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


 What’s Ahead: This Week

Hearings/Markups –

  • Tuesday, April 17
    • House Appropriations Committee, Subcommittee on Agriculture, Rural Development, FDA, and Related Agencies, “FDA FY19 Budget.”
    • House Veterans Affairs Committee, Subcommittee on Health, “Legislative Hearing on H.R. 1506; H.R. 2322; H.R. 3832; H.R. 4334; H.R. 4635; VA Medicinal Cannabis Research Act of 2018 and, a draft bill to make certain improvements in the Family Caregiver Program.”
  • Wednesday, April 18
    • House Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, “Oversight of HHS Biodefense Programs.”
  • Thursday, April 19
    • Senate Finance Committee, “Tackling Opioid and Substance Use Disorders in Medicare, Medicaid, and Human Services Programs.”
    • Senate Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, “HHS FY19 Budget.”

 Notable Policy Events –

  • Tuesday, April 17
    • Food and Drug Administration (FDA) and National Institute of Drug Abuse (NIDA), “Public Meeting for Patient-Focused Drug Development on Opioid Use Disorder.” Additional information: http://bit.ly/2EPdE1c
  • Wednesday, April 18
    • Health IT Advisory Committee, “Health IT Advisory Committee Meeting.” Additional information: http://bit.ly/2vgEDU1
    • National Institute for Health Care Management (NIHCM), “Stopping the Superbug Threat.” Additional information: https://bit.ly/2HAmWkE
    • Center for American Progress (CAP), “Maternal Health: Death by Delivery.” Additional information: https://ampr.gs/2GZPQJY
  • Thursday, April 19
    • Tatia Oden French Memorial Foundation, “Capitol Hill Briefing: Protecting America’s Mothers: Lessons from France, the U.K., and the U.S. on Reducing Maternal Mortality.” Additional information: https://bit.ly/2v67ZV5
    • The Aspen Institute, “Twenty Years of Life: Challenging Health Disparities and Inequities by Investing in Communities.” Additional information: https://bit.ly/2JF7xjL
  • Thursday, April 19 – Friday, April 20
    • Medicaid and CHIP Payment and Access Commission (MACPAC), “April Public Meeting.” Additional information: http://bit.ly/2EO5kig
  • Friday, April 20
    • Better Medicare Alliance, “Improving Consumer Understanding of Medicare Advantage.” Additional information: http://bit.ly/2vcG0D8

 

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

 Executive Orders –

  • On April 10, President Trump signed the executive order “Reducing Poverty in America by Promoting Opportunity and Economic Mobility,” which seeks to expand and improve the use of work requirements in federal poverty programs and to allow for more program flexibility. Fact sheet: https://bit.ly/2v2i8lz Executive Order: https://bit.ly/2IHWTrk

Budget –

  • On April 9, Congressional Budget Office (CBO) released its Budget and Economic Outlook: 2018 to 2028, which predicts substantial growth in the federal budget deficit and a boosting of the federal debt to nearly 100 percent of GDP by 2028. Report: https://bit.ly/2GKR1kH

