Health Care Policy Update – Weekly Wrap-up and What’s Ahead – October 30, 2023


What’s Ahead: This Week

Hearings and Markups –

  • Tuesday, October 31
    • Senate HELP Committee, Subcommittee on Employment and Workplace Safety, “AI and the Future of Work: Moving Forward Together.” Additional Information

Notable Policy Events – 

  • Monday, October 30
  • Tuesday, October 31
    • US News & World Report, “Webinar: Overcoming Burnout and Building a Health System Where Workers Thrive.” Additional Information
  • Wednesday, November 1
  • Thursday, November 2 – Friday, November 3
  • Friday, November 3
    • American Medical Association (AMA), “AMA Advocacy Insights: What’s Next With Medicare Payment Reform.” Additional Information
    • Office of the National Coordinator for Health Information Technology (ONC), “ONC Tech Forum: Aligning USCDI, FHIR US Core, C-CDA and Other Health IT Standards.” Additional Information 
    • Penn Leonard David Institute of Health Economics, “Reforming Medicare Advantage to Deliver on Its Promise.” Additional Information

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

Medicare & Medicaid –

  • On October 26, Senate Finance Chair Wyden (D-OR) sent a letter to CMS Administrator Brooks-LaSure urging CMS to take further action to prevent deceptive marketing practices by Medicare Advantage plans. Press Release Letter
  • On October 27, CMS issued a final rule that updates payment rates and policies under the end-stage renal disease (ESRD) prospective payment system (PPS) for renal dialysis services. For 2024, CMS is increasing total payments to ESRD facilities by approximately 2.1 percent. Press Release Final Rule

Marketplaces –

  • On October 25, CMS released a fact sheet for the 2024 Open Enrollment Period. For plan year 2024, 96 percent of HealthCare.gov consumers have access to three or more health insurance issuers, up from 93 percent in 2023. Fact Sheet Press Release
  • On October 27, HHS released a proposed rule on the No Surprises Act’s Federal independent dispute resolution (IDR) process intended to improve communications between payers, providers, and certified IDR entities; and create a more efficient Federal IDR process. Comments are due January 2, 2024. Press Release Fact Sheet Proposed Rule

Payment & Delivery System Models – 

  • On October 22, CMS released participant-level financial and quality results for performance year (PY) 2022 of the Global and Professional Direct Contracting (GPDC) Model. The model’s net savings to CMS was $371.5 million and the average participant received a quality score of 99.4 percent.
  • On October 23, CMS released the first evaluation report for the GPDC Model. In PY 2021, the GPDC Model did not significantly impact gross or net Medicare spending. Certain participants reduced utilization and spending in certain high-cost settings, including emergency department utilization. Evaluation
  • On October 25, Reps. Matsui (D-CA) and Johnson (R-OH), along with eight other members, sent a letter to CMS Innovation Center Director Fowler urging CMS to implement a model to provide incentive payments for behavioral health providers to adopt electronic health records. Press Release Letter

Public Health Prevention, Preparedness, & Surveillance –

  • On October 24, the HHS Office of Inspector General (OIG) reviewed the CDC’s process for developing COVID-19 test kits and found that the agency’s internal control weaknesses led to the failure of initial COVID-19 test kits. Press Release Report
  • On October 25, House Energy and Commerce Chair Rodgers (R-WA), Subcommittee on Oversight Chair Griffith (R-VA), and Subcommittee on Health Chair Guthrie (R-KY) sent a letter to CDC Director Cohen requesting documents and information related to the CDC’s COVID-19 tracker data. Press Release Letter
  • On October 27, HHS Secretary Becerra sent a letter to COVID-19 therapeutics manufacturers, distributors, pharmacies, and the health care payer community asking for ongoing partnership to distribute COVID-19 oral antiviral treatments, which will transition from government distribution to traditional health care distribution channels starting on November 1, 2023.

