What’s Ahead: This Week

Notable Health Care Policy Events –

  • Monday, April 10
    • National Coalition on Health Care, “Medicaid Per Capita Allotments: Exploring Implications for Medicare Beneficiaries.” Additional information: http://bit.ly/2omCpNX
  • Monday, April 10 – Tuesday, April 11
    • HHS Physician-Focused Payment Model Technical Advisory Committee (PTAC), “April Public Meeting.” Additional information: http://bit.ly/2oyJICU
  • Monday, April 10 – Wednesday, April 12
    • HHS Health Resources and Services Administration (HRSA), “Meeting of the National Advisory Committee on Rural Health and Human Services.” Additional information: http://bit.ly/2omseZw
  • Tuesday, April 11
    • Healthcare Leadership Council, “New Trends for Effective Health Management: Approaches to Improving Outcomes.” Additional information: http://bit.ly/2ntByHv

 Weekly Wrap Up: Notable Health Care Developments From Last Week

 Administration –

  • On April 7, Senate Finance Committee Ranking Member Wyden (D-OR) sent a letter to HHS Acting General Counsel Davis requesting information about how the agency will ensure CMS Administrator Verma is in compliance with her ethics agreement under which she has agreed to not work directly on matters involving major Medicaid consulting firms she has had financial relationships with. Press release: http://bit.ly/2ohIviw Letter: http://bit.ly/2ohKDa5

Legislative Activity –

  • On April 3, the House passed by a vote of 400-16 the Veterans Choice Program Improvement Act (S. 544), which would amend the Veterans Access, Choice, and Accountability Act of 2014 to extend the termination date for the Veterans Choice Program. Having previously passed the Senate, the bill now moves to the President for signature. Press release: http://bit.ly/2oyXO7g
  • Also on April 3, Senate HELP Committee Ranking Member Murray (D-WA) and Sen. Heller (D-NV) introduced the Women Veterans Access to Quality Care Act (S. 804), which would enhance the quality of care women veterans receive from the Department of Veterans Affairs (VA). Press release: http://bit.ly/2oyWNMu
  • Also on April 3, House Veterans Committee Chair Roe (R-TN), Energy & Commerce Committee Chair Walden (R-OR) and Rep. Higgins (R-LA) introduced the Veterans Affairs Medical Scribe Pilot Act of 2017 (H.R. 1848), which would direct the Secretary of Veterans Affairs to carry out a pilot program on the use of medical scribes in VA medical centers. Press release: http://bit.ly/2oyTlBC
  • Also on April 3, Rep. Crowley (D-NY) introduced the Kalief Browder Re-Entry Success Act (H.R. 1853), which would authorize the Attorney General, in consultation with the Director of the National Institute of Mental Health, to carry out a pilot program in correctional facilities in order to provide mental health services and other social services to eligible individuals. Press release: http://bit.ly/2oyGZJF
  • Also on April 3, Reps. Jenkins (R-WV) and Ryan (D-OH) introduced the Prescription Drug Monitoring Act (H.R. 1854), which would require the use of prescription drug monitoring programs and facilitate information sharing among the states. Press release: http://bit.ly/2oyUglr
  • Also on April 4, Sens. Nelson (D-FL), Menendez (D-NJ), Blumenthal (D-CT), and Gillibrand (D-NY) introduced the Territories Medicare Prescription Drug Assistance Equity Act of 2017 (S. 815), which would make premium and cost-sharing subsidies available to low-income Medicare part D beneficiaries who reside in Puerto Rico or another territory of the United States. Press release: http://bit.ly/2obGZOY Bill text: http://bit.ly/2obR0LY
  • Also on April 4, Rep. Faso (R-NY) and 5 cosponsors introduced the Property Tax Reduction Act (H.R. 1871), which would reduce federal financial participation for certain states that require political subdivisions to contribute towards the non-federal share of Medicaid. Press release: http://bit.ly/2ohZvFd
  • On April 5, Sens. Cassidy (R-LA) and Carper (D-DE) introduced the Treat and Reduce Obesity Act (S. 830), which would provide for the coordination of programs to prevent and treat obesity. Reps. Paulsen (R-MN) and Kind (D-WI) introduced companion legislation in the House (H.R. 1953). Press releases: http://bit.ly/2nUqIe2 and http://bit.ly/2nTQGi8 Bill text: http://bit.ly/2nUhEG6
  • Also on April 5, Sen. Grassley and nine bipartisan cosponsors introduced the introduced the Rural Hospital Access Act (S. 872), which would make permanent the extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program. Reps. Reed (R-NY) and Welch (D-VT) introduced companion legislation in the House (H.R. 1955). Press releases: http://bit.ly/2nU7vJt and http://bit.ly/2ohNDDr Bill text: http://bit.ly/2nUsImy
  • Also on April 5, Rep. Olson (R-TX) and six cosponsors introduced the Medicare Access to Radiology Care Act of 2017 (H.R. 1904), which would align physician supervision requirements under the Medicare program for radiology services performed by advanced level radiographers with state requirements. Press release: http://bit.ly/2ohRGj0
  • Also on April 5, Rep. Upton (R-MI) and five bipartisan cosponsors introduced H.R. 1920, a bill that would exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare. Press release: http://bit.ly/2ohAjyI
  • Also on April 5, Reps. Griffith (R-VA) and Welch (D-VT) introduced the Ensuring Seniors Access to Local Pharmacies Act of 2017 (H.R. 1939), which would ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage. Press release: http://bit.ly/2ohPmZ6
  • On April 6, Senate Finance Committee Chair Hatch (R-UT), Ranking Member Wyden (D-OR), Finance Committee Chronic Care Working Group Co-chairs Isakson (R-GA) and Warner (D-VA), and 9 bipartisan cosponsors introduced the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S. 870), which would implement Medicare payment policies designed to improve management of chronic disease, streamline care and coordination, and improve quality outcomes without adding to the deficit. Press release: http://bit.ly/2ohw8mw Summary: http://bit.ly/2ohHmHH Section-by-section: http://bit.ly/2ohLuaG Bill text: http://bit.ly/2ohKgwd
  • Also on April 6, Reps. McKinley (R-WV) and Welch (D-VT) introduced the Fair Access for Safe and Timely (FAST) Generics Act (H.R. 2051), which would ensure that eligible product developers have competitive access to approved drugs and licensed biological products, so as to enable eligible product developers to develop and treat new products. Press release: http://bit.ly/2nUqmnO
  • Also on April 6, Rep. Schneider (D-IL) introduced the Opioid Preventing Abuse through Continuing Education (PACE) Act (H.R. 2063), which would require certain training as a condition of registration to prescribe or dispense opioids for the treatment of pain or pain management. Press release: http://bit.ly/2nUbQwl
  • Also on April 6, Rep. Shea-Porter (D-NH) introduced the Medicare You Can Opt Into Act of 2017 (H.R. 2065), which would provide for an option for any citizen or permanent resident of the U.S. to buy into Medicare. Press release: http://bit.ly/2nUfXZl
  • Also on April 6, Reps. Speier (D-CA) and Titus (D-NV) introduced the Promoting Integrity in Medicare Act (PIMA) (H.R. 2066), which would prevent abusive billing of ancillary services to the Medicare program. Press release: http://bit.ly/2omALMd
  • Also on April 6, Reps. Wenstrup (R-OH) and Ruiz (D-CA) introduced the Restoring the Patient’s Voice Act (H.R. 2077), which would require a group health plan (or health insurance coverage offered in connection with such a plan) to provide an exceptions process for any medication step therapy protocol. Press release: http://bit.ly/2omxFb1

