November 19, 2024
Politico, 11/19, 4:30
HEALTH RULES IN THE CROSSHAIRS — Certain health care rules that the Biden administration finalized in its waning days could be targeted and killed by a Republican-controlled Congress and White House, Chelsea reports.
Under a law called the Congressional Review Act, lawmakers would have a fast-track option that bars Senate filibusters when they seek to overturn rules adopted in the final 60 legislative days of a congressional session.
Republicans in both chambers have already introduced CRA resolutions to yank back a final Biden administration nursing home rule that requires facilities to maintain minimum staffing levels.
Here are some Biden rules likely to be in the crosshairs this year:
— Preventive services under the ACA: Under this October proposal from HHS and the Departments of Labor and Treasury, Affordable Care Act plans would be required to cover certain preventive services, such as over-the-counter contraceptives, without cost-sharing.
However, President-elect Donald Trump has said he plans to overhaul the ACA, and House Speaker Mike Johnson recently said the law would undergo “massive” changes in the Trump administration.
— Organ transplant model: Last month, CMS delayed a Medicare pilot program aimed at improving access to kidney transplants from its initial January start date. Last year, the Biden administration began an overhaul of the 40-year-old network, which has been criticized for long wait times and access inequities.The delay left some transplant advocates worried about impediments to kidney transplants, while the American Hospital Association has urged CMS to rethink the model, arguing it would incentivize “sub-par” organ matches.
— Mental health parity: The rules HHS and the Labor and Treasury departments finalized in September aim to ensure insurers cover mental health care on the same terms as other types of care, as Congress required in a 2008 law. The regulations reinforce that insurers can’t impose more restrictive standards on mental health care by requiring doctors to more often seek their approval before providing care or by maintaining limited numbers of in-network providers.Republicans and insurers oppose the rule, with the latter saying they’re hamstrung by clinician shortages. However, whether the rule is subject to the CRA depends on when this Congress concludes its session.Rep. Virginia Foxx (R-N.C.), who chairs the House Education and Workforce Committee, has railed against the rules. Her office didn’t respond to questions about whether she would seek to have it rescinded using a CRA resolution.
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CMS Releases State Medicaid Director Letter Extending Medicaid Coverage of Substance Use
Today the Centers for Medicare & Medicaid Services released a letter to State Medicaid Directors providing guidance on provisions of the Consolidated Appropriations Act, 2024. Specifically, the letter addresses:
Section 201, which made permanent the mandatory Medicaid benefit for medications for opioid use disorder (MOUD)Section 204, which made permanent and amended the state plan option at section 1915(l) of the Social Security Act to provide medical assistance for certain individuals who are patients in eligible Institutions for Mental Diseases (IMDs) (NYS has already been approved)Section 211, which made permanent a managed care provision relating to Medical Loss Ratio remittances
Read the full letter on Medicaid.gov
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Trump picks Dr. Oz to be CMS administrator
By Ben Leonard
11/19/2024 04:14 PM EST
President-elect Donald Trump has chosen Mehmet Oz, the celebrity physician and TV personality known as Dr. Oz, to be administrator of CMS.
During the pandemic, Dr. Oz, 64, pushed unproven theories about Covid-19 cures, including hydroxychloroquine, that caught Trump’s eye. In 2022, Oz ran unsuccessfully for U.S. Senate in Pennsylvania, losing to now-Sen. John Fetterman (D-Pa.).
“Dr. Oz will work closely with Robert F. Kennedy Jr. to take on the illness industrial complex, and all the horrible chronic diseases left in its wake,” Trump said in a statement Tuesday. “Dr. Oz will be a leader in incentivizing Disease Prevention, so we get the best results in the World for every dollar we spend on Healthcare in our Great Country.”
Oz has been a major supporter of Medicare Advantage, the program’s private sector alternative that has grown in popularity but has come under intense scrutiny for care denials and alleged overbilling.
The pick continues a trend of Trump picking television fixtures for key administration roles, including Pete Hegseth for defense secretary and Doug Collins for VA secretary. A person familiar with the situation granted anonymity to speak candidly said Oz was not among the early candidates on the list for the job.
