The Centers for Medicare & Medicaid Services July 31 released the fiscal year 2025 final rule for inpatient rehabilitation facilities, which will update IRF payments by an estimated 3% overall (or $300 million) in FY 2025. This includes a 3.5% market basket update, which is reduced by a 0.5 percentage point cut for productivity. However, IRF payments will be further decreased by an estimated 0.2% ($20 million) due to the updated outlier threshold.
While CMS did not propose to adopt or remove any quality measures from the IRF Quality Reporting Program, the agency finalized its proposal to adopt and modify certain patient assessment items related to health-related social needs; IRFs will be required to collect and report specific data elements related to living situation, food and utilities beginning with the FY 2028 IRF QRP.
AHA members will receive a Special Bulletin with more details.
The Centers for Medicare & Medicaid Services July 31 released the fiscal year 2025 final rule for inpatient rehabilitation facilities, which will update IRF payments by an estimated 3% overall (or $300 million) in FY 2025.
The Centers for Medicare & Medicaid Services today issued a final rule for fiscal year 2025 for the skilled nursing facility prospective payment system, which will increase aggregate Medicare spending by 4.2% or $1.4 billion compared to FY 2024. This reflects a 3% market basket update, a 1.7 percentage-point increase to counter the agency’s market basket error in FY 2023, and a 0.5 percentage point cut for productivity. CMS also revised its regulations regarding its nursing home enforcement authority to allow the agency to impose additional financial penalties on facilities where health and safety deficiencies are identified.
While CMS did not propose to adopt or remove any quality measures from the SNF Quality Reporting Program, the agency finalized its proposal to adopt and modify certain patient assessment items related to health-related social needs; SNFs will be required to collect and report specific data elements related to living situation, food and utilities beginning with the FY 2027 SNF QRP. CMS also finalized its proposal to adopt a data validation process for the SNF QRP beginning the same year.
CMS also finalized a number of operational updates to the SNF Value-based Purchasing program, including policies regarding measure removal and review and corrections. The agency also makes an update to the case mix methodology used to calculate the Total Nurse Staffing measure.
The Centers for Medicare & Medicaid Services today issued a final rule for fiscal year 2025 for the skilled nursing facility prospective payment system, which will increase aggregate Medicare spending by 4.2% or $1.4 billion compared to FY 2024.
Lawmakers advanced a host of artificial intelligence bills Wednesday, marking Congress’ most significant step yet to address the technology’s risks and benefits, but emerging partisan disagreements could derail progress.
The Senate Commerce, Science, and Transportation Committee approved a number of bills that seek to boost AI research and development and establish voluntary guidelines on the technology.
Many of the panel’s Democratic and Republican members worked together over the past several months to introduce the legislation. Chair Maria Cantwell (D-Wash.) led at least three measures, which several Republicans co-sponsored and voted in favor of.
But ranking member Ted Cruz (R-Texas) blasted the effort as “overly broad” regulation that would hinder AI advancement and competition and protect the interests of major tech companies.
Both Democrats and Republicans on Capitol Hill have widely advocated for policies to strengthen AI development and maintain the US’ global lead while mitigating risks like displacing workers and perpetuating bias and discrimination. Senate Majority Leader Chuck Schumer (D-N.Y.) has called on committees to introduce and advance AI bills, and many lawmakers are eyeing to include such legislation in a year-end package.
Yet with Republicans like Cruz pushing for a more hands-off approach to AI regulation, the differences could threaten hopes for Congress to pass at least some AI bills by the end of this year.
AI ‘Roadmap’ Calls For Action on Key Bipartisan Bills, Policies
The tech industry, advocacy groups, and researchers have repeatedly called on lawmakers to respond to AI’s threats and opportunities and endorsed many of the bills approved in Wednesday’s markup.
One of Cantwell’s bills (S. 4178), co-sponsored by Sen. Todd Young (R-Ind.), would establish the US AI Safety Institute—a coalition of government officials, tech companies, civil society organizations, and academics—to create voluntary standards on AI to promote safe use and development.
The bill would formally authorize the institute that the National Institute of Standards and Technology, a lab within the Commerce Department, has already been leading under President Joe Biden’s executive order on AI signed last October. Ahead of Wednesday’s markup, tech companies, including OpenAI Inc., Meta Platforms Inc., and Microsoft Corp., as well as AI policy groups and universities, were among nearly 50 stakeholders that urged the committee to prioritize enshrining the institute into law.
“It does not include any new requirement on companies,” Cantwell said of the bill. But, she added, it would support public-private partnerships and promote US competitiveness.
Cruz, a vocal critic of Biden’s executive order, rejected the proposal. He offered a failed amendment that sought to halt federal agencies from issuing AI guidance or rules without prior congressional approval.
“Private individuals develop this amazing product—all without the government’s help,” Cruz said. “Today, we hear without a trace of irony, that American AI can only be successful now with the government’s help.”
It’s a position that’s gained traction within some conservative circles critical of Biden’s AI strategy. The Republican National Committee’s 2024 platform, backed by presidential nominee Donald Trump, proposed to rescind Biden’s executive order if the party wins the election. The order directs federal agencies to establish guidelines and standards on AI to promote safety and security.
Republican Attack on Biden AI Policy Fuels Urgency on Guardrails
Cruz instead emphasized that Congress should advance “incremental” and “targeted” AI legislation, pointing to his bipartisan bill that seeks to combat the rise of AI-generated deepfake pornography as an example. The committee on Wednesday advanced the measure (S. 4569), known as the TAKE IT DOWN Act, which would outlaw the distribution of non-consensual deepfake porn and require websites to remove such content from their platforms within 48 hours of request.
The rest of the bipartisan AI bills lawmakers advanced were the:
A New Jersey elementary school will remove Sen. Bob Menendez’s name from its building after his conviction on federal bribery charges.
A spokesperson for West New York Mayor Albio Sires confirmed on Wednesday that the name will be down before the start of the school year in September. The New Jersey Globe first reported officials’ plans to remove the disgraced Democratic senator’s name from the building.
Menendez was convicted of all charges earlier this month in a sweeping corruption trial during which he was accused of taking bribes of gold bars and cash from three New Jersey businessmen and acting as an agent for Egypt.
The three-term incumbent said recently he would be resigning from the Senate on Aug. 20, following a lifelong career in politics that started in Hudson County, where the school is located.
