This Week in Washington: All Efforts Are on Funding the Government Through the Rest of the Fiscal Year

Congress

House

• House Passes Short-Term Funding CR
• House Passes Bipartisan Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022

Senate

• Senators Push Legislation to Preserve Provider Bonus Payment

Administration

• HHS Announces Extension of Enforcement Discretion for Good Faith Billing Estimates
• HHS Secretary Encourages States to Address Mental Health Crisis
• FDA Grants Priority Review to Over-the-Counter (OTC) Opioid Overdose Reversal Drug
• FDA Grants Priority Review to Pfizer RSV Vaccine
• CMS Encourages Congress to Address Physician Pay Cuts
• CDC Seeking Greater Data Collection Authority
• Ground Ambulance and Patient Billing Advisory Committee Announced

Other Activity

• MACPAC Moves Closer to Recommending States’ Drug Coverage Restriction Flexibility

Proposed Rules

• SAMHSA Seeking Public Comments Regarding Opioid Use Disorder Treatment Medication Requirement Reforms
• SAMHSA Introduces Proposed Rule to Better Align SUD Patient Privacy with HIPAA
• CMS Proposes Benefit and Payment Parameters for 2024
• CMS Proposes MA Plan Marketing, Part D Low-income Access, Prior Authorization and Behavioral Health Reforms
• CMS Proposes Healthcare Plan Exchange Rule for 2024
• CMS Requests Information on Essential Health Benefits Proposed Rule
• HHS Proposes Adopting Healthcare Attachments Standards
• HHS Proposes Modifying Current Retail Pharmacy Transaction Standards
• FDA Proposed Rule Would Replace Investigational New Drug Annual Report
• FDA Proposes Exempting Certain Conventional Food, Dietary Supplements and Cosmetics From Investigational New Drug Requirements
• FDA Proposes Increasing Certification Service Fees and Amending Color Additive Certification
• HRSA Proposed Rule Changes Concerning 340B Disputes

Final Rules

• FDA Delays Tobacco Product Required Warning Final Rule Effective Date
• CMS Final Rule Revises Medicare Hospital Outpatient and Ambulatory Surgical Center Payment Systems for Calendar Year (CY) 2023
• CMS Issues Correction on Clinical Laboratory Improvement Amendments (CLIA) Final Rule
• CMS Final Rule Updates and Revises the End-Stage Renal Disease (ESRD) Prospective Payment System for Calendar Year (CY) 2023
• CMS Issues Final Rule Implementing Updates to Medicare Home Health Payment System
• CMS Issues Final Rule Implementing Certain Provisions of the Consolidated Appropriations Act of 2021 and Medicare Enrollment and Eligibility Rules
• CMS Hospital Outpatient Final Rule Promotes Health Equity in Rural Care Access
• CMS Issues Final Physician Payment Rule Emphasizing Access to Behavioral Health Services and Whole-Person Care

Reports

• CMS Releases Update to Medicare Telehealth Trends Report
• CMS Innovation Center Publishes 2022 Report to Congress
• MACPAC Releases 2022 MACStats: Medicaid and CHIP Data Book

Congress

House

House Passes Short-Term Funding CR

On Dec. 14, the House of Representatives passed a short-term funding bill to avoid a government shutdown since the existing Continuing Resolution would run out on Dec. 16. The Senate passed the short-term CR on Dec. 15. The federal government is now funded until Dec. 23.

In the House, nine Republicans voted with Democrats in supporting the measure after GOP leadership urged Republican members to oppose the short-term CR.

It is hoped that the language for the CR to fund the federal government through the rest of the fiscal year will be released Dec. 19.

House Passes Bipartisan Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022

On Dec. 2, the U.S. House passed the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022 with a 390-26 vote. The bipartisan bill will reauthorize the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program for an additional five years. The bill will specifically increase funding for services that support new parents and their children from pregnancy through kindergarten, with in-home support that has been shown to improve maternal and child health, family safety, family stability, child development and school readiness. It will also update the MIECHV Program to improve outcomes for families, state accountability and access to MIECHV funds.

For more information, click here.

