What’s Ahead: This Week

 Hearings/Markups –

  • Tuesday, May 29
    • Senate Finance Committee, Subcommittee on Health Care, “Field Hearing: Examining Efforts to Prevent Opioid Overutilization and Misuse in Medicare and Medicaid.” Bensalem, PA

 Notable Policy Events –

  • Tuesday, May 29
    • Brookings Institution, “The Life She Deserves: The Struggle of a Woman and her Family to Find a Treatment for Controlling Her Debilitating Epilepsy.” Additional information: https://brook.gs/2sfqKRn
  • Thursday, May 31
    • National Academy of Sciences, “Webcast: Evidence and the Individual Patient – Understanding Heterogeneous Treatment Effects for Patient-Centered Care.” Additional information: https://bit.ly/2xd7Nod


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

 Fiscal Year 2019 Appropriations –

  • On May 23, the House Appropriations Committee approved by a vote of 29-22 its fiscal year (FY) 2019 subcommittee allocations, under which Labor, HHS and Education would receive $177.10 billion in discretionary funding and Military Construction and Veterans Affairs would receive $96.92 billion in discretionary funding. The next day, the Senate Appropriations Committee unanimously approved its 2019 subcommittee allocations, under which Labor, HHS, and Education would receive $179.29 billion in discretionary funding, and Military Construction and Veterans Affairs would receive $97.09 billion in discretionary funding. Allocations: http://bit.ly/2kxMqVt and http://bit.ly/2kAAsKN