West New York’s Public School 3 was renamed for Menendez in 2013. The school will now restore its original name.
Menendez’s office declined to comment on the news. Messages were also left with school officials.
The son of Cuban immigrants and an attorney by training, Menendez was a Union City, New Jersey, school board member at age 20 and later became the mayor of the city, about a mile from West New York.
He went on to hold office in the state Legislature and the U.S. House of Representatives before getting appointed to the Senate. He subsequently won election to the Senate and had planned to seek an independent bid if exonerated at trial.
Menendez faces the possibility of decades in prison. There is a sentencing hearing scheduled for Oct. 29, a week before Election Day. He has said he plans to appeal the convictions.
Industry stakeholders, FDA and CMS officials, and health technology companies agreed successfully integrating home health technologies in the health care ecosystem requires consistent regulation laying out proper data privacy practices, telehealth accessibility and artificial intelligence guidelines. But lawmakers are already struggling to pass a two-year telehealth extension and engrossed in partisan clashes over potential data privacy and artificial intelligence legislation, all of which could slow deployment of home health technologies.
FDA Commissioner Robert Califf said at a listening session Thursday (July 24) on the agency’s “Home as a Health Care Hub” that virtual devices will increasingly leverage digital capabilities to integrate health systems.
“It’s important to understand these challenges cannot be solved by the FDA alone,” Califf said. “One of the goals of this initiative is to make sure the conversation considers the perspectives of the many people who will be impacted and who can have an impact.”
Artificial Intelligence
Many home health technologies use artificial intelligence to treat patients, including chat-bot caregiver capabilities and digital therapeutics. Targeting bias in AI is essential to ensure that home health technologies can serve all populations, according to stakeholders.
Ian McKay, cloud principal solution architect at Amazon Web Services, said he works with digital health companies to develop their home health solutions.
“This has resulted in a ladder of capabilities that support the entire connected care ecosystem, from devices in the home through big data analytics and the AI machine learning in the cloud,” McKay said.” We see and are helping solve many challenges along the entire technology chain, from in home configuration, internet connectivity, especially in rural areas or for mobile clinics, to communications and IT standards.”
Lawmakers and digital health stakeholders are grappling with how to best regulate emerging AI technologies. While lawmakers weigh legislation, some stakeholder groups would like to see increased action through existing regulatory agencies. A handful of lawmakers are considering the creation of a new regulatory agency that would solely focus on regulating AI.
FDA has put out a draft guidance on change control plan for emerging AI health technologies that calls for companies to submit future measures for mitigating bias and other algorithmic errors after the technology enters the market when they submit initial applications for approval.
Data privacy
Home health technologies often collect patient data and sometimes transmit that data to practitioners for monitoring chronic diseases. In the absence of a national data privacy framework, health tech companies find it challenging to comply with the patchwork of state privacy laws.
Paul Conway, chair of policy global affairs for the American Association of Kidney Patients, said he is concerned that health home devices don’t have sufficient privacy standards to protect patients.
“We are particularly concerned about anything that would be on the IT safety side, in terms of hackability of devices,” Conway said. “Home based use of devices would create a privacy issue for patients, meaning more data is collected than the patient is aware of. That would have to be something that’s disclosed.”
Consumer Technology Association President Gary Shapiro said during the meeting that although the Health Insurance Portability and Accountability Act protects some health data, more work needs to be done to protect sensitive health information as health home technologies become increasingly integrated in patient care.
“Many stakeholders in care fall outside of HIPAA jurisdiction,” Shapiro said. “That’s why CTA has long held a position that we need comprehensive privacy legislation that preempts varying state laws to build one standard that will engender trust. But I think we are ready to address these issues as a country, and I’m very hopeful about it.”
The latest federal privacy bill American Right to Privacy Act was stalled by partisan tensions over the bill’s private right of action. Republicans are against opening up technology giants to increased litigation over privacy issues, which may hinder technological development. Democrats are supportive of individuals’ right to hold technology companies accountable.
APRA had a carve out for health data that would not preempt state privacy legislation. Health technology stakeholders lamented that the bill would not help companies that serve patients in multiple states streamline their privacy protocols.
Telehealth
Home health technologies that monitor patients with chronic conditions often incorporate telehealth when a patient needs to connect with their physician. But stakeholders said uncertainty over whether telehealth will be accessible to Medicare beneficiaries may hinder the incorporation of home health technology.
Martin Mendoza, CMS chief health equity officer and director of the CMS Office of Minority Health, urged stakeholders to comment on the 2025 physician fee schedule, including provisions that would maintain telehealth flexibilities.
“I’ll briefly share just a few specific policy updates that you might consider as you drive your work on home health,” Mendoza said. “First is the recently finalized section 1557 which is a set of regulations and guidelines for all federally funded health entities and programs, including federal, state and local health programs, including those administered by CMS. It applies to all health care organizations, including providers, practices, facilities and home health care agencies, insurers, health plans and healthcare insurance marketplaces. It covers both telehealth and in person.”
CMS outlined in the proposed physician fee schedule its plans to repeal crucial telehealth flexibilities that would subject most digital care to pre-pandemic regulations unless Congress extends the flexibilities before they expire.
Stakeholders couch the telehealth terminology in the fee schedule as CMS urging Congress to act legislatively on expanding flexibilities, saying it’s a sign of the agency’s willingness to implement policies. But telehealth stakeholders are concerned about Congress running out the clock so close to when waivers expire at the end of the year. CMS is expected to issue the final fee schedule rule the beginning of November and it will go into effect Jan. 1.
House Oversight Committee Chairman James Comer is pressing the HHS to explain why it hasn’t issued guidance for a 2020 Trump-era rule that would shutter ineffective groups tasked with linking deceased organ donors with waiting recipients.
Twenty-four, or 42%, of organ procurement organizations operated at the lowest-performing Tier 3 level in 2021, the most recent year with available data. The rule calls for OPOs in Tier 3, based on their 2024 performance, to face decertification from the federal organ transplant program in 2026 if they fail to show improvement.
The rule is aimed at bolstering OPO performance and addressing longstanding criticism that they don’t make enough organs available for transplant. Nearly 104,000 people are on the national waiting list for an organ transplant, and an average of 17 die every day.
Another 13 exit the list each day, too sick to survive the surgery. And researchers estimate 28,000 donated organs go unused in the US each year.
