What’s Ahead: This Week

Hearings and Markups –

  • Monday, November 13
    • House Committee on Rules, “Meeting to Discuss Further Continuing Appropriations and Other Extensions Act, 2024.” Additional Information
    • House Committee on Rules, “Meeting to Discuss Labor, Health and Human Services, Education, and Related Agencies Appropriations Act, 2024 (H.R. 5894).” Additional Information
  • Tuesday, November 14
    • House Energy & Commerce Committee, Subcommittee on Communications & Technology, “Leveraging AI to Enhance American Communications.” Additional Information
    • House Veterans’ Affairs Committee, Subcommittee on Health, “Emerging Therapies: Breakthroughs in the Battle Against Suicide?” Additional Information
    • Senate Finance Committee, Subcommittee on Health Care, “Ensuring Medicare Beneficiary Access: A Path to Telehealth Permanency.” Additional Information

Notable Policy Events – 

  • Monday, November 13
    • The Heritage Foundation, “Abortion Pills: What’s Next?” Additional Information – In-Person in Washington, DC and Virtual, Free.
    • Biomedical Advanced Research and Development Authority (BARDA), “Industry Day 2023.” Additional Information
  • Tuesday, November 14
    • HHS, “World Diabetes Day Discussion.” Additional Information
    • Kaiser Family Foundation, “ A Look at Medicaid Enrollment and Spending Trends and an Array of Policy Issues Amid Unwinding of the Continuous Enrollment Provision.” Additional Information – Virtual, Free.
    • Punchbowl News, “Uplifting Black Women: A Conversation on Disparities with Reps. Brown and Williams.” Additional Information – In-Person in Washington, DC and Virtual – Free.
    • The Cato Institute, “Let Pharmacists Prescribe.” Additional Information – Virtual, Free.
  • Wednesday, November 15
    • American Academy of Actuaries, “Health Benefit Design Innovations for Advancing Health Equity.” Additional Information – In-Person in Washington, DC and Virtual, Free.
    • CMS, “Optimizing Healthcare Delivery to Improve Patient Lives: 2023 CMS Burden Reduction Conference.” Additional Information – Virtual, Free.
    • CMS, “The CMS Innovation Center’s Approach to Person-Centered Care: Elevating Care Experience Across Models to Improve Outcomes and Equity.” Additional Information – Virtual, Free.
    • Fierce Healthcare, “How Person-Centered Care Can Improve Long-Term Care.” Additional Information – Virtual, Free.
  • Thursday, November 16
    • CMS, “AHEAD Notice of Funding Opportunity (NOFO) Webinar.” Additional Information – Virtual, Free.
    • Kaiser Family Foundation, “The Health Care Workforce Under Pressure: Strikes, Shortages, and Staffing Requirements.” Additional Information – Virtual, Free.
    • National Institute for Health Care Management, “Hospital Consolidation: Mergers, Antitrust & Health Equity.” Additional Information – Virtual, Free.
    • Punchbowl News, “Pop-Up Conversation with Sen. Cortez Masto (D-NV): The State of Health Insurance and the Future of Medicare.” Additional Information – In-person in Washington, DC and Virtual, Free.
  • Friday, November 17
    • Johns Hopkins University, Hopkins Business of Health Initiative, “Physician Non-Competes: Workforce Integrity & Patient Access.” Additional Information – Virtual, Free

