White House Rescinds Federal Funding Pause
Alliance Daily
On Monday evening, January 27, the Trump Administration’s Office of Management and Budget (OMB) issued guidance pausing Federal Financial Assistance until an appointee could review whether the spending was in-line with Administration priorities. Due to the wording of the memorandum, specifically a footnote specifying that Medicare and Social Security would not be impacted, some media outlets and policymakers raised concerns that Medicaid payments would, in fact, be subject to the payment pause. However, it is important to note that Medicaid, just like Medicare and Social Security, is an entitlement and not discretionary grant funding. The mandatory nature of the funding should prevent it from being paused.
On January 29, the White House Office of Management and Budget (OMB) rescinded its earlier memo that temporarily paused certain federal grants, loans, and financial assistance programs. The initial memo, issued earlier in the week, led to some confusion about its scope and impact. While OMB had clarified that entitlement programs like Medicare and Medicaid were not affected, uncertainties remained regarding which specific grants, loans, or programs would be subject to the freeze and how these determinations would be made.
See our Alliance Daily article for additional details about the pause. This funding pause was temporarily stayed by a federal court until at least February 3, pending further legal proceedings. The Alliance will continue to monitor for any further developments.
Despite the clarification that Medicaid is not subject to the funding freeze, several news outlets are reporting that State Medicaid Officials are unable to access the Medicaid “payment management system.” This could result in some delay in payments; however, it is likely that this is a short-term issue that is tied to the broader payment freeze and is likely to be resolved once the Administration is able to implement exceptions to the halt on disbursement. The Alliance will keep members informed as we learn more about the future of these funds.
The original OMB memo is available HERE. |
CTA/BOI Reporting Remains Voluntary
SESCO Management Consultants
- The filing of Beneficial Ownership Information (BOI) Reports that was required by the Corporate Transparency Act (CTA) remains voluntary.
- The US Treasury Department's Financial Crimes Enforcement Network (FinCEN) has noted: "On January 23, 2025, the U.S. Supreme Court granted the government's motion to stay a nationwide injunction issued by a federal judge in Texas (Texas Top Cop Shop, Inc. v. McHenry). As a separate nationwide order issued by a different federal judge in Texas (Smith v. U.S. Department of the Treasury) still remains in place, employers are not currently required to file BOI reports with FinCEN despite the Supreme Court's action in Texas Top Cop Shop."
- FinCEN has also stated that employers are not subject to liability if they fail to file BOI Reports with FinCEN while the Smith order remains in force.
If you are not a retainer client, contact us to learn about our services by calling 423-764-4127 or click here. |
RFK Jr.'s First HHS Confirmation Hearing: 7 Healthcare Takeaways
Becker’s Hospital Review
President Donald Trump's HHS secretary pick Robert F. Kennedy Jr. faced more than three hours of questioning by the Senate Finance Committee Jan. 29, the first of two hearings this week in an effort to secure the nomination.
Wednesday's hearing covered a range of health topics, from vaccine mandates to rural hospital closures and plans for Medicare and Medicaid. Mr. Kennedy faces another hearing Jan. 30 with the Senate Committee on Health, Education, Labor and Pensions.
Here are seven takeaways and excerpts from the hearing. A recording of the hearing in full can be found here.
- Medicare and Medicaid: There were nearly 80 mentions of Medicaid, about 40 mentions of Medicare and only five mentions of Medicare Advantage throughout the Senate Finance Committee hearing.
The focus on Medicaid came one day after widespread disruptions to the program's portals and confusion about the program's inclusion in the Trump administration's plans to freeze an array of federal funds, grants and programs. This became a point of contention, with Sen. Ron Wyden, D-Ore., claiming the Trump budget office shut down the federal Medicaid payment portal, while Committee Chairman Sen. Mike Crapo, R-Idaho, countered that reports of disruptions were "proven false overnight," asserting that the portal was fully operational at the time of the hearing.
Sen. Bill Cassidy, MD, R-La., pressed Mr. Kennedy about his plans to reform Medicare and Medicaid, which collectively provide health coverage to more than 150 million Americans. At times, Mr. Kennedy's comments indicated confusion between the two programs. When asked about integrating Medicare and Medicaid for dual-eligible individuals, he inaccurately described Medicaid as being "fully paid for by the federal government," when in fact it is funded jointly by state and federal governments.
Mr. Kennedy suggested that most people are unhappy with federal health programs, and stated several times throughout the hearing that Medicaid premiums and deductibles are too high. A relatively small portion of Medicaid beneficiaries pay premiums and deductibles, however. He did not confirm whether he supports adding work requirements for Medicaid coverage or cuts to the program, though suggested improvements are needed. "I don't have a broad proposal for dismantling the program," Mr. Kennedy said.
A KFF poll conducted in 2023 found strong satisfaction with federal insurance programs, with 91% of Medicare beneficiaries and 83% of Medicaid enrollees rating their coverage positively.
Despite its prominence in previous policy discussions, Medicare Advantage received little attention during the hearing. One of its few mentions came when Mr. Kennedy disclosed that he is personally enrolled in a Medicare Advantage plan. "Most Americans like myself, I'm on Medicare Advantage and I'm very happy with it," he said during an exchange with Mr. Cassidy about Medicare and Medicaid…
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Centene, Aetna, Kaiser Lead in Medicare Advantage Denials: KFF
Modern Healthcare / By Nona Tepper
Aetna, Centene and Kaiser Permanente denied at least one in 10 Medicare Advantage prior authorization requests in 2023, according to a KFF analysis published Tuesday.
Across the industry, Medicare Advantage insurers increased their use of prior authorization by 7.8% to 49.8 million total requests in 2023, the health policy think tank determined using Centers for Medicare and Medicaid Services data. The increase in requests is in line with enrollment growth, KFF said. Insurers denied slightly fewer prior authorization requests in 2023, refusing to cover 6.8% of claims compared with 7.4% in 2022.
Related: Medicare Advantage prior authorization, marketing limits proposed
Legislators and regulators have called out the use of prior authorization in Medicare Advantage in recent years as a growing number of policyholders report confronting barriers to care, particularly in post-acute settings.
People in their last year of life were more than twice as likely to switch from Medicare Advantage to traditional Medicare over care access concerns, according to a 2021 report by the Health and Human Services Office of the Inspector General. Those switching from Medicare Advantage to traditional Medicare cost the federal government 27% more than those who were continuously enrolled in the fee-for-service program, KFF reported in December. At the same time, CMS has fined insurance companies for exaggerating patient conditions to improperly inflate federal reimbursements…
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