Although the rule was finalized in December 2020, the Centers for Medicare & Medicaid Services hasn’t issued guidance spelling out how the decertification process would work, and how higher-performing organ procurement groups could acquire a failing OPO or take over its service area.
The OPOs say the delay is hampering their ability to prepare for the future. Comer (R-Ky.), in a recent letter to Health and Human Services Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, said the inaction by the CMS has increased uncertainty for those who need a transplant and could erode accountability for OPOs.
“Many of these entities are continuing to call the shots and write their own rules,” Comer’s letter said of OPOS. He requested a briefing from the HHS and the CMS on the matter no later than Thursday.
“We expect the briefing to include a description of the steps CMS is taking to ensure the Final Rule is implemented without dilution or delay, including what CMS is doing to proactively issue guidance and conduct ongoing oversight so that OPOs, patients and donor families know how the next phase of the process will work.”
The CMS did not immediately respond to a request for comment.
Today, U.S. Senator U.S. Senator Cory Booker (D-NJ) reintroduced the Prescription Drug Affordability and Access Act, legislation to systematically change the way prescription drugs are priced in order to reduce drug costs for Americans and increase access to the medications they need. Senator Bernie Sanders (I-VT) joined him as an original cosponsor.
The bill would create an independent agency—the Bureau of Prescription Drug Affordability and Access—tasked with conducting reviews of drug prices and determining an appropriate list price. If companies don’t comply with the Bureau-reviewed list price, the Secretary of Health and Human Services (HHS) would allow other entities to produce the drug, thereby voiding the companies’ government-granted exclusivity and ensuring patients have access to the drug at a lower and more reasonable price determined by the Bureau.
This is one of the few bills to tackle the challenge of rising prescription drug prices by addressing the list price of drugs. The list price of a drug, also thought of as “sticker price”, is incredibly important to those who are uninsured or underinsured and may have to pay the full cost of the drug. Even patients with good insurance may pay a price tied to a percentage of the list price.
“In the wealthiest nation on earth, no one should have to choose between their medications and putting food on the table,” said Senator Booker. “This legislation aims to put an end to the outrageous price gouging by pharmaceutical companies and bring much-needed relief to the millions of Americans struggling to afford their prescriptions. Establishing a federal bureau of prescription drug affordability and access will help ensure fair pricing and increase transparency into drug pricing. It’s time to put patients before profits.”
“The American people understand that the outrageously high cost of prescription drugs is a crisis situation that must be addressed,” said Senator Sanders. “Today, one in four Americans cannot afford the medicine that they are prescribed. The status quo is simply not working. It is long due time we take on the greed of the pharmaceutical industry and work to substantially lower the prices they charge.”
The Prescription Drug Affordability and Access Act specifics when a drug manufacturer is preparing to bring a new drug to market, it would be required to submit detailed transparency information to the Bureau 45 days before, including:
The Bureau would review that information and other factors to determine an appropriate list price. If a drug manufacturer fails to adhere to the appropriate list price, the Secretary of HHS would allow other companies to produce a generic version of the drug at a cheaper price, voiding the company’s government granted exclusivity.
The Prescription Drug Affordability and Access Act is endorsed by the following organizations: Public Citizen, New Jersey Citizen Action
“The Prescription Drug Affordability and Access Act recognizes that Big Pharma charges far too much for vital medicines – and will continue to do so, until We the People make them stop. It recognizes that Big Pharma’s power comes from the grant of patent and other monopolies – and that We the People have the power to end those monopolies if drug corporations refuse to price their products reasonably. Public Citizen is proud to offer its strong endorsement of this legislation,” said Robert Weissman, President of Public Citizen
“Drugs don’t work if people can’t afford them,” said Laura Waddell, Health Care Program Director for New Jersey Citizen Action. “We applaud Senator Booker for his longtime work championing health care affordability and access for the benefit of patients throughout our nation and state. Today, we stand with him in support of the re-introduction of the Prescription Drug and Affordability and Access Act which will establish the Bureau of Prescription Drug Affordability and Access focused on reducing prescription drug costs for patients and ensuring access to lifesaving medications. The Bureau will provide the necessary oversight, patient and public engagement, and enforcement and accountability measures to make a meaningful difference in prescription drug affordability. This legislation is important to the 57% of New Jerseyans struggling with health care affordability and the 1 in 4 New Jersey adults who report not filling a prescription, cutting, or skipping doses due to cost. The efforts of the Bureau at the federal level will be the perfect complement to enacted reforms in states like New Jersey, that have established Prescription Drug Affordability Councils and Boards working on prescription affordability at the state-level. We look forward to working with Senator Booker to pass the Prescription Drug and Affordability and Access Act so that New Jersey patients and families as well as those nationally can access the prescription medications they need, whenever they need them and at a price they can afford.”
To read the full text of the bill, click here.
JULY 30, 2024
TRANSCRIPT
SPEAKERS:
SEN. RON WYDEN, D-ORE.,
CHAIR SEN. DEBBIE STABENOW, D-MICH.
SEN. MARIA CANTWELL, D-WASH.
SEN. ROBERT MENENDEZ, D-N.J.
SEN. THOMAS R. CARPER, D-DEL.
SEN. BENJAMIN L. CARDIN, D-MD.
SEN. SHERROD BROWN, D-OHIO
SEN. MICHAEL BENNET, D-COLO.
SEN. BOB CASEY, D-PA. SEN. MARK WARNER, D-VA.
SEN. SHELDON WHITEHOUSE, D-R.I.
SEN. MAGGIE HASSAN, D-N.H.
SEN. CATHERINE CORTEZ MASTO, D-NEV.
SEN. ELIZABETH WARREN, D-MASS.
SEN. MICHAEL D. CRAPO, R-IDAHO, RANKING MEMBER
SEN. CHARLES E. GRASSLEY, R-IOWA
SEN. JOHN CORNYN, R-TEXAS SEN. JOHN THUNE, R-S.D.
SEN. TIM SCOTT, R-S.C.
SEN. BILL CASSIDY, R-LA.
SEN. JAMES LANKFORD, R-OKLA.
SEN. STEVE DAINES, R-MONT.
SEN. TODD YOUNG, R-IND.
SEN. JOHN BARRASSO, R-WYO.
SEN. RON JOHNSON, R-WIS.
SEN. THOM TILLIS, R-N.C.
