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


 What’s Ahead: This Week

 Hearings/Markups –

  • Tuesday, June 5
    • Senate Appropriations Committee, Subcommittee on Military Construction Veterans Affairs, and Related Agencies, “Markup of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2019.”
  • Wednesday, June 6
    • House Ways & Means Committee, Subcommittee on Health, “Hearing on Lowering Costs and Expanding Access to Health Care through Consumer-Directed Health Plans.”
    • House Energy & Commerce Committee, Subcommittee on Health, “Examining the Reauthorization of the Pandemic and All-Hazards Preparedness Act.”
    • House Committee on Education & the Workforce, “Examining the Policies and Priorities of the U.S. Department of Health and Human Services.”
  • Thursday, June 7
    • House Veterans Affairs Committee, Subcommittee on Health, “An Assessment of the Potential Effects of Burn Pit Exposure among Veterans.”
    • Senate Appropriations Committee, “Markup of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2019.”

 Notable Policy Events –

  • Monday, June 4
    • S. Department of Veterans Affairs, Department of Defense, U.S. Food and Drug Administration, and CMS, “Medical Device Registry Summit.” Additional information: http://bit.ly/2kLd2lF
  • Wednesday, June 6
    • Bipartisan Policy Center, “The Financial Future of Social Security and Medicare: Highlights from the Trustee’ 2018 Reports.” Additional information: http://bit.ly/2kFKcmJ
  • Wednesday, June 6 – Friday, June 8
    • Global Health Care, Inc., “The National ACO, Bundled Payment and MACRA Summit.” Additional information: http://bit.ly/2soS8gz
  • Thursday, June 7
    • Axios, “The Innovation Impact on Health Care.” Additional information: http://bit.ly/2ssHOEq
    • American Enterprise Institute, “The Opioid Crisis and Foster Care Families: Gov. Doug Ducey (R-AZ) on Policies to Protect Children and Treat Parents.” Additional information: http://bit.ly/2sErob4
    • Virginia Chamber Foundation, “2018 Virginia Health Care Conference.” Additional information: http://bit.ly/2sD5ViL
  • Friday, June 8
    • Bipartisan Policy Center, “Healthy Homes Equal Healthier Lives: A Discussion with HUD Secretary Ben Carson.” Additional information: http://bit.ly/2kMpCkQ
    • Cato Institute, “Overcharged: Why Americans Pay Too Much for Health Care.” Additional information: http://bit.ly/2HhMmBW

 

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

 Appointments –

  • On May 30, President Trump named Peter O’Rourke as Acting Secretary of the Department of Veterans Affairs; former Acting Secretary Robert Wilkie has been nominated to serve as Secretary and awaits Senate confirmation. Mr. O’Rourke previously served as VA Chief of Staff. Press release: http://bit.ly/2H5TEsl

 ACA Implementation –

  • On May 30, New Jersey Governor Murphy signed into law a statewide individual mandate, which will require all New Jerseyans to have health coverage and making New Jersey the second state, after Massachusetts, to mandate health coverage. Press release: http://bit.ly/2kMwn6g
  • On June 1, Senate HELP Committee Ranking Member Murray (D-WA), Senate Finance Committee Ranking Member Wyden (D-OR), House Energy & Commerce Committee Ranking Member Pallone (D-NJ), House Ways & Means Committee Ranking Member Neal (D-MA), and House Committee on Education & the Workforce Ranking Member Scott (D-VA) sent a letter to HHS Secretary Azar, Labor Secretary Acosta, Treasury Secretary Mnuchin, and OMB Director Mulvaney to express their concern about the Departments’ proposed rule on short-term limited-duration insurance and the differences projected by the Departments’ and the CMS Office of the Actuary of its impact. Press release: http://bit.ly/2sy0T7o Letter: http://bit.ly/2sy1aXY

Medicare –

  • On May 29, U.S. Government Accountability Office (GAO) announced five new members of the Medicare Payment Advisory Commission (MedPAC): Karen DeSalvo, Marjorie Ginsberg, Jonathan Jaffery, Jonathan Perlin, and Jaewon Ryu. Press release: http://bit.ly/2GZYOGc
  • On May 30, 18 State Attorneys General sent a letter to HHS Secretary Azar and CMS Administrator Verma urging them to resume implementing reforms to skilled nursing facilities. Letter: https://on.ny.gov/2kFcQEE
  • On May 31, CMS released data on the Quality Payment Program, finding that 91 percent of all clinicians eligible for the Merit-based Incentive Payment System (MIPS) participated in the first year of the program. Blog post: http://bit.ly/2sp2jBI

 Medicaid –

  • On May 29, Utah Lieutenant Governor Cox certified that a sufficient number of signatures had been gathered to place the Utah Decides Healthcare Act of 2018, which would expand Medicaid in the state, on the November ballot. Certification: http://bit.ly/2H4LKQ1
  • On May 30, Virginia became the 33rd state to expand Medicaid, passing legislation that would expand Medicaid coverage to an estimated 400,000 people, and will also implement work requirements for the expansion population. Press release: http://bit.ly/2sqyxfT
  • On June 1, CMS released guidance on third party liability in Medicaid and CHIP policies, as amended by the Bipartisan Budget Act of 2018. Guidance: http://bit.ly/2kMq7eQ