Health IT, Privacy, & Digital Health – 

  • On October 23, the Office of the National Coordinator for Health IT (ONC) released version 4 of the United States Core Data for Interoperability (USCDI), which added 20 new data elements and one data class to USCDI version 3. USCDI Version 4
  • On October 26, ONC published a blog on its analysis of Health Information National Trends Survey (HINTS 6) data that suggested that 60 percent of people nationally were comfortable with their health care providers sharing information about their social needs. Blog
  • Also on October 26, the HHS Cybersecurity and Infrastructure Security Agency (CISA) announced that it co-hosted a roundtable discussion on cybersecurity challenges faced by the health care and public health sector. Ahead of the roundtable, CISA and HHS released a cybersecurity tool kit. Press Release Toolkit

Mental Health and Substance Use Disorder Policy –

  • On October 25, HHS published a report examining the development of novel reimbursement strategies for team-based behavioral health care. Report
  • Also on October 25, the White House published a fact sheet calling on Congress to support critical domestic needs, including steps to protect Americans from the impacts of the opioid epidemic. Fact Sheet
  • On October 27, CDC released a report on the percentage of children and adolescents who took medication for their mental health or received counseling or therapy from a mental health professional during the past 12 months, finding an increase from 2018 to 2022. Report

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

  • On October 23, FDA announced the availability of draft guidance that will provide FDA’s current thinking on common questions regarding certain communications by firms to health care providers of scientific information on unapproved use(s) of approved medical products. Press Release Draft Guidance
  • Also on October 23, Senate HELP Committee Chair Sanders (I-VT) sent a letter to HHS OIG regarding his concerns over a proposed NIH patent for a cervical cancer treatment. Press Release Letter
  • On October 26, the White House Office of Science and Technology Policy (OSTP) issued a press release on its efforts to lead a whole-of-government approach to bolster clinical trial capacity in the United States. Press Release

Veterans Health and Military Health –

  • On October 24, Sens. Bennet (D-CO), Hirono (D-HI), Duckworth (D-IL), and Shaheen (D-NH) led 30 Senators in a letter urging the Department of Defense (DoD) to ensure over-the-counter birth control is available for service members and their families on military bases, without a copay and without a prescription. Press Release Letter
  • On October 25, the Congressional Research Service (CRS) published a report on military mental health workforce provisions in the 2024 National Defense Authorization Act (NDAA). Report 
  • On October 26, the DoD released the 2022 Annual Report on Suicide in the Military, providing annual suicide data of service members and their dependents, and outlining current and ongoing suicide prevention efforts across the DoD.  Press Release Report

Health Systems & Health Care Workforce –

  • On October 24, the New York State Congressional delegation wrote to President Biden, Office of Management and Budget (OMB) Director Young, and CMS Administrator Brooks-LaSure expressing concern that payment reductions in the CMS 2024 proposed home health payment rule will disrupt access to home health services. Press Release Letter 
  • Also on October 24, CDC released a study which found that health workers reported a significant increase in poor mental health and burnout increased between 2018 and 2022. Study

