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


 What’s Ahead: This Week

 Hearings/Markups –

  • Tuesday, May 8
    • House Energy & Commerce Committee, Subcommittee on Oversight and Investigations, “Combating the Opioid Epidemic: Examining Concerns about Distribution and Diversion.”
    • House Energy & Commerce Committee, Subcommittee on Health, “Improving the Coordination and Quality of Substance Use Disorder Treatment.”
    • House Judiciary Committee, “Challenges and Solutions in the Opioid Abuse Crisis.”
    • House Committee on Education & the Workforce, Subcommittee on Workforce Protections, “The Opioid Epidemic: Implications for the Federal Employees’ Compensation Act.”
    • House Ways and Means Committee, Subcommittee on Health, “The Current Status of and Quality in the Medicare Advantage Program.”
    • House Veterans Affairs Committee, “Markup of Pending Legislation, including H.R. 5764.”
    • House Veterans Affairs Committee, Subcommittee on Oversight and Investigations, “VA Logistics Modernization: Examining the RTLS and Catamaran Projects.”
    • House Appropriations Committee, “Full Committee Markup – FY 2019 Military Construction and Veterans Affairs Appropriations Bill and FY 2019 Legislative Branch Appropriations Bill.”
  • Wednesday, May 9
    • House Energy & Commerce Committee, Markup of Opioids Bills.
    • Senate Appropriations Committee, Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, “Hearing to review the Fiscal Year 2019 funding request and budget justification for the U.S. Department of Veterans Affairs.”
  • Thursday, May 10
    • House Budget Committee, “FY19 Budget: Members’ Day.”
    • Senate Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, “Hearing to review the Fiscal Year 2019 funding request and budget justification for the U.S. Department of Health and Human Services.”

 Notable Policy Events –

  • Monday, May 7 – Wednesday, May 9
    • American Hospital Association, “Annual Membership Meeting.” Additional information: http://bit.ly/2HWRBvW
  • Tuesday, May 8
    • Health Affairs, “Policy Forum on Precision Medicine.” Additional information: https://bit.ly/2KB2aTp
    • National Council for Behavioral Health, “Briefing: The Role of Mental Health First Aid in Fighting the Opioid Crisis.”
  • Wednesday, May 9
    • Health Policy Research Consortium and Bowie State University, “Opioid Crisis Symposium.” Additional information: https://bit.ly/2JzahiH
    • Kaiser Family Foundation, “Why are Healthcare Prices So High, and What can be Done about Them?” Additional information: https://kaiserf.am/2IhkPFf
  • Wednesday, May 9 – Friday, May 11
    • American Association of Medical Colleges (AAMC), “14th Annual AAMC Health Workforce Research Conference.” Additional information: http://bit.ly/2HVelN5
  • Thursday, May 10
  • Friday, May 11
    • Alliance for Health Policy, “State Opportunities to Address Prescription Drug Costs in Medicaid.” Additional information: http://bit.ly/2IplyUS

 

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

Legislative Activity –

  • On May 2, House Energy & Commerce Committee Ranking Member Pallone (D-NJ) released the Medicare Long-Term Care Services and Supports Act, a discussion draft which would create a new Medicare long-term care benefit. Press release: https://bit.ly/2FHgSog Text: https://bit.ly/2jsyyuZ
  • On May 3, House Veterans Affairs Committee Chair Roe (R-TN) introduced the VA Maintaining Systems and Strengthening Integrated Outside Networks (MISSION) Act (H.R. 5674), which would establish a permanent community care program for veterans and establish a commission to make recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration. Press release: http://bit.ly/2IjCFaQ VA Statement: https://bit.ly/2rklYCd Section-by-section: http://bit.ly/2HWPKas Bill text: http://bit.ly/2ImwS4f
  • Also on May 3, House Ways & Means Committee, Subcommittee on Health Chair Roskam (R-IL), Ranking Member Levin (D-MI), and Reps. Lujan (D-NM) and Bilirakis (R-FL) introduced H.R. 5675, which would require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries.
  • Also on May 3, Reps. MacArthur (R-NJ), Collins (R-NY), Schweikert (R-AZ), Kuster (D-NH), Blumenauer (D-OR), and Tonko (D-NY) introduced H.R. 5676, which would authorize the suspension of payments by Medicare prescription drug plans and MA-PD plans pending investigations of credible allegations of fraud by pharmacies.

