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


  What’s Ahead: This Week

Hearings/Markups –

  • Wednesday, January 17
    • Senate Finance Committee, “Open Executive Session to Consider the Nomination of Alex Azar II and Kevin McAleenan and Subcommittee Assignments.”
    • Senate HELP Committee, “Facing 21st Century Public Health Threats: Our Nation’s Preparedness and Response Capabilities, Part I.”
    • Senate Homeland Security and Governmental Affairs Committee, “Unintended Consequences: Medicaid and the Opioid Epidemic.”
    • House Ways & Means Committee, Subcommittee on Oversight, “The Opioid Crisis: The Current Landscape and CMS Actions to Prevent Opioid Misuse.”
    • House Energy & Commerce Committee, Subcommittee on Health, “Subcommittee Vote on H.R. 1876, Good Samaritan Health Professionals Act of 2017, H.R. 2026, Pharmaceutical Informational Exchange Act, and H.R. ___ Over-the-Counter Monograph Safety, Innovation and Reform Act of 2018.”

 Notable Policy Events –

  • Wednesday, January 17
    • Bipartisan Policy Center (BPC), “Rural Health Care: A Case Study of Seven Upper Midwest States.” Additional information: http://bit.ly/2qKMEhD
  • Thursday, January 18
    • Kaiser Health News, “What the Health is Going to Happen in 2018?” Additional information: http://bit.ly/2FE9OK5
    • HHS Health IT Advisory Committee, “Health IT Advisory Committee Meeting.” Additional information: http://bit.ly/2mJZTuy

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

 Committee Changes –

  • On January 10, Senate Minority Leader Schumer (D-NY) announced that Sens. Jones (D-AL) and Smith (D-MN) will join the Senate HELP Committee, and Sen. Whitehouse (D-RI) will join the Senate Finance Committee in the wake of Sen. Jones’ election. The House Ways and Means Committee also announced that Rep. Roskam (R-IL) will be the new Chair of the Subcommittee on Health, replacing current Chair Tiberi (R-OH). Press releases: http://bit.ly/2FEa8bR and http://bit.ly/2qXVDfv

Legislative Activity –

  • On January 10, the President signed into law the Law Enforcement Mental Health and Wellness Act of 2017 (H.R. 2228), which would provide support for law enforcement efforts to protect the mental health and well-bring of law enforcement officers. Press releases: http://bit.ly/2mxzErm and http://bit.ly/2mzyCLh
  • Also on January 10, Sen. Markey (D-MA) and Warren (D-MA) introduced S. 2287, which would repeal the ACA’s medical device excise tax.
  • On January 11, Sen. Warren (D-MA) and 12 cosponsors introduced the Behavioral Health Coverage Transparency Act (S. 2301), which would strengthen parity in mental health and substance use disorder benefits. Rep. Kennedy (D-MA) and 7 cosponsors introduced companion legislation in the House (H.R. 4778). Press release: http://bit.ly/2mxBqJ3 Summary: http://bit.ly/2mxBZCF Bill text: http://bit.ly/2mxC89b
  • Also on January 11, Sens. Isakson (R-GA) and Coons (D-DE) introduced the Access to Independent Health Insurance Advisors Act (S. 2303), which would preserve consumer and employer access to licensed independent insurance producers by amending the ACA’s required calculation of medical loss ratios. Press release: http://bit.ly/2mxyXOy
  • Also on January 11, Reps. Marino (R-PA) and Bass (D-CA) introduced the Helping Americans Seek Treatment Act of 2018 (H.R. 4769), which would increase awareness about the treatment referring routing service of the Substance Abuse and Mental Health Services Administration. Press release: http://bit.ly/2my0JL8
  • Also on January 11, Rep. Dingell (D-MI) introduced the Hospital Preparedness Program Reauthorization Act of 2018 (H.R. 4776), which would reauthorize a program of partnerships for state and regional hospital preparedness to improve surge capacity. Press release: http://bit.ly/2FF4GVX
  • Also on January 11, Reps. Rosen (D-NV) and Jones (R-NC) introduced the Veterans Deserve Better Act (H.R. 4783), which would improve the scheduling of appointments, the accountability of third party administrators and payment to providers under such act. Press release: http://bit.ly/2FG8shO

ACA Market Stabilization & Implementation –

  • On January 10, Congressional Budget Office (CBO) released two presentations related to estimating the costs of proposals affecting health insurance coverage and federal subsidies for health insurance. Presentations: http://bit.ly/2r2vUCI and http://bit.ly/2qYWqx3

Medicare –

  • On January 12, CBO released an analysis of private-sector prices for physicians’ services, finding that average commercial prices were higher than Medicare fee-for-service prices, and were up to three times higher out of network than in network. Summary with link to report: http://bit.ly/2r3si3E

Medicaid –

  • On January 8, U.S. Government Accountability Office (GAO) released a report finding that although as of November 2017, 49 states are now reporting data through the Transformed-Medicaid Statistical Information System (T-MSIS), there remain ongoing barriers to the completeness and comparability of state reported data. Summary with link to report: http://bit.ly/2qHX7KI
  • On January 10, CBO released a cost estimate finding that extending funding for the Children’s Health Insurance Program (CHIP) for ten years will reduce the federal deficit by $6.0 billion from 2018-2027. Report: http://bit.ly/2r4HP3d
  • On January 11, CMS released guidance to state Medicaid directions on testing community engagement among able-bodied, working-age Medicaid beneficiaries. The next day, CMS approved the first state waiver application to implement work requirements in Kentucky. Press release: http://go.cms.gov/2qZd67t Guidance: http://bit.ly/2r1TUWN KY approval: http://bit.ly/2FESBAk
  • On January 12, House Energy & Commerce Committee Ranking Member Pallone (D-NJ) and Senate Finance Committee Ranking Member Wyden (D-OR) sent a letter to U.S. Government Accountability Office Comptroller Dodaro requesting a review of major changes that CMS has allowed states to make to their Medicaid programs through section 1115 waivers. Press release: http://bit.ly/2FGNBLE Letter: http://bit.ly/2FIzTYE

