Health Care Policy Update – Weekly Wrap-Up and What’s Ahead


 

What’s Ahead: This Week

Hearings –

  • Tuesday, October 24
    • House Energy & Commerce Committee, “Examining HHS’s Public Health Preparedness for and Response to the 2017 Hurricane Season.”
    • House Oversight & Government Reform Committee, Subcommittee on Health Care, Benefits and Administrative Rules, Legislative Hearing on several bills, including draft legislation related to the Veterans Choice Program.
    • House Appropriations Committee, Labor, HHS, Education and Related Agencies Subcommittee, “The Role of Facilities and Administrative Costs in Supporting NIH-Funded Research.”
  • Wednesday, October 25
    • House Energy & Commerce Committee, “Federal Efforts to Combat the Opioid Crisis: A Status Update on CARA and Other Initiatives.”
    • House Appropriations Committee, “Down Syndrome: Update on the State of the Science and Potential for Discoveries Across Other Major Diseases.”

 Notable Policy Events –

  • Monday, October 23 – Tuesday, October 24
  • Monday, October 23
    • Health IT Now and the Association for Behavioral Health and Wellness, “Using Health IT to Combat the Opioid Crisis.” Additional information: http://bit.ly/2yAjJyK
  • Tuesday, October 24
    • Alliance for Health Policy, “Marketplace Open Enrollment Preview.” Additional information: http://bit.ly/2yuZYZs
    • Health Affairs, “Choosing Wisely: Opportunities and Challenges in Curbing Medical Overuse.” Additional information: http://bit.ly/2yAcNSb
    • The Hill, “America’s Opioid Epidemic: Aging and Addiction.” Additional information: http://bit.ly/2yAKMtH
  • Thursday, October 26 – Friday October 27
    • Medicaid and CHIP Payment and Access Commission, “October Public Meeting.” Additional information: http://bit.ly/2yIJ8GK
  • Friday, October 27
    • NIHCM Foundation, “Transforming Health Care to Drive Value.” Additional information: http://bit.ly/2xNPCQJ

 

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

 

Senate FY 18 Budget Resolution –

  • On October 19, the Senate passed by a vote of 51-49 the fiscal year 2018 Budget Resolution (H. Con. Res. 71), which provides authority for legislation resulting in up to $1.5 trillion in net tax cuts. The Resolution now moves to the House for consideration. Press release: http://bit.ly/2yD1gBD

Legislative Activity –

  • On October 16, Rep. Connolly (D-VA) introduced the Opioid Immediate Suspension Order Act of 2017 (H.R. 4073), which would strike the definition of “imminent danger to the public health or safety” that was made law by the Ensuring Patient Access and Effective Drug Enforcement Act of 2016 for purposes of suspending a registration. Press release: http://bit.ly/2yxfSCx
  • Also on October 16, Sen. McCaskill (D-MO) and five cosponsors introduced S. 1960, which would repeal the amendments made to the Controlled Substances Act by the Ensuring Patient Access and Effective Drug Enforcement Act of 2016. Press release: http://bit.ly/2yxmjW9
  • On October 18, Sens. Brown (D-OH), Portman (R-OH), Nelson (D-FL), and Capito (R-WV) introduced the Seniors Tax Hike Prevention Act (S. 1977), which would extend the 7.5 percent threshold for the medical expense deduction for individuals age 65 or older. Press release: http://bit.ly/2xQXbpQ
  • On October 19, Senate HELP Committee Ranking Member Murray (D-WA), Sen. Casey (D-PA) and 35 Senate and House Democrats introduced the Protect Access to Birth Control Act (S. 1985), which would repeal the rules issued by the Department of the Treasury, Department of Labor, and the Department of Health and Human Services entitled, “Religious Exemptions and Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act” and “Moral Exemptions and Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act.” Reps. DeGette (D-CO) and three cosponsors introduced companion legislation in the House (H.R. 4082) Press release: http://bit.ly/2yAOljG
  • Also on October 19, Reps. Kuster (D-NH), Jenkins (R-WV), Ryan (D-OH), and Cooper (D-TN) introduced H.R. 4084, which would repeal the amendments made to the Controlled Substances Act by the Ensuring Patient Access and Effective Drug Enforcement Act of 2016. Press release: http://bit.ly/2yDpM5M