SEN. MARSHA BLACKBURN, R-TENN.
WITNESSES: SHAY HAWKINS, PRESIDENT, OPPORTUNITY FUNDS ASSOCIATION
LASHEA LOFTON, DEPUTY CITY MANAGER, CITY OF DAYTON, OHO
JULIA NELMARK, PRESIDENT & CEO, MIDWEST MINNESOTA COMMUNITY DEVELOPMENT CORPORATION
MICHAEL J. NOVOGRADAC, MANAGING PARTNER, NOVOGRADAC
WYDEN: The Finance Committee will come to order.
This morning we meet to discuss smart tax policies aimed at building local communities. Right now, the U.S. economy is red hot. Inflation is down, wages are up, and our country is in the middle of a record streak of low unemployment.
Manufacturing is booming, and you see factories under construction just about everywhere you go. Even in a strong economy, we all know that there’s a lot more to do to help local communities that struggle to get ahead. The tax code gives this committee a lot of tools to make that happen.
And I want to just give a brief example from the past. Build America Bonds or something that came from this committee. And I remember that night in 2009 when I was a pretty junior member of the Finance Committee, and I sat sort of closer to the door than closer to here, and Chairman Baucus and Senator Grassley called on me to discuss this idea that I had with a big group of members in the Senate, Democrats and Republicans, called Build America Bonds. And I didn’t know they were going to call on me. And then all of a sudden the two of them said, let’s hear from Ron and hear about these Build America Bonds.
And so I waxed eloquent or thought I was being eloquent. And I said, you know, I say to the committee we’ve never done this, never really bonded for transportation before.
I bet we could do $7-8 billion worth of bonds in transportation. It was a short-term thing. And everybody would go, wow, that’s sensational, $7 to $8 billion worth of bonds. I think everybody knows what we came in at. $180 billion worth of bonds in every nook and cranny of the country.
And the point is there’s an opportunity to be creative out there. Nobody thought that we could ever do anything like that. Maybe we’d get a few billion, nothing like $180 billion. So Congress is facing a big tax deadline at the end of next year, and we ought to be trying to find everything creative to try to give local communities a chance to tap the potential of good ideas.
Now, I think at the top of the list is the New Markets Tax Credit. It was established 25 years ago. It’s a flexible way to get private investment dollars into low-income communities, cities and towns and rural areas. All 50 states have benefited from it.
It’s helped get thousands of projects off the ground, health care and manufacturing, child care centers and schools, retail developments and housing, lots of affordable units. But it’s not permanent. It’s temporary. It expires at the end of 2025.
Now, the Congress on a bipartisan basis has extended it several times. I want to make sure this doesn’t get lost, doesn’t get lost next year in what is certainly going to be a spirited discussion about the future of the tax code. Senator Cardin has been a champion of this cause. He’s got a bill that would make it permanent, expand its value to drive even more investment in communities that need the boost.
In my view, it’s a no-brainer. I’m proud to support it. And Senator Cardin will be in retirement next year, but I look forward to being part of the call to him telling him we got this done because he’s put a lot of effort into it. It’s an obviously efficient, powerful tool in the tax code. We need to make tough choices about what works and what doesn’t.
Let’s talk for a moment about opportunity zones that were a priority for the Trump administration and some Senate Republicans. It was created as a way to boost struggling communities at a cost of around $1 billion. Unfortunately, the eligibility rules were too loose and the safeguards against waste were too lax.
So the program has helped a lot of high-wealth individuals opt out of paying taxes on investments they probably would have made with or without Opportunity Zone incentives. Now, there have been some success stories. But for every affordable housing development, it seems like there’s a casino or a crypto mining facility going up.
Just 1 percent of the areas eligible for the Opportunity Zone dollars have hoovered up nearly a half of the invested money. More than three-quarters of the ozone funding has gone to only 5 percent of eligible areas. So my sense is, thus far, that’s not been a lot of shared prosperity.
It had a $1 billion price tag at the beginning. Going forward, get this number, it costs $70 billion to extend. There is scant evidence it’s really helping to drive investment in the areas that need it most. Independent studies suggest it’s failing at that goal. I suspect we’ll have some discussion of that today.
A couple of final points. The tax exemption for municipal bonds is a key tool, helping local governments finance priorities like infrastructure and utility projects. Private activity bonds are a similar tool that have helped state and local governments get affordable housing, hospitals, schools, and highways built. Senator Brown has led the fight to protect these important tools, and I commend him for it.
The 2017 Trump tax law diminished the value of these tax-exempt bonds, unfortunately, because it made it harder for state and local governments to reduce their debt. With much of the Trump tax law expiring next — at the end of next year, there are fresh concerns that Republicans will want to go after these key — excuse me. The family is calling.
The fact is, with much of the Trump tax law expiring at the end of next year, there are fresh concerns that Republicans are going to try to go after these key financing tools, again, to pay for the multi-trillion dollar cost of extending the Trump tax cuts to the very wealthy. I will strongly oppose that effort. That would be a huge setback for our infrastructure needs and for local communities across the country.
We’re going to talk about other areas this morning. That includes the Rehabilitation Tax Credit. Senator Cortez Masto’s excellent proposal to make tribal governments fairly benefit from the New Market Tax Credit. And Senator Stabenow has a proposal to help cities turn empty commercial spaces into badly needed housing.
It’s also important to cover how tax incentives can be combined, allowing groups to drive even more dollars into communities that need help. Much to discuss. I want to thank our witnesses and look forward to questions and answers.
Senator Crapo will make his introductory statement. Senator Brown will be here to introduce a witness that he has seen doing very good work in this space. Senator Crapo?
CRAPO: Thank you very much, Mr. Chairman. I appreciate the opportunity to work with you on this critically important bipartisan topic.
Exploring incentives that encourage local economic growth is incredibly important. As we begin to consider extending Republicans’ 2017 tax law, the Tax Cuts and Jobs Act. While the TCJA contained a litany of pro-growth tax policies, one policy that is relevant for today’s hearing is the Opportunity Zones program.
Opportunity Zones have demonstrated notable success in driving investment into distressed areas. By offering tax incentives for investments in opportunity funds, private capital has flowed into areas that did not receive such levels of investment before the TCJA was enacted.