ACA Implementation and Market Stabilization –

  • On May 3, Departments of Treasury, Labor, and HHS issued a clarification of final rules for grandfathered plans, preexisting condition exclusions, lifetime and annual rescissions, dependent coverage, appeals, and patient protections under the ACA, which provides additional commentary from the Departments on their decision in a 2015 final rule not to adopt certain recommendations made by commenters. Document: https://bit.ly/2JTHnJA
  • Also on May 3, Congressional Budget Office (CBO) released a blog post describing how it incorporated payments for cost-sharing reductions in CBO’s baseline budget projections for spring 2018. Blog post: http://bit.ly/2HYGQW1
  • On May 4, House Energy & Commerce Committee Ranking Member Pallone (D-NJ), Ways & Means Committee Ranking Member Neal (D-MA), and Education & the Workforce Committee Ranking Member Scott (D-VA) sent a letter to House Speaker Ryan (R-WI) urging him to allow a vote on legislation that “would improve the affordability and accessibility of healthcare in the United States,” the Undoing Sabotage and Expanding Affordability of Health Insurance Act of 2018 (H.R. 5155). Press release: http://bit.ly/2HSaboZ Letter: http://bit.ly/2HX5wm5

Medicare –

  • On April 30, CMS Administrator Verma announced that community-based organizations can enroll in Medicare to participate in the Medicare Diabetes Prevention Program (MDPP) and encouraged eligible suppliers to participate. Blog: https://bit.ly/2JEMfCb

 Medicaid –

  • On April 30, Senate Homeland Security & Governmental Affairs Committee Chair Johnson (R-WI) penned a letter to CMS Administrator Verma requesting information about the practice of government employee unions “skimming” federal dollars from Medicaid beneficiaries before the payments are passed on to the recipients. Press release: https://bit.ly/2HKIfiN Letter: https://bit.ly/2rjWG7h
  • On May 3, CMS released a report on the Money Follows the Person (MFP) Demonstration, finding that the trajectory of MFP participants’ post-transition spending differs from the spending trajectory of others who make the same transition without the benefit of the MFP demonstration. Report: http://bit.ly/2HUknO5
  • On May 4, CMS released guidance that reiterates the importance of state Medicaid and CHIP programs properly implementing their pediatric dental periodicity schedules in order to ensure children’s access to critical dental coverage. Guidance: https://bit.ly/2Kx4GtD

Payment and Delivery System Reform –

  • On April 30, CMS released a model timeline and roadmap document for the Bundled Payments for Care Improvement (BPCI) Advanced model. Document: https://bit.ly/2HRaQas
  • On May 1, CMS posted revised Performance Year 2 results for the Independent at Home demonstration after discovering two errors in its methodology. CMS now finds that the 15 participating practices saved $7,821,374 in aggregate in Performance Year 2, compared to the previous calculated savings of $10,612,506. CMS also posted shared savings and regression methodologies for the demonstration. Updated data: http://go.cms.gov/2jtgJel Shared savings methodology: https://bit.ly/2HTwkPY Regression methodology: https://bit.ly/2KEpfUW

Mental Health and Substance Abuse –

  • On May 1, Department of Health and Human Services (HHS) announced the appointment of 28 members to the new Pain Management Best Practices Inter-Agency Task Force. The Task Force will hold its first public meeting on May 30. Press release: https://bit.ly/2I6ScdQ
  • On May 2, Substance Abuse and Mental Health Services Administration (SAMHSA) announced the availability of up to $37.5 million over the next five years for the Tribal Behavioral Health Grant Program. Applications are due June 22. Press release: https://bit.ly/2rhjQv4
  • Also on May 2, SAMHSA and the Office of the National Coordinator for Health IT (ONC) released two new fact sheets on 42 CFR Part 2 to assist with the application of Part 2 provisions across different environments. Press release: https://bit.ly/2rhozwP Fact sheets: https://bit.ly/2k3OSDA
  • On May 3, Sens. Durbin (D-IL), Manchin (D-WV), and Markey (D-MA) urged the FDA to remove ultra-high dosage opioids from the market in a letter to Commissioner Gottlieb. Press release: https://bit.ly/2jt7vj7 Letter: https://bit.ly/2HMpMXc

