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


 What’s Ahead: This Week

Hearings & Markups –

  • Tuesday, September 25
    • Senate HELP Committee, Subcommittee on Primary Health and Retirement Security, “Health Care in Rural America: Examining Experiences and Costs.”
  • Wednesday, September 26
    • House Oversight & Government Reform Committee, Subcommittee on Health Care, Benefits and Administrative Rules & Subcommittee on Intergovernmental Affairs, “Joint Hearing: Supplemental Nutrition Assistance Program Fraud.”
    • Senate Veterans Affairs Committee, “The State of the VA: A 60 Day Report.”
  • Thursday, September 27
    • Senate HELP Committee, “Reducing Health Care Costs: Improving Affordability through Innovation.”
    • House Veterans Affairs Committee, “Veteran Suicide Prevention: Maximizing Effectiveness and Increasing Awareness.”
    • House Energy & Commerce Committee, Subcommittee on Health, “Better Data and Better Outcomes: Reducing Maternal Mortality in the U.S.”
    • House Ways & Means Committee, Subcommittee on Social Security, “The State of Social Security’s Information Technology.”
  • Friday, September 28
    • House Judiciary Committee, Subcommittee on the Constitution and Civil Justice,
      Examining Sober Living Homes.”

Notable Policy Events –

  • Monday, September 24
    • National Academy of Medicine, “Meeting #2 – Committee on Integrating Social Needs into the Delivery of Health Care to Improve the Nation’s Health.” Additional information: http://bit.ly/2IaaqsL
  • Monday, September 24 – Wednesday, September 26
    • UsAgainstAlzheimer’s, “Uniting Communities for a Cure Annual Summit.” Additional information: https://bit.ly/2OVGWkk
  • Tuesday, September 25
    • Alliance for Health Policy (AHP), “Webinar: Health Care in the Courts.” Additional information: https://bit.ly/2OCWeuL
  • Wednesday, September 26
    • Bipartisan Policy Center (BPC), “Tackling the Opioid Epidemic at the Federal and State Levels.” Additional information: https://bit.ly/2xECoI2
  • Thursday, September 27
    • Partnership to Empower Physician-Led Care (PEPC), “Briefing on Value-Based Care.”
    • Kaiser Family Foundation, “A Discussion on Medical Overtreatment.” Additional information: https://bit.ly/2prwhmT
    • The Hill, “Evolution of Telehealth: Patient Awareness and Education.” Additional information: http://bit.ly/2I9rij5

 

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

 Appropriations –

  • On September 18, the Senate passed by a vote of 93-7 the conference report of the Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 (H.R. 6157), by a vote of 93-7. The conference report now moves to the House for consideration. Press release: https://bit.ly/2NR9SwX

 Nominations –

  • On September 18, the Senate Finance unanimously approved the appointment of Elizabeth Darling to serve as HHS Commissioner on Children, Youth, and Families. The nomination now moves to the full Senate for consideration. Press release: https://bit.ly/2OIQmjB
  • Also on September 18, Senate Veterans Affairs Committee approved James Gfrerer to be Chief Information Office and Assistant Secretary for Veterans Affairs Office of Information and Technology and Tamara Bonzanto to be Assistant Secretary of the VA Office of Accountability and Whistleblower Protection. The nominations now move to the full Senate for consideration. Press release: http://bit.ly/2QN3HZr

