What We’re Reading: UnitedHealthcare Accused of Violating MA Rules; COVID-19 Deaths Rise; WIC Funding Concerns

Hospital Trade Groups Accuse UnitedHealthcare of Violating New Medicare Advantage Rules

Leading hospital trade groups, including the American Hospital Association, have accused UnitedHealthcare and other Medicare Advantage (MA) plans of flouting new federal rules designed to prevent insurers from imposing restrictions on medically necessary care, according to Axios. CMS recently finalized a rule prohibiting MA plans from adding constraints to basic coverage provided by traditional Medicare. The hospital groups claim that UnitedHealthcare, the largest MA plan, is still using restrictive criteria, prompting calls for CMS to clarify and enforce the rules, with potential sanctions for noncompliant insurers. The dispute highlights the Biden administration's early challenge in enforcing regulations aimed at ensuring MA enrollees receive coverage on par with beneficiaries in the traditional Medicare program.

Several States Report COVID-19 Death Increases Amid Rising Hospitalizations Ahead of Holidays

As the holiday season approaches, 8 states, including Colorado, Illinois, Maine, Maryland, Missouri, Michigan, North Carolina, and Tennessee, are witnessing an increase in COVID-19 deaths, according to data from the CDC, reports The Hill. The absolute increases range from 0.1% to 3%, with national data showing a 0.2% rise in COVID-19 deaths and an 8.6% increase in hospitalizations. While most of the country experiences minimal or low rates of emergency department visits for positive virus tests, the CDC's Respiratory Disease Season Outlook anticipates a potentially challenging winter with hospitalization rates likely exceeding pre-pandemic levels.

Funding Showdown on Horizon for Special Supplemental Nutrition Program

The exclusion of extra aid money for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the recent spending bill sets the stage for a potential showdown in early 2024, according to Politico. WIC funding has traditionally enjoyed bipartisan support, but House Republicans argue that WIC spending cuts are needed as the nation's debt mounts. Advocates fear that without additional funding, waitlists for essential aid, including breastfeeding support and baby formula, may become necessary, impacting millions of mothers and children. The next opportunity to address WIC funding is on January 19, during negotiations for the short-term spending bill covering food and agriculture programs.