HomeHealth Telehealth, Mental Health Likely Topics for the New Congress in 2023, Experts Say

Telehealth, Mental Health Likely Topics for the New Congress in 2023, Experts Say

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With big pieces of COVID-19 legislation mostly in Congress’s rearview mirror, legislators will be turning their attention to other health-related matters, including substance abuse, telehealth, and lots of regulatory oversight, several experts said during an online briefing sponsored by the Alliance for Health Policy.

“The [current] Congress is probably the last Congress likely to do major COVID legislation,” said Josh Trent, MA, a principal at the Washington, D.C. office of consulting firm Leavitt Partners. “We’re probably at a point where most of the major COVID legislation is in the rearview mirror. That means there’s going to be a lot of focus on items like mental health, some Medicare policies which are very bipartisan, substance use disorder, and behavioral health very broadly.”

Sonja Nesbit, MPA, a senior policy advisor at the Washington office of law and consulting firm Arnold & Porter, agreed, but said despite broad COVID legislation likely being a thing of the past, “we all have folks we work with doing individual things related to trying to get [COVID] therapies and other treatments into the stockpile, trying to get them authorized and available, and to broaden diagnostics.”

Implementation of the Inflation Reduction Act is going to be a very big deal next year for the health-related committees in Congress, she added. And Republicans will be holding hearings on general health oversight issues but also “COVID — COVID’s origins and the administration’s response to it,” she said.

Oversight will also include bringing in witnesses like Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services (CMS); FDA Commissioner Robert Califf, MD; and soon-to-be-former White House medical advisor Anthony Fauci, MD, said Ipsita Smolinski, MBA, MPH, managing director at Capitol Street, a Washington-based health policy consultancy. “That takes up a lot of energy and resources for these agencies — preparing for these things, responding to requests.”

Her organization is also looking out for Medicare Advantage risk audit regulations, which are due February 1, dealing with potential upcoding of beneficiaries’ health conditions in order to get higher payments from the federal government. There is also a “must-pass” bill in September 2023 related to the Animal Drug User Fee Act, “so you could have some policies being worked out with stakeholders potentially being passed in the summer or fall of 2023” as part of that bill, she said.

Republicans also will be looking at the Medicare Hospital Insurance Trust Fund, which is currently on track to become insolvent in 2028, said Trent. “We’ll have the actuary report next May, June, or July — that’s something we’ll hear a little more about.” In addition to the Animal Drug User Fee Act, “we do have the expiration of the Community Health Center Fund that will drive a lot of the work in the [Senate] HELP [Health, Education, Labor, & Pensions] Committee and [the House] Energy and Commerce [Committee] … A lot of what they’re going to work on is ‘must-pass’ legislation for reauthorization.”

On the House side, Rep. Cathy McMorris Rodgers (R-Wash.), currently the ranking member on the House Energy and Commerce Committee — which will soon be in Republican hands — has been quite interested in the funding authorizations for the NIH and the CDC, said Trent. “There is certainly a lot of interest in telehealth,” with flexibility in telehealth rules already extended for an extra year; another year’s extension could be in the offing, he said. “Another big area of focus for McMorris Rodgers would be helping individuals with disabilities live to their fullest potential — there are some very interesting ideas in home- and community-based services, and personal care services; I think that will be a major focus as well.”

Value-based care is another potential focus area, said Smolinski. “The Center for Medicare & Medicaid Innovation has a real desire to promote value-based arrangements … I think that’s a theme we could see going forward; it’s from the agency but with bipartisan support for upside and downside risk and value-based care more generally.”

And don’t forget about surprises such as court decisions, she said. “We always call the courts the ‘third swimming lane.'” One interesting court case involves the U.S. Preventive Services Task Force (USPSTF), whose designation of worthy preventive services is used as the justification for requiring insurance coverage of those services with no patient copay. “Judge Reed O’Connor has really challenged the idea that USPSTF should be making recommendations about preventive services,” said Smolinski. “Americans have been enjoying zero-dollar copays for those services; that could go away.”

Trent said he also has been watching a proposed regulation on Medicaid eligibility and enrollment. “It’s surprisingly not gotten as much attention outside of Medicaid circles as it probably merits, but it’s a very significant regulation that would have significant implications on the enrollment eligibility processes — in many cases making enrollment much more streamlined and consumer-centered,” he said.

“I think in some cases we’ve seen the leaders of House and Senate committees — both [the Senate] Finance [Committee] and [the House] Energy and Commerce [Committee] — send an oversight letter to ask CMS a bunch of questions about some of their legal authorities in the rule and how they’re implementing it and what they’re proposing to do, and how they think about the multi-billion-dollar cost it would be for states to bear,” Trent added. “The power of the pen the administration holds for regulations is very, very powerful. Medicaid rules can be very significant … They can do a lot.”

Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow

Source : MedPageToday

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