Senate

Senators Push Legislation to Preserve Provider Bonus Payment

On Dec. 15, Sens. Sheldon Whitehouse (D-RI) and John Barrasso (R-WY) introduced “the Preserving Access to Value-Based Care Act” to save the bonus that goes away in 2023 for providers. The 5 percent bonus went to providers who agreed to sign up in an alternative payment model.

Administration

HHS Announces Extension of Enforcement Discretion for Good Faith Billing Estimates

On Dec. 2, the Department of Health and Human Services (HHS) stated that it would extend its enforcement discretion on a provision in the No Surprises Act, that requires providers granting good faith estimates (GFEs) to individuals paying their own bills, to get cost estimates from any co-provider or co-facility. HHS believes the extension will increase interoperability within the healthcare industry and grant providers and facilities more time to adhere to new requirements.

For more information, click here.

HHS Secretary Encourages States to Address Mental Health Crisis

On Dec. 14, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra urged states to take the lead in finding solutions to various health challenges, such as substance abuse and mental health problems. Secretary Becerra stated that HHS and the federal government have limited authority over taking action against healthcare challenges occurring at the state level. HHS is encouraging local communities to speak with local and state officials about these issues and push them to take action on them.

For more information, click here.

FDA Grants Priority Review to Over-the-Counter (OTC) Opioid Overdose Reversal Drug

On Dec. 6, the Food and Drug Administration (FDA) granted priority review to Emergent BioSolutions’ proposed over-the-counter (OTC) opioid overdose reversal drug Narcan (naloxone) nasal spray. The FDA has set the drug’s prescription drug user fee goal date as March 29, 2023. Emergent BioSolutions has declined to announce what it is planning to charge for the drug. The FDA priority review approval comes a month after the agency announced that certain forms of naloxone may be eligible for nonprescription use, a move intended to facilitate the development and approval of nonprescription and OTC versions of the drug.

For more information, click here.

FDA Grants Priority Review to Pfizer RSV Vaccine

On Dec. 6, the Food and Drug Administration (FDA) granted priority review to Pfizer’s respiratory syncytial virus (RSV) vaccine for people ages 60 and older. The FDA hopes to make an approval decision on the vaccine by May 2023. Pfizer announced that it is also working on a maternal RSV vaccine to administer to pregnant people to protect infants. The company is attempting to become the first to develop an FDA-approved RSV vaccine. GlaxoSmithKline, Moderna, Janssen and Novavax are currently developing their own RSV vaccines.

For more information, click here.

CMS Encourages Congress to Address Physician Pay Cuts

On Dec. 9, Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure encouraged Congress to address looming Medicare physician pay cuts. This action comes after CMS finalized the 2023 Physician Fee Schedule Final Rule, which reduces the Medicare Physician Fee Conversion Factor by 4.47 percent for calendar year (CY) 2023. Physicians are facing other pay reductions in CY 2023, with cuts planned for the clinical labor policy tied to the PAYGO scorecard from the American Rescue Plan, and the termination of 5 percent alternative pay model bonuses.

For more information, click here.

CDC Seeking Greater Data Collection Authority

On Dec. 9, Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky called on Congress to grant the agency greater data collection authority. The CDC has been working to increase awareness of its data collection limitations among lawmakers who are unaware of the extent of the agency’s collection powers. The CDC must currently create individual data-sharing agreements with local public health departments.

Ground Ambulance and Patient Billing Advisory Committee Announced

On Dec. 14, 17 individuals were announced as members of the Ground Ambulance and Patient Billing (GAPB) Advisory Committee. The GAPB Advisory Committee will be in charge of making recommendations to the U.S. Department of Labor, the U.S. Department of the Treasury and HHS on ways to improve ground ambulance price transparency and billing practices. The committee is scheduled to meet twice in 2023 and it will release a report on its recommendations no later than 180 days after its first meeting.

For more information, click here.

