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


 What’s Ahead: This Week

Hearings –

  • Tuesday, December 5
    • Senate Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, “Addressing the Opioid Crisis in America: Prevention, Treatment, and Recovery.”
  • Thursday, December 7
    • Senate HELP Committee, “Implementation of the 21st Century Cures Act: Progress and the Path Forward for Medical Innovation.”
    • House Committee on Oversight and Government Reform, Subcommittee on Information Technology, “Oversight of IT and Cybersecurity at the Department of Veterans Affairs.”
    • House Committee on Veterans Affairs, “New Names, Same Problems: The VA Medical Surgical Prime Vendor Program.”

 Notable Policy Events –

  • Monday, December 4
    • Connected Health Initiative and POLITICO, “Recognition, Reimbursement, Results: Opportunities Ahead for Remote Monitoring.” Additional information: http://bit.ly/2hZUOMc
  • Monday, December 4 – Tuesday, December 5
    • American Bar Association, “15th Annual Washington Health Law Summit.” Additional information: http://bit.ly/2hXUnBZ
  • Monday, December 4 – Wednesday, December 6
    • Workgroup for Electronic Data Interchange (WEDI), “WEDI-Con 2017: Healthcare IT’s Future Starts Here.” Additional information: http://bit.ly/2hZhX12
    • Global Digital Health Network and the Personal Connected Health Alliance, “4th Annual Global Digital Health Forum.” Additional information: http://bit.ly/2hZqz7Z
  • Tuesday, December 5
    • Axios, “A New Era in Health Care.” Additional information: http://bit.ly/2BASRhD
    • Altarum’s Center for Elder Care and Advanced Illness, “It Takes YOUR Community.” Additional information: http://bit.ly/2i1dMly
  • Wednesday, December 6 – Thursday, December 7
  • Thursday, December 7 – Friday, December 8
    • Medicare Payment Advisory Commission (MedPAC), “December Public Meeting.” Additional information: http://bit.ly/2kf59rW
  • Friday, December 8
    • Alliance for Health Policy, “The Role of the Health Care Workforce in Delivery System Reform.” Additional information: http://conta.cc/2kfreGK

 

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

 Tax Reform –

  • On December 2, the Senate passed by a vote of 51-49 the Tax Cuts and Jobs Act (H.R. 1), which reforms the tax code and repeals the ACA’s individual mandate. A similar version of the bill previously passed the House; both bills now move to conference to resolve differences. Press release: http://bit.ly/2AoTZa8 Bill text: http://bit.ly/2Aprjxo

 Appropriations –

  • On December 2, House Appropriations Chair Frelinghuysen (R-NJ) released text of a Continuing Resolution which would maintain current funding for federal options from December 8 through December 22. The bill also includes short-term CHIP funding to states. Press release: http://bit.ly/2kjBVYT Bill text: http://bit.ly/2kikzvl

