April 6, 2023
We’re settling into April with some news about Congress’ terminating the COVID-19 national emergency, some news potentially affecting preventive services coverage in employer health plans, upcoming Aledade webinars, and some state policy news.
Congress Passed Legislation to End the National Emergency
Last week, the United States Senate passed legislation to end the national emergency concerning COVID-19. This legislation was previously passed by the House and it is now headed to President Biden’s desk to be signed in the next week. CMS has clarified that the 1135 waivers are going to remain in place and the end of the National Emergency does not affect the end of the Public Health Emergency, which is still set for May 11. The previous guidance we sent out is still in effect.
Preventive Services Coverage in Employer-Sponsored Health Plans in the News
You might have seen the news that a federal judge in Texas recently struck down the requirement that employer-sponsored health plans must cover without cost-sharing certain evidence-based clinical preventive services recommended by the US Preventive Services Task Force. This ruling is expected to be appealed and the health plan community has reminded the public that contracts are in place for 2023 so there will be no immediate effect on coverage. We will continue to keep you updated on this issue.
Upcoming Webinar: Moving Beyond the Public Health Emergency: What Comes Next for Primary Care and Accountable Care Organizations
Join us for a free webinar on April 19 at noon ET where Aledade’s SVP for Policy & Economics Travis Broome will provide a complete rundown of impacted policies related to the end of the PHE most relevant to primary care physicians. We will also examine recent shifts in Medicare payment as well as record-setting years in ACO performance–and how the one-two punch of the pandemic and inflation overshadowed these gains. Finally, we will pull back the covers to learn how primary care and accountable care combine to improve quality, lower costs and create a sustainable future for primary care practices.
Save the Date: Aledade Hosts 2nd Biannual Multi-State Policy Collaborative Focusing on Prior Authorization
On Wednesday, May 24 at 7 pm ET, join us for a free webinar focused on what states are doing to reduce the burden of prior authorization for primary care practices. Learn about the latest research on the negative effects prior authorization has on primary care practices and patients as well as what states are doing to overcome these barriers and hear directly from physician advocates as well as legislators and stakeholders who have actively been involved in passing prior authorization legislation.
State Policy Corner
- As states enter the home stretch of their legislative sessions, the legislatures continue to debate policies that impact primary care and independent physicians. Our policy committees are actively engaging in advocacy on key priorities ranging from prior authorization reform to Medicaid expansion and effects around the public health emergency unwinding.
- In Colorado, the Aledade State Policy team and policy committee members are advocating on the key priorities for independent practices regarding prior authorization reform efforts. The team has convened with key stakeholders and shared practice stories highlighting the administrative burdens and overall impact prior authorization has on independent and community practices, providing a critical voice for physicians and small practices on major policy efforts in the state.
- All eyes were on North Carolina this month as Governor Cooper signed Medicaid expansion into law, an important milestone, and one that many Aledadeders, including our own Mandy Cohen, have been working towards for a long time. The funding of Medicaid expansion is tied to passing the budget, but this is an important step towards expanding access to health insurance for nearly 600,000 more North Carolinians.