Health Care Policy Update – May 22, 2017

Weekly Wrap-Up and What's Ahead

 What’s Ahead: This Week

Hearings/Markups –

  • Wednesday, May 24
    • Senate Veterans Affairs Committee, “Markup: Pending Legislation.” Hearing to discuss the Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 (S. 1094).
    • House Energy & Commerce Committee, Subcommittee on Oversight & Investigations, “U.S. Public Health Response to the Zika Virus: Continuing Challenges.”
    • House Budget Committee, “The President’s Fiscal Year 2018 Budget.”
    • House Ways & Means Committee, “Hearing on the President’s Fiscal Year 2018 Budget Proposals with U.S. Secretary of the Treasury Steven Mnuchin.”
    • House Veterans Affairs Committee, “U.S. Department of Veterans Affairs Budget Request for Fiscal Year 2018.”
    • House Veterans Affairs Committee, Subcommittee on Oversight and Investigations, “VA Financial Management.”
  • Thursday, May 25
    • Senate Budget Committee, “Hearing on the President’s Fiscal Year 2018 Budget Proposal.”

 Notable Policy Events –

  • Tuesday, May 23
    • Bipartisan Policy Center (BPC), “Patient Safety and Information Technology.” Additional information: http://bit.ly/2qOY4Aa
  • Wednesday, May 24
    • Alliance for Health Reform and the National Institute for Health Care Management Foundation, “Where Medicaid Stands: From the AHCA to State Waivers.” Additional information: http://bit.ly/2qMli7n
    • Council of Accountable Physician Practices and the American Cancer Society, “Better Together Health 2017.” Additional information: http://bit.ly/2qOD9NT

 Weekly Wrap Up: Notable Health Care Developments From Last Week

 Administration –

  • On May 16, Senate HELP Committee Ranking Member Murray (D-WA) led a group of 11 Democrats in a letter to President Trump urging him to drop plans implement a proposed 18 percent reduction, as laid out in his proposed budget and cuts to the federal civilian workforce at HHS. Press release: http://bit.ly/2qOsVwI Letter: http://bit.ly/2qOt9UA

