Monday Roundup

David Ermer–End of the PHE, NE, Medicare, U.S. Healthcare–
Photo by Sven Read on Unsplash

From the end of the PHE/National Emergency (NE) front, yesterday President Biden signed into law a bill (HR 7) that ends the Covid NE immediately, instead of May 11, as the Administration planned. In addition, the NE law calls for a 60-day phase-out period following termination. Consequently, the statutory changes tied to the NE end will phase out on June 7, 2023.

The statutory changes about employer-sponsored health plans falling into this category directly impact employers and concern topics, e.g., COBRA continuation coverage and ERISA appeal rights, that do not affect FEHBP.

In contrast, the statutory changes tied to the end of PHE, e.g., no-cost Covid testing, preventive services etc., do not impact FEHB plans. The available guidance on that matter is found in ACA FAQ 58.

From the post-Dobbs front, the Wall Street Journal reports

  • “The Biden administration filed an emergency request Monday asking a federal appeals court to block a ruling that suspended approval of a widely used abortion pill, while some Democratic-led states announced contingency plans to stockpile abortion drugs.
  • “In a filing with the New Orleans-based Fifth U.S. Circuit Court of Appeals, the Justice Department said a federal judge in Texas engaged in an “extraordinary and unprecedented” usurpation of the U.S. Food and Drug Administration’s authority by ruling that the pill shouldn’t have been approved. 
  • “The department said U.S. District Judge Matthew Kacsmaryk in Amarillo, Texas, upended decades of reliance on the abortion pill, known as mifepristone, “based on the court’s own misguided assessment of the drug’s safety.”
  • “The drug’s brand-name manufacturer, Danco Laboratories, which sells mifepristone marketed as Mifeprex, filed a similar motion. The company said that in addition to the potential harm the ruling posed to millions of women who rely on the pill, it also threatened Danco’s livelihood as a one-drug company. 
  • “Hundreds of pharmaceutical industry leaders, meanwhile, weighed in, saying in an open letter that the Texas decision could threaten FDA regulation of medicines more broadly.”

From the Medicare front, Fierce Healthcare informs us

  • “The Centers for Medicare & Medicaid Services (CMS) released the proposed Inpatient Prospective Payment Systems (IPPS) rule and the Long-Term Care Hospital pay rule. In addition to changes to payment rates, the agency is proposing to measure hospitals on how they tackle health equity. 
  • “CMS is helping to build a resilient healthcare system that promotes good outcomes, patient safety, equity and accessibility for everyone,” said CMS Administrator Chiquita Brooks-LaSure in a statement. 
  • “Hospitals that participate in the IPPS Quality Reporting Program and meaningfully use electronic records are projected to get a 2.8% increase to payments for fiscal year 2024, which begins in October. The pay raise is based on a 3% projected hospital market basket update of 3%, which is “reduced by a projected 0.2 percentage point productivity adjustment,” according to a release on the rule. 
  • “Overall, this will lead to a $3.3 billion increase in inpatient payments. However, long-term care hospitals are expected to get reduced payments by 2.5%, or $59 million.
  • “Overall, CMS expects [long-term care] payments under the dual-rate payment system to decrease by 0.9%, or $24 million, primarily due to a projected decrease in high-cost outlier payments in FY 2024 compared to FY 2023,” the agency said.”
  • Hospital groups slammed the proposed payment rates for the IPPS and long-term care hospitals as inadequate.

From the Postal Service front, Federal News Network tells us that USPS marked the first anniversary of the Postal Reform Act by proposing a price increase on stamps for the summer of 2023.

  • “The agency announced Monday that it plans to raise rates again. The proposed rates would go into effect on July 9, and would raise the price of a first-class stamp to 66 cents.
  • “USPS said operating expenses fueled by inflation continue to rise, and that the agency making up for years of operating under a “defective pricing model.”
  • “USPS raised the price of a first-class stamp to 63 cents in January, after raising it from 58 cents to 60 cents in July 2022.”

In consumer health news, the Wall Street Journal discusses the impact of the new generation of weight loss drugs on the $76 billion diet industry and offers guidance on buying lower-priced hearing aids over the counter. Interesting tidbit, most OTC hearing aids include useful customer support.