Other Activity

MACPAC Moves Closer to Recommending States’ Drug Coverage Restriction Flexibility

On Dec. 8, Medicaid and CHIP Payment and Access Commission (MACPAC) advisors discussed whether to send a recommendation to Congress that would urge them to grant states flexibility to restrict coverage of doctor-administered drugs that are subject to national coverage policies under Medicare. State Medicaid directors have been pondering ways to obtain flexibility to restrict coverage of drugs for which there are outstanding questions regarding their safety and efficacy regardless of their approval status, an authority that Medicare currently possesses. At the moment, state Medicaid programs are required to pay for all drugs approved by the FDA in exchange for a minimum of 23 percent rebate from drug companies on all drugs. MACPAC’s draft recommendation asks Congress to amend the Social Security Act, to grant states restriction flexibility. The proposal is not likely to affect many drugs in Medicaid because it would only apply to doctor-administered drugs or drugs specific to the Medicare Part B program.

For more information, click here.

Proposed Rules

SAMHSA Seeking Public Comments Regarding Opioid Use Disorder Treatment Medication Requirement Reforms

On Dec. 16, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a notice of proposed rulemaking. SAMHSA is requesting public comments on its proposal to modify regulations for opioid use disorder treatment medications. The proposed rule seeks to make treatment in Opioid Treatment Programs (OTP) more accessible to patients, and easier to deliver to providers. The proposed rule also seeks to increase the uptake of evidence-based treatments for substance use disorders and is in line with the Department of Health and Human Services’ (HHS) Overdose Prevention Strategy.

Public comments will be accepted until Feb. 14, 2023. For more information, click here.

SAMHSA Introduces Proposed Rule to Better Align SUD Patient Privacy with HIPAA

On Nov. 28, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule that would align certain policies in the Confidentiality of Substance Use Disorder Patient Records with the Health Insurance Portability and Accountability Act (HIPAA), per Congress’ instruction in the CARES Act.

The proposed rule would allow providers to disclose Part 2 records after patients give consent once, and that consent would apply to all future uses. They would also be able to redisclose those records as permitted by the HIPAA privacy rule. Additionally, the rule would give patients the ability to obtain a list of disclosure situations and the right to request restrictions on certain disclosures. It would also give the Department of Health and Human Services (HHS) new enforcement powers, like civil money penalties for those that violate Part 2 protections.

Public comments will be accepted until Jan. 31, 2023. For more information, click here.

CMS Proposes Benefit and Payment Parameters for 2024

On Dec. 14, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that lays out proposed payment parameters for Department of Health and Human Services (HHS)-operated risk adjustment and risk adjustment data validation programs. The proposed rule also reveals proposed 2024 user fee rates for issuers who offer qualified health plans (QHPs) on federally-facilitated exchanges (FFEs) and state-based exchanges.

Public comments will be accepted until Jan. 30, 2023. For more information, click here.

CMS Proposes MA Plan Marketing, Part D Low-income Access, Prior Authorization and Behavioral Health Reforms

On Dec. 14, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that seeks to overhaul marketing practices for Medicare Advantage (MA) plans. The proposed rule comes after CMS told MA plan issuers that it was concerned with the manner in which MA plans were marketed, particularly on television and by third-party marketing organization ads.

Some of the proposed rule changes include:

• Prohibiting television advertisements that don’t specify a plan name.
• Prohibiting advertisements that use words and imagery that may mislead or confuse MA plan beneficiaries.
• Prohibiting the use of Medicare language or logos in advertisements.
• Prohibiting MA plan marketers from using the words “best” and “most” to describe their plans, unless they have documentation to support such statements.
• Banning sales presentations that immediately follow an educational event.
• Banning agent distribution and collection of Scope of Appointment and Business Reply Cards at educational events.
• Banning agents from conducting sales or enrollment meetings with beneficiaries within 48 hours after obtaining their consent.

Additionally, the proposed rule seeks to expand access to low-income Part D subsidies and biosimilars. CMS would like to grant Part D low-income subsidies to individuals who currently qualify for partial low-income subsidies. The agency wants to ensure that individuals who qualify for full low-income subsidies do not have to face deductibles, premiums or fixed copay requirements for certain drugs. CMS is also proposing that Part D plan sponsors be able to substitute brand drugs with lower-cost options.

The proposed rule also contains language regarding the prior authorization process and behavioral health reforms. CMS is incorporating several recommendations from a report on prior authorization request denials, issued by the Office of the Inspector General (OIG). The proposed rule also includes provisions that seek to grant MA enrollees access to behavioral health service providers. The proposed rule would require MA organizations to include behavioral health services in care coordination programs.