Mental Health and Substance Abuse –

  • On May 29, GAO released a report finding that although CMS provided oversight on prescribing drugs at high risk of abuse through a variety of projects, it did not analyze data specifically on opioids nor identify providers who may be inappropriately prescribing large amounts of opioids separately from other drugs. Summary with link to report: http://bit.ly/2smh4EI
  • On May 30, Substance Abuse and Mental Health Services Administration (SAMHSA) announced it is accepting applications from states for $196 million to treat opioid use disorder through its Targeted Capacity Expansion: Medication Assisted Treatment-Prescription Drug Opioid Addiction grant program. Applications are due by July 9. Press release: http://bit.ly/2H8sEsi Funding opportunity announcement: http://bit.ly/2H5IPXr
  • Also on May 30, Food and Drug Administration (FDA) announced an innovation challenge to spur the development of medical devices, including digital health technologies and diagnostic tests that could provide novel solutions to detecting, treating, and preventing addiction, addressing diversion and treating pain. Applications are due by September 30. Press release: http://bit.ly/2ssV247
  • Also on May 30, HHS released data finding that from 2010 to 2015, the share of opioid-related inpatient stays and emergency department shifts shifted away from private payers and no insurance and toward public payers. Report: http://bit.ly/2sp03dI
  • Also on May 30, Energy & Commerce Committee Chair Walden (R-OR) and Ranking Member Pallone (D-NJ) sent a series of letters to eight call aggregators, who help to connect individuals seeking treatment to sober living homes, requesting information about their business practices. Press release: http://bit.ly/2smBLkF Link to letters: http://bit.ly/2kFcbTS
  • Also on May 30, Sen. Markey (D-MA) led a bipartisan group of 8 senators in a letter to the U.S. Government Accountability Office requesting that it examine how substance use disorder, and particularly opioid use disorder, is addressed by the Bureau of Prisons and in state correctional facilities. Press release: http://bit.ly/2sBUZly Letter: http://bit.ly/2Hi1ejQ

Drug Prices and Regulation –

  • On May 31, FDA announced two new policies to reduce the ability of brand drug makers to use Risk Evaluation and Mitigation Strategy (REMS) programs as a way to block timely generic drug entry. The first policy outlines the process in which drugmakers must share a REMS. The second guidance outlines when and how the FDA will consider waivers from required single shared REMS and how generic drugmakers can request the waivers. Comments are due by August 1. Press releases: http://bit.ly/2slY3mG and http://bit.ly/2smzZA7 Draft guidance documents: http://bit.ly/2sn6Pkk and http://bit.ly/2kFdTVi
  • Also on May 31, FDA Commissioner Gottlieb released a statement on FDA’s work to mitigate shortages of intravenous drugs, shorten supply disruptions and better predict vulnerabilities. Statement: http://bit.ly/2ssbZvd
  • Also on May 31, Senate Committee on Homeland Security and Governmental Affairs Chair Johnson (R-WI) sent a letter to FDA Commissioner Gottlieb urging him to implement the Right to Try Act “in a manner consistent with the law’s intent.” Press release: http://bit.ly/2sErHmj Letter: http://bit.ly/2sE0gZJ
  • On June 1, HHS published a final rule further delaying the effective date of a final rule on the 340B Drug Pricing Program to July 1, 2019 from its original January 5, 2017 effective date. Final rule: http://bit.ly/2kHWZFk

Military & Veterans’ Health –

  • On May 29, GAO released a report finding that the Veterans Health Administration has made progress improving opioid safety through its Opioid Safety Initiative, but further efforts to assess progress and reduce risk are needed. Summary with link to report: http://bit.ly/2sp0LXw
  • On May 31, VA announced that the White House has approved an interagency plan to implement an executive order supporting veterans with mental health care and suicide-prevention resources during their transition from uniformed services to civilian life. Press release: http://bit.ly/2su9YyB Joint Action Plan: http://bit.ly/2kMTIol

Health IT –

  • On May 31, HHS released a systematic review evaluating the effectiveness of telehealth consultations for inpatient, emergency and outpatient care, finding that telehealth is generally clinically effective. Summary with link to report: http://bit.ly/2sD2ZTp

 Misc. –

  • On May 29, Sen. Cassidy (R-LA) released a white paper on healthcare affordability, recommending that Congress take commonsense actions in six policy areas: empowering patients to reduce healthcare costs, lowering health insurance premiums, increasing competition, decreasing drug costs, eliminating administrative burden and reducing costs through prevention and chronic disease management. Press release: http://bit.ly/2soXHdY White paper: http://bit.ly/2GYeKsM
  • On May 30, HHS Office of Inspector General released a report finding that 25 percent of the health centers receiving grants through the Health Resources and Services Administration’s (HRSA) Health Center Program had elevated programmatic or financial risks in fiscal year 2014. Summary with link to report: http://bit.ly/2kEWwE3
  • Also on May 30, HHS released a report finding that the rate of emergency department visits per 100,000 people reached a 10-year high in 2015 for all age groups and increased the most for patients between 45-64 years. Report: http://bit.ly/2spDRjF
  • On June 1, Centers for Disease Control and Prevention (CDC) released data finding that during 2014, 12.7 percent of workers aged 18-64 years were uninsured, which was a 21 percent decline from 2013, and that the rate of decline differed based on occupation. Report: http://bit.ly/2sxLxQe
  • Also on June 1, CDC released a report finding that the total death rate for persons aged 10-19 increased 12 percent between 2013 and 2016, which it attributes to an increase in injury deaths, including unintentional, suicide and homicide. Report: http://bit.ly/2sxYkSR
  • Also on June 1, HHS Office of the Inspector General released its semiannual report to Congress covering the period from October 1, 2017 through March 31, 2018. Report: http://bit.ly/2HiqS81