In Idaho, within just the first two years of the Opportunity Zones program, 54 percent of the state’s Opportunity Zones saw investments. According to the Joint Committee on Taxation, by the end of 2022, Idaho had received $130 million in Opportunity Zone investment. Without the TCJA, these investments may have remained on the sidelines.
Across the country, investments are being made in rural areas and economically distressed communities that need it the most. According to research conducted by two Treasury Department economists and compiled by the Economic Innovation Group, in the first two years of the program, the average Opportunity Zone that received investment was in the 87th percentile of poverty, 81st percentile for average median household income, and the 80th percentile for unemployment.
While the Opportunity Zone program has come a long way, there is still more to be done. Senator Scott continues to be a leader on this issue, just as he was when we were writing the TCJA, and he and Senator Booker previously introduced legislation to extend and improve the program, including by requiring reports so Congress can monitor how investments in Opportunity Zones are working.
One of our witnesses today, Shay Hawkins, was a member of Senator Scott’s staff in 2017. He was instrumental in developing the Opportunity Zones program, and he’s here today to share his expertise as president of the Opportunity Funds Association. Mr. Hawkins, I look forward to hearing from you today about how improving and extending the program will ensure that private investment continues to flow to distressed communities.
Opportunity Zones, the new — excuse me, the markets tax credit, the historic tax credit, the tax-exempt bonds, and the low-income housing tax credit all spur local economic development. And we can see tangible results in communities around the country. In Twin Falls, Idaho, two local developers opened one of our state’s first Opportunity Zone projects, the Second South Market Food Hall.
Located in the 1920s-era warehouse, the Second South Market houses local food vendors and is the first of its kind in Idaho. In Mountain Home, Idaho, the Desert Sage Health Center recently opened a new 30,000-square-foot primary care facility. It will serve a more rural part of my state that was made possible due to the new markets tax credit investment.
There are many other examples of projects in Idaho and across the country that demonstrate how these incentives are being put to work. Several members of this committee have been working across the aisle to promote these and other incentives. For example, Senators Daines and Cardin have introduced legislation to permanently extend the new markets tax credit.
Senators Cassidy, Cardin, Collins, and Cantwell have introduced legislation to expand the historic tax credit. I look forward to discussing existing policies and new ideas, including how these tax tools are working, how they can be improved, and how Congress can continue to support local economic development in a fiscally responsible way.
Thank you to our witnesses today for being here, and thank you,
Mr. Chairman, for holding this important hearing. I yield back. WYDEN: Thank you, Senator Crapo.
Now I would like to ask Senator Brown to introduce our first witness, LaShea Lofton. Senator Brown?
BROWN: Thank you, Mr. Chairman. It’s my honor to introduce LaShea Lofton from Dayton, Ohio. Mr. Chair, thanks for inviting an outstanding Ohio witness to this hearing. Ms. Lofton has dedicated her career to service working for the city of Dayton for more than 30 years.
She currently serves as Dayton’s Deputy City Manager. She provides oversight to the city’s Departments of Aviation. The city is the home of Wright-Patterson Air Force Base. Finance, public works, and information technology. She’s a member of the National Government Finance Officer Association. She was awarded their Hero Award four years ago in 2020.
She has a long list of accomplishments from her time with the city of Dayton, including during the seven years she served as the city’s Finance Director. She’s helped to develop and manage multimillion-dollar operating and capital programs.
The city of Dayton, during her tenure, has consistently received clean state audits. They’ve increased their credit ratings in a community that’s met a lot of economic challenges, so thank you especially for that. She will discuss the federal programs already in place and have brought investments to places like Dayton.
There are ways we can improve these tools. I know that Chair Wyden is working on that, so communities of all kinds can have access to the finances they need to improve infrastructure and to invest in neighborhoods. You’ll hear in her testimony about the need to restore advanced refunding of tax-exempt bonds.
I’m co-sponsoring a bipartisan bill to do that. She’ll also discuss the need to end sequestration for Build America Bonds. Thank you, Mr. Chairman, your work there. I’m preparing legislation to do that. Both will help our municipalities save money that they can reinvest in West Dayton, East Dayton, North Dayton, all over that city.
She understands the assets we have in the Miami Valley, skilled workers, one of the proudest industrial heritages in the world, schools like UD and Wright State and Central State, and of course the jewel of the Air Force, Wright-Patt, and all the aerospace innovations and talent that has grown up around it. Dayton is really the reason that Ohio is known as the premier aerospace state in the country.
Ms. Lofton has spent her career working with us to leverage those assets and create opportunities in Dayton. We need to give leaders like her the tools our communities need to create jobs and opportunities for workers around the country, in Ohio and around the country.
She earned her bachelor’s degree from the University of Dayton. She serves on the board of my daughter’s and my mother’s favorite organization, the YWCA. Thank you so much, Ms. Lofton, for being here today. It’s an honor to introduce you. Thank you.
WYDEN: Thank you, Senator Brown, and thank you for arranging to have Ms. Lofton here, and we’ll look forward to hearing from you in a minute.
To introduce our other witnesses, let me just highlight some of their background. Julia Nelmark is the President and CEO of the Midwest Minnesota Community Development Corporation, a mission-based lender and developer headquartered in Detroit Lakes, Minnesota. She’s also the president and CEO of the White Earth Investment Initiative, an important effort that helps Native Americans throughout Minnesota.
Mr. Michael Novogradac is the managing partner of the Novogradac firm. He’s got years of experience in affordable housing and also renewable energy tax incentives, which we have had a great interest in. And very pleased to have Shay Hawkins here. He’s the co-founder of the Opportunity Funds Association. Prior to this role, he was the staff director for the Subcommittee on Energy, Natural Resources, and Infrastructure, and the senior tax and economic policy adviser to Senator Tim Scott.
I will just say we always welcome alums of the Finance Committee to come as witnesses, so we’ll look forward to hearing from you in a little bit, Mr. Hawkins. Let’s begin with you, Ms. Lofton.
LOFTON: Good morning, Chairman Wyden, Ranking Member Crapo, and distinguished members of the committee. Thank you for holding today’s hearing on tax tools for local economic development.
My name is LaShea Lofton, and I am the deputy city manager for the City of Dayton, Ohio. My remarks today both represent Dayton and the over 24,000 members of the Government Finance Officers Association. GFOA is dedicated to the professional management of governmental financial resources, including issues related to tax-exempt bonds.