 Legislative Activity –

  • On May 16, Senate Judiciary Committee Chair Grassley (R-IA), and Sens. Klobuchar (D-MN) and Gardner (R-CO) introduced the Rural Emergency Acute Care Hospital (REACH) Act (S. 1130), which would create a new Emergency Hospital classification under Medicare. Press release: http://bit.ly/2rspfOB Bill text: http://bit.ly/2rsrhho
  • Also on May 16, Sens. Baldwin (D-WI) and McCain (R-AZ) introduced the Fair Accountability and Innovative Research (FAIR) Drug Pricing Act (S. 1131), which would require drug manufacturer reporting regarding certain drug price increases. Reps. Schakowsky (D-IL), DeLauro (D-CT), Doggett (D-TX), Cummings (D-MD), and Welch (D-VT) introduced companion legislation in the House (H.R. 2439). Press releases: http://bit.ly/2qSMJ2f and http://bit.ly/2qSj7lI Summaries: http://bit.ly/2qSeJD4 and http://bit.ly/2qSq4mF Bill text: http://bit.ly/2qSgLD8
  • Also on May 16, Sens. Cassidy (R-LA), Klobuchar (D-MN) and King (I-ME) introduced the Steve Gleason Enduring Voices Act (S. 1132), which would make permanent the removal of the rental cap for durable medical equipment under the Medicare program with respect to speech generating devices. Reps. McMorris Rodgers (R-WA) and 11 bipartisan cosponsors also introduced companion legislation in the House (H.R. 4265). Press releases: http://bit.ly/2rsvull and http://bit.ly/2rsC2Av
  • Also on May 16, Sen. Lankford (R-OK) and 9 cosponsors introduced the Patient Access to Higher Quality Health Care Act of 2017 (S. 1133), which would repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Rep. Johnson (R-TX) previously introduced companion legislation in the House (H.R. 1156). Press release: http://bit.ly/2rsAW7P
  • Also on May 16, Sens. Shaheen (D-NH) and Hassan (D-NH) introduced the Office of National Drug Control Policy (ONDCP) Reauthorization Act of 2017 (S. 1141), which would reauthorize funding for the ONDCP. Press release: http://bit.ly/2qTbqf2c
  • Also on May 16, Reps. Walters (R-CA) and Bera (D-CA) introduced the Medical Product Review Harmonization Act of 2017 (H.R. 2474), which would provide an alternative standard for substantial equivalence determinations for devices. Press release: http://bit.ly/2qTcKyn
  • On May 17, Sen. Kennedy (R-LA) introduced the Medicaid Reform and Personal Responsibility Act of 2017 (S. 1150), which would require states to impose a work requirement for able-bodied adults without dependents who are eligible for medical assistance. Press release: http://bit.ly/2rzWuiT
  • Also on May 17, Senate Majority Whip Cornyn (R-TX), Senate Finance Committee Chair Hatch (R-UT), and Sens. Nelson (D-FL), Cotton (R-AR) and Cruz (R-TX) introduced the Veterans’ Health Care Integrity Act (S. 1163), which would require the Secretary of Veterans Affairs to ensure compliance of the medical facilities of the VA with requirements relating to the scheduling of appointments, and would require appointment by the President and confirmation of the Senate of certain health care officials. On May 9, Reps. Love (R-UT) and Sinema (D-AZ) introduced companion legislation in the House (H.R. 2555). Press releases: http://bit.ly/2rA2cBn and http://bit.ly/2rI6o22
  • Also on May 17, Senate Minority Whip Durbin (D-IL) and Sens. Portman (R-OH), Brown (D-OH), Capito (R-WV), King (I-ME), and Collins (R-ME) introduced the Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act (S. 1169), which would provide states with an option to provide inpatient services to treat substance use disorders at certain facilities for individuals between the ages of 22 and 64 Press release: http://bit.ly/2rzUE1k
  • Also on May 17, House Veterans Affairs Committee advanced 11 bills: the VET protection Act of 2017 (H.R. 1461), the Veterans Appeals Improvement and Modernization Act of 2017 (H.R. 2288), the Quicker Veterans Benefits Delivery Act of 2017 (H.R. 1725), the Veterans Compensation Cost-of-Living Adjustment Act of 2017 (H.R. 1329), the VA Scheduling Accountability Act (H.R. 467), the VA Prescription Data Accountability Act of 2017 (H.R. 1545), the Veterans Affairs Medical Scribe Pilot Act of 2017 (H.R. 1848), the Building Supportive Networks for Women Veterans Act (H.R. 91), the No Hero Left Untreated Act (H.R. 1162), H.R. 1005 and H.R. 1662. Press release: http://bit.ly/2rzA6X1 Bill text: http://bit.ly/2rA5AML
  • Also on May 17, Reps. Collins (R-GA), Coffman (R-CO), Ryan (D-OH), and Smith (R-TX) introduced the Expanding Veterans’ Access to Choice Act (H.R. 2478), which would amend the Veterans Access, Choice, and Accountability Act of 2014 to clarify the distance requirement with respect to determining the eligibility of veterans to receive hospital care and medical services from non-Department of Veterans Affairs facilities. Press release: http://bit.ly/2rzXiUQ
  • Also on May 17, Reps. Hudson (R-NC) and Bucshon (R-IN) introduced the Quality Systems Certification Act of 2017 (H.R. 2483), which would provide for the establishment of a third-party quality system assessment program for medical devices. Press release: http://bit.ly/2rzWLCl
  • Also on May 17, Reps. Ryan (D-OH) and Thompson (R-PA) introduced the Veterans Wellness Act of 2017 (H.R. 2506), which would direct the Secretary of the VA to establish a pilot program to award grants to nonprofit veterans service organizations to upgrade the community facilities of such organizations. Press release: http://bit.ly/2rAiWZ5
  • Also on May 17, Rep. Tonko (D-NY) and five cosponsors introduced the Medicare Mental Health Inpatient Equity Act of 2017 (H.R. 2509), which would eliminate Medicare’s 190-day lifetime limit on inpatient psychiatric hospital services. Press release: http://bit.ly/2rzSpLq
  • On May 18, Senate Finance Committee approved by a vote of 26-0 the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S. 870). The bill now moves to the full Senate for consideration. Press release: http://bit.ly/2rzHfGS
  • On May 18, House Energy & Commerce Committee advanced by a voice vote the Food and Drug Administration (FDA) Reauthorization Act of 2017 (H.R. 2430), which would reauthorize FDA’s user fee programs. The Committee also approved four amendments to the legislation, which allow for increase generic drug competition, increase penalties for selling or distributing counterfeit drugs, update the FDA’s medical device inspection process to a risk-based program, and establish a category of FDA-approved over-the-counter hearing aids. A similar bill is currently under consideration in the Senate (S. 934). The Committee also approved by voice vote two public health bills, the Congenital Health Future Reauthorization Act of 2017 (H.R. 1222) and the Sickle Cell Disease Research, Surveillance, Prevention and Treatment Act of 2017 (H.R. 2410). The bills now move to the full House for consideration. Press release: http://bit.ly/2rzwqo5 Bill text: http://bit.ly/2rrxnPj
  • Also on May 18, Sens. Donnelly (D-IN) and Gardner (R-OH) introduced the FDA Regulatory Efficiency Act (S. 1183), which would establish a third-party quality system assessment program. Press release: http://bit.ly/2rAMvd1
  • Also on May 18, Senate Aging Committee Chair Collins (R-ME) and Sen. Baldwin (D-WI) introduced the Lifespan Respite Care Reauthorization Act of 2017 (S. 1188), which would reauthorize the program. Reps. Langevin (D-RI) and Harper (R-MS) introduced companion legislation in the House (H.R. 2535). Press releases: http://bit.ly/2rAngHJ and http://bit.ly/2rAEk0D
  • On May 19, Reps. Thompson (D-CA), Harper (R-MS), Black (R-TN), and Welch (D-VT) introduced the Medicare Telehealth Parity Act (H.R. 2550), which would provide for an incremental expansion of telehealth coverage under the Medicare program. Press release: http://bit.ly/2rI92Vg
  • Also on May 19, Reps. Reps. Thompson (D-CA), Harper (R-MS), Black (R-TN), Welch (D-VT), Johnson (R-OH) and Matsui (D-CA) introduced the CONNECT for Health Act (H.R. 2556), which would expand access to telehealth services in the Medicare Program. Sen. Schatz (D-HI) and twelve cosponsors previously introduced the CONNECT for Health Act in the Senate (S. 1016). Press release: http://bit.ly/2rI92Vg

