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


 Programming Note: We will be taking a publishing hiatus over the holidays. The next weekly update will be sent on Tuesday, January 2. Happy holidays!

 

What’s Ahead: This Week

Notable Policy Events –

  • Monday, December 18 – Tuesday, December 19
    • Physician-Focused Payment Model Technical Advisory Committee, “Public Meeting.” Additional information: http://bit.ly/2mn4L9v

 

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

 Appropriations –

  • On December 13, House Appropriations Committee released H. J. Res. 124, which would extend fiscal year 2017 funding through January 19, would fully fund defense appropriations for fiscal year 2018, and would provide five years of funding for the Children’s Health Insurance Program. Press release: http://bit.ly/2kt7gVm Bill text: http://bit.ly/2kvcTT4

Tax Reform –

  • On December 15, members of the Tax Cuts and Jobs Act (H.R. 1) House-Senate Conference Committee signed the conference report for the legislation and filed the conference report in the House. The bill includes a repeal of the ACA’s individual mandate. The bill now moves to the full House for consideration. Press release: http://bit.ly/2Bo5qwY Summary: http://bit.ly/2BnSbwu Bill text: http://bit.ly/2Bppkbc

 Legislative Activity –

  • On December 11, Rep. McMorris-Rodgers (R-WA) and seven bipartisan cosponsors introduced the Ensuring Patient Access to Healthcare Records Act (H.R. 4613), which would allow the use of claims, eligibility, and payment data to produce reports, analyses, and presentations to benefit Medicare, and other similar health insurance programs, entities, researchers, and healthcare providers, to help develop cost-saving approaches, standards, and reference materials, and to support medical care and improved payment models. Press release: http://bit.ly/2BEEtZ8
  • On December 12, Sens. Enzi (R-WY) and Carper (D-DE) introduced the Medicare Patient Access to Hospice Act (S. 2214), which would provide for the recognition of attending physician assistants as attending physician to serve hospice patients. Press release: http://bit.ly/2z9Or2b
  • On December 14, Sen. Stabenow (D-MI) introduced the Veterans Deserve Better Act (S. 2239), which would amend the Veterans Access, Choice, and Accountability Act of 2014 to improve the scheduling of appointments, the accountability of third party administrators, and payment to provides. Press release: http://bit.ly/2kyBYfT
  • Also on December 14, Sens. Portman (R-OH) and Cantwell (D-WA) introduced the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act (EMPOWER Care Act) (S. 2227), which would reauthorize the Money Follows the Person Demonstration program. Press release: http://bit.ly/2kuj1Lg Bill text: http://bit.ly/2kzPsrU
  • Also on December 14, Rep. Tipton (R-CO) introduced the Veterans Improved Access and Care Act of 2017 (H.R. 4642), 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/2CtGnI7

 ACA Market Stabilization & Implementation –

  • On December 12, Reps. Kelly (R-PA) and Nunes (R-CA) introduced H.R. 4616, which would provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage. Press release: http://bit.ly/2zaAZeu
  • Also on December 12, Reps. Paulsen (R-MN) and Walorski (R-IN) introduced H.R. 4617, which would provide for a temporary moratorium on the medical device excise tax. Press release: http://bit.ly/2zawyQU
  • Also on December 12, Rep. Jenkins (R-KS) introduced the Restoring Access to Medication Act (H.R. 4618), which would provide for a temporary moratorium on certain taxes affecting purchases of prescription medication. Press release: http://bit.ly/2zaycSz
  • Also on December 12, Reps. Curbelo (R-FL), Gonzalez-Colon (R-FL) and Murphy (D-FL) introduced H.R. 4619, which would provide temporary relief from the annual fee imposed on health insurance providers, to the extent that such fee is due to Puerto Rican health insurance. Press release: http://bit.ly/2z9IGkQ
  • Also on December 12, Rep. Noem introduced the Protecting Families and Small Businesses Act (H.R. 4620), which would provide temporary relief from the annual fee imposed on health insurance providers. Press release: http://bit.ly/2zaX9No
  • Also on December 12, Sen. Johnson (R-WI) introduced the Repeal Insurance Plans of the Multi-State Program Act (RIP MSP Act) (S. 2221), which would repeal the ACA’s multi-state plan program. Rep. Meadows (R-SC) introduced companion legislation in the House (H.R. 4664). Press release: http://bit.ly/2zazQ6I
  • On December 12, Senate Finance Committee Ranking Member Wyden (D-OR) and Senate HELP Committee Ranking Member Murray (D-WA) sent a letter to HHS Acting Secretary Hargan and CMS Administrator Verma urging them to extend open enrollment for the individual insurance market from December 15 until January 31, 2018 to give consumers more time to purchase health insurance. Press release: http://bit.ly/2iYud2z Letter: http://bit.ly/2iZG28J
  • On December 13, CMS released updated enrollment data for the sixth week of Open Enrollment, finding that over 1.07 million people selected plans using Healthcare.gov, including almost 389,000 new consumers, totaling over 4.68 million since the beginning of open enrollment. Press release: http://go.cms.gov/2za6GUU
  • Also on December 13, CMS released a report on effectuated enrollment for the first half of 2017, finding that as of September 15, 2017, an average of 10.1 million individuals has effectuated coverage through June 2017, meaning that they had selected a plan and paid their premium. Press release: http://go.cms.gov/2ktikBM
  • Also on December 13, Senate Finance Committee Ranking Member Wyden (D-OR), Senate HELP Committee Ranking Member Murray (D-WA), Sen. Casey (D-PA), House Ways & Means Committee Ranking Member Neal (D-MA), and House Energy & Commerce Committee Ranking Member Pallone (D-NJ) sent a letter to HHS Acting Secretary Hargan and CMS Administrator Verma requesting that HHS and CMS offer people seeking to obtain health coverage on the final day of eligibility a grace period if they are unable to access Healthcare.gov due to high demand. Press release: http://bit.ly/2krJDws Letter: http://bit.ly/2krSSwN
  • On December 14, U.S. Government Accountability Office (GAO) released a report on the individual health insurance marketplaces, finding that from 2015 to 2016, the median monthly premium increase for those who were automatically re-enrolled, after tax credits, was $22, whereas the increase was only $5 for those who chose to actively re-enroll. Summary with link to report: http://bit.ly/2kvRBEK