 Legislative Activity –

  • On September 17, the Senate passed by a vote of 99-1 the SUPPORT for Patients and Communities Act (H.R. 6). The bill aims to address the opioid crisis, and now moves to a conference committee between the House and Senate for consideration. Press release: https://bit.ly/2NTY3Gd Bill text: https://bit.ly/2xmVgw1
  • Also on September 17, the Senate passed by a vote of 98-2 the Patient Right to Know Drug Prices Act (S. 2554), which would prohibit health insurance issuers and group health plans from utilizing pharmacy gag clauses. The measure now moves to the House for consideration. Press release: https://bit.ly/2QIFELk Bill text: https://bit.ly/2DcRI4D
  • On September 18, President Trump signed into law the Children’s Hospital GME Support Reauthorization Act (H.R. 5385), which would reauthorize the program of payments to children’s hospitals that operate graduate medical education programs. Bill text: https://bit.ly/2wQq9HZ Energy and Commerce press release: https://bit.ly/2I8C89e
  • Also on September 18, Sens. Cassidy (R-LA), Bennet (D-CO), Grassley (R-IA), Carper (D-DE), Young (R-IN), and McCaskill (D-MO) released draft legislation which would protect patients from surprise medical bills in situations where they see an out-of-network provider at an in-network facility. Press release: https://bit.ly/2NTuDIn Discussion draft: https://bit.ly/2xCP2r7
  • Also on September 18, Sens. Portman (R-OH), Durbin (D-IL), Cardin (D-MD), and Brown (D-OH) introduced the Improving Coverage for Addiction Recovery Expansion Act (S. 3462), which would lift the Medicaid IMD exclusion for treatment of substance use disorder. Press release: https://bit.ly/2Nkhk4d Text: https://bit.ly/2xmWs2t
  • Also on September 18, Sens. Inhofe (R-OK) and Sanders (I-VT) introduced the CT Colonography Screening for Colorectal Cancer Act of 2018 (S. 3465), which would cover screening computed tomography colonography as a colorectal cancer screening test under the Medicare program. Press release: https://bit.ly/2DbdTYZ Bill text: https://bit.ly/2MOz4zA
  • On September 19, Sens. Cassidy (R-LA) and Smith (D-MN) introduced the Reducing Administrative Costs and Burdens in Health Care Act (S. 3434), which would provide for grants to enable states to carry out activities to reduce administrative costs and burdens in health care. Press release: https://bit.ly/2xwsf0P Bill text: https://bit.ly/2Dl282o
  • On September 20, Reps. Bishop (R-MI) and Coffman (R-CO) introduced the VA Safe Opioid Return Act (H.R. 6848), which would require a physical pill drop off receptacle at all VA medical facilities nationwide, if such VA centers have an on-site pharmacy or law enforcement officer. Press release: https://bit.ly/2DjCqLB Bill text: https://bit.ly/2DigccQ
  • Also on September 20, Rep. MacArthur (R-NJ) led the New Jersey House delegation in introducing H.R. 6855, which would codify and permanently extend the Medicare hospital wage index imputed rural floor. Press release: https://bit.ly/2pu0YYG

ACA Implementation –

  • On September 21, House Oversight & Government Reform Committee Ranking Member Cummings (D-MD) sent a letter to Committee Chair Gowdy (R-SC) requesting that he issue a subpoena to compel HHS and CMS to produce documents regarding the scrubbing of content about the Affordable Care Act from the Medicare.gov website. Press release: https://bit.ly/2prWFwX Letter: https://bit.ly/2puySMO

 Medicare

  • On September 17, CMS issued a proposed rule to revise the applicable conditions of participation for providers and conditions for coverage as a continuation of the Administration’s efforts to reduce regulatory burden in accordance with the January 2017 Executive Order 13771. Comments are due by November 19. CMS Administrator Verma’s remarks: https://go.cms.gov/2NZyzHB Press release: https://go.cms.gov/2PUEtY0 Fact sheet: https://go.cms.gov/2xkTYRZ Proposed rule: https://bit.ly/2xeZzt6
  • On September 18, HHS Office of Inspector General (OIG) released a report recommending that CMS improve its existing IT controls to enhance the resiliency of the Medicare enrollment system. Report: https://bit.ly/2MRBa1N
  • On September 20, HHS OIG released a report on Medicare payments for clinical diagnostic laboratory tests in 2017, showing that the program paid $7.1 billion under Part B for lab tests in 2017 – a number that has changed very little from 2014. Report: https://bit.ly/2I51MLZ
  • On September 19, Senate Judiciary Committee Chair Grassley (R-IA) penned a letter to CMS Administrator Verma expressing his concern about CMS’ efforts to ensure quality nursing home care to Medicare and Medicaid beneficiaries. Press release: https://bit.ly/2xutmy6 Letter: https://bit.ly/2I6tQPd
  • On September 21, CMS awarded seven organizations funding to develop, improve, update, or expand quality measures for Medicare’s Quality Payment Program (QPP). Press release: https://go.cms.gov/2zlFl2r

 Medicaid –

  • Also on September 20, House Oversight & Government Reform Full Committee Ranking Member Cummings (D-MD) and Subcommittee on Health Care, Benefits, and Administrative Rules Ranking Member Krishnamoorthi penned a letter to Full Committee Chair Gowdy (R-SC) seeking a subpoena for the documents from HHS and CMS regarding the Administration’s continued push for states to impose work requirements for Medicaid beneficiaries. Press release: https://bit.ly/2PSa8JB Letter: https://bit.ly/2Dnasid
  • Also on September 21, CMS deemed complete and released for public comment Alabama’s section 1115 waiver application to impose work requirements for its parent caretaker beneficiaries. Comments are due by October 21. Waiver: http://bit.ly/2QQBiSv

