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


 What’s Ahead: This Week

Hearings/Markups –

  • Tuesday, June 12
    • Senate Finance Committee, “Markup of Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018.”
    • Senate HELP Committee, “The Cost of Prescription Drugs: Examining the President’s Blueprint ‘American Patients First’ to Lower Drug Prices.”
  • Wednesday, June 13
    • House Veterans’ Affairs Committee, Subcommittee on Health, “Legislative Hearing on H.R. 2787; H.R. 3696; H.R. 5693; H.R. 5864; H.R. 5974; Draft bill, the Veterans Serving Veterans Act; and Draft bill, to improve the productivity and management of VA health care facilities.”
  • Thursday, June 14
    • Senate Judiciary Committee, “Executive Business Meeting, including to consider S. 2837, the Preventing Drug Diversion Act of 2018, and S. 974, the CREATES Act of 2017.”
  • Friday, June 15
    • House Energy & Commerce Committee, Subcommittee on Oversight & Investigations, “The State of U.S. Public Health Biopreparedness: Responding to Biological Attacks, Pandemics, and Emerging Infectious Disease Outbreaks.”

 Notable Policy Events –

  • Tuesday, June 12
    • National Coalition on Health Care, “Briefing: Policy Options to Address Drug Costs & Ensure Better Care for Seniors.” Additional information: https://bit.ly/2sIlFBX
    • The Hill, “Maternal and Child Health: Tackling Disparities, Improving Outcomes.” Additional information: https://bit.ly/2JElXDK
    • Intel Policy, “Tech + Policy @ Intel: Opioids and Telehealth.” Additional information: http://bit.ly/2JFxeUb
  • Wednesday, June 13
    • Patient-Centered Outcomes Research Institute (PCORI), “Briefing: Overcoming Gaps in the Treatment of Mental Illness: The Role of Patient-Centered Research.” Additional information: https://bit.ly/2McvH6G
    • American Hospital Association, “Innovations in Hospital and Community Health Partnerships.” Additional information: http://bit.ly/2JIjXKv
    • The Atlantic, “Forum: Healing the Divide on Health Equity.” Additional information: https://bit.ly/2jUdxd3
    • The Washington Post, “Mental Health and Well-Being in America.” Additional information: https://wapo.st/2xWYb14
  • Thursday, June 14
    • Alliance for Health Policy, “Webinar: Prescription Drug Costs: Can Increased Competition Restrain Prices?” Additional information: https://bit.ly/2JtB0g0
    • S. Chamber of Commerce, “Aligning Incentives for Better Health.” Additional information: https://uscham.com/2HtYHmE
  • Thursday, June 14 – Friday, June 15
    • Mental Health America, “Mental Health America Annual Conference: Fit for the Future.” Additional information: http://bit.ly/2sNqj1u

 

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

 Appropriations –

  • On June 6, the House passed by a vote of 210-206 the Spending Cuts to Expired and Unnecessary Programs Act (H.R. 3), which would rescind approximately $15 billion in budget authority over 2018-2028, including $7 billion in funding for CHIP. The bill now moves to the Senate for consideration. Bill text: https://bit.ly/2JvtoKe
  • On June 7, Senate Appropriations Committee unanimously approved the fiscal year (FY) 2019 Military Construction, Veterans Affairs, and Related Agencies appropriations bill, which would provide $86.4 billion in discretionary funding for the VA. The bill now moves to the full Senate for consideration. Press release: http://bit.ly/2LB2LEf Bill text: http://bit.ly/2LHrqXV Bill report: http://bit.ly/2HCxj62
  • On June 8, the House approved by a vote of 235-179 a package of three FY 2019 appropriations bulls, including Military Constriction and Veterans Affairs (H.R. 5895). The bills now move to the Senate for consideration. Press release: http://bit.ly/2LB1LzZ Bill text: http://bit.ly/2HBzaYQ Draft VA bill report: http://bit.ly/2LAGHtl

