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


ACA Repeal and Replacement Activity –

  • On August 9, New Hampshire Governor Sununu sent a letter to President Trump urging him to provide a clear roadmap to Congress on ACA reform, commit to funding cost-sharing reductions in 2017 and 2018, commit funds to stabilizing state markets, and provide carriers and states additional time to file 2018 rates. Letter: http://bit.ly/2vJNx95
  • On August 15, Congressional Budget Office released an analysis on the effects of terminating payments for cost-sharing reductions, finding that it would cause premiums to increase by 20 percent in 2018, and would increase the deficit by $194 billion over a decade. Analysis: http://bit.ly/2vGp9W6

ACA Implementation –

  • On August 10, CMS announced the delay of a final deadline for health insurance issuers to submit their final rates for the 2018 plan year to September 5. Guidance: http://bit.ly/2vJyuwf
  • Also on August 10, CMS released a final notice intended to be sent to consumers that are enrolled in both Marketplace coverage with advance payments of the premium tax credit and in Medicaid or CHIP, to inform them that the Marketplace will end their financial assistance. Notice: http://bit.ly/2w8ySao
  • On August 14, House Committee on Energy & Commerce Ranking Member Pallone (D-NJ) and House Ways & Means Committee Ranking Member Neal (D-MA) sent a letter to the Government Accountability Office (GAO) urging the agency to investigate the Administration’s enforcement of the ACA’s individual mandate. Press release: http://bit.ly/2vJIENg Letter: http://bit.ly/2vJFGIF
  • Also on August 15, Senate HELP Committee Ranking Member Murray (D-WA) and 15 Senate Democrats sent a letter to HHS Secretary Price requesting information on his plans for enforcement of section 1557 of the ACA, which prohibits discrimination on health care on the basis of race, color, national origin, sec, age, and disability. Press release: http://bit.ly/2vJVV8w Letter: http://bit.ly/2vJz5hq
  • On August 16, CMS posted an update to the Health Insurance Exchanges Issuer County Map, which projects two counties with no issuers in 2018 and 1,486 counties with only one issuer. Press release: http://go.cms.gov/2vPPnpc
  • On August 17, the Congressional Hispanic Caucus sent a letter to HHS Secretary Price urging HHS to prioritize Latino outreach and enrollment efforts. Press release with text of letter: http://bit.ly/2vPU9Tv
  • Also on August 17, Senate Committee on Homeland Security & Governmental Affairs Chair Johnson (R-WI) sent a letter to Office of Personal Management Acting Director Kathleen McGettigan asking for information related to a regulation that enables members of Congress and their staff to purchase health insurance offered by the DC Small Business Health Options Plan (SHOP) and to receive an employer contribution. Press release with text of letter: http://bit.ly/2vQAbYE
  • Also on August 17, House Committee on Energy & Commerce Ranking Member Pallone (D-NJ), House Committee on Ways & Means Ranking Member Neal (D-MA), Senate HELP Committee Murray (D-WA), Senate Finance Committee Ranking Member Wyden (D-OR), and Senate Aging Committee Ranking Member Casey (D-PA) sent a letter to HHS Secretary Price and CMS Administrator Verma raising concerns over perceived attempts to undermine the ACA’s Marketplaces and requesting a briefing on the Administration’s preparation for the upcoming Open Enrollment season. Press release: http://bit.ly/2vQvfTF Letter: http://bit.ly/2vQlzIR

 Medicare –

  • On August 7, Senate Finance Committee Ranking Member Wyden (D-OR), Sen. Franken (D-MN) and 29 Senate Democrats sent a letter to CMS Administrator Verma urging her to maintain protections that prevent nursing homes and long-term care facilities from locking residents into forced arbitration agreements. Press release: http://bit.ly/2vJvKid Letter: http://bit.ly/2vJIeGQ
  • On August 9, CMS announced the second annual release of the Medicare Hospice Utilization and Payment Public Use File. More information: http://go.cms.gov/2vOUUMB
  • On August 16, CMS announced a new Hospice Compare website, which displays a snapshot of the quality of care in hospices across the country. Press release: http://go.cms.gov/2vQchwm Fact sheet: http://go.cms.gov/2vQMFzE Website: http://bit.ly/2vQt02V

 Medicaid –

  • On August 8, Rep. Kind (D-WI) sent a letter to Wisconsin Governor Walker requesting that he accept federal money to expand the state’s Medicaid program, BadgerCare, to “give Wisconsin’s seniors, veterans, and vulnerable rural residents the support they need.” Press release with text of letter: http://bit.ly/2vJwIuR
  • On August 10, CMS announced the release of the Medicaid Eligibility and Enrollment Toolkit version 2.2, developed to provide additional technical assistance to the states and their vendor partners in the development and implementation of their eligibility and enrollment systems. More information: http://bit.ly/2w9qxDn
  • On August 17, CMS announced an agreement with Mylan to reclassify EpiPen as a brand name drug, which would lower rebates under the Medicaid Drug Rebate program. Press release: http://go.cms.gov/2vPio49
  • On August 18, CMS released guidance addressing common questions related to payment to managed care organizations for an enrollee that is a patient in an institution for mental disease. Guidance: http://bit.ly/2vQptBH

