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


 What’s Ahead: This Week

Hearings and Markups –

  • Tuesday, February 5
    • Senate HELP Committee, “How Primary Care Affects Health Care Costs and Outcomes.”
    • Senate Appropriations Committee, Subcommittee on MilCon and VA, “Implementation Update on VA EHR Modernization.”
  • Wednesday, February 6
    • House Energy & Commerce Committee, Subcommittee on Health, “Texas v. U.S.: The Republican Lawsuit and Its Impacts on Americans with Pre-Existing Conditions.”
    • House Education & Labor Committee, “Examining Threats to Workers with Pre-Existing Conditions.”
    • House Appropriations Committee, Subcommittee on Labor, HHS, and Education, “Impact of the Administration’s Policies Affecting the Affordable Care Act.”

 Notable Policy Events –

  • Monday, February 4 – Tuesday, February 5
  • Tuesday, February 5 – Thursday, February 7
    • National Rural Health Association, “Rural Health Policy Institute.” Additional information: http://bit.ly/2l11BZd

 

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

 116th Congress –

  • On January 30, House Energy & Commerce Committee Chair Pallone (D-NJ) announced the Vice Chairs for the Committee’s six subcommittees in the 116th Congress, and Ranking Member Walden (R-OR) announced the minority senior staff for the 116th Press releases: https://bit.ly/2sVHX2R and https://bit.ly/2Rx7g5a
  • Also on January 30, House Oversight & Reform Committee Ranking Member Jordan (R-OH) announced subcommittee assignments for the 116th Press release: https://bit.ly/2SdrUMi
  • On January 31, Senate Finance Committee Chair Grassley (R-IA) and Ranking Member Wyden (D-OR) announced expected subcommittee membership for the 116th Press release: https://bit.ly/2G40vGG
  • Also on January 31, Senate Homeland Security & Governmental Affairs Committee Chair Johnson (R-WI) and Ranking Member Peters (D-MI) announced subcommittee membership for the 116th Press release: https://bit.ly/2G55Tcz
  • Also on January 31, House Veterans’ Affairs Committee Chair Takano (D-CA) announced Vice Chair and subcommittee assignments for the 116th Press release: https://bit.ly/2UAJEie
  • Also on January 31, House Appropriations Committee Chair Lowey (D-NY) announced subcommittee vice chairs for the 116th Press release: https://bit.ly/2DOlw5Q

