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


 What’s Ahead: This Week

Hearings & Markups –

  • Tuesday, August 21
    • Senate Homeland Security & Governmental Affairs Committee, “Examining CMS’s Efforts to Fight Medicaid Fraud and Overpayments.”
  • Wednesday, August 22
    • Senate Finance Committee, “Nomination of Elizabeth Darling to be HHS Commissioner of Children, Youth, and Families.”
  • Thursday, August 23
    • Senate HELP Committee, “Prioritizing Cures: Science and Stewardship at the National Institutes of Health.”

 Notable Policy Events –

  • Monday, August 20
    • Partnership to Empower Physician-Led Care (PEPC), “Webinar: Impact of ACO Rule for Independent Physicians.”
  • Wednesday, August 22
    • Alliance for Health Policy (AHP), “Briefing: Dying of Despair? Understanding Declining Life Expectancy in the United States.” Additional information: https://conta.cc/2MVivCW

 

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

 Legislative Activity –

  • On August 16, Sens. Merkley (D-OR), Blumenthal (D-CT), Feinstein (D-CA), Warren (D-MA), Durbin (D-IL), Menendez (D-NJ), and Hassan (D-NH) introduced the Medical Debt Relief Act (S. 3351), which would institute a 180-day waiting period before medical debt will be reported on a consumer’s credit report and to remove paid-off and settled medical debts from credit reports that have been fully paid for settled, to amend the Fair Debt Collection Practices Act to provide a timetable for verification of medical debt and to increase the efficiency of credit markets with more perfect information. Press release: http://bit.ly/2Mm1tla Bill text: http://bit.ly/2vWuxWe

 ACA Implementation –

  • On August 13, HHS Office of Inspector General (OIG) released a study finding that CMS did not always accurately authorize financial assistance payments to qualified health plan issuers in accordance with federal requirements during the 2014 benefit year, estimating that over $434 million was improperly paid to issuers. Summary: https://bit.ly/2wc5AWl Report: https://bit.ly/2Pd1pSC
  • On August 16, CMS approved New Jersey’s waiver for a reinsurance program under a Section 1332 waiver. The program will be partially funded by the expected revenue from the state’s individual mandate penalty. Approval: https://go.cms.gov/2MoxXey

 Medicare –

  • On August 14, Senate Finance Committee Ranking Member Wyden (D-OR) penned a letter to CMS Administrator Verma, asking the agency for further details on its recent efforts to update the Skilled Nursing Facility (SNF) 5-Star Quality Rating System. Press release: https://bit.ly/2OGbLJM Letter: https://bit.ly/2BgtKEA
  • On August 15, House Ways & Means Committee Chair Brady (R-TX) and Health Subcommittee Chair Roskam (R-IL) released a report outlining the Committee’s progress in soliciting feedback on how lawmakers and the Administration can cut regulatory burdens in the Medicare program, as well as the Committee’s next steps. Press release: https://bit.ly/2OBVMfN Report: https://bit.ly/2ODDMS5

 Medicaid –

  • On August 13, Sen. Harris (D-CA) and Reps. Eshoo (D-CA) and Lofgren (D-CA) led California’s Democratic congressional delegation in a letter to HHS Secretary Azar expressing concern over CMS’ proposed rule to restrict home care workers’ ability to voluntarily have union dues or health insurance automatically deducted from their paychecks. Press release: https://bit.ly/2OLSlTT Letter: https://bit.ly/2KYeyeV
  • On August 14, Southern Poverty Law Center and other advocacy groups filed a lawsuit on behalf of three beneficiaries against the Trump administration, challenging the federal government’s approval of Arkansas’ secton 1115 waiver allowing the state require beneficiaries to meet community engagement requirements as a condition of receiving Medicaid benefits. Press release: https://bit.ly/2MkgmVo Lawsuit: https://bit.ly/2BfkIb7
  • On August 16, CMS released an informational bulletin on the agency’s State Plan Amendment and Section 1915 waiver process improvements, which are intended to improve processing times and communication with states. Press release: https://go.cms.gov/2MPXHwQ Bulletin: https://bit.ly/2vOquLs

 New Payment and Delivery System Reforms –

  • On August 17, CMS released the first evaluation report for the Home Health Value-Based Purchasing Model, finding that the model has resulted in early overall improvement in home health agency total performance scores but mixed results for Medicare spending and utilization. Report: http://bit.ly/2MqZcp5