Legislative Activity –

Introduced Legislation –

  • On October 24, Reps. Obernolte (R-CA) and DelBene (D-WA) introduced the Honor Our Living Donors (HOLD) Act (H.R. 6020), which would eliminate consideration of the income of organ recipients in providing reimbursement of expenses to donating individuals. Press Release
  • Also on October 24, Rep. Carbajal (D-CA) and Bacon (R-NE) introduced the Veteran Restitution and Justice Act (H.R. 6023), which would provide for the retroactive payment of benefits for veterans with covered mental health conditions based on military sexual trauma. Bill Text Press Release
  • Also on October 24, Rep. Panetta (D-CA) and six cosponsors introduced the Disaster Relief Medicaid Act (DRMA) (H.R. 6029), which would provide Medicaid assistance to individuals and families affected by a disaster or emergency. Sen. Casey (D-PA) and 10 cosponsors introduced the companion legislation in the Senate (S. 3120). Press Release
  • Also on October 24, Rep. Phillips (D-MN) and eight cosponsors introduced the Expanding Health Care Options for First Responders Act (H.R. 6030), which would provide an option for first responders age 50 to 64 who are separated from service due to retirement or disability to buy into Medicare. Sens. Brown (D-OH), Blumenthal (D-CT), and Fetterman (D-PA) introduced the companion legislation in the Senate (S. 3113). Press Release
  • Also on October 24, Rep. Steel (R-CA) and 14 bipartisan cosponsors introduced the Supporting Patient Education and Knowledge (SPEAK) Act of 2023 (H.R. 6033), which would establish a task force to improve access to health care information technology for non-English speakers. Press Release
  • Also on October 24, Reps. Wasserman Schultz (D-FL), Krishnamoorthi (D-IL), and DeSaulnier (D-CA) introduced the Preventing Opportunities for Teen E-Cigarette and Tobacco Addiction (PROTECT) Act (H.R. 6038), which would provide for a Reducing Youth Use of E-Cigarettes Initiative. Sen. Blumenthal (D-CT) and eight cosponsors introduced the companion legislation in the Senate (S. 3108). Press Release
  • Also on October 24, Sens. Markey (D-MA), Capito (R-WV), Sinema (I-AZ), Collins (R-ME), Casey (D-PA), and Tillis (R-NC) introduced the Alleviating Barriers for Caregivers (ABC) Act (S. 3109), which would review and simplify the processes, procedures, forms, and communications for family caregivers to assist individuals in establishing eligibility for, enrolling in, and maintaining and utilizing coverage and benefits under Medicare, Medicaid, CHIP, and Social Security programs. Bill Text Press Release
  • Also on October 24, Sen. Casey (D-PA) and 20 cosponsors introduced the Home and Community-Based Services (HCBS) Relief Act (S. 3118), which would provide for an emergency increase in Federal funding to State Medicaid programs for expenditures on home and community-based services. One Pager Press Release
  • On October 26, Reps. Ciscomani (R-AZ), Cherfilus-McCormick (D-FL), James (R-MI), Trone (D-MD), Kiggans (R-VA), and Perez (D-WA) introduced the Grants for Resources in Occupational Workforce Training for Healthcare (GROWTH) Act (H.R. 6078), which would make community colleges eligible to participate in the Nurse Education, Practice, Quality, and Retention-Pathway to Registered Nurse Program. Bill Text Press Release
  • Also on October 26, Reps. Matsui (D-CA), Dunn (R-FL), Thompson (D-CA), and Kelly (R-PA) introduced the Providing Realistic Opportunity to Equal and Comparable Treatment for Rare (PROTECT Rare) Act (H.R. 6094), which would refine the set of information sources for determining coverage of certain drugs and biologicals used in the treatment or management of a rare disease or condition. Bill Text Press Release
  • Also on October 26, Rep. Pressley (D-MA) and 15 cosponsors introduced the Support Through Loss Act (H.R. 6103), which would allow Americans to receive paid leave time during the period following a pregnancy loss, an unsuccessful round of intrauterine insemination or of an assisted reproductive technology procedure, a failed adoption or surrogacy arrangement, or a diagnosis or event that impacts pregnancy or fertility. Sen. Duckworth (D-IL) and 11 cosponsors introduced the companion legislation in the Senate (S. 3137). Bill Text One Pager Press Release
  • Also on October 26, Reps. Thompson (R-PA) and Courtney (D-CT) introduced the Access to Inpatient Rehabilitation Therapy Act (H.R. 6110), which would restore physician judgment to prescribe the appropriate mix of skilled modalities that constitute an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. Press Release
  • Also on October 26, Sens. Brown (D-OH), Baldwin (D-WI), Warren (D-WA), and Whitehouse (D-RI) introduced the Stabilize Medicaid and CHIP Coverage Act (S. 3138), which would provide for 12-month continuous enrollment of individuals under the Medicaid program and Children’s Health Insurance Program. Bill Text Press Release