The Senate has to confirm Oz. As CMS Administrator, Oz will oversee a broad agency that provides coverage through Medicare, Medicaid and other programs to more than 160 million people.
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On November 15th, Judge Sean D. Jordan of the U.S. District Court for the Eastern District of Texas blocked the Department of Labor Overtime rule issued earlier this year. This ruling applies nationwide, halting implementation of the second salary level increase that was to come into effect January 1, 2025. The previous 2019 salary threshold of $35,568 per year is set to go back into effect. It is possible the decision could be appealed. Stand by for further details.
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Politico, 11/19- A stabbing spree in Manhattan that left three dead yesterday has New York’s Democrats playing defense.
Gov. Kathy Hochul and Mayor Eric Adams agreed that yesterday’s rampage — in which a mentally ill homeless man fatally stabbed three people at random, apparently walking with blood soaked kitchen knives across town as he made his disparate attacks — was a dramatic failure of government.
“It is a clear, clear example of the criminal justice system, mental health system that continues to fail New Yorkers,” the Democratic mayor said Tuesday, hours after the stabbings.
The mea culpa comes amid an onslaught from New York Republicans, the state’s political minority that is leaning into its ongoing argument that Democrats are soft on crime.
It’s the latest example of how the fraught debate around criminal justice reform continues to bubble up with each act of violence in the city — even as stats show murders and shootings have declined since the pandemic, while felony assaults are on the rise.
The perpetrator of Tuesday’s attack wasn’t someone benefiting from Albany’s reformed and oft-maligned bail reform laws at the time of the attack. But he was a repeat offender who assaulted a correction officer in May while inside Bellevue Hospital’s psychiatric center, according to the New York Post. He later went to jail for burglary and assault convictions, and was released in October, the Post reported.
“I agree with the mayor that the system here in the city failed,” Hochul said today. “Someone who assaults a corrections officer gets out for good behavior? If that’s good behavior, how are we defining bad behavior? This is when you look at it like, ‘What the hell is going on here?’”
She pointed out her work to tighten bail laws after they were loosened under former Gov. Andrew Cuomo.
During a City Hall press conference today, Adams noted his past work on the issue, saying his administration increasing the involuntary removal of mentally ill New Yorkers from public locations and the subway system into hospitals has been worthwhile.
“People dealing with severe mental health illness didn’t start showing on our streets Jan. 1, 2022,” Adams said, referring to his first day in office. “The system has been failing for a long time. … What I was willing to do and will continue to be willing to do is confront it.”
The city moved 40 of the city’s most vulnerable people living on the street into supportive housing in the first year since the policy change, and has been averaging about 126 involuntary removals per week since the beginning of the year, a City Hall spokesperson said.
But Adams acknowledged “there isn’t a one-size, a magic pill, to solving the mental health issue that we’re facing,” and listed a long list of fixes he’d like to see, such as an increase in long-term psychiatric beds, funding for mental health clubhouses and a better system of follow-up care when somebody leaves treatment.
He also called on state legislators to pass the Supportive Intervention Act, an Assembly bill that would clarify the standards for involuntary hospitalizing severely mentally ill people. Adams also touted the bill after the 2023 killing of subway performer Jordan Neely, but it never made it out of committee.
Meanwhile Republicans are already on the attack mode as the local issue draws national condemnation.
“People need to understand something important. Nothing — NOTHING — will convince progressives to reconsider their criminal justice reforms which repeatedly enable horrors like this,” Republican City Council Member Vickie Paladino wrote on X.
Elon Musk’s political action coalition, America PAC, also weighed in.
“The justice system is failing to protect the people,” the PAC also wrote on the platform, sharing a photo of The Post’s “MANHATTAN BLOODBATH” headline to the tune of 16.5 million views.
Adams, a Democrat who leans right on matters of criminal justice, added: “We are still looking over his record, but there’s a real question on why he was on the street.” — Jason Beeferman and Jeff Coltin