Public comments will be accepted until Feb. 13, 2023. For more information, click here.

CMS Proposes Healthcare Plan Exchange Rule for 2024

On Dec. 12, the Centers for Medicare and Medicaid Services (CMS) released the 2024 proposed rule for plans in the exchange. The proposed rule includes key changes to network adequacy standards and will slightly lower user fees for 2024. In addition, the rule:

• Proposes to limit to two the nonstandardized plan options for each product network type and metal tier level, with an exception for catastrophic plans. This requirement only applies to HealthCare.gov, which residents in 38 states use to buy ACA plans. It does not apply to state-run marketplaces.
• Seeks to add to the standardized plan option requirements including a proposal to no longer include a standard option for the nonexpanded bronze plan tier.

Public comments will be accepted until March 13, 2023. For more information, click here.

CMS Requests Information on Essential Health Benefits Proposed Rule

On Dec. 2, the Centers for Medicare and Medicaid Services (CMS) issued a request for information on a proposed rule that relates to the essential health benefits (EHBs) included in the Patient Protection and Affordable Care Act (ACA). CMS is requesting comments to gain a better understanding of the coverage of EHBs in health plans, and to evaluate whether EHBs should be modified or updated to account for changes in medical evidence and scientific advancements.

Public comments will be accepted until Jan. 31, 2023. For more information, click here.

HHS Proposes Adopting Healthcare Attachments Standards

On Dec. 15, the Office of the Secretary of the Department of Health and Human Services (HHS) released a proposed rule that would implement standards for “health care attachments” transactions, to support healthcare claims and prior authorization transactions. The proposed rules would also implement a standard for electronic signatures and modify the standard for referral certification and authorization transactions.

Public comments will be accepted until March 21, 2023. For more information, click here.

HHS Proposes Modifying Current Retail Pharmacy Transaction Standards

On Nov. 9, the Office of the Secretary of the Department of Health and Human Services (HHS) released a proposed rule that seeks to adopt updated versions of the retail pharmacy standards for electronic transactions, adopted under the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Apart from retail pharmacy transactions, the updated versions would modify healthcare claims or equivalent encounter information, health plan eligibility, referral certification and authorization, and benefits coordination. The proposed rule would also broaden the applicability of the Medicaid pharmacy subrogation transaction to all health plans. Additionally, it would rename and revise the definition of the transaction and adopt an updated standard that would be a modification for state Medicaid agencies and an initial standard for all other health plans.

Public comments will be accepted until Jan. 9, 2023. For more information, click here.

FDA Proposed Rule Would Replace Investigational New Drug Annual Report

On Dec. 9, the Food and Drug Administration (FDA) released a proposed rule that would change the investigational new drug (IND) annual reporting requirement. The proposed rule would replace the IND annual report with a new report titled the Food and Drug Administration Development Safety Update Report (FDA DSUR). The FDA intends to make the new report consistent with the format and content of the development safety update report that is supported by the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH).

Public comments will be accepted until March 9, 2023. For more information, click here.

FDA Proposes Exempting Certain Conventional Food, Dietary Supplements and Cosmetics From Investigational New Drug Requirements

On Dec. 9, the Food and Drug Administration (FDA) released a proposed rule that seeks to exempt certain clinical investigations of lawfully marketed conventional foods, dietary supplements and cosmetics from the investigational new drug application (IND) requirement, when the clinical investigations are conducted for the purposes of studying the products’ potential use as a drug. Although these products would be exempt from IND requirements, they would still be subject to other investigations to ensure the rights and safety of individuals. The FDA believes the proposed rule will reduce regulatory burden on the agency.

Public comments will be accepted until March 9, 2023. For more information, click here.

FDA Proposes Increasing Certification Service Fees and Amending Color Additive Certification

On Nov. 2, the Food and Drug Administration (FDA) released a proposed rule that would amend the color additive regulation to increase the fee for certification services. The fees are intended to recover the full operational costs of the FDA’s color certification program. The change in fee would allow the FDA to continue maintaining an adequate color certification program as required by the Federal Food, Drug, and Cosmetic Act (FD&C Act).

