September 19, 2024

Despite the fact that lawmakers in D.C. are largely spinning their wheels when it comes to enacting a new federal budget (the new federal fiscal year begins October 1 and as such the federal government faces a potential and at least partial shutdown unless a Continuing Resolution extending current year spending is enacted). Nevertheless, the powerful House Energy and Commerce Committee met yesterday to mark up bills re: Medicare telehealth and more.  The House advanced a bill that includes a two-year extension of Medicare telehealth pandemic-related flexibilities set to expire at the end of this year.  This has potential  implications for future policy making in the Medicaid space although Medicare is largely regulated by the federal government whereas the power over Medicaid telehealth flexibilities is largely vested with individual states.

Here in NY, the future of important Medicaid telehealth flexibilities extended during the COVID-19 epidemic are scheduled to expire in 2025 and this includes current requirements for Medicaid MCOs and the state’s Fee for Service Program to reimburse OASAS and OMH-regulated mental health and substance use disorder telehealth services at face-to-face rates, as well as other flexibilities. 

Unfortunately and despite significant advocacy during the legislative session that concluded in June, current telehealth reimbursement practices do not currently include a requirement to pay FQHCs at their face to face rates for telehealth services.  These issues are a top priority for the NYS Council as we head into the 2025 legislative session.  

In related news and as mentioned above, the House yesterday rejected Speaker Mike Johnson’s proposal that would have linked temporary funding for the federal government for 6 months (beyond October 1) with a mandate that states require proof of citizenship when people register to vote according to the AP. Now, House Speaker Johnson has to decide whether to put up a clean (unencumbered) six-month Continuing Resolution, propose something else entirely, or simply swallow what senators and a bipartisan group in the House want: a three-month Continuing Resolution that would in effect create a pre-holiday federal government crisis at the end of the year.  Use of Continuing Resolutions that extend current year funding levels has become something of a standard operating practice in Washington.  

House tees up telehealth talks

The House Energy & Commerce Committee on Wednesday unanimously advanced a two-year extension of pandemic-era telehealth flexibilities, firming up the House’s negotiating position ahead of potential December negotiations with the Senate, I report with my colleague Mario Aguilar. 

Energy & Commerce paid for the telehealth policy with PBM reforms, including transparency measures and a policy to ensure payments to PBM from drugmakers aren’t tied to drugs’ list prices. Stay tuned for updates on whether the Senate will go along with the plan. 

The panel also narrowly passed a measure to vacate the Biden administration’s nursing home staffing rule on a 21-18 vote. It’s unclear whether that measure could have any future in the Senate.