Wednesday, July 10, 2024

House Commitee Proposes Defunding the AHRQ ($0); Notes on CMS budget

 It's budget and politicking time again.  Each year, various House committees propose budgets for government agencies for the coming fiscal year (FY2025).   Actual budgets are worked out being House and Senate over a period of months.

The 349-page budget plan for House Labor & Health has been released.   

Notably, it suggests not funding the AHRQ (page 141).   I don't see any separate remark for USPSTF; as far as I know, USPSTF is embedded in the AHRQ and its budget.   The recent budget was $369M.

The document proposes dropping the federal budget for Medicaid from $406B to $383B.  

The Medicare trust funds expenditures are expected to rrise from $476B to $521B.

However, they suggest that CMS "program management" drop from $3.7B to $3.4B (4.3B was requested).

Numerous specific comments and recommendations for CMS operations follow, from page 142ff.

A sampling of topics mentioned include 

  • algorithm-based health services; 
  • AI in Prior Auth; 
  • Cancer care planning; 
  • chronic kidney disease guidelines incl Dx; 
  • making organ recovery financing less opaque; 
  • providing more frequent screening for CRC after finding known polyps; 
  • some negative comments about "blatant political activism" at CMS such as in contact centers; 
  • better coverage of digital mammography esp across States; 
  • improved diagnostic testing for neurodegenerative disease including skin tests [147] [ALZ]; 
  • timely payment under No Surprises Act situations; 
  • better access for non-opioid pain relief; 
  • nuclear diagnostics / adverse packaging of nuclear scan ligands [including ALZ]; 
  • a section about "overestimating utilization of new codes in the fee schedule," 
  • reduce false positives (skin) in sepsis blood cultures; 
  • avoid over-reliance on death certificiates in organ transplant measures; 
  • issues with radiosurgery codes; introduce self-sampling for cervical screening; 
  • update Stark Laws (re fair market value); 
  • ensure timely access to treatments and diagnostics for Alzheimer's disease [155] [ALZ]; 
  • whole genome sequencing for Medicad [156], 
  • a note that Federal Administration funding is reduced $100M (155).