Health Care Policy Update – Weekly Wrap-up and What’s Ahead – September 30, 2024


When is Congress in session? House 2024 Calendar Senate 2024 Calendar

What’s Ahead: This Week

Hearings and Markups – No notable hearings. Congress is not in session.

Notable Policy Events –
  • Tuesday, October 1
    • Behavioral Health Business, “Expanding Access to Crisis Care by Breaking Down Social and Technology Barriers.” Free, Virtual. Additional Information
    • KFF, “What the 2024 Election Could Mean for Health Coverage, Affordability, and the Budget.” Free, Virtual. Additional Information
    • The Washington Post, “The AI Revolution in Health Care.” Free, Virtual. Additional Information
  • Wednesday, October 2
    • Alliance for Health Policy, “2024 Signature Series Public Congressional Briefing: Navigating AI in Health Care Policy.” Free, In-Person. Additional Information
    • Duke Margolis Institute for Health Policy, “Medicare Accountable Care in 2025 and Beyond: Building on Successes and Finding New Opportunities.” Free, Hybrid. Additional Information
    • Milbank Memorial Fund, “Recommendations for a Standardized State Methodology to Measure Clinical Behavioral Health Spending.” Free, Virtual. Additional Information
  • Thursday, October 3
    • Center for Connected Health Policy, “Cross-state Licensure Court Cases.” Free, Virtual. Additional Information

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

Government Funding – On September 25, the House passed the Continuing Appropriations and Extension Act, 2025 (H.R. 9747) by a vote of 341-82 and the Senate passed by a vote of 78-18. On September 26, President Biden signed the bill into law. The bill would fund the government through December 20, 2024. Health care provisions include extending the availability of funding to implement the surprise billing law enacted in late 2020, Medicaid funding for the Northern Mariana Islands, and delaying pending clinical laboratory payment cuts under Medicare. Bill Text Press Release

Medicare  –

  • On September 23, the HHS Office of Inspector General (OIG) issued a report finding that Medicare and Medicaid beneficiaries in many high-need areas may lack access to medications for opioid use disorder (OUD). Report Report In Brief
  • On September 25, HHS OIG issued a report on a Medicare Advantage (MA) compliance audit of high-risk diagnosis codes of a large health plan. Report Report in Brief
  • Also on September 25, HHS OIG issued a MA compliance audit report of a health plan. Report Report in Brief
  • On September 26, HHS OIG issued a MA compliance audit of diagnosis codes of a nonprofit health plan. Report Report in Brief
  • Also on September 26, CMS announced that the average monthly plan premium for all MA plans, which includes MA plans that provide prescription drug coverage and MA Special Needs Plans (SNPs), is projected to decrease from $18.23 in 2024 to $17.00 in 2025. Fact Sheet Press Release On September 17, the HHS Office of Inspector General (OIG) issued a report on the impact of price substitutions for Medicare Part B drug payments. Report Report In Brief

Medicaid –

  • On September 23, House Budget Committee Chair Arrington (R-TX) sent a letter to Congressional Budget Office (CBO) Director Swagel asking CBO to produce data on Medicaid spending on emergency services for undocumented immigrants from Fiscal Year (FY) 2017 to FY 2023. Letter Press Release
  • Also on September 23, HHS released a study on the opioid use treatment of pregnant and postpartum women and their children in Medicaid. Report
  • Also on September 23, Senate HELP Committee Ranking Member Cassidy (R-LA) sent letters to two drug manufacturers requesting information as part of an investigation of the 340B drug pricing program. Press Release
  • On September 24, CMS approved a five-year extension of Mississippi’s “Healthier Mississippi” section 1115 demonstration, which covers individuals who are aged, blind, and disabled with income at or below 135 percent of the federal poverty level (FPL) who are not eligible for Medicare and are not eligible under the Medicaid state plan. Announcement Approval Letter
  • On September 25, CMS released 2023 Medicaid and CHIP Child and Adult Core Set data products along with summary tables about states’ Medicaid and CHIP managed care programs for 2023-2024. Methods Brief Quality Measures Dataset Fact Sheet  Performance Tables
  • On September 26, CMS released guidance on health coverage requirements for children and youth enrolled in Medicaid and CHIP. The guidance provides information to states regarding Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements. EPSDT Benefit Guidance Press Release
  • Also on September 26, HHS released an issue brief, which examines the economic and health impacts of Medicaid coverage for low-income children and adults. Issue Brief
  • On September 27, Senate Finance Committee Chair Wyden (D-OR) and House Energy & Commerce Committee Ranking Member Pallone (D-NJ) released a statement on CMS’ action on EPSDT requirements. Statement
  • Also on September 27, CMS issued a notice for state planning grants, which would support continuity of care for Medicaid and CHIP beneficiaries following incarceration. Applications are due November 26, 2024. Notice