 Legislative Activity –

  • On June 5, Reps. DelBene (D-WA), Sewell (D-AL), Walorski (R-IN), Bilirakis (R-FL), and Cardenas (D-CA) introduced the Ensuring Patient Access to Critical Breakthrough Products Act of 2018 (H.R. 5997), which would require Medicare to cover all breakthrough products that are approved through the FDA’s expedited review process for three years. Press release: https://bit.ly/2JGQxfQ Bill text: https://bit.ly/2M90PE9
  • Also on June 5, Rep. Schakowsky (D-IL) introduced the Securing Experts to Control, Understand, and Respond to Emergencies (SECURE) Act (H.R. 5998), which would reauthorize a loan repayment program under which health professionals agree to conduct prevention activities. Text: https://bit.ly/2kXxTSY
  • Also on June 5, Reps. Jenkins (R-WV) and Turner (R-OH) introduced the Caring Recovery for Infants and Babies (CRIB) Act (H.R. 6004), which would provide states with the option of providing medical assistance at a residential pediatric recovery center to infants with neonatal abstinence syndrome. Press release: https://bit.ly/2JGUdhE Text: https://bit.ly/2Lxs5uU
  • On June 5, President Trump signed into law the John S. McCain III, Daniel K. Alaska, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act, which will streamline several VA community care programs. White House Press release and statement: http://bit.ly/2HzqK4h and http://bit.ly/2LFzDLU Press releases from House and Senate VA committees: http://bit.ly/2LAJjYb and http://bit.ly/2LGNd1R VA press release: https://bit.ly/2JraRi4
  • On June 6, Congressional Budget Office (CBO) released a cost estimate for the 59 opioid bills approved by the House Energy & Commerce Committee, finding that 20 of the bills would affect direct spending, however the majority of bills would not have a substantial impact on net direct spending over the next ten years. Analysis: http://bit.ly/2HDiNuZ
  • Also on June 6, Sens. Young (R-IN) and Donnelly (D-IN) introduced the Dr. Todd Graham Pain Management Improvement Act of 2018 (S. 3008), which would require HHS to solicit stakeholder feedback and submit a pain management study to Congress on recommendations to improve payment and coverage policies related to the use of non-opioid treatments for acute and chronic pain management for beneficiaries enrolled in Medicare Parts A or B. Press release: https://bit.ly/2Hxx1xg Text: https://bit.ly/2Hxi8Ln
  • Also on June 6, Sen. Gardner (R-CO) introduced the Rural Physician Workforce Production Act (S. 3014), which would establish a national per-resident payment amount in order to make accepting residents a viable option for rural hospitals. Press release: https://bit.ly/2sHNLgG
  • Also on June 6, Sens. Booker (D-NJ), Cassidy (R-LA), Hirono (D-HI), and Scott (R-SC) introduced the Action for Dental Health Act of 2018 (S. 3016), which would reauthorize CDC oral health promotion and disease prevention activities and expand a grant program through HRSA that helps states increase their oral health workforce. Press release: https://bit.ly/2Jtzo64
  • On June 7, House Energy and Commerce Subcommittee on Health Vice Chair Guthrie (R-KY) introduced H.R. 6042, which would delay the reduction in federal medical assistance percentage (FMAP) for Medicaid personal care services furnished without an electronic visit verification system. Press release: http://bit.ly/2JIFzqg
  • Also on June 7, Sens. Thune (R-SD), and Rounds (R-SD) introduced the Tribal School Federal Insurance Parity Act (S. 3030), which would allow tribal grant schools to participate in the Federal Employee Health Benefits program. Rep. Noem (R-SD) introduced companion legislation in the House (H.R. 6030). Press release: http://bit.ly/2sJYeYS Bill text: http://bit.ly/2JN70iV
  • Also on June 7, Senate HELP Committee Chair Alexander (R-TN) and Sen. Bennet (D-CO) introduced S. 3029, which would revise and extend the Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Act. Press release: https://bit.ly/2HwMsG9
  • Also on June 7, Sens. Warren (D-MA) and Gardner (R-CO) introduced the Strengthening the Tenth Amendment Through Entrusting States Act (STATES Act) (S. 3032), which would amend the Controlled Substances Act to provide for a new rule regarding the application of the Act to marijuana. Reps. Joyce (R-OH) and Blumenauer (D-OR) introduced companion legislation in the House (H.R. 6043). Press release: http://bit.ly/2JHL8p2 Fact sheet: http://bit.ly/2sNng9H Bill text: http://bit.ly/2JG91NH
  • On June 8, Rep. Grothman (R-WI) introduced H.R. 6057, which would provide for enhanced penalties for trafficking in fentanyl. Press release: http://bit.ly/2JJqFjv