Legislative Activity –

  • On April 10, Rep. DeLauro (D-CT) introduced the Access to Substance Abuse Treatment Act of 2018 (H.R. 5456), which would authorize grants to health centers to expand access to evidence-based substance abuse treatment services. Text: https://bit.ly/2EKHYu2
  • Also on April 10, Reps. Engel (D-NY) and Stivers (R-OH) introduced the Quality Care for Moms and Babies Act (H.R. 5457), which would develop maternity care quality measures and support maternity care quality collaboratives within the Medicaid and CHIP programs. Sen. Stabenow (D-MI) introduced companion legislation (S. 2637) in the Senate. Press release: https://bit.ly/2HAJjqw
  • Also on April 10, Sens. Collins (R-ME) and Klobuchar (D-MN) introduced the Community Action Opioid Response Act of 2018 (S. 2636), which would establish a new grant program to help fund Community Action Agencies (CAAs) and Community Action Partnerships (CAPs). Press release: https://bit.ly/2HAJK48 Text: https://bit.ly/2IUvYsl
  • Also on April 10, Sens. Jones (D-AL), Kaine (D-VA), and Young (R-IN) introduced the Jobs Plus Recovery Act (S. 2642), which would establish a pilot program to provide individuals impacted by opioid addiction or substance use disorders access to career training and support services. Press release: https://bit.ly/2EIyr6T Text: https://bit.ly/2JKxdeQ
  • On April 11, Rep. Comstock (R-VA) introduced the Better Pain Management Through Better Data Act (H.R. 5473), which would help facilitate better clinical data on non-opioid alternatives. Press release: https://bit.ly/2vcqAyP Text: https://bit.ly/2ITeIDQ
  • Also on April 11, Rep. O’Halleran (D-AZ) introduced the Rural Developing Opioid Capacity Services (Rural DOCS) Act (H.R. 5477), which would provide for a demonstration project to increase substance use provider capacity under the Medicaid program. Press release: http://bit.ly/2vhePqP
  • Also on April 11, Sens. Ernst (R-IA), Blumenthal (D-CT), and Grassley (R-IA) introduced the Access to Increased Drug Disposal (AIDD) Act of 2018 (S. 2645), which would create a demonstration program allowing five states to apply for grant funding from the Department of Justice to develop drug takeback programs. Press release: https://bit.ly/2qwOZtp Text: https://bit.ly/2GWD6bc
  • Also on April 11, Sen. Brown (D-OH) and Capito (R-WV) introduced the Collectively Achieving Recovery and Employment (CARE) Act (S. 2646), which would establish a pilot program administered by the Secretary of Labor, in collaboration with the Secretary of health and Human Services, to award competitive grants to counties (or other equivalent entities) and Tribal entities to administer combined workforce training and drug addiction treatment and recovery programs. Press release: http://bit.ly/2ELnnWx
  • On April 12, Reps. Carter (R-GA) and Bustos (D-IL) introduced the Special Registration for Telemedicine Clarification Act (H.R. 5483), which allow for the prescription of medication-assisted treatment (MAT) and other controlled substances via telemedicine. Press release: https://bit.ly/2GXlYSN
  • Also on April 12, House Energy and Commerce Subcommittee on Health Vice Chairman Guthrie (R-KY) and Rep. Lujan (D-NM) introduced the Material Opioid Treatment, Health, Education, and Recovery (MOTHER) Act of 2018 (H.R. 5492), which would prioritize access to treatment and recovery resources for pregnant women and newborn babies addicted to opioids. Press release: https://bit.ly/2quaqLJ
  • Also on April 12, Reps. Peterson (D-MN) and Tipton (R-CO) introduced the Rural Hospital Frontier Fairness Act (H.R. 5498), which would provide Sole Community Hospitals with increased funding for workforce development and expand the 340B drug pricing program. Press release: https://bit.ly/2qxlU0K
  • Also on April 12, Sens. Collins (R-ME) and Shaheen (D-NH) introduced the Opioid Peer Support Networks Act of 2018 (S. 2657), which would provide peer support networks with resources and training to combat the opioid crisis. Press release: https://bit.ly/2HlOMne Text: https://bit.ly/2IRKD7z
  • Also on April 12, Sens. Nelson (D-FL) and Rubio (R-FL) introduced S. 2658, which would give states more funding to track, analyze, and research babies born with neonatal abstinence syndrome. Press release: https://bit.ly/2GVeY4z Text: https://bit.ly/2HxSMyL
  • Also on April 12, Sens. Hassan (D-NH), Collins (R-ME), Capito (R-WV), Baldwin (D-WI), and Warren (D-MA) introduced the Safe Disposal of Unused Medication Act of 2018 (S. 2659), which would authorize employees of hospice programs to handle controlled substances in the residences of certain hospice patients to assist in disposal of those controlled substances. Press release: https://bit.ly/2vbPlet Text: https://bit.ly/2EKtDh1
  • Also on April 12, Sens. Warren (D-MA), Rubio (R-FL), Hassan (D-NH), and Collins (R-ME) introduced the Hospice Safe Drug Disposal Act (S. 2661), which would allow hospice providers to dispose of leftover prescription medications. Press release: https://bit.ly/2EJKPTO Text: https://bit.ly/2HkprtT