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

Medicare & Medicaid –

  • On November 6, CMS released the Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program proposed rule. The proposed rule would establish new guardrails for agents and brokers, increase access to behavioral health providers, and provide additional outreach to beneficiaries regarding supplemental benefits. Comments are due January 5, 2024. Fact Sheet Press Release Proposed Rule
  • Also on November 6, CMS released a blog post outlining recently finalized policies to improve access to behavioral health in Medicare, including expanding the behavioral health workforce and paying more accurately for behavioral health services. Blog 
  • On November 7, CMS released an informational bulletin to provide additional tools to improve the monitoring and oversight of managed care in Medicaid and CHIP, including reporting requirements for managed care programs and new technical assistance toolkits. Bulletin
  • Also on November 7, the HHS Office of Inspector General (OIG) released a report which highlighted additional steps that CMS can take to identify unreported incidents of potential abuse or neglect of Medicare beneficiaries through claims data. Report in Brief Report
  • On November 8, Senate Special Committee on Aging Chair Casey (D-PA) and Senate Finance Committee Chair Wyden (D-OR) led a letter to CMS Administrator Brooks-LaSure encouraging the agency to finalize and implement the proposed rule establishing minimum staffing requirements for nursing homes. Press Release Letter
  • Also on November 8, Rep. Pocan (D-WI) led three letters to CMS Administer Brooks-LaSure urging increased oversight of Medicare Advantage. The letters call for additional action to ensure network adequacy; prevent inappropriate denials and delays of care; and implement a higher coding intensity adjustment. Prior Authorization Letter Network Adequacy Letter Coding Intensity Letter
  • On November 9, CMS released guidance on adding sexual orientation and gender identity questions to State Medicare and CHIP applications for health coverage. Guidance

Marketplaces – On November 9, House Ways & Means Republican leaders sent a letter to HHS Secretary Becerra, Treasury Secretary Yellen, and Acting Labor Secretary Su highlighting concerns of the Administration’s implementation of the No Surprises Act. Letter Press Release

Payment & Delivery System Models – On November 6, CMS released the final evaluation report of the Medicare Care Choices Model (MCCM). Over the six years of the model, MCCM reduced Medicare expenditures and use of acute care services and improved the quality of end-of-life care. Report

Public Health Prevention, Preparedness, & Surveillance –

  • On November 6, the CDC announced that it will expand testing of international air traveler samples to include flu RSV and other respiratory viruses through a new pilot on samples it is collecting as part of its Traveler-based Genomic Surveillance (TGS) program that will provide early detection. Press Release
  • Also on November 7, the Senate confirmed Monica Bertagnolli to become the new National Institutes of Health (NIH) Director. Press Release
  • Also on November 7, the Government Accountability Office (GAO) issued a report on public health preparedness related to maintaining infrastructure created during the COVID-19 pandemic. Press Release Report
  • On November 8, CDC launched Insight Net, which, in partnership with the Center for Forecasting and Outbreak Analytics (CFA) grantees, to establish a national network for outbreak response and disease modeling. Insight Net

Health IT, Privacy, & Digital Health – 

  • On November 6, House Energy & Commerce Committee Chair McMorris Rodgers (R-WA) and Rep. Obernolte (R-CA) co-authored an op-ed in Bloomberg Law on why establishing a national data privacy and security standard is an essential first step towards ensuring American leadership in AI. Press Release Op-ed
  • On November 8, Senate Finance Committee Chair Wyden (D-OR) and Ranking Member Crapo (R-ID) sent a letter to HHS, U.S. Customs and Border Protection (CBP) and the Department of Homeland Security (DHS) requesting information on how the agencies are employing the use of AI and what steps they are taking to ensure the appropriate use of AI. Press Release CBP and DHS Letter HHS Letter

Mental Health and Substance Use Disorder Policy –

  • On November 8, House Energy and Commerce Committee Chair Rodgers (R-WA), Subcommittee on Health Chair Guthrie (R-KY), and Subcommittee on Oversight and Investigations Chair Griffith (R-VA), sent a letter to Substance Abuse and Mental Health Services Administration (SAMHSA) requesting expenditure information. This is the second follow up from the Committee and final notice before the Committee will seek to issue a subpoena. Press Release Letter
  • Also on November 8, HHS published a report examining the behavioral health diagnoses and treatment services received by children and youth involved with the child welfare system in 2019. Report
  • On November 9, Senate HELP Committee Ranking Member Cassidy (R-LA) released a statement urging the Committee to reauthorize the SUPPORT Act. Press Release
  • Also on November 9, SAMHSA released a blog detailing the importance of peer support for veteran mental health and substance use disorders. Blog