Drugs and Medical Device Regulation –

  • On May 3, Food and Drug Administration (FDA) Commissioner Gottlieb delivered a keynote address at the 2018 Food and Drug Law Institute Annual Conference. His remarks focused on the opioid epidemic, drug pricing, and innovation. Transcript: https://bit.ly/2FHMLNp
  • Also on May 3, FDA issued guidance for assessing user fees under the Prescription Drug User Fee Amendments of 2017. Guidance: http://bit.ly/2xHBmZO
  • On May 4, FDA approved new uses for two drugs administered together for the treatment of thyroid cancer. Press release: https://bit.ly/2HR8C6F
  • Also on May 4, HHS released a proposed rule again delaying the effective date of the 340B Drug Pricing Program final rule from July 1, 2018 to July 1, 2019. Comments are due by May 22. Proposed rule: http://bit.ly/2Ikqbj7

 Military & Veterans’ Health –

  • On April 30, Department of Veterans Affairs (VA) released a statement on the success of its virtual medical room app, VA Video Connect. Press release: https://bit.ly/2I6AKGF
  • Also on April 30, VA introduced a new online feature via the My HealtheVet portal that allows veterans to access their medical images and associated study reports online. Press release: https://bit.ly/2HGLDvj
  • On May 1, Acting VA Secretary Wilkie released a statement again calling on Congress to pass legislation to make funding for VA’s Veterans Choice program permanent. Press release: https://bit.ly/2FJ4J1T
  • On May 2, House Veterans Affairs Committee Subcommittee on Oversight and Investigations Ranking Member Kuster (D-NH), and Subcommittee on Health Ranking Member Brownley (D-CA) sent a letter to Acting VA Secretary Wilkie requesting that he and the VA Inspector General investigate continued delays in finalizing a contract to implement a new VA electronic health record system. Press release with text of letter: http://bit.ly/2IpmatE
  • On May 4, VA released a statement touting a recent study by the RAND Corporation finding that veterans receive the same or better care at VA medical facilities as patients at non-VA hospitals. Press release: https://bit.ly/2rjQmfa
  • Also on May 4, VA announced that it is offering two opportunities for early participation in the new decision review process outlined in the Veterans Appeals Improvement and Modernization Act of 2017. Press release: https://bit.ly/2JVbeB5

 Misc. –

  • On May 1, HHS issued a request for information (RFI) on ways to streamline administrative and reduce burden related to several programs, including the Bureau of Primary Health Care, the Healthcare Systems Bureau, the HID/AIDS Bureau, the Bureau of Health Workforce, and the Office of Federal Assistance Management. Comments are due by July 2. RFI: https://bit.ly/2rmC0f1
  • Also on May 1, Sens. Blunt (R-MO), Ernst (R-IA), Lankford (R-OK), and Daines (R-MT) led 37 of their Senate Republican colleagues in a letter to HHS Secretary Azar, urging the department to restore Title X Family Planning regulations that bar grantees from co-locating with abortion clinics, or from promoting, counseling, or referring clients for abortions. Press release: https://bit.ly/2jtErIj Letter: https://bit.ly/2rkdpGQ. Reps. Estes (R-KS), Hartzler (R-MO), Smith (R-NJ), and Black (R-TN) led 149 of their House colleagues in a similar companion letter. Letter: https://bit.ly/2rfmG3N
  • Also on May 1, National Institutes of Health (NIH) called for improvements in research on natural experiments to combat the obesity epidemic. Press release: https://bit.ly/2rn0Iex
  • On May 2, HHS released a public comment index for the National Alzheimer’s Project Act (NAPA). Index: https://bit.ly/2KE1VHc
  • Also on May 2, HHS released a report finding that in 2014-2015, the percentage uninsured among those under age 65 did not differ between metro and non-metro residents. Non-metro residents, however, were more likely to have public health insurance and less likely to have private health insurance. Summary with link to report: http://bit.ly/2wl3uGI
  • On May 4, HHS released the 17th Annual Report to Congress on welfare dependence indicators, reflecting changes that have taken place since the enactment of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in 1996. Report: http://bit.ly/2wfa69H