 ACA Implementation –

  • On June 7, the Justice Department filed a motion with the U.S. District Court for the Northern District of Texas, stating that it will no longer defend the ACA in the ongoing Texas v. U.S. and California, et al, case, due to the unconstitutionality of the law. Brief: http://bit.ly/2sKP9z1
  • On June 8, Sens. Johnson (R-WI) led a group of 35 republican senators in a letter to Treasury Secretary Mnuchin, HHS Secretary Azar, and Labor Secretary Acosta encouraging them to allow short-term limited-duration insurance plans to be available for up to 12 months. Press release: http://bit.ly/2HAjK7e Letter: http://bit.ly/2LGbp46
  • Also on June 8, CMS sent a letter to Maine informing the state that its section 1332 waiver request application to establish a reinsurance program is complete and beginning the 30-day public comment period. Comments will be due by July 8. Letter: https://go.cms.gov/2LG1mMv

 Medicare –

  • On June 4, HHS Office of Inspector General (OIG) released a report finding that total reimbursement for all brand name drugs in Part D increased by 77 percent from 2011 to 2015, despite a 17 percent decrease in the number of prescriptions for these drugs. Summary with link to report: http://bit.ly/2LGR5jp
  • On June 5, the Medicare Board of Trustees released a report on the financial operations and actuarial status of the Medicare program, finding that the hospital trust fund is expected to be depleted in 2026, three years earlier than previously projected. Additionally, Medicare’s total costs will grow from 3.7 percent of gross domestic product in 2017 to 5.8 percent by 2038. Report: https://go.cms.gov/2LGSBSD

Medicaid –

  • On June 4, a Maine State Superior Court judge released a decision requiring that Governor LePage’s administration must file paperwork by next week to the federal government to adopt Medicaid expansion in the state. On Thursday, Governor LePage filed an appeal to the decision. Decision: http://bit.ly/2LGrtTD
  • On June 5, CMS launched the CMS Medicaid and CHIP Scorecard, which includes measures voluntarily reported by states as well as federally reported measures in three areas: state health system performance; state administrative accountability; and federal administrative accountability. Press release: https://go.cms.gov/2LHt1gn Blog post: https://bit.ly/2syIXtQ Scorecard: https://bit.ly/2M6ZKg3
  • Also on June 5, CMS released a report on Medicaid expenditures for long-term services and supports (LTSS) in FY 2016, finding that spending rose 24 percent between FY 2015 and 2016. Report: http://bit.ly/2HC87fX
  • On June 6, U.S. Government Accountability Office (GAO) released a report finding that CMS’ estimate of improper payments for Medicaid managed care has limitations that are not mitigated by the agency’s and states’ current oversight efforts and recommending that CMS should take steps to mitigate program integrity risks. Summary with link to report: https://bit.ly/2JvFlQ6

 New Payment and Delivery System Reforms –

  • On June 8, CMS announced a partnership with the state of Maryland to test the Maryland Total Cost of Care (TCOC) Model, which sets a per capita limit on Medicare total cost of care in the state. It is the first CMS Innovation Center model to hold a state fully at risk for the total cost of care for Medicare beneficiaries and expands on the Maryland All-Payer Model. Model details: https://bit.ly/2sIpozo
  • Also on June 8, CMS released a final rule on changes to the Comprehensive Care for Joint Replacement Payment Model (CJR) for participant hospitals located in areas impacted by extreme and uncontrollable circumstances for performance years 3 through 5. Final rule: https://bit.ly/2sGUBD1