Legislative Activity –

  • On November 28, the House unanimously passed the Law Enforcement Mental Health and Wellness Act of 2017 (H.R. 2228), which would provide support for law enforcement agency efforts to protect the mental health and well-bring of law enforcement officers. The bill now moves to the Senate for consideration. Press release: http://bit.ly/2BzCdyQ
  • Also on November 28, Sens. King (I-ME), Crapo (R-ID), Cardin (D-MD), and Udall (D-NM) introduced the Preventive Health Savings Act (S. 2164), which would amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. Press release: http://bit.ly/2BAj3sI Also on November 28, Sen. Gardner (R-CO) introduced the Veterans Improved Access and Care Act of 2017 (S. 2168), which would amend the Veterans Access, Choice, and Accountability Act of 2014 to include in the Veterans Choice Program all veterans enrolled in the patient enrollment system of the Department of Veterans Affairs. Press release: http://bit.ly/2BzBKN6
  • On November 29, Sen. Warren (D-MA) and six cosponsored introduced the Medical Innovation Act of 2017 (S. 2172), which would authorize the collection of supplemental payments to increase congressional investments in medical research. Rep. Welch (D-VT) introduced companion legislation in the House (H.R. 4487) Press release: http://bit.ly/2BzxWM0 Fact sheet: http://bit.ly/2BAeUVx Bill text: http://bit.ly/2BBe2Qw
  • Also on November 29, Reps. Meadows (R-NC) and Renacci (R-OH) introduced the Opioid Abuse Deterrence, Research, and Recovery Act (H.R. 4482), which would establish additional registration requirements for prescribers of opioids, to encourage the development of abuse-deterrent formulations, and to require a study and report on policy changes that may have contributed to the opioid epidemic. Press release: http://bit.ly/2BzD4Qb
  • Also on November 29, the Senate Committee on Veterans Affairs approved by a vote of 14-1 the Caring for Our Veterans Act of 2017, which would establish a permanent, streamlined ‘Veterans Community Care Program’ to provide veterans with access to health care and services in their own communities. The bill now moves to the full Senate for consideration. Press release: http://bit.ly/2kdxA9r Summary: http://bit.ly/2kbSx4C Section-by-section: http://bit.ly/2kfQMU0 Bill text: http://bit.ly/2kgLiZ6
  • On November 30, Reps. Loebsack (D-IA), Shea-Porter (D-NH), Napolitano (D-CA), and Kuster (D-NH) introduced the Combatting the Opioid Epidemic Act (H.R. 4501), which would increase funding for the state response to the opioid misuse crisis and to provide funding for research on addiction and pain related to the substance misuse crisis. Sen. Casey (D-PA) previously introduced companion legislation (S. 2004). Press release: http://bit.ly/2BD2nAG
  • On December 1, Sen. Heller (R-NV) introduced the CHIP Stability Act (S. 2183), which would provide for a special rule during the first quarter of fiscal year 2018 for the redistribution of certain Children’s Health Insurance Program allocations for certain shortfall states. Reps. Costello (R-PA), Emmer (R-MN), Walden (R-OR), and Burgess (R-TX) introduced companion legislation in the House (H.R. 4515). Press releases: http://bit.ly/2Amt4vA and http://bit.ly/2AlBbIN

 ACA Market Stabilization & Implementation –

  • On November 27, CMS released several documents related to the Plan Year 2019 Open Enrollment period, including a draft bulletin highlighting the proposed timing and submission of rate filing justifications for the 2018 filing year for single risk pool coverage and a draft letter to issuers highlighting policies for plan year 2019. Comments are due by December 11. Fact sheet: http://go.cms.gov/2jvpq8v Draft bulletin: http://go.cms.gov/2hXuOkp Draft letter to issuers: http://go.cms.gov/2hWKDb8 Key dates: http://go.cms.gov/2hYnrcr
  • On November 29, CMS released data showing that 504,181 consumers enrolled in coverage using Healthcare.gov in the third week of Open Enrollment, including 152,243 new consumers. Press release: http://go.cms.gov/2Bpkf1b
  • On November 30, Congressional Budget Office announced that the Alexander-Murray proposal would have a limited impact on the projected 10 percent increase in premiums or the loss of coverage caused by a repeal of the individual mandate. Letter: http://bit.ly/2BniB08
  • Also on November 30, CMS released guidance addressing notice requirements related to recently published interim final rules addressing the ACA’s contraceptive coverage requirements. Guidance: http://go.cms.gov/2BC5Xvd

Medicare –

  • On November 27, HHS Office of Inspector General released a report finding that excluding non-covered versions of drugs when setting payment for two part B drugs would have resulted in lower drug costs for Medicare and its beneficiaries. Summary with link to report: http://bit.ly/2hXSsNN
  • On November 28, CMS released an update to the Market Saturation and Utilization Data tool which includes interactive maps and a dataset that shows national-, state-, and county-level provider services and utilization data for selected healthcare service areas. Press release: http://go.cms.gov/2i0IJWY
  • On November 30, CMS posted the Measures Under Consideration (MUC) List for 2018 pre-rulemaking, which contains 32 measures with “the potential to drive improvement in quality across numerous settings of care.” Blog post: http://bit.ly/2dNwniZ MUC List: http://go.cms.gov/2keccB5
  • On December 1, CMS released a notice updating the calendar year 2018 application fee to $569 for institutional providers that are initially enrolling in the Medicare, Medicaid or CHIP programs. Notice: http://bit.ly/2kmAQiP

Medicaid and CHIP –

  • On November 29, the National Governors Association sent a letter Senate Majority Leader McConnell (R-KY), Minority Leader Schumer (D-NY), House Speaker Ryan (R-WI) and Minority Leader Pelosi (D-CA) urging them to reach an agreement by the end of the year so that the CHIP program and Community Health Center Fund are both fully funded. Press release: http://bit.ly/2kfmL74 Letter: http://bit.ly/2kd6kb9
  • On December 1, Senate Finance Committee Ranking Member Wyden (D-OR) and House Energy & Commerce Committee Ranking Member Pallone (D-NJ) sent a letter to CMS Administrator Verma expressing concerns about Iowa’s recently approved amendment to the state’s section 1115 Medicaid waiver, which waives a requirement for the state to provide retroactive coverage. Press release: http://bit.ly/2BBqNuI Letter: http://bit.ly/2BCs5pc

