Missed Last Week’s Healthcare.com Roundup? Here’s what happened:
This week’s series covers:
- FCC’s One-to-One Consent Rule Delayed, Then Overturned by Eleventh Circuit Court
- AHIP Report Predicts Medicare Advantage Challenges with Insufficient Funding
- Texas Sen. Schwertner Files Bill to Curb AI Use in Health Insurance Claim Decisions
FCC’s 1:1 Consent Rule Postponed and Overturned on the Brink of Implementation
The Federal Communications Commission (FCC) has announced a delay in implementing revisions to section 64.1200(f)(9) of its rules under the Telephone Consumer Protection Act (TCPA). Originally scheduled to take effect on January 27, 2025, the new rule will now be postponed by 12 months, until January 26, 2026, or until a court decision is reached regarding a legal challenge filed by the Insurance Marketing Coalition (IMC).
This decision was made under the Administrative Procedure Act, which allows agencies to delay a rule’s implementation when deemed necessary for fairness.
Key details include:
- Reason for the Delay: The postponement allows time for the Eleventh Circuit Court to review the rule while addressing concerns raised by stakeholders about compliance challenges and potential legal risks.
- Current Rules Remain in Effect: The existing consent requirements under the TCPA will continue to apply during this delay.
- Court Challenge: The IMC filed a legal challenge against the revised rule, with oral arguments heard in December 2024. A decision from the court is still pending.
- Stakeholder Feedback: Businesses, particularly smaller ones, have expressed concerns over the compliance burden and unintended consequences of the rule. These concerns influenced the FCC’s decision to minimize disruptions.
- Purpose of the Delay: This temporary postponement maintains the current regulatory framework, avoids unnecessary challenges for businesses, and provides additional time to prepare for compliance if the rule is upheld.
The FCC will issue a public notice in the Federal Register to announce the revised effective date once the court decides.
AHIP Report: Medicare Advantage Faces Challenges with Insufficient Funding
The Report highlights that CMS proposed a 2.23% funding increase for Medicare Advantage (MA) in 2026, despite medical costs rising by 8-9%. These policies were introduced in mid-January, ahead of the inauguration, and are expected to be finalized by early April.
- Recent cuts have already led to higher out-of-pocket expenses, reduced benefits like transportation and prescription drug coverage, and fewer plan options, forcing nearly 2 million seniors to switch plans.
- Policymakers must address funding gaps to avoid further negative impacts on the 34 million Americans who rely on MA.
Texas Sen. Schwertner Files Bill to Curb AI Use in Health Insurance Claim Decisions
This bill (S.B. No. 815) aims to regulate the use of artificial intelligence (AI) in health benefit plan reviews in Texas. It prohibits AI algorithms from being the only factor in decisions to deny, delay, or change healthcare services based on medical necessity or appropriateness.
These decisions must be made by a physician or licensed healthcare provider. The bill also allows the state insurance commissioner to audit and inspect how AI is used in these reviews. If passed, the law will take effect on September 1, 2025.
Explore our Resources and Blog for more content.