Mental Health and Substance Abuse –

  • On June 4, Substance Abuse and Mental Health Administration (SAMHSA) announced the availability of Providers Clinical Support System – Universities (PCSS – Universities) grants totaling up to $10.8 million over the next three years. Applications are due July 25. Press release: https://bit.ly/2sCKFug
  • On June 5, U.S. Preventive Services Task Force issued a draft recommendation statement on screening and behavioral interventions for unhealthy alcohol use in adolescents and adults. Draft recommendation: https://bit.ly/2JrLCvV
  • On June 7, the White House announced a new series of advertisements as part of a national campaign to promote awareness opioid addiction. White House fact sheet: http://bit.ly/2sLvi30 HHS press release: https://bit.ly/2HwNbHn
  • Also on June 7, CDC released a study finding that suicide rates rose across the United States from 1999 to 2016, with nearly 45,000 Americans aged 10 or older dying by suicide in 2016. Press release: https://bit.ly/2Jl54hQ
  • Also on June 7, CDC released data showing that among adults aged 18 and over, the rate of mental health-related physician office visits to psychiatrists was higher compared with the rate to primary care physicians overall. Summary with link to report: http://bit.ly/2LGCUun
  • Also on June 7, House Energy & Commerce Committee Ranking Member Pallone (D-NJ) released a letter from the National Institutes of Health announcing the agency will ask the National Academies of Sciences, Engineering, and Medicine to conduct a study on Medication Assisted Treatment for Opioid Use Disorder. Press release: http://bit.ly/2LGlHRX Letter: http://bit.ly/2LFHObc
  • Also on June 7, Centers for Disease Control and Prevention (CDC) released a study showing a decline in youth tobacco use from 2011 to 2017. Press release: https://bit.ly/2Majboi

Drug Prices and Regulation –

  • On June 4, Food and Drug Administration (FDA) Commissioner Gottlieb released a statement on the proposed modernization of FDA’s drug review office. Statement: https://bit.ly/2sqnSC3
  • Also on June 4, Sen. Durbin penned letters to FDA Commissioner Gottlieb and Pfizer’s Meridian Medical Technologies, Inc., pressing the entities for information on EpiPen shortages. Press release: https://bit.ly/2sJ3zjf Letter to FDA: https://bit.ly/2kWtBv2 Letter to Pfizer: https://bit.ly/2M5cCTT
  • On June 6, FDA Commissioner Gottlieb and FDA Deputy Commissioner for Policy, Planning, Legislation, and Analysis Abram wrote a blog post highlighting the FDA’s efforts to advance biotechnology innovation. Blog post: http://bit.ly/2sjaaDj
  • On June 7, HHS Secretary Azar held a roundtable with medical device leaders to explore ways to break down barriers to innovation and lower the cost of health care. Press release: https://bit.ly/2JqLOeZ

Military & Veterans’ Health –

  • On June 4, U.S. Government Accountability Office (GAO) released a report recommending that improvements are needed to address access-related challenges as the VA plans consolidation of its community care programs. Summary and report: https://bit.ly/2Jchys6
  • Also on June 4, VA announced that the Board of Veterans’ Appeals has resolved a record number of claims to-date for FY 2018. Press release: http://bit.ly/2HCAMl4
  • On June 8, VA announced it has opened its third Veterans Crisis Line call center in Topeka, Kansas, helping to support increased demand. Press release: http://bit.ly/2HBC0x7

Health IT –

  • On June 5, House Energy & Commerce Committee Chair Walden (R-OR), Ranking Member Pallone (D-NJ), Senate HELP Committee Chair Alexander (R-TN), and Ranking Member Murray (D-WA) penned a letter to HHS Secretary Azar raising concerns around the implementation of cyber security measures in health care. Press release: https://bit.ly/2LZWyTl Letter: https://bit.ly/2kZxwre

 Misc. –

  • On June 4, National Institutes of Health released its Strategic Plan for Data Science, including its plans for managing and researching data in areas such as genomics and electronic health records. Strategic plan: http://bit.ly/2HAhdKg
  • On June 5, HHS released data showing that a decline in hospital-acquired conditions prevented an estimated 8,000 deaths and saved $2.9 billion between 2014 and 2016. Press release: https://go.cms.gov/2sGkqDo Fact sheet: https://go.cms.gov/2LCih2G Report: https://bit.ly/2JlO9Mi
  • Also on June 5, CDC released data on office-based physician visits, finding that there were an estimated 313 office-based physician visits per 100 persons in 2015. Summary with link to report: http://bit.ly/2LGrQ0t
  • On June 7, HHS published a request for information (RFI) on the facilitation of public-private dialogue to increase innovation and investment in the health care sector. Comments are due by July 7. RFI: http://bit.ly/2JNFuBw