Mental Health and Substance Use –

  • On August 15, Centers for Disease Control and Prevention (CDC) released provisional data finding that drug overdoses were responsible for nearly 71,000 deaths in 2017, up from about 65,000 in 2016. Report: https://bit.ly/2rS8W1C
  • On August 16, Drug Enforcement Administration (DEA) issued a proposed rule to reduce production quotas for nearly all Schedule II prescription opioids by an average of 10 percent in 2019. Press release: https://bit.ly/2PfddDT Proposed rule: https://bit.ly/2OLtkIl Durbin (D-IL) and Kennedy (R-LA) statement: https://bit.ly/2MmAxlh
  • Also on August 16, Food and Drug Administration (FDA) Commissioner Gottlieb released a statement on the significant public health value and cost savings resulting from the agency’s youth smoking prevention campaign, finding that the campaign saved more than $31 billion. Press release: https://bit.ly/2MWTV4S
  • On August 17, HHS released an Opioid Management Toolkit for primary care providers. Toolkit: http://bit.ly/2vWnLzM
  • Also on August 17, Sen. Markey (D-MA) sent a letter to FDA Commissioner Gottlieb requesting information on the FDA’s efforts to administer, monitor and analyze the Risk Evaluation and Mitigation Strategy for prescription opioids, including fentanyl. Press release: http://bit.ly/2Bsc60X Letter: http://bit.ly/2BsbVCP

Drug Prices and Regulation –

  • On August 14, Senate Judiciary Committee Chair Grassley (R-IA) penned a letter to Assistant Attorney General for Antitrust Delrahim requesting that the Department of Justice conduct a vigorous review of the proposed mergers of Cigna with Express Scripts, and CVS Health with Aetna to ensure that competitive markets in the pharmaceutical supply chain are not impacted adversely. On August 17, Chair Grassley also sent a similar letter to the Federal Trade Commission. Press releases: https://bit.ly/2nG2W7h and http://bit.ly/2BuvZEE Letters: https://bit.ly/2ONgVUv and http://bit.ly/2BsINv1
  • On August 16, FDA approved the first generic version of EpiPen auto-injector for the emergency treatment of allergic reactions. Press release: https://bit.ly/2OBbUhm House Energy and Commerce Majority press release: https://bit.ly/2nKLHS8 Grassley press release: https://bit.ly/2MSgdV7
  • Also on August 16, HHS Secretary Azar met with specialty and patient groups regarding the department’s new initiative to allow Medicare Advantage plans to use step therapy or prior authorization to negotiate lower drug prices. Press release: https://bit.ly/2Mz0FZF
  • On August 17, Sens. Warren (D-MA) and Smith (D-MN) penned a letter to HHS Secretary Azar, pressing him on his June 2018 testimony blaming pharmacy benefit managers and drug distributers for the fact that drug manufacturers have refused to meaningfully reduce prices. Press release: https://bit.ly/2L1g2VS Letter: https://bit.ly/2nJcmil

Military & Veterans’ Health –

  • On August 13, Department of Veterans Affairs (VA) announced several leadership changes within the department. Pamela Powers will serve as VA Chief of Staff; Peter O’Rourke will serve as Senior Advisor; Jacquelyn Hayes-Bird will serve as Acting Assistant Secretary for Human Resources and Administration; and Chris Syrek will serve as VA Deputy Chief of Staff. Press release: https://bit.ly/2MtIZ1s
  • Also on August 13, VA updated the disability rating schedule that evaluates conditions related to the skin. Press release: https://bit.ly/2MjaP13
  • On August 16, VA Office of Inspector General (OIG) released a report showing that management improvements are needed in the department’s program of comprehensive assistance for family caregivers. Summary: https://bit.ly/2PiIGVS Report: https://bit.ly/2MmBeuT
  • On August 17, VA announced a partnership with Walgreens to coordinate patient and pharmaceutical care for VA-enrolled patients. Press release: https://bit.ly/2OLbghC

 Health IT –

  • On August 13, HHS launched the Step Up Challenge, a three-phase competition to address the need for greater use of standardized patient-reported outcomes data in clinical care and research. The total prize pool is $250,000. Press release: https://bit.ly/2MVq10N
  • On August 15, CDC released a report on patient health information shared electronically by office-based physicians in 2015. The report provides the first national estimates for types of patient health information that are electronically handled by physicians with EHR system, and could be used as a benchmark for future studies. Report: https://bit.ly/2vRcr7Z

Misc. –

  • On August 15, HHS announced $125 million in Quality Improvement grant awards to 1,352 community health centers across the country. Press release: https://bit.ly/2weGVAa
  • On August 17, CDC released a report showing that a 25.7 percent of American adults have a disability that impacts a major aspect of their lives. Mobility was the most prevalent disability type, following by cognition and independent living. Report: https://bit.ly/2BijQTd