Health Care Policy Update – Weekly Wrap-up and What’s Ahead


 What’s Ahead: This Week

Hearings and Markups –

  • Tuesday, March 5
    • Senate HELP Committee, “Vaccines Save Lives: What is Driving Preventable Disease Outbreaks?”
  • Wednesday, March 6
    • Senate Aging Committee, “Reducing Prescription Drug Prices, Part I.”
    • Senate Finance Committee, “Not Forgotten: Protecting Americans from Abuse and Neglect in Nursing Homes.”
    • House Energy & Commerce Committee, Subcommittee on Health, “Strengthening Our Health Care System: Legislation to Lower Consumer Costs and Expand Access.”
    • House Appropriations Committee, Subcommittee on MilCon and VA, “Electronic Health Record Modernization and Information Technology Oversight.”
  • Thursday, March 7
    • Senate Aging Committee, “Reducing Prescription Drug Prices, Part II.”
    • House Ways & Means Committee, Subcommittee on Health, “Promoting Competition to Lower Medicare Drug Prices.”
    • House Appropriations Committee, Subcommittee on Labor, HHS, and Education, “Addressing the Public Health Emergency of Gun Violence.”
    • House Appropriations Committee, Subcommittee on MilCon and VA, “VA Whole Health, Mental Health, and Homelessness.”
    • House Judiciary Committee, Subcommittee on Antitrust, Commercial and Administrative Law, “Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets.”

Notable Policy Events –

  • Tuesday, March 5
  • Wednesday, March 6
    • The Hill, “Overcoming Obstacles: Patient Access to Innovation.” Additional information: https://bit.ly/2EC7uVF
  • Thursday, March 7
    • Information Technology and Innovation Foundation (ITIF), “Preserving Bayh-Doyle: The ‘Inspired’ Law that Underpins U.S. Leadership in Life-Sciences Innovation.” Additional information: https://bit.ly/2tEKcbk
  • Thursday, March 7 – Friday, March 8
    • Medicare Payment Advisory Commission (MedPAC), “March Public Meeting.” Additional information: http://bit.ly/2IYLYhI
    • Medicaid and CHIP Payment and Access Commission (MACPAC), “March Public Meeting.” Additional information: http://bit.ly/2IRMZbw

 