Our system of federalism requires a strong federal, state, and local government partnership to achieve our shared goals. A prime example of that partnership at work is the tax-exempt municipal bond. I am here today to urge Congress to protect this vital tool and adopt specific provisions to further enhance its effectiveness.
Providing infrastructure in our communities is a national priority, one shared at all levels of government. Over time, the tax-exempt bonds issued by state and local governments and non-profit entities have financed over three-quarters of our nation’s infrastructure.
In 2022, the City of Dayton issued over $21 million in municipal tax-exempt bonds for capital projects that foster economic and community development in our neighborhoods. Critical street reconstruction and resurfacing projects attracted further investment along our main corridors.
Capital improvements in parks and playing fields enhanced the vibrancy of our city, further spurring millions of private and other public investments in housing and economic development. Dayton also financed essential public safety equipment, such as a fire engine and waste collection trucks, which help us provide essential services to our residents and our business community.
These types of strategic investments are the catalyst required for Dayton’s economic growth and vitality. While it is true that federal tax-exemption reduces the cost of issuing municipal bonds, it is the combination of local control and local responsibility that makes municipal bonds work.
For over a century, this local tool has worked to our mutual advantage in enhancing livable communities. Congress’s efforts to protect the full tax exemption are important and necessary to achieve our mutual goals. The support for tax-exempt municipal bonds is bipartisan, bicameral, and very strong, but additional federal policy could strengthen this tool further.
In the next legislative package addressing taxes and public finance, we urge Congress to include the following. First, we ask you to restore advanced refunding to tax-exempt bonds. Doing so frees up billions of dollars that governments and non-profits can spend on more projects that directly strengthen the precarious state of our community’s infrastructure.
Between 2007 and 2017, there were over 12,000 tax-exempt advance refundings nationwide, generating over $18 billion in savings for tax and ratepayers over the 10-year period. In 2018, Dayton issued just over $11 million in debt to finance capital improvements.
If tax-exempt advance refunding were still available to us, we could potentially generate a minimum of over $300,000 in savings on those bonds. While this may not seem like much to some, for our roughly 136,000 residents, it’s enough to renovate another park or upgrade the streets and sidewalks leading up to our neighborhood libraries.
Restoring advance refunding for tax-exempt bonds would be an incredible boost to the resources local governments need for continued investment and attracting more capital, especially as we seek ways to improve our local economies.
Second, we ask you to increase access to capital for small borrowers. For many thousands of small issuers, government and non-profit borrowers, increasing the bank-qualified borrowing limit from $10 million to $30 million and having it apply at the borrow level would provide access to low-cost capital.
Bank-qualified bond issuers save between 25 and 40 basis points on average. On a 15-year $10 million bond at current interest rates, that translates to anywhere between $232,000 and $370,000 in savings for small communities. Third, we ask you to restore and expand the use of direct pay bonds, with specific attention to protecting the subsidy from sequestration. In prior years, Congress authorized governments to attract — to issue taxable direct subsidy bonds, a good supplement to municipal bonds. However, sequestration ate into those subsidies for Build America Bonds, so we ask that any effort to restore direct subsidy bonds include definitive protection from sequestration.
I hope my comments emphasize and demonstrate the federal government’s crucial role in supporting local decision-making for local capital improvements. Municipal bonds are key tools in this process.
Thank you for your attention today, and I appreciate your consideration of these vital initiatives and for convening this very important hearing today.
WYDEN: Well said, Ms. Lofton. I know you’re going to get some questions in a moment.
Ms. Nelmark?
NELMARK: Thank you, Mr. Chairman. In addition to leading the Midwest Minnesota Community Development Corporation and Wide Earth Investment Initiative, I’m also the vice chair of the New Markets Tax Credit Coalition, a national membership organization comprised of New Markets practitioners.
The coalition conducts policy research and advocates on behalf of the credit. New Markets is one of the most effective tools we have for community development. It provides lower-cost financing for businesses and community facilities in America’s most distressed urban and rural communities.
And New Markets is a simple concept. Taxpayers receive a 39 percent tax credit over seven years for qualified investments into community development entities, or CDEs, to finance manufacturing and business expansions, healthcare and daycare facilities, business incubators, and other important projects. Its flexibility makes it particularly useful in supporting the needs of each business and community as determined by those working on the ground.
Since its inception, the New Markets Tax Credit has delivered over $135 billion in financing to over 8,500 businesses and community development projects and creating over 1.2 million jobs to date at a cost to the federal government of under $20,000 per job. In Minnesota, New Markets has financed 274 projects, totaling $3.4 billion. And this credit isn’t just for large businesses.
Of the 116 New Markets projects MMCDC has financed to date, over half were below $4 million and over a third were below $2 million, such as a $1.8 million loan to Wind River Internet in rural Wyoming to help finance equipment and fiber connections to homes and businesses, financing difficult to obtain from banks.
The vast majority of New Markets financing goes to the most severely distressed communities, both urban and rural. The coalition urges Congress to pass the bipartisan New Markets Tax Credit Extension Act of 2023, introduced by Senators Cardin and Daines.
This would do three things. First, it would make New Markets a permanent part of the tax code, which would boost its efficiency by providing certainty and raising pricing. Second, it would index future allocation levels to inflation. As businesses’ costs grow, so do their funding needs.
Third, it would provide New Markets investors with relief from the Alternative Minimum Tax, or AMT, like most federal community development tax credits, to increase the pool of investors, which would also increase the dollars flowing to these communities. Together, these changes will increase certainty for CDEs, investors, and communities, lead to better pricing, and increase dollars flowing to distressed communities.
Many have been concerned that New Markets does not adequately reach tribal communities. To date, just 3 percent of New Markets financing supported these communities, although we’ve seen some recent increase in this trend and more Native-focused allocation. As a CDE focused in Minnesota and the Dakotas, we have funded over $63 million in Native projects, primarily health care, education, and cultural centers.
These are often more time-consuming to bring to closing and suffer from significant appraisal valuation gaps. One project on a Minnesota reservation needed additional collateral equity and other funds as the appraised value for the project was half of the total developed costs. While we’ve recently seen an uptick in investment in Indian Country, more is needed.
The New Markets Coalition supports the Tribal Tax Investment and Reform Act of 2024, bipartisan legislation introduced in the House to provide $175 million in additional allocation for tribal communities. New Markets has helped hundreds of small farming towns and rural communities across the country with the capital they need for business expansions, health care centers, broadband expansions, and other locally prioritized projects.
