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


 What’s Ahead: This Week

 Hearings/Markups –

  • Monday, May 21
    • House Rules Committee, “Meeting for S. 204, the Right to Try Act; H.R. 5155; and S. 2155.”
  • Tuesday, May 22
    • Senate HELP Committee, “The Health Care Workforce: Addressing Shortages and Improving Care.”
    • Senate Commerce Committee, “Markup of S. 2842, the Opioid Addiction Recovery Fraud Prevention Act of 2018; S. 2848, the Fighting Opioid Abuse in Transportation Act; and other legislation.”
    • Senate Appropriations Committee, Subcommittee on Agriculture, Rural Development, FDA, and Related Agencies, “Markup of FY2019 Agriculture and FDA Appropriations.”
    • House Veterans Affairs Committee, “The Curious Case of the VISN Takeover: Assessing VA’s Governance Structure.”
  • Wednesday, May 23
    • Senate HELP Committee, “Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018.”
    • Senate Special Committee on Aging, “Preventing and Treating Opioid Misuse Among Older Americans.”
    • House Energy & Commerce Committee, Subcommittee on Health, “Hearing on H.R. 5385, the Children’s Hospital GME Support Reauthorization Act of 2018.”
    • Senate Appropriations Committee, Subcommittee on Interior, Environment, and Related Agencies, “Hearing on FY19 Indian Health Service Budget.”
  • Thursday, May 24
    • Senate Finance Committee, “Rural Health Care in America: Challenges and Opportunities.”

 Notable Policy Events –

  • Monday, May 21
    • Research!America, “Briefing on New Vaccine Survey Data and Highlights from Smithsonian’s ‘Outbreak’.” Additional information: https://bit.ly/2GeB5BT
  • Tuesday, May 22
    • Northern Virginia Health Policy Forum, “The Way Forward: A Media Perspective on CMS, HHS, and the Trump Administration’s Healthcare Priorities.” Additional information: https://bit.ly/2Kv6CTC
    • Coalition to Stop Opioid Overdose, “Transforming Addiction Treatment: A Bigger, Bolder Response to America’s Opioid Overdose Epidemic.” Additional information: https://bit.ly/2IuU0ys
    • The Hill, “America’s Opioid Epidemic: Youth Awareness and Prevention.” Additional information: https://bit.ly/2L8L1R0
    • The Atlantic, “Children and Cancer.” Additional information: https://theatln.tc/2IT7LGC
  • Wednesday, May 23
    • The Atlantic, “The State of Care: Patient Access and Affordability.” Additional information: https://bit.ly/2KdXDoM
    • The Bipartisan Policy Center, “Using Medicare to Improve Chronic Care: Opportunities and Challenges.” Additional information: https://bit.ly/2Isji0f
  • Thursday, May 24
    • Alliance for Health Policy, “Summit on Health Care Costs in America.” Additional information: https://bit.ly/2IvdF16
    • American Psychological Association, “Innovations and Challenges in Providing Mental Health Services to People in Prison and Those Re-entering the Community.”
    • Brookings Institution, “The Trade: Opioids in America.” Additional information: https://brook.gs/2IOARXr

 