 Market Stabilization & Reform –

  • On October 17, Democratic leaders from the House Committees on Energy & Commerce, Ways & Means, and Education & the Workforce, as well as Senate Committees on Finance, HELP and Aging sent letters to President Trump and HHS Acting Secretary Hargan requesting information and documents used to justify the Administration’s decision to terminate cost-sharing reduction (CSR) payments, “including any analyses of the decision’s impact on consumer health insurance costs, access to health insurance, and federal spending.” Press release: http://bit.ly/2yxnOUm Letter: http://bit.ly/2yy1j1u
  • Also on October 17, Sens. Toomey (R-PA) and Cotton (R-AR) introduced the Mandate Relief Act of 2017 (S. 1967), which would provide additional exemptions to the individual mandate for individuals who earn less than the national median household income, whose state’s average premium increased by more than 10 percent, and who live in a county with only one health insurance issuer. Press release: http://bit.ly/2yybF1J
  • Also on October 17, Sens. Bennet (D-CO), Kaine (D-VA), and Feinstein (D-CA) introduced the Medicare-X Choice Act of 2017 (S. 1970), which would build on the Medicare framework to establish a public insurance plan offered on the individual and small business health exchanges. The Medicare-X plan would initially be available in areas where there is a shortage of insurers or higher health care costs due to less competition, but would expand everywhere by 2023. Press release: http://bit.ly/2yy7QcT Summary: http://bit.ly/2yya4sD Bill text: http://bit.ly/2yyaQG9
  • On October 17, Sens. Carper (D-DE), Cassidy (R-LA), Warner (D-VA) and Scott (R-SC) introduced the Increasing Access to Care Act S. 1976), which would allow all individuals purchasing health insurance in the individual market the option to purchase a lower premium copper plan. Press release: http://bit.ly/2yDd4E0
  • On October 18, Sens. Heitkamp (D-ND), Shaheen (D-NH) and Donnelly (D-IN) introduced S. 1978, which would delay the annual fee on health insurance providers until 2020 and to make the fee tax-deductible. Press release: http://bit.ly/2yAetLq
  • Also on October 18, a bipartisan group of 10 Governors wrote to Congressional leadership urging them to give the bipartisan stabilization legislation a vote in both Chambers. Press release with text of letter: http://bit.ly/2xReBTm
  • On October 19, Senate HELP Committee Chairs Alexander (R-TN) and Murray (D-WA) released bill text for the Bipartisan Health Care Stabilization Act of 2017, which would provide funding for CSRs through 2019 in exchange for additional 1332 flexibility, among other provisions. Press release: http://bit.ly/2yAGylQ Section-by-section: http://bit.ly/2yAHHd6 Bill text: http://bit.ly/2yAJyif

ACA Implementation –

  • On October 16, Minnesota’s Governor Dayton signed a federal waiver agreement to secure Minnesota’s state-based reinsurance program, which has lowered 2018 health insurance premiums by an average of 20 percent for the 166,000 Minnesotans who purchase their coverage on the state’s individual market. Press release: http://bit.ly/2xQJGXs
  • On October 18, Internal Revenue Service announced in a notice that it will not accept electronically filed tax returns during the 2018 filing season from taxpayers who don’t state whether they have health coverage or have qualified for an exemption from the coverage requirement. Notice: http://bit.ly/2yxTvwN
  • Also on October 18, House Energy & Commerce Committee Ranking Member Pallone (D-NJ), Health Subcommittee Ranking Member Green (D-TX), Vice Ranking Member Castor (D-FL) and Rep. DeGette (D-CO) wrote a letter to HHS noting concerns about an Interim Final Rule that significantly broaden the exemption for certain organizations to comply with the contraceptive coverage requirements provided by the ACA. Press release: http://bit.ly/2xR9XVk Letter: http://bit.ly/2xR4r5b
  • On October 19, CMS approved Oregon’s section 1332 state innovation waiver, which would establish a state-based reinsurance program in the state using federal pass-through funds. CMS letter: http://go.cms.gov/2xQWnBe
  • Also on October 19, CMS sent a letter to Iowa Insurance Commissioner Ommen describing how federal pass-through payments would be calculated under the state’s proposed section 1332 waiver, if it were to be approved. Letter: http://go.cms.gov/2yIfNw0