 New Payment and Delivery System Models –

  • On August 9, CMS posted the final evaluation report for the Medicaid Incentives for the Prevention of Chronic Diseases Model. Report: http://bit.ly/2vCV7SQ
  • On August 15, CMS released a proposed rule which would reduce the number mandatory geographic areas participating in the Comprehensive Care for Joint Replacement Model from 67 to 34 and would cancel the Episode Payment Models and the Cardiac Rehabilitation Incentive payment model, arguing that by changing the scope of the models, CMS is better able to “test and evaluate improvements in care processes that will improve quality, reduce costs, and ease burdens on hospitals.” Comments are due by October 16. Press release: http://go.cms.gov/2vPOzAy Fact sheet: http://go.cms.gov/2vQ73kA Proposed rule: http://bit.ly/2vQgXTh
  • On August 17, CMS posted a communications guidance document for year two participants of the Medicare Advantage Value-Based Insurance Design model. Guidance: http://bit.ly/2vQ9Z0o

 Health IT –

  • On August 15, Agency for Healthcare Research and Quality (AHRQ) announced that it is seeking information submissions from the public to inform their review of Mobile Health Technology for Diabetes. Notice: http://bit.ly/2w99SQf

 Mental Health and Substance Abuse –

  • On August 10, Substance Abuse and Mental Health Services Administration (SAMHSA) released the fourth edition of its Behavioral Health Barometer state report, which provides an overview and data on behavioral health in each state and DC. Press release: http://bit.ly/2vCRPz2
  • On August 11, President Trump announced his intention to declare a public health emergency to respond to the opioid abuse epidemic. The statement from the White House instructs his “Administration to use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.” White House Press release: http://bit.ly/2vYPPDR HHS Press release: http://bit.ly/2vQik4n
  • On August 15, SAMHSA published a report finding that substance use is more likely among 12th grade aged dropouts than among 16 to 18 year olds who were still in school. Press release: http://bit.ly/2vPAK4Y
  • On August 16, HHS announced the appointment of several members to a new Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), which was established by the 21st Century Cures Act to “improve federal coordination of efforts to address the pressing needs of adults with serious mental illness and children and youth with serious emotional disturbance.” Press release: http://bit.ly/2vJKdL8

Drug Prices –

  • On August 17, HHS released a notice of proposed rulemaking further delaying the effective date of the 340B drug pricing program final rule to July 1, 2018, “in order to allow a more deliberate process of considering alternative and supplemental regulatory provisions and to allow for sufficient time for additional rulemaking.” Comments are due by September 17. Proposed rule: http://bit.ly/2vQKMTA

 Veterans Health –

  • On August 11, the Department of Veterans Affairs (VA) announced plans to target highly qualified veterans to staff the new White House VA Hotline, instead of contracting the service to a third-party vendor; VA is also hiring additional VA personnel to complete the planned move to a 24-hour operation. Press release: http://bit.ly/2vCwLZK
  • On August 13, VA Office of Inspectors General (VA OIG) published a report finding that the Veterans Health Administration did not provide effective governance necessary to ensure oversight and control over the health care enrollment program medical facilities. Report: http://bit.ly/2vPyRFC

 Misc. –

  • On August 8, Food and Drug Administration (FDA) announced the expansion of a public education campaign to focus on the prevention of youth e-cigarette use. Press release: http://bit.ly/2vESKle
  • On August 9, HHS published a report finding that the percent of non-elderly adults ages 18-64 uninsured for an entire calendar year declined from 18.8 percent in 2013 to 11.7 percent in 2015. Report: http://bit.ly/2vPkgK6
  • On August 10, House Committee on Energy & Commerce Ranking Member Pallone (D-NJ), Health Subcommittee Ranking Member Green (D-TX), Oversight & Investigations Subcommittee Ranking Member DeGette (D-CO), and Environment Subcommittee Ranking Member Tonko (D-NY) sent a letter to Centers for Disease Control and Prevention (CDC) Acting Director Schuchat requesting additional information on the Childhood Lead Poisoning Prevention Program, the CDC’s role in the Flint water crisis response, and federal investment in lead poisoning prevention and surveillance. Press release: http://bit.ly/2vJz50X Letter: http://bit.ly/2vK52X2
  • Also on August 10, FDA released guidance formalizing the Medical Device Development Tools program and describing a new voluntary process within the Center for Devices and Radiological Health for the qualification of medical device development tools for use in device development and evaluation programs. Notice: http://bit.ly/2w9jM4b
  • On August 15, HHS announced the award of nearly $105 million to 1,333 health centers in all U.S. states, territories, and the District of Columbia to further improve the quality, efficiency, and effectiveness of the health care delivered to the communities they serve. Press release: http://bit.ly/2vPhnZL