Marketplaces – On September 25, Sens. Duckworth (D-IL) and Merkley (D-OR) sent a letter to the Department of Labor (DOL), urging DOL to issue guidance for private health insurance plans and insurers to comply with federal law by covering in-person lactation support, supplies and counseling for pregnant and nursing parents. Letter Press Release

Payment & Delivery System Models – 

  • On September 24, CMS issued a final rule, Mitigating the Impact of Significant, Anomalous, and Highly Suspect (SAHS) Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023. CMS finalized its proposals to retroactively remove payment amounts for codes displaying SAHS billing activity in CY 2023 from Shared Savings Program expenditure and revenue calculations: A4352 (Intermittent urinary catheter; Coude (curved) tip, with or without coating (Teflon, silicone, silicone elastomeric, or hydrophilic, etc.), and A4353 (Intermittent urinary catheter, with insertion supplies). These regulations are effective on October 15, 2024. CMS Fact Sheet Final Rule
  • On September 27, CMS announced the Calendar Year (CY) 2025 participants in the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model. Fact Sheet MA VBID Model

Public Health Prevention, Preparedness, Surveillance – On September 25, HHS released a report summarizing lessons learned from using communities of practice (CoPs) to support state, tribal, local and territorial (STLT) public health agencies during the COVID-19 pandemic. Report

Health IT, Privacy, & Digital Health –

  • On September 23, the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) released the 2024 Draft Federal FHIR Action Plan. Announcement Draft Action Plan
  • Also on September 23, Sens. Schatz (D-HI), Wicker (R-MS), Cardin (D-MD), Hyde-Smith (R-MS), and Warner (D-VA) sent a letter to Senate Majority Leader Schumer (D-NY) and Minority Leader McConnell (R-KY) requesting consideration of legislation to permanently extend telehealth flexibilities. Letter Press Release
  • On September 24, HHS OIG released a report on remote patient monitoring, requesting additional oversight from CMS. Report Report in Brief
  • Also on September 24, HHS released a report on the Agency for Healthcare Research and Quality’s (AHRQ) funded studies and projects focused on digital technologies. Press Release Report Report at a Glance
  • On September 26, the FDA published a digital health and artificial intelligence glossary as an education resource to help support consistent use of terminology. Glossary
Mental Health and Substance Use Disorder Policy – 
  • On September 23, Senate Veterans’ Affairs Committee Chair Tester (D-MT) sent a letter to the Department of Veterans Affairs (VA), requesting the VA to conduct a comprehensive review of the Veterans Crisis Line. Letter Press Release
  • On September 25, the National Institutes of Health (NIH) published a study, which found that doses of buprenorphine may improve treatment outcomes for people with OUD. Press Release Study
  • Also on September 25, HHS announced the 988 Suicide & Crisis Lifeline is routing cellular phone calls to 988 contact centers based on callers’ approximate location for a more localized response. Press Release 988 Suicide & Crisis Lifeline
  • On September 26, HHS announced funding for the FY 2024 State Opioid Response (SOR), Tribal Opioid Response (TOR) and SOR/TOR Technical Assistance grants. Announcement
  • On September 27, the VA awarded $4.3 million in cooperative agreements to states and territories to help prevent veteran suicide. Press Release Cooperative Agreements
Prescription Drugs & Health Innovation – 
  • On September 23, Rep. Doggett (D-TX), Sen. Warren (D-MA) and 15 colleagues sent a letter to HHS urging Secretary Becerra to use existing legal authority to lower the price of Ozempic and Wegovy. Letter Press Release
  • On September 26, HHS announced funding for the Transforming Antibiotic R&D with Generative AI to stop Emerging Threats (TARGET) project, which will use AI to speed the discovery and development of new classes of antibiotics. Press Release TARGET Project

