August 2024
Senate Committee Advances NIH Spending Bill
On August 1, the Senate Appropriations Committee advanced its fiscal year (FY) 2025 Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) appropriations bill by a bipartisan vote of 25-3. The bill would provide a total of $48.851 billion for the National Institutes of Health’s (NIH’s) base, a net increase of $1.770 billion over the comparable FY 2024 level. Additionally, the bill would maintain funding for the Advanced Research Projects Agency for Health (ARPA-H) at the FY 2024 total of $1.5 billion, bringing the combined total for the two agencies to $50.351 billion. The bill approved by the House Appropriations Committee in July would maintain overall funding for NIH and ARPA-H at the FY 2024 funding level of $48.581 billion. The Senate bill does not include the structural reforms or other new policy provisions that were included in the House committee’s bill that would restrict certain types of research and related activities.
The Senate bill also includes an overall funding increase for the Centers for Disease Control and Prevention (CDC), which received a 22 percent cut in funding in the House committee approved bill. Funding for the Sickle Cell Data Collection program within the CDC is maintained at the current funding level of $6 million in the Senate bill.
Although the House was expected to be considered on the floor by the full House during the week of July 29, leadership instead adjourned early for the August district work period, leaving the fate of the bill in the House uncertain. Senate leaders have not indicated plans for considering their bill on the Senate floor when members return from the August congressional recess in early September.
Your elected officials also need to hear directly from you about the impact that research and public health funding has on hematology. Visit the ASH Advocacy Center to send a message to your elected officials on this important matter.
CMS Releases the FY 2025 Hospice Rule
On Monday July 29, the Centers for Medicare & Medicaid Services released the FY 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements. The rule will implement final policy changes and update hospice payment rates for CY 2025.
The Society submitted comments on the proposed rule, responding to a request for information on payment mechanisms for high intensity palliative care services. One such service is the use of blood transfusions. CMS did not respond to specific comments; however, the Agency was appreciative of all comments submitted. CMS also notes that it will consider recommendations made by stakeholders if the Agency develops payment policy for high intensity palliative care services. CMS is accepting additional comments or information from stakeholders, and those may be submitted to [email protected].
CMS Releases FY 2025 Skilled Nursing Facility Final Rule
On July 31, CMS issued a final rule updating Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for FY 2025. CMS is updating SNF payment rates by 4.2% in FY 2025.The rule finalizes changes to the Agency’s enforcement policies to impose civil monetary penalties for health and safety violations as part of CMS’ work to increase the safety and care provided in nursing homes. The Agency also finalized several changes to the SNF quality payment program measure sets. The final rule can be viewed here.
CMS Releases Final FY 2025 IPPS Rule
On August 1, CMS issued the FY 2025 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) final rule updating Medicare payments and policies for inpatient hospitals and long-term care hospitals. In May, ASH commented on several aspects of the proposed rule. Below, are the final changes made to the policies the Society commented on in the proposed rule.
This final rule implemented the ICD-10-CM codes for Duffy null S\status, which ASH worked to create. The Agency recognized ASH’s comments in support and will finalize the new codes.
CMS is also finalizing the severity designation of seven ICD-10-CM diagnosis codes that describe inadequate housing and housing instability from non-complication or comorbidity to complication or comorbidity.
The IPPS proposed rule was the first released after the approval for the two gene therapies for sickle cell disease (SCD). CMS proposed to increase the New Technology Add-On Payment (NTAP) for gene therapies indicated for SCD from 65% to 75%. ASH’s comments focused on ensuring appropriate access for patients; while ASH appreciated the Agency’s intention to provide additional support for these therapies, we urged the Agency to rethink their proposal and implement the NTAP at 100%. Despite our comments, CMS finalized this policy as proposed and the NTAP for gene therapies for SCD will be 75%. Additionally, CMS determined that Casgevy and Lyfgenia meet the criteria for approval for NTAP, which ASH supported.
CMS also finalized the policy to continue to exclude clinical trial cases when calculating the weight of the MS-DRG cases for CAR T-cell therapy, which the Society supported. Because the CAR-T product is provided at no cost in clinical trial cases, the inclusion of these cases in the MS-DRG calculations would skew its weight.
Finally, ASH provided feedback to CMS on the Medicare Graduate Medical Education program. While no policy was finalized, CMS appreciated the response to their request for information and will carefully consider comments received in future rulemaking.
CDC Releases Contraception Recommendations for Individuals with Medical Conditions
On August 6, the Centers for Disease Control and Prevention (CDC) released the 2024 US Medical Eligibility for Contraceptive Use (US MEC) and the 2024 US Selected Practice Recommendations for Contraceptive Use (US SPR). These recommendations aim to support the provision of contraceptive counseling and remove medical barriers to contraceptives. The US MEC addresses the use of specific contraceptive methods by persons who have certain characteristics or medical conditions, including sickle cell disease and thrombosis. Learn more here.
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