New Payment and Delivery System Models –

  • On November 30, CMS issued final rules that cancel the Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model and make certain changes to the Comprehensive Care for Joint Replacement (CJR) Model; the rule makes participation voluntary for all CJR eligible hospitals. Press release: http://go.cms.gov/2BzOFPn Fact sheet: http://go.cms.gov/2BzOPGt Final rule: http://bit.ly/2BBto7W

 Mental Health and Substance Abuse –

  • On November 29, CMS released an updated version of the Medicare opioid prescribing mapping tool, which visually presents geographic comparisons of Medicare Part D opioid prescribing rates. Press release: http://go.cms.gov/2BzzpSk Tool: http://go.cms.gov/2ByeWxc
  • Also on November 29, HHS released a report providing an overview of data sources that could be leveraged to study the opioid crisis within each of HHS’ five strategic areas. Report: http://bit.ly/2BzgGX4
  • Also on November 29, Substance Abuse and Mental Health Services Administration (SAMHSA) announced it is accepting applications for $1 million in grants for Opioid State Targeted Response Supplement grants, which are available for states with the highest overdose death rates and rate of increase in death rates. Press release: http://bit.ly/2BCnh3h
  • Also on November 29, Attorney General Sessions and Acting DEA Administrator Patterson announced several new resources and efforts to address the opioid crisis, including over $12 million in grant funding to assist law enforcement in combating illegal manufacturing and distribution activities, among other steps. Press release: http://bit.ly/2BBSp2C
  • On November 30, HHS released a report on total expenses, total utilization, distribution by source of payment and average total and out-of-pocket payments for outpatient prescription opioids in the U.S. adult civilian population, finding that outpatient opioid expenses totaled $10.7 billion in 2015. Report: http://bit.ly/2BA4WDU
  • Also on November 30, Food and Drug Administration announced the approval of the first one-monthly buprenorphine injection, a medication-assisted treatment option for moderate-to-severe opioid use disorder. Press release: http://bit.ly/2BvJwHP Commissioner Statement: http://bit.ly/2BvJNul

 Veterans Health –

  • On November 27, U.S. Government Accountability Office released a report reviewing the VA’s oversight of physician quality at its medical centers, finding that VA officials did not report eight of nine doctors that should have been reported. Summary with link to report: http://bit.ly/2i0O68y
  • On November 29, VA announced that the application process for a national Veterans Identification Card is now available. Press release: http://bit.ly/2BBsYhU
  • Also on November 29, VA announced that the White House VA Hotline, which was first launched in June, is now fully staffed and has served more than 10,000 callers since full service began in October. Press release: http://bit.ly/2BCy65g
  • Also on November 29, Sens. Gardner (R-CO) and Bennet (D-CO) sent a letter to VA Secretary Shulkin regarding a VA Inspector General report that found unofficial wait lists at a number of Colorado VA facilities. Press release with text of letter: http://bit.ly/2BzT0Sx

Misc. –

  • On November 27, Centers for Disease Control and Prevention (CDC) released a report finding that during 2014-2016 the prevalence of children aged 3-17 who had ever been diagnosed with a developmental disability increased from 5.75 percent to 6.99 percent. Report: http://bit.ly/2kg7DGm
  • On November 29, Senate HELP Committee Ranking Member Murray (D-WA) and 26 Senate Democrats sent a letter to Acting HHS Secretary Hargan requesting an explanation of changes to the Teen Pregnancy Prevention Program. Press release: http://bit.ly/2BA6q0Q Letter: http://bit.ly/2BzyRvR
  • On November 30, FDA announced the approval of the first breakthrough designated, next generation sequencing in vitro diagnostic (IVD) test that can detect genetic mutations. Simultaneously, CMS announced proposed coverage of the test. This is the second IVD to be approved and covered through the FDA’s and CMS’ Parallel Review Program. Press releases: http://go.cms.gov/2kjkO9L and http://bit.ly/2kfCSRM
  • On November 30, National Academies of Medicine released a new report offering eight recommendations to make prescription drugs more affordable and to promote the development of more effective drugs. Summary with link to report: http://bit.ly/2BDHy8g