Weekly Wrap-Up: Notable Health Care Developments From Last Week

 Legislative Activity –

  • On February 25, the House passed by a voice vote the Poison Center Network Enhancement Act of 2019 (H.R. 501), which would reauthorize and enhance the poison center national toll-free number, national media campaign, and grant program. The bill now moves to the Senate for consideration. Press release: https://bit.ly/2XtpyZo Bill text: https://bit.ly/2Xw6IRd
  • Also on February 25, the House passed by a voice vote the Strengthening the Health Care Fraud Prevention Task Force Act of 2019 (H.R. 525), which would direct the HHS Secretary to establish a public-private partnership to identify health care waste, fraud, and abuse. The bill now moves to the Senate for consideration. Press release: https://bit.ly/2XucIKw Bill text: https://bit.ly/2UcTbMv
  • Also on February 25, Reps. Tonko (D-NY) and Turner (R-OH) introduced the Medicaid Reentry Act (H.R. 1329), which would allow for medical assistance under Medicaid for inmates during the 30-day period preceding release from a public institution. Press release: http://bit.ly/2TkFwWD
  • Also on February 25, Rep. Westerman (R-AR) introduced the Fair Care Act of 2019 (H.R. 1332), which would establish high-risk insurance pools and increase the federal minimum age band rating from 3:1 to 5:1. Press release: https://bit.ly/2T4RVhU
  • Also on February 25, Reps. Dingell (D-MI) and Guthrie (R-KY) introduced the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources (EMPOWER) and Care Act (H.R. 1342), which would reauthorize the Money Follows the Person Demonstration Program for five years. Sens. Portman (R-OH) and Cantwell (D-WA) introduced companion legislation in the Senate (S. 548). Press release: https://bit.ly/2IIqy8K
  • Also on February 25, Reps. Dingell (D-MI) and Upton (R-MI) introduced the Protecting Married Seniors from Impoverishment Act (H.R. 1343), which would make permanent the protection for recipients of home and community-based services against spousal impoverishment. Press release: https://bit.ly/2IIqy8K
  • Also on February 25, Rep. Hastings (D-FL) and 8 cosponsors introduced the Restoring the Partnership for County Health Care Costs of 2019 (H.R. 1345), which would remove limitations on Medicare, Medicaid, SSI, and CHIP benefits for persons in custody pending disposition of charges. Press release: https://bit.ly/2IICibi Bill text: https://bit.ly/2EEPI3X
  • Also on February 25, Rep. Higgins (D-NY) and 29 cosponsors introduced the Medicare Buy-In and Health Care Stabilization Act (H.R. 1346), which would provide an option for individuals age 50 to 64 to buy into Medicare and provide for insurance market stabilization. Press release: https://bit.ly/2EarrCE
  • Also on February 25, Sens. Durbin (D-IL) and Portman (R-OH) introduced the Recovering Excessive Funds for Unused and Needless Drugs (REFUND) Act (S. 551), which would require manufacturers of certain single-dose vial drugs payable under Medicare Part B to provide rebates with respect to amounts of such drugs discarded. Press release: https://bit.ly/2EEPTw8
  • On February 26, Rep. Kind (D-WI) and 7 bipartisan cosponsors introduced the Advancing Medical Resident Training in Community Hospitals Act (H.R. 1358), which would establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations. Press release: https://bit.ly/2GSlOeW Bill text: https://bit.ly/2II62VG
  • Also on February 26, Rep. Bost (R-IL) and 19 bipartisan cosponsors introduced the VA Health Center Management Stability and Improvement Act (H.R. 1360), which would direct the VA Secretary to develop and implement a plan to hire directors of VA medical centers. Press release: https://bit.ly/2SYR4zj
  • Also on February 26, Rep. Emmer (R-MN) introduced the Medical Innovation Never Stops Act (H.R. 1362), which would allow, during a lapse in appropriations, acceptance of certain device submissions and registrations with the corresponding fees made available for obligation and expenditure for the process for the review of device applications. Press release: https://bit.ly/2C1rLSF Bill text: https://bit.ly/2EETElh
  • Also on February 26, Reps. Stivers (R-OH) and Gonzalez (D-TX) and 16 bipartisan cosponsors introduced the Responsible Additions and Increases to Sustain Employee (RAISE) Health Benefits Act (H.R. 1366), which would increase flexible spending account (FSA) allowable contributions and allow unused funds to roll over each year. Sens. Blunt (R-MO) and Sinema (D-AZ) introduced companion legislation in the Senate (S. 503). Press release: https://bit.ly/2UeFhto
  • Also on February 26 Reps. Raskin (D-MD) and Budd (R-NC) introduced the Children and Media Research Advancement (CAMRA) Act (H.R. 1367), which would authorize the National Institutes of Health (NIH) to lead a research program on technology and media’s effects on infants, children, and adolescents in core areas of cognitive, physical, and socio-emotional development. Sens. Schatz (D-HI), Markey (D-MA), Blunt (R-MO), Sasse (R-NE), Bennet (D-CO), and Collins (R-ME) introduced companion legislation in the Senate (S. 558). Press release: https://bit.ly/2EDS8zT Bill text: https://bit.ly/2UeFooO
  • Also on February 26, Reps. Chu (D-CA) and Walorski (R-IN) introduced the Breast Cancer Patient Equity Act (H.R. 1370), which would provide coverage for custom fabricated breast prostheses following a mastectomy under the Medicare program. Sens. Duckworth (D-IL) and Murkowski (R-AK) introduced companion legislation in the Senate (S. 562). Press release: https://bit.ly/2Sui04U
  • Also on February 26, Rep. Peterson (D-MN) and 7 bipartisan cosponsors introduced H.R. 1379, which would require that group and individual health insurance coverage and group health plans provide coverage for treatment of a congenital anomaly or birth defect. Sen. Baldwin (D-WI) and 3 bipartisan cosponsors introduced companion legislation in the Senate (S. 560). Press release: https://bit.ly/2UcHZQ3