 New Payment & Delivery System Models –

  • On January 8, CMS released a health-related social needs screening tool as part of the Accountable Health Communities Model. Tool: http://bit.ly/2qN5Xac
  • On January 9, CMS announced a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced), under which, participants can earn additional payment if all expenditures for a beneficiary’s episode of care are under a spending target that factors in quality. Applications are due by March 12. Press release: http://go.cms.gov/2qOMKFf FAQ: http://bit.ly/2qUT9yy
  • On January 10, CMS released the first annual report for the State Innovation Models round two awards. Report: http://bit.ly/2qZu5Xl

 Mental Health and Substance Abuse –

  • On January 11, the Bipartisan Heroin Task Force released its legislative agenda for 2018, which includes bipartisan legislation to address the opioid epidemic by supporting prevention, treatment, recovery, and law enforcement efforts. Press release: http://bit.ly/2qZJy9Q Agenda: http://bit.ly/2qWzQF7
  • Also on January 11, Substance Abuse and Mental Health Services Administration (SAMHSA) announced a new approach to implementation of evidence-based practices after cancelling a contract for the current National Registry of Evidence-Based Programs and Practices. Press release: http://bit.ly/2r0hcfv
  • Also on January 11, Food and Drug Administration (FDA) announced it is requiring safety labeling changes to limit the use of prescription cough and cold medicines containing codeine or hydrocodone in children younger than 18 years. Press release: http://bit.ly/2qYP4JU
  • On January 12, Sens. Manchin (D-WV), and 10 Democratic senators sent a letter to President Trump urging him to renew the opioid public health emergency declaration, which will expire on January 23. Press release: http://bit.ly/2mxNLwB Letter: http://bit.ly/2mztDKJ

Veterans Health –

  • On January 9, President Trump signed an Executive Order that directs the Departments of Defense, Veterans Affairs (VA), and Homeland Security to develop a plan to ensure that all new veterans receive mental health care for at least one year following their separation from service. Press release: http://bit.ly/2qOWLlC and http://bit.ly/2qMGxto EO: http://bit.ly/2qLwaGi
  • On January 10, VA released an interim final rule (IFR) related to payment for reimbursement for emergency treatment for non-service connected conditions at non-VA facilities. Comments are due by March 12. Press release: http://bit.ly/2qWysSV IFR: http://bit.ly/2r1EYYC
  • On January 11, Centers for Disease Control and Prevention (CDC) released data finding that about three in ten U.S. veterans use tobacco products, a rate much higher than for non-veterans. Summary with link to report: http://bit.ly/2qZGKtk
  • Also on January 11, VA announced that it has begun publicly posting information on opioids dispensed from VA pharmacies, along with VA’s strategies to prescribe these pain medications more appropriately and safely. Press release: http://bit.ly/2r3oQpI Data: http://bit.ly/2r10VH9
  • On January 12, VA announced that 100 percent of its more than 1000 medical facilities offer same-day services for urgent primary and mental health-care needs. Press release: http://bit.ly/2r10Djx

 Drug and Device Regulation –

  • On January 8, FDA Commissioner Gottlieb penned a blog post reflecting on the FDA’s accomplishments in 2017 and looking ahead to 2018. Blog post: http://bit.ly/2qXKFqx
  • On January 10, House Energy & Commerce Committee staff released a report on the 340B program, which highlights that while the program enjoys strong bipartisan support, the program has certain weaknesses, in that “Congress did not clearly identify the intent of the program and did not identify clear parameters.” Press release: http://bit.ly/2r23cSE Report: http://bit.ly/2qTTxxa
  • On January 11, FDA released is 2018 Strategic Policy Roadmap, which describes the areas in which the FDA will focus on in 2018: reducing the burden of the opioid crisis; leveraging innovation and competition to improve healthcare; empower consumers to make better and more informed decisions about their diets and health; and strengthen the FDA’s scientific workforce and its tools for risk management. Roadmap: http://bit.ly/2qXYRj7
  • On January 12, FDA proposed to delay the effective date of a final rule to amend the agency’s existing intended use regulations. Comments are due by March 19. Press release: http://bit.ly/2qZ8Rsv Proposed rule: http://bit.ly/2qYlLHp

 Misc. –

  • On January 9, HHS released data finding that in 2015 the overall median amount paid out-of-pocket for non-elderly families for healthcare was $451. Report: http://bit.ly/2qYRhoG
  • On January 11, HHS released data on adverse drug events in U.S. hospitals, finding that the overall number of hospital stays involving an adverse drug event remained relatively stable from 2010-2014. Summary with link to report: http://bit.ly/2qV9bbC
  • On January 12, National Institutes of Health released a study finding that the rate of alcohol-related visits to emergency departments increased by nearly 50 percent between 2006 and 2014. Press release: http://bit.ly/2mJKbzH
  • Also on January 12, HHS released updated poverty guidelines to account for last year’s increase in prices as measured by the consumer price index. Notice: http://bit.ly/2mK1Hnp