 ACA Repeal and Replacement Activity and Legislation –

  • On May 18, Reps. Young (R-IA), King (R-IA) and Blum (R-IA) introduced the Freedom from the ACA Tax Penalty Act (H.R. 2516) which would waive the individual mandate in areas with no exchange plans. Press release: http://bit.ly/2rAEdlE
  • On May 19, Congressional Budget Office (CBO) announced that it would release a cost estimate for the American Health Care Act (H.R. 1628) on Wednesday, May 24. Post: http://bit.ly/2rzRJWK

 ACA Implementation –

  • On May 15, CMS announced it is ending the Federally-Facilitated Small Business Health Options Program (FF-SHOP) given low enrollment, and instead is offering employers the option to use direct enrollment. Press release: http://go.cms.gov/2rrJZpE Guidance: http://go.cms.gov/2rroBRk
  • On May 16, CMS posted a press release announcing its previously released Checklist for Section 1332 State Innovation Waivers, intended to “help states complete waiver applications that allow them to establish high-risk pools/state-operated reinsurance programs.” Press release: http://go.cms.gov/2rrAoiE
  • On May 17, CMS announced that consumers in states using the Federally-facilitated Marketplace applying for individual coverage through direct enrollment partners will now be able to complete their enrollment process using one website. Press release: http://go.cms.gov/2rrzCSw Guidance: http://go.cms.gov/2rrmNYy
  • Also on May 17, National Association of Insurance Commissioners sent letters to Congressional leaders and to OMB Director Mulvaney urging the federal government to provide full funding for cost-sharing reduction payments in 2017 and 2018. Letters: http://bit.ly/2rwI0Aa and http://bit.ly/2rwMXJo
  • On May 18, Attorneys General from 15 states and the District of Columbia filed a Motion to Intervene in House v. Price, the ongoing suit over the ACA’s cost-sharing reduction payments. Motion: http://bit.ly/2q04NXW
  • Also on May 18, House Ways & Means Committee Ranking Member Pallone (D-NJ) sent a letter to Government Accountability Office Comptroller General Dodaro requesting the GAO conduct a study evaluating HHS’ efforts to prepare for the upcoming open enrollment season for the 2018 plan year. Press release: http://bit.ly/2rzRWJd Letter: http://bit.ly/2rzypIV
  • On May 21, Senate Finance Committee Ranking Member Wyden (D-OR), HELP Committee Ranking Member Murray (D-WA), House Ways & Means Committee Ranking Member Neal (D-MA) and Energy & Commerce Committee Ranking Member Pallone (D-NJ) sent a letter to CMS Administrator Verma requesting information about a reports that she sought health insurance executive’s political support for the AHCA in exchange for cost-sharing reduction payments. Letter: http://bit.ly/2rIlHrn