Medicare –

  • On December 11, CMS released information about the first two years of the Medicare Care Choices Model. Press release: http://go.cms.gov/2Ba7niA
  • On December 12, CMS announced the addition of new measures to the Long-Term Care Hospital (LTCH) Compare and the Inpatient Rehabilitation Facility Compare websites, including measures related to the flu vaccine and hospital-acquired infection rates. Fact sheets: http://go.cms.gov/2B8307M and http://go.cms.gov/2B9KZpA Compare websites: http://bit.ly/2Bak9h0 and http://bit.ly/2Bap5SY
  • On December 14, HHS Office of Inspector General released a report on CMS’ management of the Quality Payment Program (QPP), finding that CMS has made progress in providing guidance and technical assistance to clinicians and in developing necessary IT systems to support the program. Summary with link to report: http://bit.ly/2krJl8X
  • Also on December 14, CMS announced the additional of new quality information to the Physician Compare website, including 2016 performance information. Press release: http://go.cms.gov/2kucrUU

Medicaid and CHIP –

  • On December 12, CDC released a report on coverage, access, and utilization by Medicaid expansion status in 2016. Report: http://bit.ly/2zadWQU
  • On December 15, CMS released a State Medicaid Director letter describing its plans to phase out expenditure authority for Designated State Health Programs in section 1115 demonstrations. Letter: http://bit.ly/2BpBq44

Mental Health and Substance Abuse –

  • On December 11, Food and Drug Administration (FDA) released a notice of public hearing and a request for comments to receive stakeholder input on how the FDA might improve the safe use of opioid analgesics by curbing overprescribing. Comments are due by March 16. Notice: http://bit.ly/2BGxoHv
  • On December 13, the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) released its first Report to Congress on challenges and recommendations to improve service access and delivery of care for people with serious mental illness and serious emotional disturbances. Press release: http://bit.ly/2krb7SS Summary: http://bit.ly/2kubSKO Report: http://bit.ly/2ksBR5u
  • On December 14, Sen. Markey (D-MA) sent a letter to Attorney General Sessions requesting information about the role that the Department of Justice played in designing, funding and supporting media campaigns intended to confront opioid overdoses. Letter: http://bit.ly/2ksQ5U5
  • Also on December 14, National Institutes of Health released data finding that opioid misuse is at historic lows among teens, although vape use is on the rise. Press release: http://bit.ly/2ktFxUE
  • Also on December 14, Senate HELP Committee Chair Alexander (R-TN) and Ranking Member Murray (D-WA) sent a letter to every governor and state insurance commissioner asking for their specific recommendations on how the federal government can be the most effective partner for states in the battle against the opioid epidemic. Press release with text of letter: http://bit.ly/2kweY0Y
  • On December 15, Sens. Collins (R-ME) and King (I-ME) joined a group of 7 bipartisan Senators in a letter to Senate Majority Leader McConnell (R-KY) and Minority Leader Schumer (D-NY) urging them to include additional funding dedicated to addressing the opioid crisis in the upcoming supplemental and omnibus appropriations legislation. Press release: http://bit.ly/2Cri4dY Letter: http://bit.ly/2CsbNyD

 Veterans Health –

  • On December 12, Department of Veterans Affairs (VA) announced new enhancements to its Decision Ready Claim program, which will expand the pool of veterans and others eligible to participate in the program. Press release: http://bit.ly/2zab7zi
  • Also on December 12, VA and the Substance Abuse and Mental Health Services Administration announced the inaugural Mayor’s Challenge to Prevent Suicide among service members, veterans and their families. Press release: http://bit.ly/2z9HGNC