Prescription Drugs, Medical Devices, Biomedical Research, & Health Innovation –

  • On November 6, FDA announced its recognition of a key consensus standard to support medical device sponsors as they address cybersecurity concerns. Recognized Consensus Standards: Medical Devices
  • On November 8, FDA approved Zepbound injection for chronic weight management in adults. Announcement
  • On November 9, FDA cleared for marketing the first over-the-counter (OTC) home antigen test for COVID-19. ACON Laboratories’ Flowflex COVID-19 Antigen Home Test, originally authorized for emergency use in 2021, is now the second home COVID-19 test to successfully complete a traditional FDA premarket review pathway, and the first indicated for use in children under 18. Press Release
  • On November 10, FDA cleared for marketing the Control-IQ Technology, a software-only device intended for use with compatible integrated continuous glucose monitors (iCGMs) and alternate controller-enabled insulin pumps (ACE pumps) for the management of type 1 diabetes in persons two (2) years of age and older. Premarket Notification

Veterans Health and Military Health – On November 6, the Department of Veterans Affairs (VA) announced its care and benefits delivered to Veterans in fiscal year 2023. Press Release

SDOH & Health Equity –

  • On November 6, HHS announced the top 10 percent of health centers receiving a Gold Health Center Quality Leader badge. The digital badges, part of the Community Health Quality Recognition (CHQR) badge program, honor the health centers across the country that have attained the best overall clinical quality performance. Press Release Recipients
  • On November 8, the GAO published a report which found that many federal Indian Health Service (IHS) facilities are in fair or poor condition, and there is a need for better data on medical equipment. Press Release Report

Health Systems & Health Care Workforce – On November 7, HHS released an issue brief on its strategy and approach to strengthen primary care across a range of domains including workforce, health IT, and increasing access to high quality, coordinated care. Press Release Issue Brief 

Reproductive & Maternal Health –

  • On November 7, the CDC recommended concerted action to stop the increase of newborn syphilis cases, as new data indicates that more than 3,700 babies were born with syphilis in 2022, which was more than 10 times the number in 2012. Press Release Report
  • On November 8, CMS announced its use of the “Birthing-Friendly” designation icon on CMS’s Care Compare online tool. The new designation would identify hospitals and health systems that participate in a statewide or national perinatal quality improvement collaborative program and that implement evidence-based care to improve maternal health. Press Release

Misc. – On November 6, the Agency for Healthcare Research and Quality (AHRQ) published a study examining the sources of financial strain for patients paying for health care in the United States. Press Release Study

Legislative Activity 

Votes and Committee Activity –  On November 8, the Senate Finance Committee advanced the Better Mental Health Care, Lower Drug Cost, and Extenders Act by a vote of 26-0. The legislation would expand mental health care and substance use disorder services under Medicaid and Medicare, reduce prescription drug costs for seniors at the pharmacy counter, extend essential Medicaid and Medicare provisions that will expire this year, and increase Medicare payments to support physicians and other providers. The bill now heads to the full Senate for consideration. Bill Description Press Release Section-by-Section