Medicaid/CHIP –

  • On May 17, CMS released guidance outlining federal funding methodology for the Basic Health Program for Program Year 2018. Guidance: http://bit.ly/2rzZtYv
  • On May 19, HHS Office of Inspector General (OIG) released a report on the State Medicaid Fraud Control Units, finding that units reported 1,564 convictions in FY 2016, over a third of which involved personal care services attendants. Summary with link to report: http://bit.ly/2q0bbOY

 New Payment and Delivery System Models –

  • On May 17, CMS announced the selection of four regions for Round 2 of the Comprehensive Primary Care Plus (CPC+) model. Interested eligible practices located in these regions must apply by July 13. Press release: http://go.cms.gov/2rrrHF3
  • On May 18, CMS released an updated hospital list for the Comprehensive Care for Joint Replacement Model (CJR). List available for download here: http://bit.ly/2cb62Yx
  • On May 19, CMS released a final rule delaying the effective date of the Advancing Care Coordination through Episodic Payment Models, Cardiac Rehabilitation Incentive Payment Model and changes to the Comprehensive Care for Joint Replacement Model (CJR) from July 1, 2017 to January 1, 2018. Final rule: http://bit.ly/2rAvVdm
  • Also on May 19, HHS released a final rule further delaying the effective date of 340B Drug Pricing Program Ceiling Price and Manufacturer Civil Monetary Penalties final rule from January 5, 2017 to October 1, 2017. Final rule: http://bit.ly/2rAwd3W

 Veterans Health –

  • On May 17, VA announced several new strategic partnerships with private industry and national sports organizations to promote dialogue and collaboration on traumatic brain injury and post-traumatic stress disorder. Press release: http://bit.ly/2rrBKK4
  • Also on May 17, VA announced the award of a contract for a commercially available, off-the-shelf online patient self-scheduling system through a mobile application intended to improve access to care. Press release: http://bit.ly/2rA33C4
  • On May 18, VA OIG released a report evaluating suicide prevention programs in Veterans Health Administration facilities, finding that most facilities had a process for responding to referrals from the Veterans Crisis Line and a process to follow up on high-risk patients who missed appointments. Summary with link to report: http://bit.ly/2q0p6Vi

 Drug Prices and User Fee Agreements –

  • On May 15, Senate Judiciary Committee Chair Grassley (R-IA), and Sens. Klobuchar (D-MN) and McCain (R-AZ) sent a letter to White House Office of Management and Budget Director Mulvaney urging him to use existing executive authority to bring down prescription drug costs, including by certifying importation of prescription drugs from Canada. Press release with text of letter: http://bit.ly/2qRwEKc
  • Also on May 15, Rep. Schakowsky (D-IL) led a group of 35 Democrats in a letter to President Trump, urging him to work with Congress to use the upcoming reauthorization of the User Fee Agreements to reform the drug pricing system. Press release: http://bit.ly/2qRpjdF Letter: http://bit.ly/2qRh2WX
  • On May 16, Senate HELP Committee Ranking Member Murray (D-WA) released a statement and posted a letter sent by HHS Secretary Price to Congressional leaders requesting that Congress increase the user fee contributions from industry being negotiated as part of the FDA User Fee Agreements. Letter from HHS Secretary Price: http://bit.ly/2rrlhFL Statement from Ranking Member Murray: http://bit.ly/2rrEHKJ