SDOH & Health Equity –

  • On September 23, HHS announced funding to support substance use disorder treatment services in rural North Carolina. Press Release
  • On September 24, HHS announced nearly $75 million to support health care services in rural America. FY 2024 Rural Health Awards Press Release
  • On September 27, HRSA issued a notice for information collection, which would authorize awards for special projects of regional and national significance in maternal and child health. Comments are due October 27, 2024. Notice

Health Systems & Health Care Workforce – 

  • On September 23, the Government Accountability Office (GAO) issued a report which finds that improved oversight of contractors is needed to better ensure the quality of TRICARE network providers. Full Report Highlights
  • On September 25, the CDC announced more than $176 million in funding to support 48 public health partners to strengthen public health infrastructure. Press Release

Misc. – On September 27, HHS released an interim final rule, which would set the foundational requirements for Federal financial assistance, including grants and cooperative agreements. Interim Final Rule Press Release

Legislative Activity –
Votes and Committee Activity –

  • On September 23, the House passed several health bills. Press Release
    • The Charlotte Woodward Organ Transplant Discrimination Prevention Act (H.R. 2706) passed by voice vote. The bill would prohibit discrimination on the basis of mental or physical disability in cases of organ transplants. The bill now heads to the Senate for consideration. Bill Text
    • The Give Kids a Chance Act of 2024 (H.R. 3433) passed by voice vote. The bill would amend the Federal Food, Drug, and Cosmetic Act with respect to molecularly targeted pediatric cancer investigations. The bill now heads to the Senate for consideration. Bill Text
    • The Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2023 (H.R. 3884) passed by voice vote. The bill would reauthorize the program providing for sickle cell disease and other heritable blood disorders research, surveillance, prevention, and treatment. The bill now heads to the Senate for consideration. Bill Text
    • The HEARTS Act of 2024 (H.R. 6829) passed by voice vote. The bill would authorize and support the creation and dissemination of cardiomyopathy education, awareness, and risk assessment materials and resources to identify more at-risk families, to authorize research and surveillance activities relating to cardiomyopathy. The bill now heads to the Senate for consideration. Bill Text
    • The Care for Military Kids Act (H.R. 8108) passed by voice vote. The bill would add a Medicaid State plan requirement with respect to the determination of residency of certain individuals serving in the Armed Forces. The bill now heads to the Senate for consideration. Bill Text
    • The NAPA Reauthorization Act (S. 133) passed by voice vote. The bill would extend through 2035 and other changes to the National Alzheimer’s Project. This project supports coordination of federal planning, programs, and other efforts to address Alzheimer’s disease and related dementias. The bill now heads to the Senate for consideration. Bill Text
    • The Alzheimer’s Accountability and Investment Act (S. 134) passed by voice vote. The bill would require an annual budget estimate for the initiatives of the National Institutes of Health pursuant to reports and recommendations made under the National Alzheimer’s Project Act. The bill now heads to the Senate for consideration. Bill Text
  • On September 23, the House passed the Congenital Heart Futures Reauthorization Act of 2024 (H.R. 7189) by voice vote. On September 27, the Senate passed by voice vote. The bill would reauthorize a national congenital heart disease research, surveillance, and awareness program. The bill now heads to the President to be signed into law. Bill Text Press Release
Introduced Legislation –
