Rep. Mike Kelly R-PA from the House Ways and Means Health Subcommittee is sponsoring the Health Care Sharing Ministry Tax Parity Act (HCSM). The bill would allow members of faith-based organizations and ministries to deduct healthcare related expenses from their taxes to achieve tax fairness for ministries that share health care costs. The rules make it clear that these organizations would not be able to offer health insurance to ensure there would be no loopholes with the current tax rules. Millions of Americans participate in HCSM programs sharing the cost of more than $1 billion in medical expenses.

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights and the Centers for Medicare & Medicaid Services (CMS) recently issued a final rule under Section 1557 of the Affordable Care Act (ACA) to strengthen nondiscrimination protections and advance civil rights in health care. This rule reinstates non-discrimination standards for all Health and Human Services health programs and activities, protects LGBTQI+ patients from discrimination, requires that all entities including insurers and providers let people know language assistance and services are available, requires staff training on sections of the 1557 policies and respects federal guarantees regarding religious freedoms and conscience as set for by 45 CFR 92.3 and 92.302. See the Fact Sheet.

The Maternal and Child Health Stillbirth Prevention Act of 2024, HR 4581, passed through both the House and the Senate, and now awaits President Biden’s signature before it becomes law. The bipartisan bill amends the Maternal and Child Health Services Block Grant program to allow states to use those dollars for stillbirth prevention and research activities but does not include additional funding.

On Tuesday, June 25, by a margin of 133-69, lawmakers in the Pennsylvania House passed House Bill 1140, which would require health insurance policies – as well as government health insurance programs like Medical Assistance and the Children’s Health Insurance Program (CHIP) – to cover FDA-approved contraceptive drugs, devices and products for covered individuals. The bill’s prime sponsor, Democratic state Rep. Leanne Krueger, said in a statement after the House vote that the bill would establish state-level protections for contraceptive access. “Pennsylvania currently has no protections in state law for contraceptive access, so attacks at the federal level jeopardize our access,” Krueger said. The bill currently awaits action from the state Senate.

Health committees in the Pennsylvania House and Senate are working on a compromise agreement that will increase oversight of pharmacy benefit managers (PBMs). The Pennsylvania legislation would allow the state’s Insurance Department to regulate certain aspects of pharmacy benefit managers’ business that have been called anti-competitive. Read more. Included in this legislation is language that will prohibit PBMs from reimbursing qualified health centers participating in 340B less than they would reimburse similar entities that do not participate in the program. This is an evolving process so stay tuned for updates.

Legislation addressing worker shortages in healthcare and facilitating Pennsylvania’s entry into interstate compacts has been sent to Gov. Josh Shapiro to be signed into law. Sponsored by Rep. Frank Burns, D-Cambria, HB 2200 enables interstate licensing compacts to become operational. The legislation requires applicants in healthcare professions to submit fingerprints as part of their criminal history records check and lays out the process that Pennsylvania State Police and state licensing boards must follow in considering them. The change in law allows licensees to practice in other participating states with just one license. Without the fingerprinting process in place, previous efforts to implement the compacts were unsuccessful.

– Tuesday, July 16 at 2:00 pm Eastern. In this hour-long session, the Centers for Medicare and Medicaid Innovation will provide an overview of the new ACO Primary Care Flex Model (ACO PC Flex Model), which will focus on primary care delivery in the Medicare Shared Savings Program (SSP).  CMS has released a Request for Applications  and the application portal is open until August 1 for new or renewing ACOs who submitted an application to SSP by June 17, 2024.  CMS plans to announce applicants selected to participate in October 2024.  This model seeks to increase accountable care relationships for people with Medicare, especially those in rural and underserved communities.

– Monday, July 15 at 2:00 pm Eastern. The National Association of Rural Health Clinics (NARHC) will host the free, FORHP-supported webinar, with information on the Department of Health and Human Services (HHS) Office of Civil Rights and the Centers for Medicare & Medicaid Services final rule under Section 1557 of the Affordable Care Act Nondiscrimination in Health Programs and Activities and the RHC impacts, including:

• Requirement to post a notice of nondiscrimination.
• Requirements to post notice of availability of translation and auxiliary aid services in top 15 foreign languages.
• Requirement to establish and train employees on policies and procedures related to nondiscrimination.

Additional time for Q&A will be provided. Advanced registration is required.

– Comment by July 29. This week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for mitigating the impact of significant, anomalous, and highly suspect (SAHS) billing activity on the Medicare Shared Savings Program financial calculations in calendar year 2023. This proposed rule is part of a larger strategy to address significant, anomalous, and highly suspect (SAHS) within ACO reconciliation, and additional information will be forthcoming in the Physician Fee Schedule. Due to a recent, observed increase in Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) billing to Medicare for selected intermittent urinary catheter supplies in CY 2023, CMS  proposes to exclude use of these codes from any supplier in 2023 from ACO expenditure and revenue calculations.