Health Plan Weekly

✦ Effective July 1, 2021, Humana Inc. will become the fifth Medicaid managed care organization to contract with South Carolina, the insurer said on Jan. 27. Centene Corp., Blue Cross Blue Shield of South Carolina, SelectHealth and UnitedHealthcare are the state’s four other MCOs, Citi analyst Ralph Giacobbe pointed out in a research note. Starting on Jan. 1, 2022, Humana will also begin enrolling new Healthy Connections Prime members, a new “expanded option for South Carolinians who have both Medicare and Medicaid, operating under a joint demonstration contract between the state and the federal government.” Read more at https://bit.ly/3t8BnUq.

✦ During the Trump administration, federal spending on consumer assistance and marketing for the Affordable Care Act exchanges dropped while revenue from exchange user fees held steady. The result, according to a new issue brief from the Kaiser Family Foundation, is that “it appears that more than $1 billion in unspent federal user fee revenue has accumulated and could be used to invest in changes that would make it easier for consumers to enroll in health coverage.” Read more at https://bit.ly/3oAVLuh.

As CMS re-evaluates its priorities under the new Biden administration, it should seriously consider making policy changes that integrate “drivers of health” (DOH) into payment policies for Medicare, Medicaid and the individual market, says a new report from four top independent health care foundations and think tanks.

The recommended changes would make it easier for insurers and providers to implement initiatives that address socioeconomic, environmental and behavioral factors that directly impact health, according to the report, “Investing in Health: A Federal Action Plan.” Manatt Health, The Health Initiative, Blue Shield of California Foundation and the Commonwealth Fund sponsored the report.

✦ Not long after his inauguration on Jan. 20, President Joe Biden issued a “regulatory freeze” memo to the heads of executive departments and agencies — a routine move for new administrations that temporarily halts last-minute regulations issued by the preceding administration pending review. The memo forbids any new rules from being proposed until they are approved by a department head designated by the new president, and it orders those rules not yet published in the Federal Register to be withdrawn for review. For those regulations that have been published but have not yet taken effect, the memo asks the department/agency leaders to consider postponing the rules’ effective dates for 60 days in order to review “any questions of fact, law, and policy the rules may raise.” Read the memo at https://bit.ly/2KA4VZQ.

✦ Also on Jan. 20, Biden unveiled a list of individuals who will serve in acting capacities across his administration until the Senate confirms permanent leaders. Norris Cochran, who previously served as HHS deputy assistant secretary of budget, will be the acting HHS secretary pending the confirmation of Biden’s pick to lead the department, California Attorney General Xavier Becerra. Citing a Democratic aide familiar with Biden’s plans, Bloomberg Law reported that the Senate Finance Committee isn’t expected to take up the Becerra nomination until February. Read more at https://bit.ly/3qE0CvY and https://bit.ly/3ixw9Ng.

As one of its final moves before the Trump administration officially ended, CMS on Jan. 15 gave Medicare Advantage (MA) plans a 2022 payment increase that impressed Wall Street analysts.

The 2022 Medicare Advantage and Part D Rate Announcement — which the administration released early in order to offer some additional guidance to plan sponsors during the COVID-19 pandemic — indicated that MA organizations will see an average reimbursement boost of 4.08% next year. That’s a significant improvement from the 2.8% rate increase that CMS projected in October, which Citi analyst Ralph Giacobbe suggested “represents a positive final parting shot by CMS and the Trump administration for the MA program, and de-risks any rate concerns for 2022.”