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

Nominations –

 Legislative Activity –

  • On May 14, Sen. Hassan (D-NH) introduced the Preventing Drug Diversion Act (S. 2837), which would strengthen the Drug Enforcement Administration’s (DEA) system for addressing suspicious orders of opioid-based prescription drugs from distributors. Press release: https://bit.ly/2IqMvZn Text: https://bit.ly/2rQyp95
  • On May 15, House Energy & Commerce Committee, Subcommittee on Health Ranking Member Green (D-TX) and Reps. Young (R-AK), Engel (D-NY), and Ros-Lehtinen (R-FL) introduced the Comprehensive TB Elimination Act of 2018 (H.R. 5794), which would provide support to domestic programs that combat tuberculosis. Press release: https://bit.ly/2rSV18Y Text: https://bit.ly/2GkxKBs
  • Also on May 15, Reps. Tenney (R-NY), DelBene (D-WA), and McKinley (R-WV) introduced the Expanding Oversight of Opioid Prescribing and Payment Act of 2018 (H.R. 5723), which would require MedPAC to evaluate and report on adverse incentives that lead to overprescribing of opioids. Press release: https://bit.ly/2wGUWdF
  • Also on May 15, Sens. Feinstein (D-CA), Grassley (R-IA), Capito (R-WV), and Durbin (D-IL) introduced the Using Data to Prevent Opioid Diversion Act of 2018 (S. 2838), which would provide drug manufacturers and distributors with data to identify pharmacies that are suspiciously ordering prescription opioids. Press release: https://bit.ly/2KDujbI Text: https://bit.ly/2KxFItp
  • Also on May 15, Sens. Capito (R-WV) and Cortez Masto (D-NV) introduced the Opioid Addiction Recovery Fraud Prevention Act (S. 2842), which would empower the Federal Trade Commission (FTC) and state attorneys general to bring enforcement actions against fraudulent substance abuse treatment programs. Press release: https://bit.ly/2KsMil4 Text: https://bit.ly/2IzN7be
  • Also on May 15, Sen. Nelson (D-FL) introduced the Opioid Workforce Act (S. 2843), which would create 1,000 new Medicare-supported positions at hospitals throughout the country. Press release: https://bit.ly/2GvSHJN
  • Also on May 15, Senate HELP Committee Chairman Alexander (R-TN), Ranking Member Murray (D-WA), and Sens. Casey (D-PA) and Burr (R-NC) introduced the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018 (S. 2852), which would reauthorize the Pandemic and All-Hazards Preparedness Act. Press release: https://bit.ly/2wWaUkc Summary: https://bit.ly/2IpMRzg
  • On May 16, the House approved by a vote of 347-70 the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act (H.R. 5674), which would establish a permanent community care program for veterans. The bill now moves to the Senate for consideration. Press release: https://bit.ly/2Irltkl VA Press release: https://bit.ly/2IwE4aP
  • Also on May 16, the House Ways & Means Committee approved by voice vote seven bills relating to the opioid crisis. The bills now move to the full House for consideration. Bills: https://bit.ly/2wIPeIg
  • Also on May 16, Reps. Crowley (D-NY) and Costello (R-PA) introduced the Opioid Workforce Act of 2018 (H.R. 5818), which would provide for the distribution of additional residency positions to help combat the opioid crisis. Press release: http://bit.ly/2Iwzdud
  • On May 17, the House Energy & Commerce Committee voted to approve 32 bills relating to the opioid crisis. The Committee has now approved 57 bills in total relating to the crisis, which now move to the full House for consideration. Bills: https://bit.ly/2k417z7
  • Also on May 17, Reps. Doggett (D-TX) and Pingree (D-ME) introduced the Reducing Drug Waste Act (H.R. 5867), which would authorize a joint action plan and report on drug waste. Press release: https://bit.ly/2KzwVXY
  • Also on May 17, Sens. Cassidy (R-LA), Nelson (D-FL), and Cardin (D-MD) introduced the Comprehensive Opioid Management and Bundled Addiction Treatment (COMBAT) Act (S. 2875), which would provide coverage and reimbursement in the form of a bundled payment for opioid treatment programs and services. Press release: https://bit.ly/2wSrHob Text: https://bit.ly/2LbzAIg
  • Also on May 17, Sen. Smith (D-MN) introduced the Disclosing Pharmaceutical Company Windfall Profits Act (S. 2885), which would make it possible for consumers to access financial data from publicly traded pharmaceutical companies. Press release: https://bit.ly/2GuNvFK

ACA Implementation and Market Stabilization –

  • On May 15, Sens. Wyden and Merkely (D-OR) issued a statement following Oregon’s announcement of increased proposed premium rates for plan year 2019. Press release: https://bit.ly/2IrcsYN
  • On May 16, California Attorney General Becerra led a group of 16 attorneys general in securing the right to intervene in Texas et al. v. United States et al., a lawsuit filed in federal court that seeks to dismantle the ACA. Press release: https://bit.ly/2IKcwSG
  • Also on May 16, CMS Office of the Actuary released a report originally drafted in April finding that the Administration’s proposed rule on Short-Term Limited-Duration Insurance would result in 800,000 fewer individuals choosing to purchase marketplace coverage in 2022. Letter: https://go.cms.gov/2Iy8bCZ
  • On May 17, CMS sent a letter to the Ohio Insurance Department informing the state that its application for a section 1332 State Innovation Waiver was incomplete. Letter: https://go.cms.gov/2IT4as2