Introduced Legislation –

  • On November 6, Reps. Gallego (D-AZ) and Nunn (R-IA) introduced the Overdose Reversal Medication Act (H.R. 6243), which would issue an occupational safety and health standard that requires employers to keep opioid overdose reversal drugs onsite and develop and implement training plans to respond to drug overdose emergencies and to amend the Omnibus Crime Control and Safe Streets Act of 1968 to expand the grants authorized under the Comprehensive Opioid Abuse Grant Program. Press Release
  • On November 7, Rep. Balint (D-VT) introduced the Emergency Medical Services Reimbursement for On-scene Care and Support (EMS ROCS) Act (H.R. 6257), which would provide Medicare coverage of ambulance services that do not include transportation. Sens. Welch (D-VT), Sanders (I-VT), and Smith (D-MN) introduced the companion legislation in the Senate (S. 3236). Bill Text One Pager Press Release
  • Also on November 7, Reps. Perez (D-WA), Casten (D-IL), and Connolly (D-VA) introduced the Protecting Consumer Access to Generic Drugs Act of 2023 (H.R. 6275), which would prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products. Bill Summary Press Release
  • Also on November 7, Reps. Steel (R-CA), Bera (D-CA), and Schweikert (R-AZ) introduced the Wearable Equipment Adoption and Reinforcement and Investment in Technology (WEAR IT) Act (H.R. 6279), which would allow certain wearable devices to be purchased using health savings accounts and other spending arrangements and reimbursement accounts. Press Release
  • Also on November 7, Sens. Peters (D-MI) and Capito (R-WV) introduced the Preventing Diabetes in Medicare Act (S. 3233), which would reduce the occurrence of diabetes in Medicare beneficiaries by extending coverage under Medicare for medical nutrition therapy services to such beneficiaries with pre-diabetes or with risk factors for developing type 2 diabetes. Press Release
  • On November 8, Rep. Miller-Meeks (R-IA) and seven bipartisan cosponsors introduced the Delinking Revenue from Unfair Gouging (DRUG) Act (H.R. 6283), which would improve services provided by pharmacy benefit managers. Bill Text One Pager Press Release
  • Also on November 8, Rep. Grothman (R-WI) and six bipartisan cosponsors introduced the Cancer Drug Parity Act (H.R. 6301), which would require a group health plan (or health insurance coverage offered in connection with such a plan) to provide for cost-sharing for oral anticancer drugs on terms no less favorable than the cost-sharing provided for anticancer medications administered by a health care provider. Bill Text Press Release
  • Also on November 8, Reps. Huffman (D-CA), Raskin (D-MD), Pocan (D-WI), Casten (D-IL), and Del. Norton (D-DC) introduced the Health Share Transparency Act (H.R. 6302), which would establish requirements for the disclosure of certain information relating to health care sharing ministries. Bill Text One Pager Press Release
  • Also on November 8, Reps. Luna (R-FL), Miller (R-IL), and Crane (R-AZ) introduced the Terminate CDC Overreach Act (H.R. 6305), which would impose a limitation on regulations relating to the control of communicable diseases. Bill Text Press Release
  • Also on November 8, Reps. Smith (R-NE), LaHood (R-IL), Sewell (D-AL), and Stansbury (D-NM) introduced the Keep Physicians Serving Patients Act (H.R. 6313), which would improve the accuracy of geographic adjustment factors under the Medicare program and to permanently extend certain adjustments to such factors for certain localities. Bill Text Press Release
  • Also on November 8, Sens. Collins (R-ME), Shaheen (D-NH), Lujan (D-NM), and Cornyn (R-TX) introduced the Peer Support Services Center of Excellence Act (S. 3259), which would reauthorize and expand technical assistance and support for recovery community organizations and peer support networks. Press Release
  • On November 9, Rep. Crow (D-CO) and seven bipartisan cosponsors introduced the Veterans’ Sentinel Act (H.R. 6330), which would direct the Secretary of Veterans Affairs to carry out a pilot program to collect and analyze data regarding suicides and attempted suicides by veterans on the property of the Department of Veterans Affairs. Bill Text Press Release
  • Also on November 9, Rep. Dingell (D-MI) introduced the Veterans Emergency Care Reimbursement Act (H.R. 6333), which would modify the limitation on reimbursement for emergency treatment of amounts owed to a third party or for which the veteran is responsible under a health-plan contract. Bill Text Press Release
  • Also on November 9, Rep. Manning (D-NC) introduced the Capping Prescription Costs Act (H.R. 6347), which would limit cost-sharing for prescription drugs. Bill Text Press Release