 Legislative Activity –

  • On May 21, the House passed a number of veterans health bills, including the VA Billing Accountability Act (H.R. 1972), the Military SAVE Act (H.R. 2642), the Veterans Opioid Abuse Prevention Act (H.R. 3832), and the Veterans Electronic Health Record Modernization Oversight Act of 2017 (H.R. 4245), among others. The bills now move to the Senate for consideration. Press release: http://bit.ly/2skASZb
  • Also on May 21, Reps. Brat (R-VA) and O’Halleran (D-AZ) introduced the Recognizing Early Childhood Trauma Related to Substance Abuse Act (H.R. 5889), which would require the HHS Secretary to disseminate information and resources to early childhood care and education providers on ways to properly recognize and respond to substance abuse-related trauma. Press release: https://bit.ly/2GFUOuB
  • Also on May 21, Reps. Garrett (R-VA) and Murphy (D-FL) introduced the Assisting States’ Implementation of the Plans of Safe Care Act (H.R. 5890), which would require the HHS Secretary to provide assistance to states in complying with and implementing certain provisions of the Plans of Safe Care Act in order to promote better protections for young children and family-centered responses. Press release: https://bit.ly/2ICHKrD Text: https://bit.ly/2kjrWzB
  • Also on May 21, Reps. Grothman (R-WI) and Lamb (D-PA) introduced the Improving the Federal Response to Families Impacted by Substance Use Disorder Act (H.R. 5891), which would establish a federal taskforce with the mission of coordinating a federal response to the opioid crisis. Press release: https://bit.ly/2KNTNmN
  • Also on May 21, Reps. Lewis (R-MN) and Cartwright (D-PA) introduced H.R. 5892, which would establish an advisory committee to advise the Secretary of Labor on actions the department can take to address opioid abuse in the workplace. Press release: https://bit.ly/2IIGpn9
  • Also on May 21, Reps. Faso (R-NY), Tonko (D-NY), Upton (R-MI), and Sarbanes (D-MD) introduced H.R. 5899, which would reauthorize the School-Based Health Centers program through 2023. Press release: https://bit.ly/2LqQCm6 Text: https://bit.ly/2GL13NA
  • Also on May 21, Reps. Smith (R-NJ), Peterson (D-MN), Faso (R-NY), Posey (R-FL), and Comstock (R-VA) introduced H.R. 5900, which would provide for a national strategy to address and overcome Lyme disease and other tick-borne diseases. Press release: http://bit.ly/2kxSnSg
  • Also on May 21, Senate Aging Committee Chair Collins (R-ME) and Ranking Member Casey (D-PA) introduced the Geriatrics Workforce Improvement Act (S. 2888), which would reauthorize the Geriatrics Workforce Enhancement Program (GWEP) and reinstate the Geriatric Academic Career Awards (GACA) program. Press release: https://bit.ly/2ICYXoU
  • On May 22, the House of Representatives passed by a vote of 250-169 the Right to Try Act (S. 204), which would allow terminally ill patients to use non-FDA approved experimental drugs. Having previously passed the Senate, the bill now moves to the President for signature. Press releases: http://bit.ly/2IOqzYg and http://bit.ly/2LBz2vx
  • Also on May 22, Rep. Roybal-Allard (D-CA) introduced the Professionals’ Access to Health (PATH) Workforce Integration Act (H.R. 5917), which would authorize the HHS Secretary to award career support grants for skilled, internationally educated health professionals. Press release: https://bit.ly/2LnyKs0
  • Also on May 22, Reps. Stefanik (R-NY) and Ryan (D-OH) introduced the Vietnam Era Veterans Hepatitis C Testing Enhancement Act (H.R. 5922), which would direct the VA Secretary to carry out a pilot program to increase access to hepatitis C testing for Vietnam-era veterans. Press release: https://bit.ly/2s2FGD3 Text: https://bit.ly/2IGzoDx
  • Also on May 22, Senate Finance Committee members introduced a package of 22 Medicare, Medicaid, and human services bills relating to the opioid crisis. Press release: https://bit.ly/2IIa0cw List of bills: https://bit.ly/2Lsco8Q
  • Also on May 22, Senate HELP Committee Ranking Member Murray (D-WA) along with Sens. Murkowski (R-AK), Feinstein (D-CA), Sullivan (R-AK), Klobuchar (D-MN), Smith (D-MN), and Portman (R-OH) introduced S. 2897, which would delay the reduction in FMAP for Medicaid personal care services furnished without an electronic visit verification system. Reps. Langevin (D-RI), Stivers (R-OH), DeGette (D-CO), and Young (R-AK) also introduced companion legislation in the House (H.R. 5912). Press release: https://bit.ly/2xjCmbV
  • Also on May 22, Sens. Smith (D-MN), Jones (D-AL), and Rounds (R-SD) introduced the Rural Health Liaison Act, which would create a liaison within the U.S. Department of Agriculture (USDA) responsible for working with the Department of Health and Human Services (HHS) and other agencies on rural health issues. Press release: https://bit.ly/2x7TAsk
  • On May 23, the Senate passed by a vote of 92-5 the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION Act) of 2018 (S. 2372). Having previously passed the House, the bill now moves to the President for signature. Press releases: http://bit.ly/2GXPdjp and http://bit.ly/2GXPkLR
  • Also on May 23, Reps. Rothfus (R-PA) and Keating (D-MA) introduced the Naloxone Guidelines Act (H.R. 5926), which would require the Secretary of HHS to issue guidelines for prescribing naloxone. Press release: http://bit.ly/2sfvWFD
  • Also on May 23, Reps. Collins (R-GA) and Deutch (D-FL) introduced the Substance Abuse Prevention Act (H.R. 5933), which would reauthorize the Office of National Drug Control Policy as well as many other anti-drug programs. Press release: https://bit.ly/2J5x48n
  • Also on May 23, Rep. Lee (D-CA) and 57 cosponsors introduced the Health Equity and Accountability Act of 2018 (H.R. 5942), which reforms policies and expands federal health care resources for racial and ethnic minorities as well as other underserved populations. Press release: https://bit.ly/2KQer5y
  • Also on May 23, the Senate HELP Committee approved by a vote a 22-1 the Pandemic and All-Hazards Preparedness Reauthorization Act (S. 2852). The bill now moves to the full Senate for consideration. Press release: http://bit.ly/2kwLhgz
  • Also on May 23, Sens. Markey (D-MA), Hassan (D-NH), and Murkowski (R-AK) introduced the National Milestones to Measure Progress in Ending the Opioid Epidemic Act (S. 2931), which would require the federal government to set tangible benchmarks in measuring progress on key objectives such as reducing overdose deaths and expanding treatment availability. Press release: https://bit.ly/2klVPzl Text: https://bit.ly/2kpbqhA
  • Also on May 23, Sen. Daines (R-MT) introduced the Tribal Employment and Jobs Protection Act (S. 2943), which would exempt tribes and tribal employers from the Affordable Care Act’s employer mandate. Press release: https://bit.ly/2GL5iZv Text: https://bit.ly/2ks8vop
  • On May 24, Reps. Schiff (D-CA), Moulton (D-MA), and Jackson Lee (D-TX) introduced the Veterans Crisis Response Corps Act (H.R. 5951), which would establish the Veterans Crisis Response Corps. Press release: http://bit.ly/2sgmsK4
  • Also on May 24, Reps. Collins (R-GA) and Gonzalez (D-TX) introduced the Phair Pricing Act of 2018 (H.R. 5958), which would direct all price concessions, incentive payments, and price adjustments between a pharmacy and PDP sponsor or PBM be included at the point of sale. Press release: https://bit.ly/2x9OjRn
  • Also on May 24, Reps. Noem (R-SD) Walorski (R-IN), Sinema (D-AZ) and Bera (D-CA) introduced the Health Insurance Premium Reduction Act (H.R. 5963), which would delay the Affordable Care Act’s Health Insurance Tax (HIT) for two years. Press release: https://bit.ly/2s74klN
  • Also on May 24, Rep. DeLauro (D-CT) introduced the Access to Infertility Treatment and Care Act (H.R. 5965), which would require private health insurance plans to provide coverage for treatment of infertility without raising insurance or copayment costs. Sen. Booker (D-NJ) introduced companion legislation in the Senate (S. 2960). Press release: https://bit.ly/2GONugc