 Mental Health and Substance Abuse –

  • On May 16, House Committee on Oversight and Government Reform Ranking Member Cummings (D-MD) and 70 bipartisan Representatives sent a letter to Office of Management and Budget (OMB) Director Mulvaney urging him to maintain funding for the Office of National Drug Control Policy (ONDCP) in the fiscal year 2018 budget. Press release: http://bit.ly/2rzQMxy Letter: http://bit.ly/2rzFtoZ
  • On May 18, Sens. Baldwin (D-WI), Markey (D-MA), Menendez (D-NJ), and Shaheen (D-NH) led a group of 28 senators in a letter to Senate Appropriations Committee Chair Cochran (R-MS), Ranking Member Leahy (D-VT), and Subcommittee on Labor-HHS-Education Chair Blunt (R-MO) and Ranking Member Murray (D-WA), calling for increased federal funding to help combat the opioid and illicit drug abuse epidemic. Press release: http://bit.ly/2rAEll2 Letter: http://bit.ly/2rAdllB
  • Also on May 18, HHS released a request for supplemental evidence and data submissions on noninvasive, non-pharmacological treatment for chronic pain. Submissions are due by June 19. Notice: http://bit.ly/2rAoaUE
  • On May 19, Substance Abuse and Mental Health Services Administration (SAMHSA) announced it is accepting applications for up to $39.5 million in grants to implement suicide prevention and intervention programs. Applications are due by July 18. Press release: http://bit.ly/2q0dJN0

 Zika –

  • On May 18, Senate Majority Whip Cornyn (R-TX) and Sen. Cruz (R-TX) sent a letter to Center for Disease Control and Prevention (CDC) Acting Director Schuchat asking how the agency is coordinating with Texas public health officials to prepare for the Zika virus threat this summer and how the CDC plans to spend its remaining Zika prevention funds. Press release with text of letter: http://bit.ly/2rzYKGT
  • On May 19, House Energy & Commerce Committee Ranking Member Pallone (D-NJ), Vice Ranking Member Castor (D-FL), Subcommittee on Health Ranking Member Green (D-TX), and Subcommittee on Oversight & Investigations Ranking Member DeGette (D-CO), sent a letter to CDC Acting Director Schuchat requesting information about the CDC’s Zika virus outbreak preparedness and response capabilities in anticipation of the increase in cases of Zika virus infections. Press release: http://bit.ly/2qMo5xs Letter: http://bit.ly/2qM1KjB

 Misc. –

  • On May 16, Centers for Disease Control and Prevention (CDC) released new data finding that 28.6 (9.0%) of persons of all ages were uninsured in 2016, the same as in 2015. Data: http://bit.ly/2rrBpqO
  • On May 17, HHS announced the selection of five entrepreneurial projects for a total investment of $375,000 by the Secretary’s Venture’s Fund (HHS Ventures). Press release: http://bit.ly/2rzEYes
  • Also on May 17, HHS OIG released a compendium focusing on the top 25 recommendations that, in OIG’s view, would most positively affect HHS programs in terms of cost-savings, program effectiveness and efficiency. Summary with link to report: http://bit.ly/2q0daCS
  • On May 18, House Energy & Commerce Committee Chair Walden (R-OR) and Ranking Member Pallone (D-NJ) announced the creation of the Indian Health Service (IHS) Task Force, which will be chaired by Reps. Mullin (R-OK) and Ruiz (D-CA) and will review the health care delivery system for American Indians and Alaska Natives (AI/AN). Press release: http://bit.ly/2rzx4lh
  • On May 18, Reps. Chu (D-CA), DeGette (D-CO), Slaughter (D-NY), DeBene (D-WA), Lee (D-CA), and Speier (D-CA) sent a letter to Ivanka Trump, inviting her to a meeting on women’s health issues, including access to affordable contraception. Press release with text of letter: http://bit.ly/2rAnJJZ