What’s Ahead: This Week

Hearings and Markups –

  • There are currently no relevant hearings or markups scheduled for this week.

Notable Policy Events –

  • Tuesday, December 19
    • Competitive Enterprise Institute, “Unauthorized and Unprepared: Refocusing the CDC after COVID-19.” Additional Information – Free, Virtual

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

Medicare & Medicaid–

  • On December 12, CMS released guidance which outlines how states can utilize worker management platforms, often called registries, to connect individuals receiving Medicaid-covered home and community-based services (HCBS) have awareness of and access to qualified workers who deliver services. Guidance Press Release
  • Also on December 12, CMS released data on how enhanced funding for HCBS provided through the American Rescue Plan (ARP) has been invested to strengthen access to HCBS. Data
  • On December 13, CMS released data on national health expenditures in 2022. U.S. health care spending grew 4.1 percent to reach $4.5 trillion in 2022, faster than the increase of 3.2 percent in 2021, but much slower than the rate of 10.6 percent in 2020. Analysis Fact Sheet
  • Also on December 13, Reps. Miller-Meeks (R-IA), Bera, (D-CA), Bucshon (R-IN), and Schrier (D-WA) sent a letter to House and Senate leadership urging Congressional action to prevent the impending 3.37% cut in Medicare reimbursement to physicians. Press Release
  • On December 14, HHS issued a report which provides an in-depth review of the 10 drugs selected for the first cycle of Medicare drug price negotiations. Report Press Release
  • Also on December 14, CMS released guidance to State Medicaid agencies, which provides background information on the enrollment of mental health counselors (MHCs), marriage and family therapists (MFTs) and providers of intensive outpatient services (IOP). Guidance

Marketplaces – On December 15, HHS announced that it had reopened the Federal Independent Dispute Resolution (IDR) portal to process all dispute types, including previously initiated batched disputes, new batched disputes, and new single disputes involving air ambulance services. FAQs

Payment & Delivery System Models –

  • On December 13, CMS published a blog post outlining changes to the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model it will implement in 2025 to address higher Medicare costs associated with VBID contracts/plans. This includes adding new reporting requirements related to risk score trends and utilization of supplemental benefits. Blog Post
  • On December 14, CMS released participation data for the Frontier Community Health Integration Project Demonstration – Extension (EFCHIP), Pennsylvania Rural Health Model (PARHM), and the Rural Community Hospital Demonstration (RCH) as part of the CMMI Model Data Sharing Initiative. EFCHIP Data PARHM Data RCH Data
  • On December 15, CMS announced the Transforming Maternal Health (TMaH) Model, which will support participating state Medicaid agencies in the development of a whole-person approach to pregnancy, childbirth, and postpartum care. CMS will release a Notice of Funding Opportunity (NOFO) in Spring 2024, with applications due in Summer 2024. Press Release TMaH Model

Health IT, Privacy, & Digital Health –

  • On December 11, the Office of the National Coordinator for Health Information Technology (ONC) published the first blog in a new series titled, “A Decade of Data Examined”. In this kick-off blog post, ONC discusses progress made in patient access to electronic health information over the past 10 years. Blog
  • On December 12, ONC announced the nationwide health data exchange governed by the Trusted Exchange Framework and Common Agreement (TEFCA) is now operational with the official designation of five Qualified Health Information Networks (QHINs). Announcement
  • Also on December 12, ONC National Coordinator, Micky Tripathi and CEO at the Sequoia Project, Mariann Yeager, published a blog in Health Affairs on the launch of TEFCA. Blog
  • Also on December 12, the Government Accountability Office (GAO) released a report on the use and implementation of AI within federal agencies. GAO notes that there are several requirements within federal law and guidance for agencies implementing AI, but not all have been met. Given this, GAO issued 35 recommendations that address these issues. Report
  • Also on December 12, Senate Finance Committee Chair Wyden (D-OR), and Reps. Jayapal (D-WA) and Jacobs (D-CA) sent a letter to HHS requesting it to improve federal health privacy regulations to better protect Americans’ prescriptions and other health records held by pharmacies, and to conduct follow-up pharmacy privacy policy surveys. Letter to HHS Press Release
  • On December 13, ONC released the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Final Rule. The final rule advances interoperability, improves transparency, and supports the access, exchange, and use of electronic health information. Final Rule Press Release General Overview Fact Sheet Final Rule At-a-Glance Fact Sheet
  • On December 14, HHS released its Data Strategy, which seeks to advance HHS’s management and use of data to improve human health outcomes. It envisions data that is available, accessible, timely, equitable, meaningfully usable, and protected–and can be effectively used by HHS, its partners, and the public. Data Strategy Press Release
  • Also on December 14, the White House published a blog announcing voluntary commitments from 28 health care providers and payers to ensure the safe development of AI tools. Blog