Legislative Activity –

  • On January 28, Reps. Blumenauer (D-OR) and Reed (R-NY) introduced the Promoting Access to Diabetic Shoes Act (H.R. 808), which would permit nurse practitioners and physician assistants to satisfy the documentation requirement under the Medicare program for coverage of certain shoes for individuals with diabetes. Companion legislation (S. 237) was introduced by Sens. Brown (D-OH) and Collins (R-ME) in the Senate. Press release: https://bit.ly/2RuBFkv
  • On January 29, Reps. Webster (R-FL) and Peterson (D-MN) introduced the Physician Pro Bono Care Act (H.R. 856), which would provide a tax deduction to health care providers for pro-bono health services to individuals and families who rely on Medicaid or CHIP. Press release: https://bit.ly/2Sg0mFX Text: https://bit.ly/2HL79U2
  • Also on January 29, GOP Doctors Caucus Co-Chairs Roe (R-TN) and Harris (R-MD), along with Drs. Ruiz (D-CA) and Bera (D-CA), introduced H. Con. Res. 8, a resolution expressing the sense of Congress that all medical professionals should receive proper training on pain management and opioid prescribing. Press release: https://bit.ly/2SaGIeD Text: https://bit.ly/2DLOfZ7
  • Also on January 29, Reps. Brownley (D-CA) and Higgins (D-NY) introduced the Veterans’ Access to Child Care Act (H.R. 840), which would make permanent and expand the VA’s Child Care Pilot Program so that veterans have access to free child care when they have VA medical appointments. Press release: https://bit.ly/2G0AGY4
  • On January 30, Reps. Matsui (D-CA) and Johnson (R-OH) introduced the DXM Abuse Prevention Act (H.R. 863), which would establish a national age-18 requirement for the purchase of medicines containing dextromethorphan. Press release: https://bit.ly/2GbuaNz
  • Also on January 30, Rep. Latta (R-OH) led four Republican cosponsors in introducing the Stop Penalizing Working Seniors Act (H.R. 908), which would allow individuals only enrolled in Medicare Part A to contribute to health savings accounts. Press release: http://bit.ly/2GpIbai
  • Also on January 30, Senate Finance Committee Chair Grassley (R-IA) and Sen. Klobuchar (D-MN) introduced the Veterans Access to Care Act, which would allow VA medical facilities with a need for additional health care professionals to apply to be designated as a Health Professional Shortage Area (HPSA). Press release: https://bit.ly/2UvZ6Mh
  • On January 31, Reps. Schrader (D-OR) and Welch (D-VT) introduced H.R. 937, which would impose civil monetary penalties on drug manufacturers that misclassify drugs in the Medicaid drug rebate program. Press release: http://bit.ly/2GmAF0e
  • Also on January 31, Reps. Schrader (D-OR) and Carter (R-GA) introduced the Bringing Low-cost Options and Competition while Keeping Incentives for New Generics (BLOCKING) Act (H.R. 938), which would prevent drug manufacturers from “parking” exclusivity when they are the first generic drug to market. Press release: https://bit.ly/2BbjF9O
  • Also on January 31, Reps. Murphy (D-FL), Shalala (D-FL), and Castor (D-FL) introduced the Smart Choices Act (H.R. 944), which would require the Medicaid and CHIP Payment and Access Commission to publish an annual report on the estimated impact in each state that has adopted Medicaid expansion, including the estimated impact that adopting such expansion would have in states that have not expanded their programs. Sen. Jones (R-AL) previously introduced companion legislation in the Senate (S. 68) Press release: http://bit.ly/2Gla43y Bill text: http://bit.ly/2GlWBs0
  • Also on January 31, Reps. Thompson (D-CA) and Katko (R-NY) introduced the Mental Health Access Improvement Act (H.R. 945), which would allow Medicare Part B coverage to include marriage and family therapists and mental health counselors. Sens. Barrasso (R-WY) and Stabenow (D-MI) introduced companion legislation in the Senate (S. 286). Press release: https://bit.ly/2t4n1ql
  • Also on January 31, Sens. Gardner (R-CO), Hyde-Smith (R-MS), and Tester (D-MT) introduced the Rural Physician Workforce Production Act (S. 289), which would alter the Graduate Medical Education (GME) program to provide medical students with the opportunity to practice in a rural area. Press release: https://bit.ly/2WxucVD
  • Also on January 31, Senate Aging Committee Chair Collins (R-ME) and Ranking Member Casey (D-PA) introduced the Geriatrics Workforce Improvement Act (S. 296), which would reauthorize the Geriatrics Workforce Enhancement Program (GWEP) at $45 million per year over the next five years. Press release: https://bit.ly/2TrZtY6
  • On February 1, Sen. Durbin (D-IL) announced his intention to introduced the Forcing Limits on Abusive and Tumultuous (FLAT) Drug Prices Act of 2019, which would reduce the patent time length for prescription drugs with significant price increases. Press release: http://bit.ly/2Tvu7jB                                                                               

ACA and Individual Insurance Markets –

  • On January 28, U.S. Government Accountability Office (GAO) released a report showing that claims costs and federal and state policies drove issuer participation, premiums, and plan design in the health insurance exchanges. Summary with link to report: https://bit.ly/2G9BB86
  • On January 31, Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) published a report estimating that roughly 5 million people are projected to be enrolled in association health plans or short-term plans as a result of the Administration’s recent regulations over the next ten years. Summary with link to report: https://bit.ly/2Rt0ayJ

