Policy Update: What We’re Tracking in January

Congress is back in session, and the Policy team has hit the ground running in 2024. Here is what we are watching:

• President Biden signed a stopgap funding bill that will keep the government open into early March. The legislation did not address the Medicare pay cuts or extend the Advanced Alternative Payment Model incentive payments. There continue to be ongoing discussions in Congress about both of these priorities, and we will keep you updated.
• What about today? The cuts are in effect and vary by code, for example the national rate for a 99214 is down 1.9% even though the headline cut is 3.37%. Historically, when Congress makes a change after the start of the year, it is retroactive, but that is not guaranteed.
• On a more upbeat note, several of the improvements in the Medicare Shared Savings Program that we achieved in 2022 and 2023 went into effect Jan 1, 2024, to measure the savings achieved by the ACO as accurately as possible.

We also already have our first regulation comment letter of the year submitted and are tracking the kickoff of state legislative sessions in several states.

Aledade supports more transparency around prior authorization and use of supplemental benefits in Medicare Advantage

In our comments to CMS on proposals for policy and technical changes to MA for 2025, we shared our support for more transparency from health plans on the use of supplemental benefits as well as ensuring prior authorization policies do not impede access to essential services for beneficiaries with social risk factors.  

State Policy Corner

 State legislature start dates and session lengths vary depending on the state, but some legislatures officially hit the ground running and are back in session this week. We are officially running state policy committees in 13 states, and our analysts will be sending out regular legislative updates during session, specifically focused on policies that may affect our practices. For questions about policy in your state, reach out to policy@aledade.com.