  • On September 23, Reps. Pettersen (D-CO) and Salazar (R-FL) introduced the Catching Up Family Caregivers Act (H.R. 9764), which would allow additional catch-up contributions for certain family caregivers. Sen. Collins (R-ME) introduced companion legislation in the Senate (S. 5149) on September 24. Bill Text Press Release
  • Also on September 23, Reps. Pettersen (D-CO) and Salazar (R-FL) introduced the Improving Retirement Security for Family Caregivers Act (H.R. 9765), which would allow certain family caregivers to contribute to a Roth IRA. Sens. Collins (R-ME) and Warner (D-VA) introduced companion legislation in the Senate (S. 5148) on September 24. Bill Text Press Release
  • On September 24, Rep. Underwood (D-IL) and 27 cosponsors introduced the Health Care Affordability Act (H.R. 9774), which would expand eligibility for the refundable credit for coverage under a qualified health plan. Sen. Shaheen (D-NH) and 45 cosponsors introduced companion legislation in the Senate (S. 5194) on September 25. Press Release
  • Also on September 24, Reps. Sykes (D-OH), Brown (D-OH), and McClellan (D-VA) introduced the Feed Our Families Act (H.R. 9792), which would provide appropriations for the Food and Nutrition Act of 2008 during the first lapse in appropriations in a fiscal year. Press Release
  • Also on September 24, Sens. Britt (R-AL) and Fetterman (D-PA) introduced the Stop the Scroll Act (S. 5150), which would implement a mental health warning label on social media platforms. Bill Text Press Release
  • On September 25, Rep. Blumenauer (D-OR) introduced the Hospice Care Accountability, Reform, and Enforcement (CARE) Act (H.R. 9803), which would ensure the integrity of hospice care furnished under the Medicare program. Bill Text One-Pager Press Release
  • Also on September 25, Reps. Bucshon (R-IN), Schrier (D-WA), and Kilmer (D-WA) introduced the Access to Claims Data Act (H.R. 9805), which would require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. Press Release
  • Also on September 25, Reps. Flood (R-NE) and Smith (R-NE) introduced the Supporting Access to Rural Community Hospitals Act of 2024 (H.R. 9823), which would waive certain distance requirements for certain hospitals electing to be designated as critical access hospitals. Sen. Fischer (R-NE) introduced the companion language in the Senate (S. 5189). Bill Text Press Release
  • Also on September 25, Reps. Miller (R-WV), Carter (R-GA), Sewell (D-AL), and Kuster (D-NH) introduced the Rural Communities Opioid Response Program (RCORP) Authorization Act (H.R. 9842), which would maintain the Rural Communities Opioid Response Program. Bill Text Press Release
  • Also on September 25, Sens. Sullivan (R-AK) and Cortez Masto (D-NV) introduced the Utilizing National Data, Effectively Reforming Standards and Tools, to Address Negative Determinants (UNDERSTAND) of Health Act (S. 5182), which would require the collection of information regarding social determinants of health. Bill Text One-Pager Press Release
  • Also on September 25, Sens. Fetterman (D-PA) and Cornyn (R-TX) introduced the Affordable Mental Health Care for Selected Reserve Act (S. 5217), which would eliminate cost-sharing requirements for behavioral health care under TRICARE Reserve Select. Bill Text Press Release
  • Also on September 25, Sens. Wyden (D-OR) and Warner (D-VA) introduced the Health Infrastructure Security and Accountability Act (S. 5218), which would strengthen, increase oversight of, and compliance with, security standards for health information. Bill Text One-Pager Press Release Section-by-Section
  • Also on September 25, Sens. Rounds (R-SD) and Heinrich (D-NM) introduced the MedShield Act of 2024 (S. 5222), which would implement a pandemic preparedness and response program using artificial intelligence. Bill Text Press Release
  • On September 27, Rep. Rosendale (R-MT) and nine cosponsors introduced the Path to Independence Act, which would permit States to apply a work requirement for nondisabled, nonelderly, nonpregnant adults under Medicaid. Bill Text Press Release