Medicaid –

  • This week, CMS posted an annual update on long-term services and supports (LTSS) beneficiaries, finding that approximately 5.2 million people received Medicaid-funded LTSS during CY 2013. Report: http://bit.ly/2xRsXmC
  • Also this week, CMS also posted an annual update to a report describing section 1915© home and community based services waiver programs, finding over 1.6 million people received services in 2014 and the number of waiver participants has increased by an average of 4 percent per year since 2009. Report: http://bit.ly/2xRIi6J

 New Payment and Delivery System Models –

  • On October 20, CMS released a preliminary year 1 savings report for the Financial Alignment Initiative demonstration in Colorado. Report: http://bit.ly/2xYqAyx
  • Also on October 20, CMS released the final evaluation report for the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents. Report: http://bit.ly/2xYzkoc

 Mental Health and Substance Abuse –

  • On October 17, Rep. Marino (R-PA) requested that President Trump withdraw his name from consideration to lead the Office of National Drug Control Policy following criticism of a 2016 bill he sponsored, the Ensuring Patient Access and Effective Drug Enforcement Act of 2016. Press release with statement: http://bit.ly/2xRod0k
  • On October 19, Centers for Disease Control and Prevention (CDC) released a report finding that rates of drug overdose deaths are rising in nonmetropolitan areas, surpassing rates on metropolitan areas. Press release: http://bit.ly/2xYA0Kg Report: http://bit.ly/2xYsX4i
  • On October 20, Heroin Task Force leaders Reps. Kuster (D-NH), MacArthur (R-NJ), Norcross (D-NJ), and Fitzpatrick (R-PA) led nearly 100 lawmakers in a letter to President Trump urging him to follow through on this commitment to declare the opioid epidemic a national emergency. Press release: http://bit.ly/2yDqVu3 Letter: http://bit.ly/2yCRHmk
  • Also on October 20, Sens. Brown (D-OH), Durbin (D=IL) and Markey (D-MA) sent a letter to HHS and the Drug Enforcement Administration requesting information on the impact of the Ensuring Patient Access and Effective Drug Enforcement Act highlighted in a recent report. Press release with text of letter: http://bit.ly/2xYQ131

 Veterans Health –

  • On October 16, Department of Veterans Affairs (VA) announced that it presented the House and Senate Veterans Affairs Committees with the a draft proposal of the Veterans Coordinated Access and Rewarding Experiences (CARE) Act, which is designed to improve veterans’ experiences with and access to health care by replacing the current 30-day/40-mile limit on entering the Choice program. Press releases: http://bit.ly/2xQXWz6 and http://bit.ly/2xYNtSv
  • On October 17, Senate Judiciary Chair Grassley (R-IA) and Senate Committee on Homeland Security and Governmental Affairs Chair Johnson (R-WI) sent a letter to VA Secretary Shulkin requesting information regarding allegations of severe retaliation of a Phoenix VA Health Care System whistleblower who reported serious patient list improprieties at the facilities. Press release: http://bit.ly/2yB3iSP Letter: http://bit.ly/2yAQUT4
  • Also on October 17, Sen. Sasse (R-NE) sent a letter to VA Secretary Shulkin requesting information related to reports that VA employees kept a secret waiting list of patients from Nebraska and Iowa, obscuring actual wait times for veterans who sought appointments. Press release with text of letter: http://bit.ly/2yARgcm
  • On October 19, Senate Judiciary Chair Grassley (R-IA) and Sen. Ernst (R-IA) sent a letter to VA Secretary Shulkin in response to a report of unauthorized waiting lists outside the VA patient tracking system for some mental health appointments in Omaha. Press release: http://bit.ly/2yDvSTJ Letter: http://bit.ly/2yCJyya
  • Also on October 19, U.S. Government Accountability Office (GAO) published a report evaluating whether the Veterans Health Administration (VHA) has enough doctors to keep up with veterans’ growing health care needs, and recommending that VHA develop a process to track all physicians and evaluate its recruitment and retention strategies. Report: http://bit.ly/2xQZt8B
  • Also on October 19, VA Office of Inspector General (VA OIG) published a report on its healthcare inspection in response to allegations in 2015 regarding the Opioid Agonist Treatment Program (OATP) at the Baltimore VA Medical Center. Report: http://bit.ly/2xQQBzQ
  • Also on October 19, VA announced the release of a Request for Information (RFI) seeking interest from potential partners who want to support efforts to build world-class healthcare facilities for veterans. Press release: http://bit.ly/2yAD03b RFI: http://bit.ly/2yByJwt