Prescription Drugs & Health Innovation –

  • On December 12, FDA announced it is creating a new advisory committee related to potential treatments for genetic metabolic diseases. Press Release
  • On December 14, CMS sent a letter to health plans and pharmacies regarding concerns about certain practices by some plans and pharmacy benefit managers (PBMs) that threaten the sustainability of many pharmacies, impede access to care, and put increased burden on health care providers. Letter
  • Also on December 14, CMS released revised guidance for the Medicare Prescription Drug Inflation Rebate Program for certain drugs covered under Medicare Part B and Part D. CMS also released the list of 48 prescription drugs for which Part B beneficiary coinsurances may be lower between January 1-March 31, 2024. Press Release

SDOH & Health Equity – On December 11, HHS hosted a meeting with lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) civil rights organizations in Washington to discuss actions the Department has taken to advance health equity, increase access to health care, secure non-discrimination protections, and increase access to behavioral health for the LGBTQI+ community. Press Release

Misc. – On December 12, HHS released a 2023 update to its National Plan to Address Alzheimer’s Disease. National Plan  Press Release

Legislative Activity –

Votes and Committee Activity –

  • On December 11, the House of Representatives passed the Lower Costs, More Transparency Act (H.R. 5378) by a vote of 320-71. The bill would promote price transparency in the health care sector. The bill now heads to the Senate for consideration. Bill Text Press Release Section-by-Section
  • On December 12, the House of Representatives passed the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023 (H.R. 4531) by a vote of 386 to 37. The bill would reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment. The bill now heads to the Senate for consideration. Bill Text Press Release Section-by-Section
  • Also on December 12, the Senate HELP Committee passed, as amended, the SUPPORT for Patients and Communities Reauthorization Act (S. 3393) by a vote of 19-1. The bill would reauthorize the SUPPORT for Patients and Communities Act. The bill now heads to the full Senate for consideration. Bill Text Section-by-Section
  • On December 13, the Senate passed the National Defense Authorization Act for Fiscal Year 2024 (H.R. 2670) by a vote of 87-13. The bill would authorize appropriations for fiscal year 2024 for military activities of the Department of Defense and for military construction, and for defense activities of the Department of Energy, to prescribe military personnel strengths for such fiscal year. The bill now heads to the President to be signed into law. Bill Text Press Release

Introduced Legislation –

  • On December 11, Reps. Buchanan (R-FL), Kilmer (D-WA), Steel (R-CA), and Buschon (R-IN) introduced the Lung Cancer Screening and Prevention Act (H.R. 6693), which would authorize the coverage of additional lung cancer screening tests under the Medicare program. Press Release
  • On December 12, Reps. Smith (R-NE), Buchanan (R-FL), and Wenstrup (R-OH) introduced the (H.R. 6732), which would clarify parameters for model testing and add accountability to model expansion under the Center for Medicare and Medicaid Innovation. Press Release
  • On December 13, Reps. Chu (D-CA) and Smith (R-NE) introduced the Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act (H.R. 6748), which would provide for coverage of peer support services under the Medicare program. Sens. Cortez Masto (D-NV) and Cassidy (R-LA) introduced the companion legislation in the Senate (S. 3498). Bill Text Press Release
  • Also on December 13, Rep. Stansbury (D-NM) and 21 cosponsors introduced the Public Health Nursing Act (H.R. 6768), which would require the Secretary of Health and Human Services to carry out activities to establish, expand, and sustain a public health nursing workforce. Press Release
  • Also on December 13, Sens. Capito (R-WV) and Klobuchar (D-MN) introduced the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (S. 3481), which would expand and expedite access to cardiac rehabilitation programs and pulmonary rehabilitation programs under the Medicare program. Bill Text One Pager Press Release
  • Also on December 13, Sen. Whitehouse (D-RI) and six bipartisan cosponsors introduced the Value in Health Care Act (S. 3503), which would direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other alternative payment arrangements to encourage participation in such program. Section-by-Section Press Release
  • Also on December 14, Reps. Cherfilus-McCormick (D-FL), Ruiz (D-CA), and Sewell (D-AL) introduced the RPM Cost Sharing Elimination Study Act of 2023 (H.R. 6801), which would ensure that remote physiologic monitoring services are not subject to cost sharing under the Medicare program. Bill Text Press Release
  • Also on December 14, Sens. Casey (D-PA) and Brown (D-OH) introduced the Supporting All Students Act (S. 3525), which would maintain a peer-to-peer support line to provide emotional support, information, brief intervention, and mental health resources to youth who are experiencing stress or who are at risk of, or affected by, mental health disorders, and to establish a grant program for local educational agencies to employ school-based mental health coordinators. Press Release
  • Also on December 14, Sens. Kaine (D-VA), Murphy (D-CT), Smith (D-MN) introduced the Improving Data Accessibility Through Advancements (DATA) in Public Health Act (S. 3545), which would amend the Public Health Service Act with respect to public health data accessibility. Bill Text Press Release
  • Also on December 14, Sens. Cornyn (R-TX0, Hassan (D-NH), Bennet (D-CO), and Tillis (R-NC) introduced the Veterans Mental Health and Addiction Therapy Quality of Care Act (S. 3546), which would require a study on the quality-of-care difference between mental health and addiction therapy care provided by health care providers of the Department of Veterans Affairs compared to non-Department providers. Press Release