groups. However, it’s unlikely the cuts go into effect as proposed, as Congress historically steps in to mitigate dramatic decreases to doctor pay.

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Editor's Note
The rule also proposes new payments for providers that help patients at high risk of suicide or overdose, digital tools for delivering behavioral health treatments and more drugs to treat opioid use disorder and overdoses.

Bonus Article

Just for Fun

Math Joke:

What is a math teacher’s favorite snake?

Prior Week

Q: Why is it sad that parallel lines have so much in common?
A: Because they’ll never meet

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