HealthCare Roundtable e-News – October 2, 2023

 

Special Reminder for the 2023 Annual Conference

Reserve Your Conference Hotel Room TODAY!

Deadline: Wednesday, October 4, 2023

 

Register Today

Reserve Your Room at the Mayflower Hotel

Keynote Speaker Announced – Additional speakers will be announced later this week.


Top News

CMS Releases 2024 MA and MAPD Premium Information

CMS released (plan-specific information here) Medicare Advantage (MA) and Medicare Advantage-Prescription Drug (MAPD) premiums for 2024, ahead of Medicare Open Enrollment beginning on October 15, 2023. CMS reports that the average monthly plan premium for all MA plans, including MAPD plans, is projected to increase from $17.86 in 2023 to $18.50 in 2024 (an increase of $0.64). MA supplemental benefit offerings will also increase slightly in 2024. Enrollment in Medicare Advantage is projected to increase from 31.6 million in 2023 to 33.8 million in 2024, representing approximately 50% of all people enrolled in Medicare, compared to approximately 48% for 2023.

  • In addition, more than 1,500 Medicare Advantage plans will participate in the CMS Innovation Center’s Medicare Advantage Value-Based Insurance Design (VBID) Model in 2024. The VBID Model expands access to additional supplemental benefits that can address a wide range of needs, such as food and nutrition benefits, and offers flexibility to target these benefits to people with chronic conditions or low incomes.

 

Senate Finance Committee Introduces Pharmacy Benefit Manager Bill

Senate Finance Committee Chair Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) introduced the Modernizing and Ensuring PBM Accountability (MEPA) Act. The legislative text reflects the Chairman’s Mark that was reported out of the Finance Committee in July. The bill looks to update federal prescription drug programs to address the practices of pharmacy benefit managers. Among its provisions, the bill prohibits pharmacy benefit manager compensation in Medicare from being tied to the sticker price of a drug, increases transparency by creating independent audit and enforcement measures, and provides relief to independent community pharmacies.

Congressional Action

  • The House Ways and Means Committee conducted a hearing on September 19 to address issues arising from the flawed implementation of surprise medical billing protections, particularly through the No Surprises Act (NSA). Witnesses included healthcare professionals and industry representatives. The hearing focused on the detrimental effects of the complex independent resolution dispute (IDR) process on patients, healthcare providers, and facilities. Committee members emphasized that the current process does not align with the original intent of the legislation and stressed the importance of transparency, fairness, and enforcement in the IDR process. Witnesses warned that if these issues are not resolved, providers and healthcare organizations may have to reduce services, harming patients’ access to care. Representatives expressed frustration with the problematic implementation of this bipartisan legislation.
  • The House Committee on Energy & Commerce Subcommittee on Health recently held a hearing titled Examining Policies to Improve Seniors’ Access to Innovative Drugs, Medical Devices, and Technology. The hearing consisted of two witnesses, from CMS and the U.S. Government Accountability Office (GAO). Chairman Guthrie (R-KY) opened the session by discussing the financial burden on seniors due to healthcare costs, expressing support for bills to improve Medicare coverage for breakthrough therapies, and creating a more consistent process for national coverage determinations. Additionally, the Chairman suggested exploring better ways to manage chronic diseases and emphasized the need to prevent seniors and taxpayers from overpaying for drugs.

Regulatory Action

The Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule related to the fees established by the No Surprises Act for the Federal independent dispute resolution (IDR) process. These proposed rules seek to modify existing regulations by specifying that the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (the Departments) will determine the administrative fee amount for participation in the Federal IDR process. Additionally, the proposed rules will establish the fee ranges for certified IDR entities for both single and batched determinations, with these ranges to be established by the Departments through a notice and comment rulemaking process. Furthermore, these proposed rules will detail the methodology employed to calculate the administrative fee and the factors considered when establishing the certified IDR entity fee ranges. CMS is taking comments on the proposed rule for 30 days following the publication of the proposed rule on September 26th, 2023.

Research

The Better Medicare Alliance (BMA) released their annual State of Medicare Advantage report, which provides enrollment statistics by demographics, geography, condition, and plan type, as well as information on benefit design and cost-sharing. The report highlights that the Medicare Advantage population now comprises 31 million beneficiaries, or 51% of the Medicare population. Of note, the report highlights continued growth in Employer Group Waiver Plans (EGWPs) year over year, with 5.3 million beneficiaries enrolled in 2023.


Registration Open for 2023 Annual Conference

The Public Sector HealthCare Roundtable 2023 Annual Conference Moves to Washington, DC

The conference features a new location, a revised format, and a great agenda!

Wednesday, Nov. 1 to Friday, Nov. 3, 2023

 

The Roundtable’s highly-regarded annual conference provides members and guests a unique opportunity to hear presentations by high level government officials and key experts – from Congress and the Administration, academics, benefit consultants, plan administrators, advocates and industry leaders in an intimate dialogue-oriented setting.

After years of successful conferences in Old Town Alexandria, we have outgrown our space at the Alexandrian Hotel. This year we will hold our conference at the historic Mayflower Hotel in Washington, DC. The new location will undoubtedly improve the overall experience for all of our attendees.

In recent years, many of our attendees have urged us to schedule more free time in the conference agenda for networking. Since we understand the importance of this networking time, we have revised this year’s agenda to incorporate longer breaks and more time before evening receptions.

This year, the conference will begin at Noon on Wednesday, November 1st and will conclude at Noon on Friday, November 3rd. By adding time on Wednesday, we have been able to add critical content, lengthen our breaks, and add free time prior to any evening activities.

Although we certainly believe the best way to experience our conference is in-person, this year’s conference will once again feature a virtual option. Any health plan that registers at least one individual to join us in Washington, will be eligible to register online attendees.

Register Today

Reserve Your Room at the Mayflower Hotel