 ACA Implementation and Market Stabilization –

  • On May 23, Reps. Brownley (D-CA), Nadler (D-NY), DeGette (D-CO), and Lee (D-CA) led 127 House Democrats in a letter to Office of Management and Budget (OMB) Director Mulvaney, urging him to uphold the Health Care Rights Law, also known as Section 1557 of the Affordable Care Act, which protects patients from discrimination in health care. Press release: https://bit.ly/2koqFY8 Letter: https://bit.ly/2s8KtCd
  • Also on May 23, Congressional Budget Office (CBO) released a report projecting that federal subsidies, taxes, and penalties associated with health insurance coverage for people under age 65 will result in a net subsidy from the federal government of $685 billion in 2018. CBO also increased its estimate of the number of Americans projected to be uninsured in 2027 by five million for a total of 35 million. Report: http://bit.ly/2slPGGD

Medicare –

  • On May 21, U.S. Government Accountability Office (GAO) released a report finding that Medicare’s prior authorization approach has reduced spending by as much as $1.9 billion since 2012, and recommending that CMS continue prior authorization efforts. Report: https://bit.ly/2KPCKk2

 Medicaid –

  • On May 22, CMS issued guidance related to coordination of appeals among insurance affordability programs in states that have elected for the Federally-facilitated Exchange (FFE) to make an assessment of eligibility for Medicaid and CHIP. Guidance: https://bit.ly/2KPEEBc
  • On May 23, HHS Office of Inspector General released a report finding that CMS did not always provide accurate Medicaid unit rebate offset amounts to state Medicaid agencies. Summary: https://bit.ly/2s8kASW Report: https://bit.ly/2s6Qb8o
  • On May 24, CMS released an informational bulletin with an update to the 2018 Supplemental Security Income (SSI) and Spousal Impoverishment Standards. Bulletin: https://bit.ly/2Jb5wPb