 ACA Repeal and Replace Activity and Legislation –

  • On April 3, Sens. Baldwin (D-WI), Whitehouse (D-RI), Warren (D-MA), Hassan (D-NH), and Murphy (D-CT) sent a letter to President Trump, calling on him to halt efforts to dismantle the ACA and to help stabilize the insurance market by taking action to protect the cost-sharing subsidies that help lower out-of-pocket health care costs for working families. Press release: http://bit.ly/2nUD5Yl Letter: http://bit.ly/2nUqk01
  • On April 4, Sen. Casey (D-PA) and 19 democratic Senators sent a letter to HHS Secretary Price, calling on him to release a plan originally presented to the House Freedom Caucus listing specific ACA rules that the Administration was willing to repeal or dismantle. Press release with text of letter: http://bit.ly/2nUAVrG
  • On April 5, Reps. Duncan (R-TN) and Roe (R-TN) introduced the Health Care Options Act of 2017 (H.R. 1933), which would allow individuals to receive a premium assistance credit for insurance not purchased on an exchange. Press release: http://bit.ly/2ohMqfb
  • Also on April 5, the House passed by a vote of 400-16 the Self-Insurance Protection Act (H.R. 1304), which would exclude from the definition of health insurance coverage certain medical stop-loss insurance policies obtained by certain plan sponsors of group health plans. The bill now moves to the Senate for consideration. Press release: http://bit.ly/2ohCzpJ
  • On April 6, the House Rules Committee approved by a vote of 9-2 an amendment to the American Health Care Act (H.R. 1628) introduced by Reps. Schweikert (R-CA) and Palmer (R-AL), which would allocate $15 billion through 2026 for a risk sharing program to help lower premiums for health coverage offered in the individual market. Amendment summary: http://bit.ly/2oFzfWk Text: http://bit.ly/2nUjqaj
  • Also on April 6, House Majority Leader McCarthy (R-CA) sent an update to House Republicans describing progress on negotiations and efforts to repeal and replace the ACA and informing members that if a deal is reached over the upcoming recess, they may need to return to DC for a vote. Update: http://bit.ly/2nP9IWM

 ACA Implementation –

  • On April 6, CMS released guidance for ending Special Enrollment Periods (SEPs) for coverage during calendar year 2016. Guidance: http://go.cms.gov/2nSQmA6
  • On April 7, CMS released the final 2018 Unified Rate Review (URR) reporting requirements for single risk pool plans. Instructions: http://go.cms.gov/2nT15uf

