What’s Ahead: This Week

 Hearings/Markups –

  • Tuesday, July 10
    • Senate Veterans’ Affairs Committee, “Meeting to Consider the Pending Nomination of Robert Wilkie.”
  • Wednesday, July 11
    • House Energy & Commerce Committee, Subcommittee on Health, “Opportunities to Improve the 340B Drug Pricing Program.”
  • Thursday, July 12
    • House Veterans Affairs Committee, “Business Meeting to Assign New Members to New HVAC Subcommittee and Full Committee Markup on Pending Legislation.”

 Notable Policy Events –

  • Monday, July 9
    • American Enterprise Institute (AEI), “Whiplash: The Affordable Care Act’s Twisted Path through Implementation, Litigation, and Reinterpretation.” Additional information: https://bit.ly/2KT6tsU
  • Tuesday, July 10
    • Pew Charitable Trusts, “State Efforts to Lower Drug Spending.” Additional information: https://bit.ly/2KTRGhp
  • Wednesday, July 11
    • National Academy of Science, “The Intersection of Behavioral Health, Mental Health, and Health Literacy: A Workshop.” Additional information: http://bit.ly/2ND6VwX
  • Thursday, July 12
    • Alliance for Health Policy (AHP), “Reporting on the Future of Health Care.” Additional information: https://conta.cc/2ze4nCl
    • Altarum Center for Value in Health Care, “Sustainable U.S. Health Spending: Serious Issues – Sound Policy Solutions.” Additional information: http://bit.ly/2KQoPOf
    • Cato Institute, “Patient Safety: To Err is Human.” Additional information: https://bit.ly/2u3iPbF
  • Friday, July 13
    • Brookings Institution, “(De)stabilizing the Affordable Care Act’s Individual Market: A View from the States.” Additional information: https://brook.gs/2lTZLb9


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

 ACA Implementation –

  • On July 2, CMS published the Early 2018 Effectuated Enrollment Snapshot, which shows enrollment in Federal and State-Based Exchanges based on payment of the first month’s premium; the number of individuals with effectuated coverage for February 2018 is approximately 3 percent higher than the February 2017 effectuated enrollment. Press release: https://go.cms.gov/2IUnIID Report: https://go.cms.gov/2zeTHng Exchange Trends Report: https://go.cms.gov/2KDMnWt Trends in Subsidized and Unsubsidized Marketplace Enrollment: https://go.cms.gov/2lV1nS7
  • On July 5, CMS deemed complete and released for public comment Maryland’s proposed section 1332 State Innovation Waiver, which would establish a state-based reinsurance program. Comments are due by August 4. Letter to MD: https://go.cms.gov/2KRnVxH Waiver: http://bit.ly/2kQR8Od
  • On July 6, CMS released guidance on the annual eligibility redetermination and re-enrollment for exchange coverage for 2019 and later years. Guidance: https://go.cms.gov/2L16knj
  • On July 7, CMS announced it will no longer collect or make payments under the ACA’s risk adjustment program, including amounts for the 2017 benefit year, citing a February 28, 2018 ruling from the U.S. District Court for the District of New Mexico and the ongoing litigation. Press release: https://go.cms.gov/2NCcMTq

 Medicare –

  • On July 2, U.S. Government Accountability Office (GAO) released a report detailing small and rural practices’ experiences in previous payment programs in Medicare and expected performance in the Merit-based Incentive Payment System (MIPS). Report: https://bit.ly/2lWRW4I
  • Also on July 2, CMS released its Annual Report to Congress on the Open Payments Program, which includes information about financial relationships between the health care industry and health care providers. Report: https://go.cms.gov/2KPyamg Grassley statement: https://bit.ly/2tXqMPw
  • Also on July 2, CMS released the proposed calendar year (CY) 2019 Home Health Prospective Payment System Rate Update and CY20 Case-Mix Adjustment Methodology Refinements, which would shorten home health episodes from 60 days to 30 days and provide for remote patient monitoring reimbursement. Comments are due by August 31. Press release: https://go.cms.gov/2MGclGn Fact sheet: https://go.cms.gov/2z7KZab Proposed rule: https://bit.ly/2lNvryX

 Medicaid –

  • On July 2, Kentucky Department of Health and Family Services announced that it would no longer cover vision and dental services for Medicaid expansion beneficiaries in the wake of a ruling preventing the state from implementing its proposed work requirements. Announcement: http://bit.ly/2NyakgB
  • On July 6, CMS announced the final federal share disproportionate share hospital (DSH) allotments for fiscal year (FY) 2016 and the preliminary federal share DSH allotments for FY18. The notice also announces the final FY16 and preliminary FY18 limitations on aggregate DSH payments that states may make to institutions for mental disease and other mental health facilities. Notice: https://bit.ly/2zflvHV

 New Payment and Delivery System Reforms –

  • On July 3, CMS released a toolkit to help organizations to meet the overall goals of the Bundled Payments for Care Improvement initiative. Toolkit: http://bit.ly/2KVhHx3

Mental Health & Substance Abuse –

  • On July 6, Sen. Brown (D-OH) led a bipartisan group of senators in a letter to CDC calling for more resources and better support for forensic medicine practitioners given the recent rise in overdose deaths in the U.S. Press release with text of letter: http://bit.ly/2KQHdGS

 Military & Veterans’ Health –

  • On July 2, Department of Veterans Affairs (VA) released state-level veteran suicide data as a follow-up to its 2015 National Suicide Data Report which was released on June 18, along with the National Strategy for Preventing Veteran Suicide. Press release: https://bit.ly/2NsbBpq State-level data: https://bit.ly/2xtDWpp Suicide Prevention Strategy: https://bit.ly/2NsLQFF
  • On July 6, VA kicked off a new “Choose VA” marketing campaign, meant to highlight veterans benefits and services and to attract and retain employees. Press release: http://bit.ly/2KSgREm Campaign: http://bit.ly/2KVkJVq

 Health IT

  • On July 2, HHS Office of the National Coordinator for Health IT (ONC) announced a funding opportunity of up to $2 million for two recipients to expand the scope, scale, and utility of population-level data-focused application programming interfaces and to advance clinical knowledge at the point of care. Applications are due by August 17. Press release: http://bit.ly/2KUKthd


  • On July 6, Centers for Disease Control and Prevention (CDC) released a report evaluating occupational exposure limits for heat stress in outdoor workers in the United States between 2011 and 2016. Report: https://bit.ly/2KD5pxi