Senators Push for Enforcement of Mental Health Parity

A bipartisan group of senators have written to the U.S. Department of Health and Human Services (HHS) and the Department of Labor asking the administration to fully implement and enforce the Mental Health Parity and Addiction Equity Act (MHPAEA). The letter, signed by 22 senators, was spearheaded by Sen. Chris Murphy (D-Conn.) and Sen. Kelly Ayotte (R-N.H.). Although the law was enacted over seven years ago, the senators outline their concerns that “parity is still not a reality for individuals living with mental illness and addiction, and that health plans routinely refuse to disclose medical management information making it impossible for consumers and providers to determine if the plans are treating behavioral and physical health equally.” The senators request that the administration conduct audits to determine MHPAEA compliance, issue additional guidance on mental health parity, and release final Medicaid parity regulations.

Legislation Introduced to Extend Payment Sunshine Rules to Nurse Practitioners, Physician Assistants

Sen. Chuck Grassley (R-Iowa) and Sen. Richard Blumenthal (D-Conn.) have introduced the Provider Patient Sunshine Act (S. 2153 ), legislation that would expand payment transparency requirements to nurse practitioners and physician assistants in the same manner as others who prescribe medications. These regulations require the disclosure of drug company and medical device maker payments for promotional talks, consulting, and other interactions. Doctors, dentists, chiropractors, optometrists, and podiatrists are already subject to the disclosures. Since the creation of the Open Payments database through the Physician Payment Sunshine Act in 2013, the database has made 15.71 million records and $9.92 billion in payments publically available.

McConnell Appoints Task Force to Examine Senate Rules

Senate Majority Leader Mitch McConnell (R-Ky.) has appointed members to a special task force to study potential changes to the Senate’s filibuster process and other procedural rules. Sen. Lamar Alexander (R-Tenn.), Senate Rules Committee Chairman Roy Blunt (R-Mo.), Sen. James Lankford (R-Okla.), Sen. Cory Gardner (R-Colo.), and Sen. Thom Tillis (R-N.C.) will serve on the task force. While it is unlikely that McConnell would want to do away with the filibuster altogether, it is possible that the task force would consider changes such as eliminating filibusters on motions to proceed on legislation.

Kaiser Predicts Decline in Medicaid Growth, Rising Part D Costs

Although every state experienced an increase in Medicaid spending and enrollment in FY 2015, a new report from the Kaiser Family Foundation projects that this growth will slow in the coming year. As a result of the Affordable Care Act (ACA) states were able to accept federal funds to expand their Medicaid programs to individuals with incomes up to 138 percent of the federal poverty level beginning in 2014. While thirty states and the District of Columbia have chosen to expand their programs, Medicaid growth was experienced across the board even in non-expansion states. The number of people enrolled in Medicaid increased by 13.8 percent, up from a growth rate of 8.3 percent in fiscal 2014. Medicaid spending increased on average by 13.9 percent. The report predicts, however, that this growth will slow in FY 2016 as a result of less people applying for Medicaid due to an improved economy. Kaiser projects that enrollment will increase by only 4 percent, and spending will increase by 6.9 percent. In another Kaiser study released last week, the organization estimates that the average premium for seniors’ prescription drug plans (PDPs) will grow by 13 percent in 2016, the largest increase in seven years. Their analysis finds that two-thirds of plans will have deductibles, and a growing share of these plans will impose the maximum deductible allowed by law – $360 in 2016. Beneficiaries will be able to choose from 26 PDPs, down from 30 PDPs in 2015.

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