  • Also on February 26, House Appropriations Labor-HHS Subcommittee Chair DeLauro (D-CT) introduced the Flu Vaccine Act (H.R. 1371), which calls for a total investment of $1 billion from FY 2020 through FY 2024 to support research for a universal flu vaccine. Sen. Markey (D-MA) introduced companion legislation (S. 570) in the Senate. Press release: https://bit.ly/2UeBBYB Bill text: https://bit.ly/2ILWiKd
  • Also on February 26, Sens. Smith (D-MN) and Tillis (R-NC) introduced the Mark Takai Atomic Veterans Healthcare Parity Act (S. 555), which would allow veterans who participated in the cleanup of the Enewetak Atoll on the Marshall Islands to receive the same health care and benefits given to other servicemembers who were involved in active nuclear tests. Companion legislation (H.R. 1377) was introduced in the House by Rep. Meng (D-NY). Press release: https://bit.ly/2TrkTb9
  • On February 27, Rep. Jayapal (D-WA) and 106 cosponsors introduced the Medicare for All Act of 2019 (H.R. 1384), which would establish a single payer national health insurance program to be phased in over two years. Press release: https://bit.ly/2Nza3uq Summary: http://bit.ly/2TpVsa4 Section-by-section: http://bit.ly/2TsGShU Bill text: http://bit.ly/2TqsLJV
  • Also on February 27, Reps. Kim (D-NJ) and Fitzpatrick (R-PA) introduced the State Allowance for a Variety of Exchanges (SAVE) Act (H.R. 1385), which would use $200 million in competitive grant money to help states move from federally-facilitated exchanges to state-based exchanges. Press release: https://bit.ly/2UcZXC1
  • Also on February 27, Reps. Brooks (R-IN) and Clarke (D-NY) introduced the Mobile Health Record Act (H.R. 1390), which would allow Medicaid and Medicaid beneficiaries to access their personal medical claim data, including prescriptions, tests, and diagnoses, through a mobile health record application of the individual’s choosing. Press release: https://bit.ly/2EF974W
  • Also on February 27, Rep. Bera (D-CA) and 12 bipartisan cosponsors introduced the Health Insurance Tax Relief Act (H.R. 1398), which would delay the re-imposition of the annual fee on health insurance providers until after 2021. Press release: https://bit.ly/2EFaVLg
  • Also on February 27, Reps. Perlmutter (D-CO) and Gallagher (R-WI) and 6 bipartisan cosponsors introduced the Transparency in All Health Care Pricing Act of 2019 (H.R. 1409), which would require all price disclosures to be available and accessible at the point of purchase. Press release: https://bit.ly/2SyPizE
  • Also on February 27, Sen. Warner (D-VA) and 8 cosponsors introduced the States Achieve Medicaid Expansion (SAME) Act of 2019 (S. 585), which would provide the same level of federal matching assistance for every state that chooses to expand Medicaid coverage to newly eligible individuals, regardless of when such expansion takes place. Press release: https://bit.ly/2EiWN8W Bill text: https://bit.ly/2H8pj02
  • Also on February 27, Sen. Roberts (R-KS) and 7 bipartisan cosponsors introduced S. 586, which would remove the 96-hour physician certification requirement for inpatient critical access hospital services. Press release: https://bit.ly/2Xuxvxy
  • On February 28, Reps. DeFazio (D-OR), Gosar (R-AZ) and 8 bipartisan cosponsors introduced the Competitive Health Insurance Reform Act (H.R. 1418), which would restore the application of the federal antitrust laws to the business of health insurance to protect competition and consumers. Press release: http://bit.ly/2IYKVyi
  • Also on February 28, Reps. Craig (D-MN) and Peters (D-CA) introduced the State Health Care Premium Reduction Act (H.R. 1425), which would provide for an Improve Health Insurance Affordability Fund to provide for reinsurance payments in the individual market. Press release: https://bit.ly/2EDmGS8
  • Also on February 28, Rep. Welch (D-VT) introduced H.R. 1478, which would allow for the importation of insulin by wholesale distributors, pharmacies, and individuals. Press release: https://bit.ly/2U4gnwa
  • Also on February 28, Sens. Cassidy (R-LA) and Durbin (D-IL) introduced the Preserving Rehabilitation Innovation Centers Act (S. 594), which would establish a definition for Rehabilitation Innovation Center under the Medicare program and direct MedPAC to conduct a study on the adequacy of current payment rates to such facilities. Press release: https://bit.ly/2ILFfrp
  • Also on February 28, Sen. Cassidy (R-LA) and 7 bipartisan cosponsors introduced the Treat and Reduce Obesity Act (S. 595), which would cover intensive behavioral therapy and weight loss management drugs for the obese under the Medicare program. Press release: https://bit.ly/2XwXcgP
  • Also on February 28, Sens. Barrasso (R-WY) and Carper (D-DE) introduced the Physician Assistant Direct Payment Act (S. 596), which would provide for direct payment to physician assistants under the Medicare program for services they furnish. Press release: https://bit.ly/2Sy6MMS
  • Also on February 28, Sen. Shaheen (D-NH) introduced the E-Cigarette Youth Protection Act (S. 616), which would impose user fees on manufacturers and importers of electronic nicotine delivery systems. Press release: http://bit.ly/2INm54p Bill text: http://bit.ly/2ILo1dF
  • Also on February 28, Senate Veterans’ Affairs Committee Ranking Member Tester (D-MT), Senate HELP Committee Ranking Member Murray (D-WA), and Sens. Blumenthal (D-CT) and Brown (D-OH) introduced the Accountability in VA Scheduling and Consult Management Act (S. 629), which would require the VA Secretary to review the processes and requirements of VA for scheduling appointments and conducting consultations under laws administered by the Secretary. Press release: https://bit.ly/2GUgEPA Bill text: https://bit.ly/2tGHr9s
  • Also on February 28, Sen. Blumenthal (D-CT) and 5 cosponsors introduced the Combatting Unreasonable Rises and Excessively (CURE) High Drug Prices Act (S. 637), which would prohibit price gouging in the sale of drugs. Press release: http://bit.ly/2IPwUTT Bill text: http://bit.ly/2IRAUmD