 Medicare –

  • On May 15, CMS announced it is initiating its Annual Call for Measures process for the Medicare Promoting Interoperability Program. Measure proposals are due by June 29. Information: https://go.cms.gov/2IyYvYP

 Medicaid –

  • On May 16, CMS released guidance to assist states in implementing electronic visit verification systems for Medicaid personal care services and home health care services. Guidance: https://bit.ly/2IsK0pw FAQ: https://bit.ly/2KBLf23

Payment and Delivery System Reform –

  • On May 15, Maryland Governor Hogan (R) announced the approval of a contract between CMS and the Maryland Department of Health for a five-year contract for an innovative provider payment system, otherwise known as the All-Payer Model. Press release: https://bit.ly/2IAxD6R

Mental Health and Substance Abuse –

  • On May 16, New York Acting Attorney General Underwood and Governor Cuomo announced a lawsuit against Purdue Pharma for the company’s role in the opioid crisis. Press release: https://on.ny.gov/2GoJxyC
  • Also on May 16, Food and Drug Administration (FDA) announced the approval of Lucemyra, the first non-opioid treatment for management of opioid withdrawal symptoms in adults. Press release: https://bit.ly/2ILlvmE HHS Secretary Azar statement: https://bit.ly/2wShGHs
  • On May 17, U.S. Government Accountability Office (GAO) released a report finding that the Office of National Drug Control Policy and other agencies need to better assess strategic efforts relating to the opioid crisis. Summary: https://bit.ly/2ka9hWW Report: https://bit.ly/2rVnvyj
  • On May 18, Reps. Doggett (D-TX) and Welch (D-VT), co-chairs of the Affordable Prescription Drug Task Force, and Rep. Cummings sent a letter to Counselor to the President Conway, urging the Administration to take steps to lower the cost of Naloxone. Press release: http://bit.ly/2wY1uVf Letter: http://bit.ly/2KIG7cy

Drug Prices –

  • On May 14, HHS Secretary Azar delivered remarks to stakeholders, news media, and others regarding the Administration’s previously introduced Drug Pricing Blueprint. Transcript: https://bit.ly/2Iz9GfU
  • On May 15, U.S. Government Accountability Office (GAO) released a report on the status of agency efforts to improve 340B program oversight. Summary: https://bit.ly/2Ld8Yaa Report: https://bit.ly/2IwgHyh
  • On May 15, CMS unveiled revamped Drug Spending Dashboards, which show the list prices of individual drugs that Medicare and Medicaid pay for, as well as year-over-year price changes. Press release: https://go.cms.gov/2IkwMuB Fact sheet: https://go.cms.gov/2IuNqIj Database: https://go.cms.gov/1T0FBWD
  • On May 16, HHS issued a request for information (RFI) seeking comment on the department’s Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. Comments are due July 16, 2018. RFI: https://bit.ly/2rSRAhS
  • On May 17, CMS sent a letter to Medicare Part D prescription drug plan sponsors stating that so-called “gag clauses” are unacceptable, as part of the Administration’s initiative to lower prescription drug costs. Press release: https://go.cms.gov/2rRrKe1 Letter: https://go.cms.gov/2IsMtAi
  • Also on May 17, FDA released a list of companies that have potentially been blocking access to samples of their branded products that would otherwise be used to create generic versions. Press release: http://bit.ly/2IVdFHe List: http://bit.ly/2IT6gbr
  • On May 18, Sens. Durbin (D-IL), Hassan (D-NH), King (I-ME), Gillibrand (D-NY) and Brown (D-OH) sent a letter to a number of drug manufacturers calling for price transparency in advertising to consumers. Press release: http://bit.ly/2KEdjlx Letter: http://bit.ly/2KIA4os
  • Also on May 18, Senate Finance Committee Ranking Member Wyden (D-OR) sent a letter to U.S. Trade Representative Lighthouzer, HHS Secretary Azar, and National Economic Council Director Kudlow requesting clarification regarding some of the “trade aspects of the president’s recently announced plan to address the high price of prescription drugs.” Press release: http://bit.ly/2wZU8AK Letter: http://bit.ly/2KK8BT5