 Payment and Delivery System Reforms –

 Mental Health and Substance Use –

  • On September 18, HHS released a report on opioid-related inpatient stays and emergency department visits among patients aged 65 years and older in 2010 and 2015, finding that inpatient stays increased by almost 55 percent, and ED visits increased by 100 percent. Report: https://bit.ly/2zlyN3R
  • Also on September 18, Assistant Secretary for Health Giroir posted a blog on how telemedicine can effectively be used to combat the opioid epidemic. Blog: https://bit.ly/2pjG0LU
  • Also on September 18, Food and Drug Administration (FDA) released the final Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS), which requires that training be made available to all health care providers who are involved in the management of patients with pain, including nurses and pharmacists. Press release: https://bit.ly/2Np8v9m Strategy: https://bit.ly/2iaLyUT
  • Also on September 18, FDA announced a comprehensive campaign to warn kids about the dangers of e-cigarette use. Press release: https://bit.ly/2ODhAIi FDA Commissioner Gottlieb’s statement: https://bit.ly/2xx3fps
  • On September 19, Centers for Disease Control and Prevention (CDC) announced $155 million in funding to states and territories to advance the understand of the opioid epidemic and scale-up prevention and response efforts. Press release: https://bit.ly/2xtXGJi
  • Also on September 19, HHS announced that it is awarding over $1 billion to combat the opioid crisis, including $930 million in State Targeted Response Grants. Press release: https://bit.ly/2OGojkT
  • Also on September 19, National Institutes of Health (NIH) announced six research awards totaling $9.4 million over three years to study the impact of behavioral interventions on drug usage and recovery. Press release: https://bit.ly/2QPD862
  • On September 20, the U.S. Surgeon General released a report providing an in-depth review of the nation’s substance abuse problems and potential pathways to recovery. Press release: https://bit.ly/2QPznh5 Report: https://bit.ly/2PUmIrK
  • Also on September 20, Sens. Portman (R-OH) and Whitehouse (D-RI) sent a letter to Senate Majority Leader McConnell (R-KY), Minority Leader Schumer (D-NY), Senate HELP Committee Chair Alexander (R-TN) and Ranking Member Murray (D-WA) urging them to include the CARA 2.0 Act of 2018 into the House-Senate conference negotiations of the opioids package. Press release: https://bit.ly/2QSyNz9 Letter: https://bit.ly/2xCDcxa CARA 2.0 bill text: https://bit.ly/2xuc8kx
  • Also on September 20, HHS announced that it is sponsoring the development of an intranasal form of a long-acting opioid overdose reversal drug. Press release: https://bit.ly/2OD0cDp
  • Also on September 20, Substance Abuse and Mental Health Services Administration (SAMHSA) released guides to help women navigate opioid use disorder treatment while pregnant. Press release: https://bit.ly/2NsaXMq

Drug Prices and Regulation –

  • On September 17, Department of Justice (DoJ) approved the pending merger between Cigna Corporation and Express Scripts Holding Company. Press release: https://bit.ly/2MHfHsn

 Military & Veterans’ Health –

  • On September 17, U.S. Government Accountability Office (GAO) released a report recommending that Department of Defense (DoD) use common key quality measures, expand their range, and develop consistent performance standards and requirements for all providers. Report: https://bit.ly/2PTXhX4
  • On September 18, Department of Veterans Affairs (VA) announced that it exceeded its goal to deliver 81,000 appeals decisions of disability benefits and services to veterans in FY18, a 28,000 increase from FY17. Press release: https://bit.ly/2pquBK6
  • Also on September 18, VA announced that its web-based report scorecard showed that the majority of VA medical centers have improved over the past year in quality of services provided to veterans. Press release: https://bit.ly/2xv7cf3
  • Also on September 18, Sens. Blumenthal (D-CT) and Brown (D-OH) penned a letter to VA Inspector General Missal urging OIG to investigate recent reports of undue influence by outside individuals on policy and personnel decisions at VA. Letter: https://bit.ly/2pst9qI

Health IT –

  • On September 17, HHS released a report on the state of data sharing at the Department, noting that identifying use cases and demonstrating the business value of data sharing will be critical to the Department’s efforts to addressing these challenges. Press release: https://bit.ly/2MSwFEi Report: https://bit.ly/2MRHZQQ
  • On September 21, the White House released a National Cyber Strategy: Plan: http://bit.ly/2QQP0o9

 Misc. –

  • On September 19, Centers for Disease Control and Prevention (CDC) released data on the prevalence of total, diagnosed, and undiagnosed diabetes among adults in the United States between 2013 and 2016. The data showed that the prevalence of total diabetes was 14 percent, the prevalence of diagnosed diabetes was 9.7 percent, and the prevalence of undiagnosed diabetes was 4.3 percent. Report: https://bit.ly/2OOYBuc
  • Also on September 19, CDC released a report on mortality trends in the U.S., finding that death rates increased for five of the leading 12 causes of death from 2000 to 2016. Report: http://bit.ly/2QQ9OvZ
  • On September 19, HHS Deputy Secretary Hargan announced the creation of the Deputy Secretary’s Innovation and Investment Summit (DSIIS), a yearlong collaboration between health care innovation and investment professionals and HHS personnel who will meet quarterly to discuss innovation and investment in the health care sector. The announcement follows a June 2018 RFI requesting feedback on this issue. Press release: https://bit.ly/2Nx7k7S RFI: https://bit.ly/2kZ8UP8