Public comments will be accepted until Jan. 3, 2023. For more information, click here.

HRSA Proposed Rule Changes Concerning 340B Disputes

On Nov. 29, the Health Resources and Services Administration (HRSA) released a proposed rule that outlines changes to how the administrative dispute resolution (ADR) process should be handled, for diversions, duplicate discounts and overcharges under the 340B program. HRSA aims to make the process less formal and more expeditious. The proposed changes include:

• Establishing a more accessible and timely ADR process, while structuring the process to be less formal and rigid.
• Eliminating the $25,000 minimum dispute threshold for drug makers and 340B providers to use the process.
• Restructuring the ADR panel to be composed of subject-matter experts from HRSA’s Office of Pharmacy Affairs.
• Requiring that covered entities and drug companies attempt to resolve disputes in good faith on their own before the ADR process is initiated.
• Allowing for a reconsideration process when either covered entities or drug companies are dissatisfied with the ADR panel’s decision.

Public comments will be accepted until Jan. 30, 2023. For more information, click here.

Final Rules

FDA Delays Tobacco Product Required Warning Final Rule Effective Date

On Nov. 25, the Food and Drug Administration (FDA), in compliance with an order issued by the U.S. District Court for the Eastern District of Texas, delayed the effective date of a final rule published on March 18, 2020, titled “Tobacco Products; Required Warnings for Cigarette Packages and Advertisements.” The rule, which was originally supposed to go into effect on June 18, 2021, establishes new cigarette health warnings for cigarette packages and advertisements.

The rule is now set to go into effect on Nov. 6, 2023. For more information, click here.

CMS Final Rule Revises Medicare Hospital Outpatient and Ambulatory Surgical Center Payment Systems for Calendar Year (CY) 2023

On Nov. 23, the Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment period that revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2023. The rule outlines changes to the amounts and factors used when determining payment rates for Medicare services paid under the OPPS and the ASC payment systems. It also updates requirements for Organ Acquisition, Rural Emergency Hospitals (REHs), Prior Authorization and Overall Hospital Quality Star Rating.

Additionally, the final rule will:

• Establish a new provider type for REHs.
• Finalize proposals regarding REH payment policies, quality measures and enrollment policies.
• Finalize the Conditions of Participation that REHs must meet in order to participate in Medicare and Medicaid programs.
• Finalize changes to Critical Access Hospital (CAH) Conditions of Participation for location and distance requirements.
• Finalize patient rights requirements and flexibilities for CAHs that are part of a larger health system.
• Finalize a number of provisions that were implemented in COVID-19 interim final rules.
• Update and refine requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program and the Rural Emergency Hospital Quality Reporting (REHQR) Program.

The rule goes into effect Jan. 1, 2023. Public comments will be accepted until Jan. 3, 2023. For more information, click here.

CMS Issues Correction on Clinical Laboratory Improvement Amendments (CLIA) Final Rule

On Nov. 17, the Centers for Medicare and Medicaid Services (CMS) corrected a technical error that was found in a final rule published in the Federal Register on July 11, 2022. The final rule updates proficiency testing (PT) regulations under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), to address analytes and newer technologies.

The rule goes into effect July 11, 2024. For more information, click here.

CMS Final Rule Updates and Revises the End-Stage Renal Disease (ESRD) Prospective Payment System for Calendar Year (CY) 2023

On Nov. 7, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that updates and revises the ESRD Prospective Payment System for CY 2023. The rule also updates the payment rule for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. Additionally, the rule updates requirements for the ESRD Quality Incentive Program and finalizes changes to the ESRD Treatment Choices Model.

The rule goes into effect Jan. 1, 2023. For more information, click here.

CMS Issues Final Rule Implementing Updates to Medicare Home Health Payment System

On Nov. 4, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that updates the Medicare home health payment rates for calendar year (CY) 2023, in accordance with existing statutory and regulatory requirements. The final rule also finalizes a methodology for determining the impact of the difference between assumed versus actual behavior change on estimated aggregate expenditures for home health payments. Additionally, the rule finalizes changes to the Home Health Quality Reporting Program (HHQRP) requirements, changes to the expanded Home Health Value-Based Purchasing (HHVBP) Model and updates to the home infusion therapy services payment rates for CY 2023.

