What’s Ahead: This Week

Notable Policy Events

  • Monday, October 29 – Tuesday, October 30
    • American Bar Association’s Joint Committee on Employee Benefits, “2018 Health and Welfare Benefit Plans National Institute.” Additional information: https://bit.ly/2O5D9jv
  • Tuesday, October 30
    • The Heritage Foundation, “Chemical Slavery: Understanding Addiction and Stopping the Drug Epidemic.” Additional information: https://herit.ag/2PnxKZR
  • Tuesday, October 30 – Wednesday October 31
    • National Academy of Sciences, Engineering, and Medicine (NASEM), Committee on Medication-Assisted Treatment for Opioid Use Disorder, “Public Workshop of the Committee on Medication-Assisted Treatment for Opioid Use Disorder.” Additional information: https://bit.ly/2Obp18H
  • Wednesday, October 31
    • Internet Innovation Alliance (IIA), “Is Next Generation Broadband the Key to Improving Patient Outcomes Through Telemedicine?” Additional information: https://bit.ly/2SjZgGe
  • Thursday, November 1
    • NASEM, “The Next Generation of Patient-Focused Care: Healthcare System Integration for Coordinated Care.” Additional information: http://bit.ly/2RkfK00v
  • Thursday, November 1 – Friday, November 2
    • Medicare Payment Advisory Committee (MedPAC), “November Public Meeting.” Additional information: https://bit.ly/2zeAzlQ

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

 Legislative Activity –

 ACA and Individual Insurance Markets –

  • On October 26, CMS announced additional consumer supports and visual enhancements to the HealthCare.gov Open Enrollment platform. Open enrollment runs from November 1, 2018 – December 15, 2018. Press release: https://go.cms.gov/2PYfMua
  • Also on October 26, HHS published information on qualified health plans (QHPs) available in the Exchange for states that use the HealthCare.gov platform, including estimates for issuer participation, premiums, and subsidies. Report: https://bit.ly/2yB3txg

 Medicare –

  • On October 23, Reps. Black (R-TN) and Welch (D-VT) led a group of seven representatives in a letter to CMS Administrator Verma expressing some concerns about CMS’s proposals to reform the Medicare Shared Savings Program by shortening the glide path for new ACOs to assume financial risk and by cutting the shared savings rate. Letter: https://bit.ly/2Jo2RPB
  • On October 24, CMS released skilled nursing facility (SNF) Quality Reporting Program (QRP) data on the agency’s Nursing Home Compare website for the first time. Fact sheet: https://go.cms.gov/2PkkaGP
  • On October 26, CMS released a proposed rule that updates Medicare Advantage and the Medicare prescription drug benefit program to implement certain provisions of the Bipartisan Budget Act of 2018, including by allowing MA plans to offer telehealth services starting in 2020; to improve quality and accessibility, to clarify program integrity policies; and to implement other changes. Comments are due by January 1. Press release: https://go.cms.gov/2zdDjQK Fact sheet: https://go.cms.gov/2zdDifE  Proposed rule: https://bit.ly/2yAhviu

 Payment and Delivery System Reforms –

  • On October 23, CMS announced the Maternal Opioid Misuse (MOM) model, which aims to better align and coordinate care of pregnant and post-partum Medicaid beneficiaries with opioid use disorder (OUD) through state-driven reform of the delivery system surrounding this population. Press release: https://go.cms.gov/2RbIqs2 Fact sheet: https://go.cms.gov/2CK6D4L Model: https://bit.ly/2JeCwTZ

 Drug Prices and Regulation

  • On October 24, HHS published a study on cost drivers in the development and validation of biomarkers used in drug development. Report: https://bit.ly/2Jiutpo
  • On October 25, CMS issued an advanced notice of proposed rulemaking (ANPRM) seeking comment on a potential international pricing index (IPI) model for Medicare Part B drugs. Comments are due December 31, 2018. Press release: https://bit.ly/2JeAROh Fact sheet: https://go.cms.gov/2Jg8DCX ANPRM: https://go.cms.gov/2JjFEyb
  • Also on October 25, HHS published a study comparing U.S. and international prices for top Medicare Part B drugs by total expenditures, finding that prices in the U.S. are 1.8 times higher than in the other countries included in the analysis. Report: https://bit.ly/2z6vQ5B
  • Also on October 25, Sens. Warren (D-MA) and Smith (D-MN) sent a letter to HHS Secretary Azar requesting information about his previous claims that pharmacy benefit managers and drug distributers are refusing to cooperate with manufacturers’ plans to lower their drug prices. Press release: https://bit.ly/2ObZAnq  Letter: https://bit.ly/2PpTYdP

 Military & Veterans’ Health –

  • On October 23, Department of Veterans Affairs (VA) announced the completion of a major modernization effort resulting in the removal of 7.8 million paper files from 60 locations in fewer than 22 months, enabling rapid scanning into VA’s electronic claims processing system by multiple third-party vendors. Press release: https://bit.ly/2Rfb6QI
  • On October 24, U.S. Government Accountability Office (GAO) released a report recommending that VA address implementation challenges and strengthen oversight of subcontracting limitations. Summary with link to report: https://bit.ly/2CELwR6

Health IT –

  • On October 25, HHS Office of the National Coordinator for Health IT posted a blog noting that acute care hospitals are more interoperable than ever, but challenges remain in achieving ubiquitous data sharing and interoperability. Blog: https://bit.ly/2Jh9q6n

 Substance Use and Mental Health –

  • On October 23, U.S. Government Accountability Office (GAO) released a report finding that the federal government has used only three of the seventeen authorities available since declaring a public health emergency to respond to the opioid crisis. Summary with link to report: https://bit.ly/2Av13l0
  • On October 24, FDA Commissioner Gottlieb released a statement on how new regulatory authorities included in the SUPPORT for Patients and Communities Act will assist the agency in addressing the opioid crisis. Statement: https://bit.ly/2Smmr2U
  • On October 25, HHS Office of Civil Rights (OCR) launched a public education campaign about civil rights protections in response to the opioid crisis, highlighting the importance of access to evidence-based treatments and recovery services. Press release: https://bit.ly/2Sk6qdA


  • Also on October 24, HHS published a study on the costs and benefits of expanding Hepatitis C screening in the Indian Health Service. Report: https://bit.ly/2PUwSZW