WASHINGTON, D.C.—Department of Health and Human Services (HHS) Secretary Xavier Becerra asked a room full of insurers—a group he has clashed with in recent weeks—for help convincing states to share key health data.
Becerra spoke Tuesday during AHIP’s 2023 Medicare, Medicaid, Duals & Commercial Markets Forum in Washington, D.C., on a range of topics. The HHS secretary specifically called for insurers to help him to convince states on sharing data after the agency’s mandatory authority goes away with the COVID-19 public health emergency that ends May 11.
“Right now, only because of the PHE were we able to collect data from states and help us determine where the gaps were and where the growing disparities were when it came to COVID,” Becerra said. “With the PHE coming down, we lose those authorities to require states to provide us that data and now we have to depend on their goodwill.”
The PHE gave the Centers for Disease Control and Prevention the power to mandate labs report test results for COVID-19. This authority goes away at the end of the emergency, and HHS will rely instead on voluntary data use agreements.
“Fortunately, the vast majority of the states have signed data use agreements,” Becerra said. “Some states are trying to get there but have issues with their privacy laws.”
Becerra said insurers can help since they are already collecting “very important information that will help us keep America healthier.”
Hospitals must still provide data to the Centers for Medicare & Medicaid Services (CMS) through April 30, 2024. However, the agency said in a PHE transition road map that the reporting requirement could be reduced from a daily basis to a “lesser frequency.”
CMS Administrator Chiquita Brooks-LaSure conceded that while some of the flexibilities of the PHE are sticking around, the ones going away could be a transition. Chief among the changes is a requirement that private insurers cover COVID-19 tests without cost-sharing.
“We are going to work with you on commercialization as we move through that path,” she said.
Some pandemic flexibilities will remain in place, though, chief among them in telehealth. A spending law passed late last year ensures that changes to telehealth regulations that made it easier to get Medicare reimbursement will be in place through 2024.
Becerra’s call for help from insurers comes as HHS has clashed with insurer groups in recent weeks over the proposed 2024 advance notice that lays out Medicare Advantage (MA) payment rates. While HHS estimates the rule which must be finalized by April 3—will lead to a 1% increase in payments to MA plans, insurers said their own analyses predict a 2.27% cut.
Providers have also called out changes to the MA risk adjustment model, including the removal of more than 2,000 diagnostic codes. While some providers agree with the decision—which CMS said was to cut down on rampant up-coding practices among plans—they have complained about the potential impact on care for dual eligible Medicare-Medicaid beneficiaries.
Becerra has fiercely pushed back that the rule will lead to a cut to plans, saying insurers’ assertions are categorically false and calling out “deceptive” commercials hitting the airwaves.
Brooks-LaSure took a measured response to the criticisms during her address at the conference.
“All of CMS’ proposals have two central goals: to make sure the MA program meets the healthcare needs of the people it serves and at CMS we have an obligation under the law to pay MA plans accurately,” she said. “Our proposals ensure that MA dollars are used efficiently and effectively.”