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APPLIED POLICY INSIGHT
A New Drug for Alzheimer's Disease
When the U.S. Food and Drug Administration (FDA) granted accelerated approval for the use of lecanemab-irmb (Leqembi) for the treatment of Alzheimer’s disease last month, patients diagnosed with Alzheimer’s, their families, caregivers, and clinicians met the news with a mixture of hope and hesitation.

Decades without progress in therapeutic options have made the Alzheimer’s community especially eager for anything new. Perceived policy missteps in the last two years have made it cautious.
What’s New(s) in Lab Test Reimbursement Around the World?
Many of Applied Policy’s clients are global organizations with a keen interest in what challenges and opportunities exist for diagnostic lab tests around the world. Particularly as healthcare systems transition from unprecedented pandemic testing situations, we see countries reassessing not only lab budgets but testing priorities. This month, we share the results of our “check-up” on developments in lab test reimbursement in five key countries. 
MedPAC Meeting Summary
The Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting on January 12 and 13, with sessions on:

  • Assessing payment adequacy and updating payments for hospital inpatient and outpatient services and supporting Medicare safety-net hospitals
  • Assessing payment adequacy and updating payments for outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, and inpatient rehabilitation facility services
  • Medicare Advantage program status report
  • Medicare clinician and outpatient behavioral health services
  • Updates on telehealth use and beneficiary and clinician experiences
  • Medicare Part D status report, and
  • Addressing high prices of Part B drugs.
Recovery Audit Contractors
Thirteen years after the Department of Health and Human Services (HHS) implemented a new framework for reducing improper payments nationwide, the program remains divisive, with proponents pointing to its outsize success in recovering overpayments but critics blasting a “bounty hunter” model which they say disadvantages providers.

At the center of the program are Recovery Audit Contractors (RACs), independent entities charged by the Centers for Medicare & Medicaid Services (CMS) with identifying and correcting improper payments made under Medicare Parts A and B.
CMS Proposes Changes Resulting in a 1% Increase in Plan Payments and Implements Inflation Reduction Act Provisions on Part D Benefit 
The Centers for Medicare & Medicaid Services (CMS) has released its Advance Notice of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies that would update program policies for Medicare Advantage and Medicare Part D beginning in 2024, if finalized. Notably, CMS proposals center on implementing provisions of the Inflation Reduction Act of 2022 (IRA) related to the Part D benefit for 2024. 
Highlights from the February
Northern Virginia Health Policy Forum Webinar on
Healthcare Headlines to Expect in 2023
On Wednesday, February 15, Applied Policy President and CEO Jim Scott hosted Julie Appleby, senior correspondent for Kaiser Health News; Maya Goldman of Axios; and John Wilkerson, Washington correspondent for STAT, for the Northern Virginia Health Policy Forum discussion of headlines we can expect in 2023.

Watch highlights below or click the link to watch the event in its entirety.
On our calendars
Under review/On the docket
Applied Policy is paying particular attention to the following rules under review at the Office of Management and Budget:

  • CMS: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; the Long-Term Care Hospital Prospective Payment System; and Fiscal Year (FY) 2024 Rates
  • CMS: FY 2024 Hospice Wage Index, Payment Rate Update, and Quality Reporting Requirements
  • CMS: Assuring Access to Medicaid Services

See all rules under OMB review here.
From the headlines
Insight Joke of the Month for February
What sort of jokes do orthopedic surgeons like?
February's Podcast Recommendation:
The GeriPal Podcast
The GeriPal podcast bills itself as a "geriatrics and palliative care podcast for every healthcare professional." But it is so much more: a regular gathering of scientists and philosophers, musicians and poets, ethicists and policy makers.

Cohosts Alex Smith, a palliative medicine physician-researcher and Professor of Medicine in the University of California San Francisco (UCSF) Division of Geriatrics, and Eric Widera, a clinician-educator in the UCSF Division of Geriatrics, bring sincerity, insight, and humor to their conversations with some of the greatest minds in geriatrics, hospice, and palliative care. 

With observations on Negotiation and Dispute Resolution and recommendations for Books on Becoming a Better Mentor (and Person), GeriPal reaches beyond the expected. In taking on the issues of racism and ageism, humor in palliative care, and opioid conversion, the show more than lives up to its billing.
Applied Policy, L.L.C., is a health policy and reimbursement consulting firm strategically located minutes from Washington, D.C.