Kim Brandt, partner at Tarplin, Downs & Young has long provided the healthcare community with her expertise in all things Washington, having spent substantial time at CMS, the OIG at HHS and on Capitol Hill.
She’ll be leading a general session at the Health Care Compliance Association Healthcare Enforcement Compliance Conference, which takes place November 8-10. In this podcast she provides a preview f her talk with insights into all that’s coming and likely to happen both from the Biden Administration and Congress.
Starting with CMS, which is in its regulatory cycle once again, expect big changes in physician fee payments. There is a 3.75% reduction across the board in the offing, with the goal of giving a bump up to primary care physicians. That means, she explains, reduction in payments to specialty care providers by as much as 8-10%. This will be on top of a delayed 2% sequester.
Telehealth, which became a standard part of care during the pandemic, will also see changes with proposals to make permanent rules permitting it for mental and behavior health, including audio-only treatment. Video will not be required.
Up on Capitol Hill she reports that Congress is considering expanding Medicare Part B to include hearing, dental, and vision. These had never been covered by Medicare before and come with a large $300 billion price tag over 10 years.
Also under consideration is increased support for home and community-based services, along with increased funding for them.
Another area of focus is likely to be the Medicaid gap. Thirteen states have not implemented a Medicaid expansion. Under consideration are measures which would allow local governments in those states to contract with CMS to expand Medicaid.
Finally, she discusses the personnel changes at CMS and the OIG at HHS. The new administration has brought changes in people, but they are not exactly new, having served in the government before.
Listen in to learn more about what’s going on in healthcare in Washington, DC. Then be sure to be a part of the 2021 Healthcare Enforcement Compliance Conference.