 ACA Implementation and Market Stabilization –

  • On April 9, CMS issued the final Notice of Benefit and Payment Parameters for the 2019 plan year, which increases state flexibility in setting required essential health benefits, makes changes with respect to risk adjustment, and modifies special enrollment period rules. Press release: https://go.cms.gov/2GQRuSk Key Dates: https://go.cms.gov/2Hm9nrC EHB Guidance: https://go.cms.gov/2qtGNuu Fact sheet: https://go.cms.gov/2IFFpvG Notice: https://bit.ly/2IRIZDc
  • Also on April 9, CMS issued the Final Letter to Issuers in the Federally-facilitated Exchanges for 2019, which provides updates on operational and technical guidance for the 2019 plan year for issuers seeking to offer qualified health plans. Letter: https://go.cms.gov/2Hlz2R7
  • Also on April 9, CMS issued guidance on hardship exemptions, which expands the list of hardship exemptions that consumers may claim in order to avoid the individual responsibility penalty. Guidance: https://go.cms.gov/2EIY4nT
  • Also on April 9, CMS released guidance extending the CMS transitional policy for certain non-grandfathered plans that do not meet ACA market rules through 2019. Guidance: https://go.cms.gov/2ISY5bw
  • Also on April 9, CMS released technical guidance relating to medical loss ratio reporting and rebate requirements and the process for a state to submit requests. Guidance https://go.cms.gov/2HkMUv6 and https://go.cms.gov/2qvEHdL
  • Also on April 9, CMS released guidance on the unified rate review timeline for the 2018 filing year and released guidance on the 2019 state-specific threshold proposal submission and review process for states. Guidance: https://go.cms.gov/2Hl9q6U and https://go.cms.gov/2Hku9YB
  • Also on April 9, U.S. Government Accountability Office (GAO) released a report on the health insurance marketplaces, finding that CMS does not have reliable data on issuer-generated terminations of coverage for enrollees’ nonpayment of premiums. Summary with link to report: https://bit.ly/2HeNJoY
  • Also on April 9, California Attorney General Becerra led a group of 16 other attorneys general in filing a motion to intervene in Texas et al. v. United States et al., a lawsuit led by another set of Attorneys General related to the ACA’s constitutionality. Press release: https://bit.ly/2JEhePI
  • On April 12, CMS issued guidance regarding Ending Special Enrollment Periods for Coverage during Calendar Year 2017. Guidance: https://go.cms.gov/2HxuCo2
  • On April 13, Ranking Members from the Senate HELP Committee, Senate Finance Committee, House Energy & Commerce, House Ways & Means Committee, and House Committee on Education and the Workforce sent a letter to HHS Secretary Azar, Labor Secretary Acosta and Treasury Secretary Mnuchin expressing concern regarding the agency’s proposed rule on short-term, limited-duration insurance, and urging the rules withdrawal. Press release: http://bit.ly/2HjhgOu Letter: http://bit.ly/2quE8AS

Medicare –

  • On April 9, CMS Office of Minority Health released Part C and Part D Performance Data stratified by race and ethnicity. Report: https://go.cms.gov/2gAfPKG
  • On April 13, CMS announced the seventh release for the Market Saturation and Utilization Data Tool, which uses Medicare fee-for-service claims data to understand local provider services and utilization data for selected health service areas. Press release: https://go.cms.gov/2qtH2FX  Tool: http://bit.ly/2qAOZcP
  • Also on April 13, HHS Office of Inspector General released a report finding that one-third of CMS payments for telehealth services did not meet federal requirements. Summary with link to report: http://bit.ly/2HlNW9T

 Medicaid –

  • On April 12, GAO released a report outlining opportunities for the Medicaid program to improve program integrity, including improving data quality, oversight, and federal-state collaboration. Summary with link to report: https://bit.ly/2GWQdF3