Payment and Delivery System Reform –

  • On May 23, CMS released its 4th Annual Report on the Evaluation of the Comprehensive Primary Care (CPC) Initiative, finding that CPC reduced hospitalizations and emergency department visits and reduced the rate of growth for Medicare expenditures, but had limited impact on quality measures or beneficiaries’ experience of care. Report: https://bit.ly/2LrBWTu
  • On May 24, HHS released a report summarizing strategies that Indian Health Service clinics have used to implement Patient-Centered Medical Home models of care, as well as challenges they faced during implementation. Report: http://bit.ly/2xibM2x
  • Also on May 24, HHS released a report summarizing findings from a small qualitative study of six health centers for that pursuing a diverse range of approaches to facilitating specialty care for patients. Report: http://bit.ly/2IQZQWU

Mental Health and Substance Abuse –

  • On May 23, GAO released a report on Protection and Advocacy for Individuals with Mental Illness (PAIMI) programs, recommending that federal procedures to oversee such programs could be further improved. Report: https://bit.ly/2KSPczy
  • Also on May 23, Substance Abuse and Mental Health Services Administration (SAMHSA) announced the availability of up to $230 million for the Strategic Prevention Framework Partnerships for Success grant program. Applications are due July 6, 2018. Press release: https://bit.ly/2IHpyx0
  • On May 24, SAMHSA announced the availability of up to $95.9 million for Certified Behavioral Health Clinic Expansion grants. Applications are due July 9, 2018. Press release: https://bit.ly/2scyO5k
  • Also on May 24, National Institutes of Health released the results of a study which may help to explain why opioid therapy may not always work well for chronic pain. Press release: http://bit.ly/2H1GPQ4

Drugs and Medical Device Regulation

  • On May 22, FDA issued a warning to companies selling illegal, unapproved kratom products marketed for opioid cessation, pain treatment, and other medical uses. Press release: https://bit.ly/2s1tB0N

 Health IT –

  • On May 22, HHS Office of the National Coordinator for Health IT announced a new challenge competition, the Easy EHR Issue Reporting Challenge, to help EHR users identify, document, and report a potential health IT safety issue when it happens. Submissions are due by October 15. Press release: http://bit.ly/2GZt9F3
  • On May 23, HHS announced that the Health Resources and Services Administration’s Office of Information Technology was the recipient of the American Council for Technology and Industry Council’s award for its new Data Analytics Platform, which speeds up the grant-making and management process for grant awards. Press release: http://bit.ly/2ISu1gu

Misc. –

  • On May 22, Centers for Disease Control and Prevention (CDC) released its Early Release Estimates from the National Health Interview Survey 2017, showing a slight increase in the uninsured rate in 2017. Report: https://bit.ly/2J3BBZb
  • Also on May 22, U.S. Preventive Services Task Force (USPSTF) issued draft recommendations on primary care interventions to prevent child maltreatment. Recommendation: https://bit.ly/2ILCzpj
  • Also on May 22, the National Institutes of Health released its Annual Report to the Nation, showing that overall cancer mortality continues to decline and prostate cancer mortality has stabilized. Press release: https://bit.ly/2GHZ5xs Report: https://bit.ly/2sa15JD
  • Also on May 22, HHS announced proposed updates to the Title X Family Planning Grant Program, which would require clear financial and physical separation between Title X funded projects and programs or facilities where abortion is a method of family planning. Press release: https://bit.ly/2INbuC2
  • On May 23, Health Resources and Services Administration (HRSA) released a request for nominations to serve on the National Advisory Council on the National Health Service Corps. Request: https://bit.ly/2KQlXNO
  • On May 24, CBO released a report on federal spending on major health care programs, projecting that net outlays for major healthcare programs will grow from about $1 trillion in 2018 to about $2 trillion in 2028. Report: http://bit.ly/2sfPybQ
  • Also on May 24, HHS released the 2017 National HIV/AIDS Strategy Progress Report, finding that the number the new HIV diagnoses decreased by nearly 5 percent from 2011 to 2015. Summary with link to report: http://bit.ly/2H03tbh