This week in Washington: Washington’s focus has been on the presidential and Senate races.


Neal, Pallone Tell CMS to Not Ease Physician-Owned Hospital Restrictions
On Oct. 21, the House Ways and Means Chair Richard Neal (D-MA) and Energy and Commerce Chair Frank Pallone (D-NJ) sent a letter to the Centers for Medicare and Medicaid Services (CMS) to voice opposition to a provision in CMS’s proposed hospital outpatient pay rule that loosens restrictions on physician-owned hospitals. Neal and Pallone added that the proposal goes against a moratorium on the expansion of physician-owned hospitals that Congress put in place to counter concerns. They also were concerned about physician-owned hospitals’ picking patients selectively, self-referring, increasing costs and utilization, and hurting the quality of care.


CMS Announces Medicare A and B Deductibles and Part B Premium
On November 6, the Centers for Medicare and Medicaid Services announced Medicare Part A and B deductibles and premiums for 2021. The Medicare Part A inpatient deductible that beneficiaries will pay when admitted to the hospital is $1,484 in 2021, an increase of $76 from $1,408 in 2020. The majority of Medicare beneficiaries pay no Part A premium. The standard monthly premium for Medicare Part B enrollees will be $148.50 in 2021, an increase of $3.90 from $144.60 in 2020. The annual deductible for Medicare Part B beneficiaries is $203 in 2021, an increase of $5 from $198 in 2020.

Exchange Rule for Plan Year 2022 Under Review by OMB
On Nov. 5, the Office of Management and Budget (OMB) reviewed the proposed annual exchange rule for the 2022 plan year that outlines key marketplace policies, including network adequacy, actuarial value, the open enrollment window and the auto-enrollment process.

CMS, Treasury Approves Waiver Letting GA Exit in 2023
On Nov. 1, the Centers for Medicare and Medicaid Services (CMS) and the Department of Treasury approved Georgia’s request to exit, take over eligibility determinations and rely on its own agents, brokers and insurance carriers for enrollment services starting 2023. The waiver, the Georgia Access Model, is the first approved under the Trump administration’s 1332 revised guidance and is expected to be challenged in court.