New Payment and Delivery System Reforms –

  • On April 13, Rep. DelBene (D-WA) led a bipartisan group of seven representatives in a letter to CMS Administrator Verma urging the agency to continue fostering Accountable Care Organizations (ACOs) participating in the beginning stage model. Press release: http://bit.ly/2vgTRZh Letter: http://bit.ly/2ENvyBJ

Mental Health and Substance Abuse –

  • On April 9, Senate HELP Committee Ranking Member Murray (D-WA) and Sen. Warren (D-MA) sent a letter to President Trump requesting information about his Administration’s implementation of the 56 recommendations issued by the Commission on Combatting Drug Addiction and the Opioid Crisis. Press release: http://bit.ly/2EOaNpi Letter: http://bit.ly/2EPgSBQ
  • Also on April 9, HHS released a final report evaluating measures reported by health plans that focus on screening and monitoring of care for comorbid conditions among people with serious mental illnesses and/or alcohol or other dependence. Summary with link to report: https://bit.ly/2vaJiXs
  • Also on April 9, Substance Abuse and Mental Health Services Administration (SAMHSA) announced the availability of up to $4.7 million for Improving Access to Overdose Treatment grants. Press release: https://bit.ly/2INDQMq
  • Also on April 9, SAMHSA announced the availability of up to $210 million for Project Advancing Wellness and Resiliency in Education (AWARE) State Education Agency grants. Press release: https://bit.ly/2v98DBf
  • On April 10, HHS announced that it plans to award up to 75 grants to rural communities as part of its upcoming Rural Communities Opioid Response Planning (RCORP) initiative in fiscal year 2018. Press release: https://bit.ly/2EKAsPQ
  • On April 11, House Ways & Means Committee staff released a white paper with recommendations to combat the opioid crisis, including improving treatment and reimbursement, utilizing tools to prevent overprescribing and abuse, and enhancing screening for opioid use disorders. Press release: https://bit.ly/2EKgkNB White Paper: https://bit.ly/2GWEQBn
  • On April 12, GAO released a report on federal agency efforts to limit the production of illicit synthetic opioids, which notes that federal agencies need to better assess their efforts, including by developing performance metrics. Summary with link to report: https://bit.ly/2HkCOtV

Drugs and Medical Devices –

  • On April 9, Rep. Ellison (D-MN) sent a letter to HHS Secretary Azar requesting an explanation of the decision to hire former CVS Caremark Vice President Daniel Best to lead the agency’s drug pricing reform effort. Press release: https://bit.ly/2H0069i Letter: https://bit.ly/2EKawUm
  • On April 10, Sen. Booker (D-NJ) released a report which describes how the ten largest pharmaceutical companies in the country are using their tax savings, finding that none have plans to pass on such savings to consumer sin the form of lower drug prices. Press release: http://bit.ly/2vfqlTz Report: http://bit.ly/2EOaBGw
  • On April 12, FDA Commissioner Gottlieb delivered remarks on leveraging innovation for the treatment of cancer. Transcript: https://bit.ly/2HA2IaT

 Veterans’ Health –

  • April 9, Department of Veterans Affairs (VA) Acting Secretary Wilkie issued a statement calling on Congress to pass legislation to align the Choice Program with the department’s other non-VA care efforts into a single, streamlined community care program. Press release: https://bit.ly/2qtmf5y
  • Also on April 9, VA announced the Centralized Benefits Communications Management Program, which will improve productivity and streamline correspondence with veterans on compensation benefits and pension burial claims. Press release: http://bit.ly/2quJso1
  • On April 12, GAO published a report detailing that improved guidance and oversight are needed for the VA Patient Advocacy Program. Report: https://bit.ly/2qsGEqA
  • Also on April 12, GAO published a report noting that actions are needed to improve the oversight of community-based outpatient clinics. Report: https://bit.ly/2HyjA1F

 Misc. –

  • On April 10, HHS announced that the agency is sponsoring its largest exercise to test the nationwide ability to move patients with highly infectious diseases safely and securely to regional treatment centers. Press release: https://bit.ly/2HnZqtS