Military & Veterans’ Health –

  • On May 14, VA updated portions of the Schedule for Rating Disabilities (VASRD) to better align with modern medicine. Press release: https://bit.ly/2KpYUcH
  • On May 15, VA announced the names of 18 facilities across the country designated as VA Whole Health Flagship sites, which will focus on empowering and equipping veterans to take charge of their health and well-being. Press release: https://bit.ly/2IwJSFa
  • Also on May 15, VA Office of the Inspector General (OIG) released a report on the department’s compliance with requirements of the Improper Payments Elimination and Recovery Act (IPERA) for fiscal year 2017. Summary: https://bit.ly/2ItDMFB Report: https://bit.ly/2wRKMH3
  • Also on May 15, Sen. Blumenthal (D-CT) and House Veterans Affairs Committee Ranking Member Walz (D-MN) led a group of 5 senators and 6 representatives in a letter to VA Deputy Secretary Bowman expressing concern with the agency’s efforts to achieve electronic health record modernization. Letter: http://bit.ly/2IT8Kqh
  • On May 17, Acting VA Secretary Wilkie announced that VA has signed a contract with Cerner to modernize the VA’s health IT system. The contract has a ceiling of $10 billion over 10 years. VA Press release: https://bit.ly/2rSvBHS Committee press releases: http://bit.ly/2Is91ku and http://bit.ly/2Iy5QaT

Health IT –

  • On May 14, GAO released a report on the fees and challenges associated with patients’ access to their medical records, finding that the fees charged vary depending on the type of request and the state in which the request is made. Report: https://bit.ly/2Le5MuU
  • Also on May 14, Sen. Heitkamp (D-ND) led a group of 30 Senators in urging the Federal Communications Commission (FCC) to increase the Rural Health Care Program’s funding cap. Press release: https://bit.ly/2LfeJUK Letter: https://bit.ly/2INc3PN
  • On May 17, HHS announced the Stage 2 winner of the Secure API Server Showdown Challenge, which sought to engage the health IT industry to identify Fast Healthcare Interoperability Resources servers that reinforce the value of following technical security best practices on an industry-wide scale. Press release: http://bit.ly/2Ish28Y
  • On May 18, HHS released the 2017 Annual Report for Health IT, which highlights the work of various HHS health IT grantees. Report: http://bit.ly/2IWX2Lh

 Misc. –

  • On May 14, more than 200 members of Congress signed a letter to HHS Secretary Azar in opposition of the Administration’s proposed changes to the Title X family planning program. Press release: https://bit.ly/2IuIMdi House letter: https://bit.ly/2rSeLZK Senate letter: https://bit.ly/2IQDg40
  • Also on May 14, House Energy & Commerce Full Committee Ranking Member Pallone (D-NJ) and Health Subcommittee Ranking Member Green (D-TX) penned a letter to Full Committee Chair Walden (R-OR) and Health Subcommittee Chair Burgess (R-TX) requesting a hearing on maternal mortality in the United States. Press release: https://bit.ly/2Iu3o1b Letter: https://bit.ly/2GuR4vL
  • Also on May 14, Sens. Klobuchar (D-MN) and Markey (D-MA) led a group of 5 Senators in urging President Trump to support a universal flu vaccine. Press release with letter text: https://bit.ly/2rVcgG7
  • On May 15, Sens. Schatz (D-HI) and Bennet (D-CO) sent a letter to the National Institutes of Health (NIH) requesting more information about technology addiction and its effect on childhood development. Press release: https://bit.ly/2rRLqPL Letter: https://bit.ly/2IrNng9
  • On May 16, Sen. Grassley (R-IA) wrote a letter to NIH Director Collins regarding a potential conflict of interest in an alcohol study conducted by the NIH. Press release: https://bit.ly/2wODILg Letter: https://bit.ly/2KBVzae
  • Also on May 16, HHS announced that it is awarding $2.8 million in grants to community-based organizations to help individuals with HIV/AIDS access care and support services. Press release: https://bit.ly/2GwkcTh