The Rural Jobs Act, introduced by Senators Roger Wicker and Mark Warner, would build on the success of the New Markets Tax Credit, providing additional resources to some of America’s hardest-hit rural areas. It would add $1 billion in New Markets allocation over two years targeted to rural job zones.
Rep. Bill Pascrell remains hospitalized but is no longer receiving breathing assistance, according to his office.
“Congressman Pascrell has been breathing on his own since last week and continues to improve every day,” Pascrell Chief of Staff Ben Rich said in a statement. “His doctors are very encouraged by his progress, have begun to discuss discharge plans, and continue to anticipate a full recovery.”
Background: The 87-year-old Democrat checked into St. Joseph’s University Medical Center in Paterson on July 14 with a fever. While Pascrell’s staff initially said he was in “good spirits” and had told staff he was “actively looking for a beer,” his condition took a turn last week. Rich in a statement Thursday said that while recovering from a respiratory infection, the congressmember suffered a “setback” and was given “breathing assistance.”
Pascrell is the oldest member of New Jersey’s congressional delegation and if reelected will become the oldest member of the House following the retirement of California Rep. Grace Napolitano. Pascrell was also hospitalized in 2020 for heart bypass surgery.
Pascrell in June easily defeated a primary challenge from Prospect Park Mayor Mohamed Khairullah based largely on disenchantment with his stance on Gaza. He faces Republican Billy Prempeh for a third time in November.
What’s next: Rich’s statement indicated that Pascrell has no plans to drop his reelection bid.
“The congressman is relieved that this illness only led to him missing a few voting days,” Rich said. “And after winning a decisive primary victory, Congressman Pascrell is excited to finish the job alongside Kamala Harris in November in defense of American democracy and New Jersey values.”
Pascrell’s illness comes three months after 10th District Rep. Donald Payne died of a heart attack following a lengthy hospitalization.
Programs to aid health care for older Americans and provide them meals would be in line for an almost 5% increase through fiscal 2029 under legislation a Senate committee approved Wednesday.
The Health, Education, Labor and Pensions Committee voted 20-1 to reauthorize the Older Americans Act, a 59-year-old law that offers grants to state and local organizations that offer training and social programs for older Americans as well as nutrition services and federal aging programs.
HELP Committee Chairman Bernie Sanders (I-Vt.) originally called for doubling funding for the programs, highlighting the problem of food insecurity among seniors.
“When we talk about the unmet needs of our nation’s seniors this is what we’re talking about,” he said.
To get agreement on the package Sanders settled for allowing a 4.62% increase each year, starting at $2.7 billion in the fiscal year starting Oct. 1. The money would still need to be part of the next bill to fund the government.
Susan Collins (Maine), the top Republican on the Senate Appropriations Committee, is a co-sponsor of the bill. Patty Murray (D-Wash.), chair of the Senate Appropriations Committee, voted for it in committee Wednesday.
Just Sen. Rand Paul(R-Ky.) voted against the bill.
Proposed Rules – 89 FR 61596
Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments
Regulating Agency:
Department of Health and Human Services
Publication Date:
07/31/2024
SUMMARY:This major proposed rule addresses: changes to the physician fee schedule (PFS); other changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; codification of, and proposing policies for, the Medicare Prescription Drug Inflation Rebate Program under the Inflation Reduction Act of 2022; updates to the Medicare Diabetes Prevention Program expanded model; payment for dental services inextricably linked to specific covered medical services; updates to drugs and biological products paid under Part B including immunosuppressive drugs and clotting factors; Medicare Shared Savings Program requirements; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; updates to policies for Rural Health Clinics and Federally Qualified Health Centers; electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan or a Medicare Advantage Prescription Drug (MA-PD) plan under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act); update to the Ambulance Fee Schedule regulations; codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2023 provisions; updates to Clinical Laboratory Fee Schedule regulations; updates to the diabetes payment structure and PHE flexibilities; expansion of colorectal cancer screening and Hepatitis B vaccine coverage and payment; establishing payment for drugs covered as additional preventive services; Medicare Parts A and B Overpayment Provisions of the Affordable Care Act.
Hospice providers will see a pay bump of 2.9%, or $790 million, next fiscal year, a significant improvement from the proposed $705 million boost though providers are still concerned it’s not enough to keep up with inflating costs.
“Good hospice care is a holistic, patient- and family-centered, compassionate approach to the dying–and it can be a godsend,” LeadingAge President and CEO Katie Smith Sloan said in a statement. “We recognize that a 2.9% is an increase, but given the challenges our mission driven and nonprofit members continue to navigate, particularly a very competitive labor market especially for registered nurses, the final rule falls short of the need.”
LeadingAge was also disappointed that CMS didn’t delay its changes to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey so there could be more time to develop the web-mode of delivery.
CMS announced Tuesday (July 30) the final hospice pay rule, finalizing an increase that’s similar to the 3.1% bump totaling $780 million that the industry received for 2024. The hospice aggregate cap on payments, which limits overall annual payments per patient made to a hospice provider, is also continuing to tick up. The cap under the fiscal 2025 pay rule increased by about $970.
The Biden administration said it upped its overall pay hike for 2025 after reviewing the productivity adjustment for the second quarter of 2024. CMS says its final amount is adequate since the Medicare Payment Advisory Commission’s analysis found hospice providers’ returns have been in the green — the 2021 fee-for-service Medicare marginal profit was about 17% — and they recommended the administration forgo an increase for fiscal 2025.
The rule also finalized adoption of the most recent White House Office of Management and Budget statistical area delineation. While one provider in Maryland disagreed with the decision, CMS didn’t change its proposal, but it reminded providers that those affected by a change in their geographic wage index can apply a 5% cap on any decrease to the wage index from the prior year.
Two new process measures were finalized for the Hospice Quality Reporting Program: Timely Follow-up for Pain Impact and Timely Follow-up for Non-Pain Symptom Impact. They will begin fiscal 2028 through the new Hospice Outcomes and Patient Evaluation tool.
The HOPE patient-level data collection tool will functionally replace the existing Hospice Item Set (HIS) structure next year, CMS says. Guidance on the new system will be released in the coming weeks.
