What to Watch: The Fiscal Year 2017 budget

February 17, 2016
|In Health Insurance Exchanges, Medicaid, Part D, Policy & Health Reform, Brain Food
|By GHG Advisors

President Obama released the Fiscal Year 2017 budget last Tuesday, which contains many significant proposals to government healthcare programs. Although both the Senate and House’s budget committees already rejected hearings from the President’s budget chief and unsurprisingly declared the bill “dead on arrival,” the proposals do contain many bipartisan provisions with significant cost savings. One such proposal organizations should watch carefully, for example, is using competitive bidding in Medicare Advantage plans.

Most of the Medicare and Medicaid proposals are estimated to provide savings.  The Congressional Budget Office’s (CBO’s) review of the budget in March will further shine light on which proposals will make it through the budget process. In a new memo, The GHG Policy team provides an overview of proposals to watch in a new memo, including:

ACA Updates

  • Medicaid Expansion Incentive
  • Uniform billing and out of network charges
  • Marketplace eligibility determinations
  • Cadillac Tax updates

Medicaid Budget Updates:

  • Medical Loss Ratio (MLR)
  • CHIP Funding
  • Health Coverage Expansion Proposals
  • Long-Term Services and Supports (LTSS)

Medicare Advantage (MA):

  • Competitive Bidding Proposal
  • Higher payments to high-quality MA plans
  • Telehealth expansion

Part D:

  • State-federal Medicaid negotiating tool
  • Part D plan sponsor incentives to better manage high prescription drug costs.
  • Increase of manufacturer rebates
  • Mandate to provide rebates consistent with Medicaid rebate levels for drugs provided to low-income Part D beneficiaries.

Alternative Payment Models (APMs):

  • Bundled Medicare payments for post-acute providers such as nursing homes and home health agencies.
  • New bonus payment for hospitals that collaborate with certain APMs.
  • Quality bonus program for the highest rated Part D plans


Resources

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