Medicare –

  • On April 3, CMS Medicare released the final 2018 Medicare Advantage (MA) and Part D Rate Announcement and Call Letter, which provides for a 0.45 percent increase in reimbursement to MA plans for plan year 2018 and reduces the percent of the current funding formula based on encounter data from 25 percent to 15 percent. CMS also issued a Request for Information (RFI) about ways to improve the MA program within the Announcement. Comments are due by April 24. Press release: http://go.cms.gov/2oetzle Fact sheet: http://go.cms.gov/2nSSeJb Announcement: http://go.cms.gov/2nU6JfM

 Medicaid –

  • On April 6, Medicare and CHIP Payment and Access Commission published a report comparing Medicaid hospital payment across states and to Medicare, finding that base Medicaid payment for inpatient services varies considerably among states, ranging from 49 percent to 169 percent of the national average, but that overall Medicaid payment is comparable or higher than Medicare. Report: http://bit.ly/2nLabt6

 New Payment and Delivery Models –

  • On April 4, CMS posted a document reflecting Model 2 awardees of the Bundled Payments for Care Improvement Initiative that are currently eligible to use a waiver from the three-day hospital stay requirement for SNF. Eligible awardees: http://bit.ly/2p6AvxX
  • On April 6, CMS announced that it had selected 32 participants to serve as local hubs linking clinical and community services with Medicare and Medicaid beneficiaries in the Accountable Health Communities Model. Press release: http://go.cms.gov/2nPAw9l Fact sheet: http://go.cms.gov/2nSP4VM Participants: http://bit.ly/2nT4UiY

 Behavioral Health –

  • On April 3, Sen. Brown (D-OH) sent a letter to President Trump calling for the release of critical resources that have been designated to address the nation’s opioid epidemic. Press release with text of letter: http://bit.ly/2nUDlXm

 Veterans Health –

  • On April 3, the Department of Veterans Affairs (VA) announced the Recovery Engagement and Coordination for Health – Veterans Enhanced Treatment (REACH VET) initiative, which uses a predictive model to analyze health records and identify those at a statistically elevated risk of suicide. Press release: http://bit.ly/2p6aYF5
  • On April 4, the GAO published a statement for the record that summarizes their 2016 report on VA oversight of the Veterans Crisis Line, noting that 3 of the 4 recommendations in the report have not been implemented. Report: http://bit.ly/2nONvs0
  • On April 6, the Department of Veterans Affairs Office of Inspector General announced a new review, called the Comprehensive Healthcare Inspection Program, to evaluate the quality of care at Veterans Health Administration facilities, replacing the Combined Assessment Program and Community Based Outpatient Clinic reviews. Press release: http://bit.ly/2o7zkAB

 Zika –

  • On April 4, CDC published a report finding that 1 in 10 U.S. pregnant women with a confirmed Zika infection had a fetus or baby with a birth defect in 2016. Press release: http://bit.ly/2oejwMY
  • On April 5, Sens. Rubio (R-FL) and Nelson (D-FL), and Reps. Diaz-Balart (R-FL) and Deutch (D-FL) led a bipartisan, bicameral group of 47 members of Congress in a letter to President Trump urging him to maintain a comprehensive effort across the Federal government to combat the Zika virus. Press release: http://bit.ly/2nUkF9B Letter: http://bit.ly/2nUhEWL

 Misc. –

  • On April 3, Sens. Brown (D-OH) and Portman (R-OH) sent a letter to HHS Secretary Price urging him to ensure that work on the National Institute for Occupational Safety and Health (NIOSH) in Cincinnati moves forward without delay. Press release with text of letter: http://bit.ly/2nUHjiQ
  • Also on April 3, Centers for Disease Control and Prevention (CDC) published a new study that shows that flu vaccinations significantly reduced a child’s risk of dying from influenza. Press release: http://bit.ly/2oBY8iv
  • On April 4, Reps. Upton (R-MI) and DeGette (D-CO) sent a letter to Office of Management and Budget Director Mulvaney expressing opposition to any cuts to the National Institutes of Health (NIH) fiscal year 2017 or 2018 budget. Press release: http://bit.ly/2obQEFg Letter: http://bit.ly/2obQFsO
  • On April 5, CDC announced the launch of the 2017 Million Hearts Hypertension Control Challenge, a program that aims to improve health care practices’ understanding of successful strategies for controlling blood pressure. Challenge registrations are due by June 2. Notice: http://bit.ly/2paiwH7
  • On April 6, Food & Drug Administration (FDA) announced that it is allowing the marketing of Personal Genome Service Genetic Health Risk tests for 10 diseases that provide information on an individual’s genetic predisposition to certain medical diseases or conditions. Press release: http://bit.ly/2oIy6gc
  • Also on April 6, CDC published a report finding that between 2011 and 2014, 7.3% of adults aged 18 – 69 in the U.S. were diagnosed with oral human papillomavirus (HPV). Report: http://bit.ly/2nINHrE





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