6 policy changes in 2023 payers should know

Several policy changes will take effect in 2023, including some of the first provisions of the inflation act. Payers are also bracing for the end of the federal public health emergency, which could leave millions of Medicaid enrollees without coverage. 

Here are six updates Becker's has covered: 

• No-cost coverage of recommended vaccines: As part of the Inflation Reduction Act, vaccines recommended by the CDC will be required to be covered at no cost to Medicare enrollees. This includes the pricey two-shot shingles vaccine. 
  
  
• Insulin caps: The price of insulin will be capped at $35 a month for Medicare Part D recipients. Notably, this price cap does not appear on the online marketplace for older adults shopping for 2023 coverage. 
  
  
• Price hike penalties for drug makers: Pharmaceutical companies will be required to pay rebates to Medicare if they raise their prices higher than the rate of inflation. 
  
  
• End of the public health emergency: The end of the public health emergency for COVID-19 is looming, and payers are prepping for a major disenrollment of beneficiaries nationwide. While the exact date when the PHE will end is unknown, HHS expects around 15 million people to lose Medicaid coverage when continuous enrollment requirements that were put in place at the beginning of the pandemic end.
  
  Payer losses from millions of disenrolled beneficiaries could be mitigated through the Inflation Reduction Act's extension of ACA premium tax credits through the end of 2025, which will allow some people to regain coverage in the individual market, analysts at Fitch say. 
  
  
• More states could expand Medicaid: Lawmakers in North Carolina and Kansas could push through Medicaid expansion in the new year. South Dakota passed expansion in November, leaving 11 states that have not expanded the program. 
  
  
• More payers join CMS value-based care programs:: The agency's Value-Based Insurance Design program for Medicare Advantage plans is expanding to 52 participating organizations in 2023, a 24 percent growth in enrollees represented from this year.