Health IT –

  • On December 12, Federal Communications Commission (FCC) and the National Cancer Institute signed a memorandum of understanding that will focus on how increasing broadband access and adoption in rural areas can improve the lives of rural cancer patients. Press release: http://bit.ly/2kwpo0K Initiative: http://bit.ly/2kya6Z9
  • On December 14, HHS Office of the National Coordinator for Health IT released a new Patient Demographic Data Quality Framework, which is intended to support health systems, large practices, health information exchanges, and payers in improving their patient demographic data quality. Framework: http://bit.ly/2kwPBMm
  • Also on December 14, FCC announced the launch of a review of the Rural Health Care Program to ensure that all communities have access to advanced telehealth services. Press release and other related documents: http://bit.ly/2kxh5lh

 Drug and Device Regulation –

  • On December 11, FDA released guidance clarifying the requirements for product name placement, size, prominence, and frequency in promotional labeling and advertisements for prescription drugs. Guidance: http://bit.ly/2BECTGG
  • Also on December 11, FDA Commissioner Gottlieb penned a blog post providing an overview of the FDA’s approach to medical technology review and regulation. Blog post: http://bit.ly/2BEibGQ
  • On December 13, FDA announced a new website that streamlines how FDA updates information used to help healthcare providers choose appropriate treatments. Press release: http://bit.ly/2zayUiy
  • On December 14, FDA released draft guidance outlining the FDA’s plan to take the “least burdensome approach” to medical device premarket evaluation in order to eliminate unnecessary burdens that may delay the marketing of beneficial new products. Comments are due by January 15. Guidance: http://bit.ly/2ksG2yj
  • Also on December 14, FDA Commissioner Gottlieb and FDA Center for Devices and Radiological Health Director Shuren released a blog post highlighting the FDA’s recent efforts to modernize the agency’s approach to regulation in the medical device system. Blog post: http://bit.ly/2kzKECS
  • Also on December 14, FDA Commissioner Gottlieb announced some of the FDA’s major policy goals for 2018, including (1) addressing the nicotine addiction crisis, (2) advancing drug safety, (3) promoting food safety, (4) empowering consumers, and (5) modernizing standards. Blog post: http://bit.ly/2kxkmAU
  • On December 15, FDA released two guidance documents that provide medical product developers with clarity on the FDA’s recommendations for researching and developing the next generation of individualized therapies. Comments are due by January 16. Press release: http://bit.ly/2k1gau3 Guidance: http://bit.ly/2jYZe7d and http://bit.ly/2jZoNoE

 Misc. –

  • On December 11, Senate HELP Committee Ranking Member Murray (D-WA) sent a letter to Centers for Disease Control and Prevention (CDC) Director Fitzgerald requesting that she resolve “ongoing conflicts of interest limiting her ability to perform her role and engage in key public health challenges.” Press release: http://bit.ly/2BG9ITx Letter: http://bit.ly/2BGa64r
  • Also on December 11, CDC released data finding that there were an estimated 282 office-based physician visits per every 100 people in the U.S. in 2014 and that 86 percent of Americans have a usual place of care. Summary with link to report: http://bit.ly/2BDvya9
  • Also on December 11, FDA announced the launch of an adult smoking cessation public education campaign aimed at encouraging cigarette smokers to quit by promoting the health benefits of quitting. Press release: http://bit.ly/2zamTtD
  • On December 12, Congressional Budget Office released a report on issues and challenges in measuring and improving the quality of health care. Report: http://bit.ly/2zaEyBh
  • Also on December 12, HHS released a report finding that in 2015, spending on healthcare accounted for 17.8 percent of the U.S. gross domestic product, yet the majority of this spending was concentrated in a relatively small percentage of the population: five percent of the population accounted for over half of health care spending. Report: http://bit.ly/2z9Jzda
  • Also on December 12, U.S. Preventive Services Task Force released a final recommendation statement on hormone therapy for the primary prevention of chronic conditions in postmenopausal women. Recommendation: http://bit.ly/2kv4hvt
  • On December 13, HHS released a report on conceptual frameworks and best practices for use in estimating medical costs for regulatory cost-benefit analyses. Report: http://bit.ly/2z9GqtS
  • On December 14, White House Office of Information and Regulatory Affairs released the 2018 Unified Agenda of Regulatory and Deregulatory Actions, which details the actions administrative agencies plan to issue in the near and long term. Unified Agenda: http://bit.ly/2kx9B1z
  • On December 15, Senate HELP Committee Ranking Member Murray (D-WA) and 7 Democrats sent a letter to President Trump objecting to “federal restrictions on abortion care that result in less access to care for millions of women in this country and around the world. Press release: http://bit.ly/2BnOoPJ Letter: http://bit.ly/2BnOnv9