CEO Update 235
Senate Faces Additional Obstacles to Passing its Reconciliation Bill
The pathway for the Senate to pass its budget reconciliation bill became more precarious this week, following increased opposition to Medicaid cuts by a growing number of senators and the Senate parliamentarian’s determinations that several key provisions violate the Byrd rule, meaning they require 60 votes to pass the Senate instead of a simple majority.
Provisions deemed to violate the Byrd rule include the proposed reduction in the permissible state provider tax threshold from 6% to 3.5%, limits to federal financial participation in Medicaid for states that offer coverage to non-citizens, and others. Republicans will now have to rewrite or remove these sections of the bill, which were estimated to collectively save hundreds of billions of dollars.
The parliamentarian’s determinations come as Senate Republican leaders and President Trump are trying to win over wavering GOP senators to support the Senate bill. Various senators are also proposing a $15 billion stabilization fund to mitigate the bill’s impacts on rural hospitals.
Majority Leader Thune is still holding out hope for an initial procedural vote today, followed by an overnight vote-a-rama rolling into a final vote on Saturday. The bill would then go to the House for a vote, though many Republicans there have concerns with the extent of Medicaid cuts.
The goal of Congressional Leadership remains for President Trump to sign the bill by July 4.
The NABH Government Affairs team is contacting senate offices to oppose the current Senate bill. NABH has also sent several Action Alerts to NABH members with information to support outreach to senators. We urge you to respond to these alerts and encourage your colleagues to do the same.
Insurers Announce Plan to Reform Prior Authorization
A group of health insurance executives joined HHS Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services Administrator Mehmet Oz on Monday to announce plans to change prior authorization practices with the aim to reduce administrative burden and improve patient care. Participating insures pledged to:
- Standardize electronic prior authorization by 2027;
- Reduce the scope of claims subject to prior authorization by 2026;
- Ensure continuity of care when patients change plans by 2026;
- Enhance communication and transparency on determinations by 2026;
- Expand real-time responses to 80% by 2027; and
- Ensure medical review of non-approved requests (in effect now).
Key questions remain about how insurers will implement some of these changes, and how their performance on these commitments will be monitored. Insurers’ approach to implementation could be controversial, such as if they rely further on artificial intelligence to improve response time.
Reminder: Please Submit Surveys on EMTALA Implementation in Psychiatric Hospitals and Patient Safety Standards Today, June 27!
NABH has released two surveys to members:
- EMTALA Implementation in Psychiatric Hospitals, which is focused on how EMTALA compliance affects operational and clinical practices, such as staffing, workflow, documentation, processes (e.g., patient transfers), and resource allocation.
- Patient Safety Standards, which is focused on standards for preventing and responding to incidents of patient violence and abuse (i.e., violence and abuse toward patients perpetrated by facility staff or other patients), particularly for inpatient and residential settings.
Please submit your responses by Friday, June 27. If you have any questions, please contact Dan Schwartz.
ICYMI: HHS Announces Funding Opportunity for Behavioral Health Information Technology Pilot
HHS recently announced a funding opportunity to promote behavioral health data exchange and pilot the implementation of a specified set of behavioral health data elements.
HHS anticipates distributing $5 million across six to 10 participants, which include a wide range of provider organizations that receive SAMHSA grant funds or partner with recipients. More information can be found in the Request for Application and Frequently Asked Questions document.
The deadline for the expression of interest is Wednesday, July 2 and full applications are due Wednesday, Aug. 27.
An HHS representative offered to schedule a meeting between NABH members and the contractor administering the program to provide more detailed information and answer questions ahead of the application deadline. Please reach out to Dan Schwartz if you are interested in attending such a meeting. If there is a sufficient interest, we will proceed with scheduling.
Reminder: CMS Releases RFI to Gather Information on Improving Hospital Price Transparency
The Centers for Medicare & Medicaid Services (CMS) has issued a Request for Information (RFI) seeking public feedback about whether and how the agency can improve hospital price transparency (HPT) compliance and enforcement processes.
This RFI relates to the President’s Executive Order 14221 to ensure compliance with the transparent reporting of complete, accurate, and meaningful HPT data. Click here to read the RFI.
Fact of the Week
A new editorial in JAMA suggests addictive screen use is more strongly linked to negative mental health outcomes than screen time alone. The results emphasize the importance of addressing not just screen time, but also addictive behaviors in adolescents. “Moving forward, targeted policies and interventions, including stronger parental involvement and better age verification measures on social media, are crucial for mitigating the risks associated with screen addiction,” the editorial said.
Happy Independence Day from NABH!
NABH will not publish CEO Update on Friday, July 4 and will resume on Friday, July 11. The NABH team wishes you, your families, and your teams a happy and safe Independence Day weekend!
For questions or comments about this CEO Update, please contact Jessica Zigmond.