The rule goes into effect Jan. 1, 2023. For more information, click here.

CMS Issues Final Rule Implementing Certain Provisions of the Consolidated Appropriations Act of 2021 and Medicare Enrollment and Eligibility Rules

On Nov. 3, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, implementing provisions of the Consolidated Appropriations Act of 2021. The final rule also proposes removing references to specific Medicare forms from the text, to provide for greater administrative flexibility. It also updates various federal regulations that affect a state’s payment of Medicare Part A and B premiums for beneficiaries enrolled in Medicare Savings programs and other eligibility groups.

The rule goes into effect Jan. 1, 2023. For more information, click here.

CMS Hospital Outpatient Final Rule Promotes Health Equity in Rural Care Access

On Nov. 1, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period. The final rule will allow Critical Access Hospitals (CAHs) and small rural hospitals to convert to a Rural Emergency Hospital (REH), as an option for rural hospitals facing closure and supports access to care in rural and underserved communities. An REH is a new Medicare provider type that furnishes outpatient services, emergency services and observation care. In this rule, Medicare will also pay hospital outpatient departments to provide remote behavioral health services to people at home, which will improve access to care in rural communities and promote health equity.

The rule goes into effect Jan. 1, 2023. For more information, click here.

CMS Issues Final Physician Payment Rule Emphasizing Access to Behavioral Health Services and Whole-Person Care

On Nov. 1, the Centers for Medicare and Medicaid Services (CMS) expanded access to behavioral healthcare, cancer screening coverage and dental care through the calendar year 2023 Physician Fee Schedule (PFS) final rule. The rule makes regulatory revisions to reduce barriers to behavioral health services for Medicare beneficiaries. Specifically, the rule makes an exception to the direct supervision requirement to allow behavioral health services to be provided under the general supervision of a physician or nonphysician practitioner (or NPP).

CMS is also clarifying that any service furnished primarily for the diagnosis and treatment of a mental health or substance use disorder can be furnished by auxiliary personnel under the general supervision of a physician or NPP who is authorized to furnish and bill for services provided incident to their own professional services.

The rule goes into effect Jan. 1, 2023. For more information, click here.

Reports

CMS Releases Update to Medicare Telehealth Trends Report

On Dec. 15, the Centers for Medicare and Medicaid Services (CMS) released an update to the Medicare Telehealth Trends Report, which reveals the trends in usage of telehealth services between Jan. 1, 2020, and June 30, 2022. The data in the report includes Medicare Fee-for-Service (FFS), Part B claims and Medicare enrollment information data.

For more information, click here.

CMS Innovation Center Publishes 2022 Report to Congress

On Dec. 12, the Centers for Medicare and Medicaid (CMS) Innovation Center published its latest Report to Congress (RTC). The 2022 RTC details activities undertaken by CMS between October 2020 and September 2022. The report highlights the CMS Innovation Center model tests that were launched or continued during this time. It also reveals details on the implementation and evaluation of five specific CMS Innovation Center demonstration projects authorized by other statutes. Approximately 33 models were operational during the period covered by the report. CMS conducts model tests to study and find potential healthcare payment and delivery improvements for advanced primary, episode-based and accountable care.

For more information, click here.

MACPAC Releases 2022 MACStats: Medicaid and CHIP Data Book

On Dec. 15, the Medicaid and CHIP Payment and Access Commission (MACPAC) released the 2022 edition of its MACStats: Medicaid and CHIP Data Book. It includes updated data and information on national and state Medicaid and Children’s Health Insurance Program (CHIP) enrollment, spending, benefits, beneficiaries’ health, service use and access to care. The new data book revealed an increase of 7.2 percent in Medicaid and CHIP enrollment between July 2021 and July 2022. Although enrollment increased, it was lower than last year, when enrollment rose by 10.4 percent during the same period of time. As of July 2022, roughly 90 million Americans are enrolled in Medicaid and CHIP.

For more information, click here.