The Washington Report
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July 19, 2023
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.
Health
CMS Publishes Notice on Reestablishing SSA Matching Program Under ACA
On July 17, 2023, the Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) published a Notice regarding the reestablishment of a matching program between CMS and the Social Security Administration (SSA), ‘‘Determining Enrollment or Eligibility for Insurance Affordability Programs Under the Patient Protection and Affordable Care Act (ACA).” Comments on the Notice are due by August 16, 2023. The reestablished matching program will commence no sooner than 30 days after publication of the Notice, provided no comments are received that warrant a change to the Notice. The matching program will be conducted for an initial term of 18 months (from approximately September 9, 2023, to March 8, 2025) and within three months of expiration may be renewed for one additional year if the parties make no change to the matching program and certify that the program has been conducted in compliance with the matching agreement.
The Notice is available here.
CMS Releases CY 2024 Medicare PFS Rule
On July 13, 2023, CMS issued the calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS) proposed rule to “announce rate updates, advance health equity, and expand access to critical medical services — including behavioral health care and certain oral health services.” The CY 2024 PFS proposed rule includes updates to PFS payments for clinicians as required by law. Overall proposed payment amounts under the PFS would be reduced by 1.25 percent compared to CY 2023, in accordance with factors specified by law. CMS is also proposing increases in payment for many visit services, such as primary care, and these proposed increases require offsetting and budget neutrality adjustments to all other services paid under the PFS, by law. The proposed CY 2024 PFS conversion factor is $32.75, a decrease of $1.14, or 3.34 percent, from CY 2023. Please refer to the news release and other resources for additional details.
The news release is available here.
A Fact Sheet on the CY 2024 PFS proposed rule is available here.
The proposed rule is available here.
HHS Issues NPRM Addressing Non-Discrimination in HHS Programs for LGBTQI+ Community
On July 11, 2023, the Department of Health and Human Services (HHS) through the Office for Civil Rights and the Assistant Secretary for Financial Resources, announced a Notice of Proposed Rulemaking (NPRM) to affirm civil rights and equal opportunity for people nationwide in HHS-funded programs and services. The proposed rule, Health and Human Services Grants Regulation (HHS Grants Rule), if finalized, would protect LGBTQI+ people from discrimination in important health and human services programs by clarifying and reaffirming the prohibition on discrimination on the basis of sexual orientation and gender identity in certain statutes. Comments on the NPRM must be received by September 11, 2023.
The news release is available here.
The NPRM is available here.
IRS Releases Draft 2023 Forms 1094-B and 1095-B
On July 11, 2023, the Internal Revenue Service (IRS) released text of Draft 2023 IRS Form 1094-B: Transmittal of Health Coverage Information Returns and Draft 2023 IRS Form 1095-B: Health Coverage. This information is in draft form and is not meant to be used for filing purposes. Please refer to the IRS documents for additional information.
The Draft 2023 IRS Form 1094-B: Transmittal of Health Coverage Information Returns, is available here.
The Draft 2023 IRS Form 1095-B: Health Coverage, is available here.
Aon Publications
Departments Clarify NSA’s Cost-Sharing Rules and ACA’s OOP Limit for Employer Health Plans
New Frequently Asked Questions (FAQs) issued by the Departments of Labor, Health and Human Services, and Treasury (Departments) provide employers with additional direction on implementing the No Surprises Act (NSA) and clarify the Affordable Care Act’s (ACA’s) rules on calculating a group health plan’s maximum annual out-of-pocket cost-sharing limit (the OOP Limit).
The FAQs Part 60, released on July 7, 2023, also prohibit group health plans from classifying certain providers as participating providers for purposes of the NSA but as out-of-network providers for purposes of the OOP Limit.
The Aon bulletin is available here.