Prescription Drugs –

  • On October 18, Food and Drug Administration (FDA) announced the approval of the second gene therapy product in the U.S., which will be used to treat adult patients with certain types of large B-cell lymphoma. Press release: http://bit.ly/2xZasNi

Natural Disasters –

  • On October 18, Senate Finance Committee Chair Hatch (R-UT) and Ranking Member Wyden (D-OR) sent a letter to CMS Administrator Verma requesting information about its new nursing home emergency preparedness requirements. Press release: http://bit.ly/2yAycuF Letter: http://bit.ly/2yB5E4f
  • On October 17, CMS posted additional details on the agency’s efforts in support of dialysis patients and providers in Puerto Rico, including working with the Kidney Community Emergency Response (KCER) center and major dialysis providers to track the status and location of over 6,000 dialysis patients and ensure they have access to care. Press release: http://go.cms.gov/2xQHhMe

 Misc. –

  • On October 16, HHS announced the award of approximately $285 million to 58 children’s hospitals across the country through the Children’s Hospitals Graduate Medical Education (CHGME) Payment Program in FY 2017, which helps free standing children’s hospitals maintain their graduate medical education programs that train resident physicians and dentists. Press release: http://bit.ly/2xQVuZq
  • Also on October 16, National Institutes of Health (NIH) published a study finding that women who have had gestational diabetes may be able to reduce or even eliminate their risk for cardiovascular disease by following a healthy lifestyle in the years after giving birth. Press release: http://bit.ly/2xRvnSt
  • On October 17, HHS announced approximately $2.36 billion in Ryan White HIV/AIDS Program grants awarded to cities, counties, states, and local community-based organizations in FY 2017 to support a comprehensive system of HIV primary medical care, medication, and essential support services to more than half a million people living with HIV in the United States. Press release: http://bit.ly/2xR3sCc
  • Also on October 17, HHS published a report finding that homeless people are more likely than members of the general public to use emergency department services. Press release: http://bit.ly/2yD2b5h Report: http://bit.ly/2xRGHOk
  • On October 18, House Energy & Commerce Committee Chair Walden (R-OR) sent a letter to HHS Acting Secretary Hargan sharing responses from other agencies that were collected by the Committee in response to a February letter soliciting ideas and initiatives to reduce administrative waste and achieve budget savings. Press release: http://bit.ly/2yB0tBv Letter to HHS: http://bit.ly/2yAZYqY Letter including HHS’ submission: http://bit.ly/2yB3odk
  • On October 19, HHS announced nearly the award of $282 million to primary health care clinicians and students through the National Health Service Corps and NURSE Corps Scholarship and Loan Repayment Programs. Press release: http://bit.ly/2xRkoZ8
  • Also on October 19, CDC issued updated interim clinical guidance for health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy, including updated information on interpreting laboratory test results for infants and infant follow-up care. Press release: http://bit.ly/2xRgpf6
  • On October 19, Senate HELP Committee Ranking Member Murray (D-WA), and Sens. Feinstein (D-CA), Menendez (D-NJ), and Blumenthal (D-CT) sent a letter to HHS Acting Secretary Hargan urging him to “cease all undue and improper interference in the health care decisions of young women in the Unaccompanied Alien Children (UAC) program. Press release: http://bit.ly/2yCK7Ii Letter: http://bit.ly/2yDTbwJ