“HOPE will collect data at multiple time points across the hospice stay, including admission, the HOPE Update Visit (HUV), and discharge,” CMS’ fact sheet says. “Compared to the HIS (which only collects data at hospice admission and discharge), HOPE will enable CMS to gather patient-level data during their hospice stay to improve patient quality of care.”
HOPE will include several domains, CMS says, including sociodemographic, diagnoses, symptom impact assessment, skin conditions and imminent death.
The fiscal 2025 hospice wage index final rule is the first of four pay rules CMS is expected to finalize this week. The White House Office of Management and Budget released the pay rules for skilled nursing facilities, inpatient rehabilitation facilities and inpatient psychiatric facilities last week and cleared the inpatient and long-term care hospital pay rule late Monday (July 29).
On July 19, 2024, Change Healthcare filed a breach report with the HHS Office for Civil Rights (OCR) concerning a ransomware attack that resulted in a breach of protected health information. Change Healthcare’s breach report to OCR identifies 500 individuals as the “approximate number of individuals affected”. This is the minimum number of individuals affected that results in a posting of a breach on the HHS Breach Portal. Change Healthcare is still determining the number of individuals affected. The posting on the HHS Breach Portal will be amended if Change Healthcare updates the total number of individuals affected by this breach. HIPAA breach reports filed on the HHS Breach Portal may be amended as the breach report form allows a filer to file an initial breach report or an addendum to a previous report.
OCR has updated the answer to question #3 on OCR’s “Change Healthcare Cybersecurity Incident Frequently Asked Questions” webpage to address this issue. OCR will continue to update the FAQs as needed.
On July 19, 2024, Change Healthcare filed a breach report with the HHS Office for Civil Rights (OCR) concerning a ransomware attack that resulted in a breach of protected health information.
New Access Points (NAP) funding supports new health center service delivery sites that expand primary health care for underserved communities. We plan to make NAP awards in fiscal year (FY) 2025, if funding is available.
The submission deadline for HRSA’s Electronic Handbooks (EHBs) is unchanged; applications in EHBs are still due by 5:00 p.m. ET on Monday, September 30. You can start your application in EHBs as soon as you submit it to Grants.gov.
Visit the NAP TA webpage to access the NOFO (HRSA-25-085) and find resources to help develop your application, including many in Spanish.
See the second story in last week’s Digest for information about the previous NOFO modification to clarify information for look-alikes (LALs).
President Joe Biden has some unfinished business on health policy, and the final months of his term in office will feature a flurry of regulations touching areas from Medicare payments to prior authorizations to cybersecurity.
The Biden administration will end in January regardless whether GOP former President Donald Trump or presumptive Democratic nominee Vice President Kamala Harris prevails on Election Day. And while Harris likely would continue along a similar trajectory as Biden, she would put her on stamp on policy from the White House as president, while Trump’s record and agenda indicate he would take health policy in a very different direction.
Earlier this month, the White House Office of Management and Budget released the administration’s unified agenda spelling out the regulatory plan for the remainder of 2024. These are the key healthcare rules the administration has planned as Biden approaches political retirement:
Starting this week, the Centers for Medicare and Medicaid Services will issue final rules setting Medicare reimbursement rates and modifying policies for inpatient hospitals, nursing homes, hospices, inpatient psychiatric facilities and inpatient rehabilitation facilities. By law, these regulations must be published by early August to take effect at the beginning of fiscal 2025 on Oct. 1.
CMS is also expected to finalize a rule that to toughen enforcement of mental health parity laws, a key priority the White House touted when the agency published a proposed rule last July. The parity rule would mandate that health insurance companies determine whether members have access to mental healthcare that is equivalent to their access to other types of care, and to modify coverage if they do not. Senate Democrats recently pressured the administration to pick up the pace.
CMS has also been working on a proposed rule to update emergency preparedness requirements for Medicare and Medicaid providers and suppliers as part of its response to lessons learned from the COVID-19 pandemic.
CMS will issue a proposed rule to prevent insurers from excluding non-physician providers who perform the same services as doctors from their networks or offer them lower reimbursements. This regulation has been delayed since 2022.
The Biden administration has made its mark on Medicare Advantage in many ways, including reducing payments and implementing restrictions on prior authorizations and marketing practices. There are a few more regulations coming.
CMS is scheduled to publish its annual update to Medicare Advantage policy in September. That’s two months earlier than most years as the administration seeks to get the regulation in place before Biden departs, just as Trump, President Barack Obama and other outgoing chief executives have done with various rules.
Telehealth providers are eagerly awaiting a revised Drug Enforcement Administration proposed rule on remote prescribing of controlled substances. The first draft provoked strong resistance from the telehealth sector, which characterized its requirement that patients get initial prescriptions during in-person visits as excessively restrictive.
Federal authorities continue to implement an overhaul of the organ donation system that began last year. This fall, the Health Resources and Services Administration is due to publish a proposed rule to set standards that would allow HIV-positive people to donate kidneys and livers to other HIV patients.
The Homeland Security Department’s Cybersecurity and Infrastructure Security Agency is set to publish a final rule that would create stronger reporting requirements regarding cyberattacks and ransom payments. The American Hospital Association has expressed concern that this regulation would duplicate existing reporting mandates.
Medicare reimbursement final rules for physicians, hospitals, dialysis and home health for calendar year 2025 are expected near the end of the year, as usual.
The Health and Human Services Department Office of the Inspector General is poised to publish a proposed rule that would create exceptions to anti-kickback laws and enable hospitals, ambulatory surgical centers, community health centers, rural emergency hospitals, rural health clinics and skilled nursing facilities to offer mental health and substance-use disorder treatments to their own doctors and clinical employees.
CMS is slated to issue another No Surprises Act final rule that would restructure the independent dispute resolution process for providers and insurers.
The agency also is set to finalize a regulation governing electronic transactions and file attachments for prior authorizations. Hospital, physician and insurance groups criticized the proposed rule, saying it would conflict with existing data exchange standards.
CMS plans to issue a separate proposed rule to regulate prescription drug prior authorizations for Medicare Advantage and health insurance exchange enrollees, which would build off an earlier rule requiring electronic processing of preapprovals requests.
HHS is expected to close out the year with a focus on cybersecurity, data privacy and digital health. For example, the Office for Civil Rights is scheduled to propose a rule that would mandate organizations covered by the Health Insurance Portability and Accountability Act of 1986 upgrade their cybersecurity infrastructure. The draft regulation also would tweak health data privacy standards.
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