ACA and Individual Market –

  • On February 28, CMS released an FAQ document regarding section 1332 State Relief and Empowerment Waiver pass-through funding. FAQ: https://go.cms.gov/2NB3RSx
  • Also on February 28, seven bipartisan freshman senators penned a letter to Senate Majority Leader McConnell (R-KY), Minority Leader Schumer (D-NY), Finance Committee Chair Grassley (R-IA), and Finance Committee Ranking Member Wyden (D-OR) urging them to delay the health insurance tax for 2020 and beyond. Press release with letter: https://bit.ly/2tHhRRC

 Medicare and Medicaid –

  • On February 28, CMS updated hospital performance data on the Hospital Compare website and on data.medicare.gov. CMS also posted a set of potential changes to the Hospital Star Ratings for public comment, which seek to enhance the methodology by making hospital comparisons more precise and consistent. Comments are due by March 29. Press release: https://go.cms.gov/2EqJB1I Star Ratings Request for Comment: https://go.cms.gov/2C1JTM8
  • Also on February 28, CMS posted December 2018 enrollment data highlights for the Medicaid program. The data show that 72.5 million individuals were enrolled in Medicaid and CHIP in December 2018. Report: https://bit.ly/2ldEN9m
  • Also on February 28, Senate Finance Committee Ranking Member Wyden (D-OR) penned a letter to CMS Administrator Verma, urging CMS to improve access to reproductive health services for women in Medicaid. Press release: https://bit.ly/2HajEqs Letter: https://bit.ly/2GPN6m0
  • Also on February 28, CMS announced a deadline extension for the Medicare, Medicaid, and CHIP Program Integrity Enhancements to the Provider Enrollment Process final rule. The new deadline is March 1, 2020. Notice: https://bit.ly/2IGSY2Y
  • On March 1, CMS Administrator Verma penned a blog post highlighting the steps that CMS has taken to empower patient and unleash health information innovation through its eMedicare initiative. Blog post: https://go.cms.gov/2C1Rqum

 Payment and Delivery System Reform –

  • On March 1, CMS released the first annual report for the Million Hearts Cardiovascular Disease Risk Reduction Model. Report: http://bit.ly/2C2vr6O

 Drug and Medical Device Prices and Regulation –

  • On February 26, Food and Drug Administration (FDA) issued a draft guidance to industry to help further support the development and implementation of continuous manufacturing for brand, generic, and over-the-counter drugs. Press release: https://bit.ly/2Exjwzs Draft guidance: https://bit.ly/2Haa9aH
  • Also on February 26, FDA, CMS, and Centers for Disease Control and Prevention (CDC) announced the launch of the Tri-Agency Task Force for Emergency Diagnostics to help leverage the expertise of each agency to advance rapid development and deployment of diagnostic tests in clinical and public health labs during public health emergencies. Press release: https://bit.ly/2XqNVqD Task force charter: https://bit.ly/2GS0gyT
  • Also on February 26, Senate Finance Committee Chair Grassley (R-IA) penned an op-ed in the Des Moines Register urging pharmaceutical executives to stop “grandstanding” and work to lower prescription drug prices. Op-ed: https://bit.ly/2BZu1tP
  • On February 28, FDA issued a warning to CanaRx for facilitating the distribution of unapproved new drugs and misbranded drugs to U.S. consumers. Press release: https://bit.ly/2NyS5rK
  • Also on February 28, Senate Finance Committee Ranking Member Wyden (D-OR) called on all seven of the major pharmaceutical manufacturers that testified before the Committee to pledge their support for federal legislation that would lower list prices if PBM rebates were significantly diminished. Press release: https://bit.ly/2IK5tuk

