The Washington Report

February 7, 2024

Note to Subscribers

While we do our best to provide timely updates, it is possible that the information shared in the newsletter may change after our publication deadline.

Executive

 

SOTU Address Scheduled for March 7
President Biden is scheduled to deliver his annual State of the Union (SOTU) address on March 7, 2024.

President Expected to Release 2025 Fiscal Budget Request to Congress on March 11
President Biden is scheduled to release his 2025 fiscal budget request to Congress on March 11. Passage of the complete budget is unlikely, as proposals are typically intended as a framework for legislative discussion.

Health

 

Departments Release FAQ About Affordable Care Act Implementation Part 65; TiC
On February 2, 2024, the Departments of Health and Human Services, Labor, and Treasury (Departments) released a Frequently Asked Question (FAQ) on Transparency in Coverage (TiC). The TiC final rules require non-grandfathered group health plans and health insurance issuers offering non-grandfathered coverage in the group and individual markets to make cost-sharing information available to participants, beneficiaries, and enrollees through an internet-based self-service tool and in paper form, upon request. This information must be made available for plan years (in the individual market, policy years) beginning on or after January 1, 2023, with respect to the 500 items and services identified by the Departments in Table 1 of the preamble to the TiC final rules, and with respect to all covered items and services, for plan or policy years beginning on or after January 1, 2024. The FAQ asks:

• Q1: How should plans and issuers comply with the cost-sharing disclosure requirements of the TiC final rules with regard to items and services with extremely low utilization when a cost estimate is based on claims data rather than prospective rates?

The FAQ About Affordable Care Act Implementation Part 65, is available here.

CMS Releases Proposed Payment Updates for 2025 MA and Part D Programs
On February 1, 2024, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Advance Notice for the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs that would update payment policies for these programs. The Advance Notice complements a proposed rule, also for CY 2025, that CMS released in November 2023 that would, if finalized, strengthen protections for those receiving MA and Medicare Part D prescription drug coverage. The Advance Notice and the Draft CY 2025 Part D Redesign Program Instructions are open for public comment, and CMS will accept comments through March 1, 2024. The CY 2025 Rate Announcement and the CY 2025 Part D Redesign Program Instructions will be published no later than April 1, 2024.

The news release is available here.

The CY 2025 Advance Notice may be viewed by going to the link and selecting “2025 Advance Notice” here.

A Fact Sheet on the CY 2025 Advance Notice, as well as FAQs, is available here.

The Draft CY 2025 Part D Redesign Program Instructions is available here.

A Fact Sheet discussing the provisions of the Draft CY 2025 Part D Redesign Program Instructions is available here.

HHS Makes First Offer for Drug Negotiation Program; Releases Reports and Launches New Resource Hub
On February 1, 2024, the Department of Health and Human Services (HHS) announced it was sending initial offers to the participating drug companies of the first 10 prescription drugs selected for negotiation in the first cycle of the Medicare Drug Price Negotiation Program, as part of the Inflation Reduction Act. HHS announced the 10 initial drugs selected for the first cycle of Medicare drug price negotiation on August 29, 2023. On October 3, HHS announced that the drug companies of all 10 selected drugs agreed to participate in negotiations with Medicare. “Today, those companies will receive the initial offer as part of the negotiation process. Negotiations will continue over the next several months, with negotiations ending by August 1, 2024. If a maximum fair price is agreed upon by the participating drug company and Medicare, those new prices will take effect in Medicare beginning in 2026.”

On the same day, HHS also:

• Released several reports detailing the cost comparison of prescription drugs in the U.S. and that of drugs in other Organisation for Economic Cooperation and Development countries. (See resource links below.)
• Launched the LowerDrugCosts.gov website. The new website will house informational materials, including key messaging, fact sheets, toolkits, social media graphics, videos, and more. HHS stated that “the user-friendly website will be a one-stop-shop for information related to the drug pricing provisions of the Inflation Reduction Act and the implementation process, and resources for Medicare enrollees and other interested parties.”

The news release is available here.

The LowerDrugCosts.gov website is available here.

The three HHS reports covering international drug price comparisons, Comparing Prescription Drugs in the U.S. and Other Countries: Prices and Availability are available here.

The HHS report, Medicare Enrollees and the Part D Drug Benefit: Improving Financial Protection through the Low-Income Subsidy is available here.

Retirement

 

PBGC Launches New e-Filing Portal
On February 1, 2024, the Pension Benefit Guaranty Corporation (PBGC) announced that it launched its new and improved e-Filing Portal. Key changes include a “new, more secure, login process and a streamlined look and feel across all applications (e.g., 4010 and reportable event filings, certain multiemployer plan filings, SFA applications).” For additional information, please refer to the e-Filing Portal Login.gov FAQs and the PBGC’s e-Filing Portal User Guide.

The e-Filing Portal Login.gov FAQs website is available here.

The e-Filing Portal User Guide is available here.