 Substance Use and Mental Health –

  • On February 26, FDA Commissioner Gottlieb issued a statement on the agency’s 2019 policy and regulatory agenda for continued action to address the opioid abuse epidemic. Statement: https://bit.ly/2XpAV4r
  • On February 27, HHS released a report assessing the impact of parity in the large group employer-sponsored insurance market, which found that the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) had significant and positive effects on any use of substance use disorder (SUD) services and frequency of SUD services used. Summary with link to report: https://bit.ly/2SAKWZ1
  • On March 1, HHS Office of Inspector General (OIG) released a fact sheet highlighting New Hampshire’s oversight of opioid prescribing and monitoring of opioid use. Summary with link to fact sheet: https://bit.ly/2H8QNmm

 Health Data and IT –

  • On March 1, HHS issued two reports to Congress on the current state of, and an evaluation of, technology-enable collaborative learning and capacity building models, such as the ECHO model. Reports: http://bit.ly/2UeDBzU and http://bit.ly/2Ui4jYl

 Veterans and Military Health –

  • On February 25, House Veterans’ Affairs Committee Chair Takano (D-CA) penned a letter to Department of Veterans Affairs (VA) Secretary Wilkie expressing his displeasure with the Department after they missed the February 22, 2019 deadline to provide documents to the Committee regarding the investigation into the “Mar-a-Lago three.” Press release with letter: https://bit.ly/2tIBoBb
  • On February 26, VA Secretary Wilkie testified that VA will accelerate disability benefits claims processing for Purple Heart Medal recipients. Press release: https://bit.ly/2UdRGgX
  • On February 28, U.S. Government Accountability Office (GAO) released a report finding that greater focus on credentialing is needed to prevent disqualified providers from delivering patient care in the Veterans Health Administration (VHA). GAO recommended more training for VHA staff who review credentials and hire providers. Summary with link to report: https://bit.ly/2Uen13h
  • On March 1, Senate HELP Committee Ranking Member Murray (D-WA) and 9 senators sent a letter to VA Secretary Wilkie requesting information about the future and management of the Department’s support program for veteran caregivers and its efforts to serve more veterans through the MISSION Act. Press release: http://bit.ly/2Ukceoa Letter: http://bit.ly/2UjrXnz

 Misc. –

  • On February 25, Senate Finance Committee Chair Grassley (R-IA) announced the renewal of a probe into non-profit, tax-exempt hospitals to ensure that they are fulfilling the standards for serving communities and low-income patients as required by law. Press release: https://bit.ly/2GTesrs
  • On February 26, House Energy & Commerce Committee Chair Pallone (D-NJ) sent a letter to HHS Secretary Azar requesting a briefing on the Trump Administration’s initiative to end the HIV epidemic in the U.S. Press release: https://bit.ly/2H9B5an Letter: https://bit.ly/2GQqqlT
  • Also on February 26, House Energy & Commerce Committee Republican leaders sent a letter to CDC Director Redfield requesting a briefing on how the agency plans to improve seasonal flu vaccination rates for seniors, and on whether a preferential recommendation should be made for adults 65 years of age and older to receive a high dose or adjuvanted flu vaccine. Press release: https://bit.ly/2NBsCOB Letter: https://bit.ly/2tLIDIt
  • Also on February 26, CDC published a report on long-term care providers and services users in the U.S. in 2015 and 2016. The report shows that in 2016, about 65,600 paid long-term care services providers served more than 8.3 million people across the country. Report: https://bit.ly/2EnBtz9
  • On March 1, House Energy & Commerce Committee Democratic leaders sent a letter to HHS Secretary Azar demanding evidence and justifications for the Trump Administration’s final Title X rule. Press release: https://bit.ly/2Ha7ayW Letter: https://bit.ly/2H9FrOO