 Medicare and Medicaid –

  • On January 28, Senate Finance Committee Chair Grassley (R-IA) sent a letter to HHS and CMS requesting an explanation as to the potential increase in costs to Medicare for laboratory services. Press release: https://bit.ly/2DP1kBa Letter: https://bit.ly/2G50xyf
  • Also on January 28, CMS launched a new app that allows individuals with traditional Medicare, caregivers, and others to check whether Medicare covers a specific medical item or service. Press release: https://go.cms.gov/2SaN7WT
  • On January 29, CMS Administrator Verma delivered remarks at the 2019 CMS Quality Conference outlining the agency’s agenda for the upcoming year. Transcript: https://go.cms.gov/2HL77f1
  • Also on January 29, HHS released an analysis finding that hospital-acquired conditions declined by nearly 1 million from 2014-2017. The estimated rate of such conditions dropped 13 percent. Press release: https://bit.ly/2sU2VPM Report: https://bit.ly/2MHF3Ii
  • Also on January 29, Joint Economic Committee Chair-Designate Lee (R-UT) sent letters to Congressional Budget Office (CBO) and CMS asking for clarification on whether the offices take social capital into account when formulating health care cost projections for federal and state governments. Press release and letter: https://bit.ly/2t1D48p
  • On January 30, CMS released Part II of the 2020 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies and Draft Call Letter. CMS is proposing to increase plan payments by 1.59 percent, improve drug utilization review controls for opioids, and introduce special supplemental benefits for the chronically ill. Comments on Part I and Part II of the proposed Advance Notice as well as the Draft Call Letter are due by March 1. Press release: https://go.cms.gov/2Sf4pCq Fact sheet: https://go.cms.gov/2sWmV4d Documents: https://go.cms.gov/2GmHkHN
  • On January 31, Senate Homeland Security & Governmental Affairs Committee Chair Johnson (R-WI) and House Oversight and Reform Ranking Member Jordan (R-OH) penned a letter to CMS Administrator Verma requesting information on a recent Medicaid audit in Louisiana that showed that 93 percent of examined expansion enrollees were ineligible for services. Press release and letter: https://bit.ly/2HJoHA4
  • Also on January 31, HHS proposed a rule which would expressly exclude from safe harbor protection under the Anti-Kickback Statute rebates on prescription drugs paid by manufacturers to pharmacy benefit managers (PBMs), Part D plans, and Medicaid managed care organizations. The proposal would also create a new safe harbor for prescription drug discounts offered directly to patients, as well as fixed fee service arrangements between drug manufacturers and PBMs. Comments are due by April 8. Press release: https://bit.ly/2GbZfRk Fact sheet: https://bit.ly/2D39cwW Proposed rule: https://bit.ly/2WzK8Xz ASPE resources related to the proposed rule: https://bit.ly/2GgJ0Cw
  • Also on January 31, CMS Office of Minority Health Director James and Federal Coordinated Health Care Office Director Engelhardt published a blog on Medicare’s role in reducing poverty among seniors in the United States. Blog: https://go.cms.gov/2WDuHxp
  • On February 1, CMS and Centers for Disease Control and Prevention (CDC) issued a notice of proposed rulemaking which includes the addition and deletion of analytes requiring proficiency testing and updates criteria for acceptable performance under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). Fact sheet: https://go.cms.gov/2Bev34O Proposed rule: https://bit.ly/2G3glBr

 Payment and Delivery System Reform –

  • On February 1, CMS posted a request for applications (RFA) and actuarial guidance documents for the Medicare Advantage Value-Based Insurance Design (VBID) model. RFA: https://bit.ly/2SjtrQH Actuarial guidance: https://bit.ly/2G3WOAO

 Drug and Medical Device Prices and Regulation –

  • On January 28, U.S. Food and Drug Administration (FDA) Commissioner Gottlieb and Center for Devices and Radiological Health Director Shuren released a statement on the agency’s record year for medical device innovation. Statement: https://bit.ly/2RuKnPQ
  • On January 30, House Energy & Commerce Committee Chair Pallone (D-NJ) and Oversight & Investigations Subcommittee Chair DeGette (D-CO) penned letters to three pharmaceutical manufacturers requesting information on the root causes of the rising cost of insulin. Press release: https://bit.ly/2BlOysf Letters: https://bit.ly/2HDLdtO
  • Also on January 30, FDA Commissioner Gottlieb released a statement on FDA’s efforts to enhance the utility of the Orange Book, a list of drug products approved by FDA that includes patent and exclusivity information, to foster drug competition. Statement: https://bit.ly/2MI1fC6
  • Also on January 30, FDA Commissioner Gottlieb released a statement on the agency’s efforts to advance the development of complex generics in 2019 as part of an agency-wide effort to improve patient access to medicines. Statement: https://bit.ly/2CT4RfU

 Veterans and Military Health –

  • On January 29, Senate Veterans’ Affairs Committee Ranking Member Tester (D-MT) led 28 senators in a letter to Department of Veterans Affairs (VA) Secretary Wilkie expressing frustration with the department’s lack of communication about critical decisions on community care access standards. Press release: https://bit.ly/2S6T6wb Letter: https://bit.ly/2Be9MZ0
  • On January 30, VA released proposed rules related to access standards for community care and urgent care under the Community Care Program. VA is proposing a 30-minute average drive time standard and 20-day appointment wait time for primary care, as well as a 60-minute average drive time standard and 28-day appointment wait time for specialty care. Comments on the proposals are due by March 4. VA Secretary Wilkie statement: https://bit.ly/2RmQXI4 Press release: https://bit.ly/2FX7JfH Urgent care proposed rule: https://bit.ly/2MJ5LQA Congressional statements: https://bit.ly/2GmXfWz and https://bit.ly/2SmylMX
  • On January 31, VA announced that it has recently formalized a partnership with the American Foundation for Suicide Prevention (AFSP) to exchange research on suicide and prevention efforts and messaging. Press release: https://bit.ly/2D2lYfb

 Substance Use and Mental Health –

  • On January 31, White House Office of National Drug Control Policy (ONDCP) released the Administration’s National Drug Control Strategy, which aims to curb rates of drug trafficking and use. Press release: https://bit.ly/2UA3l9O Document: https://bit.ly/2UA3JoM
  • On February 2, HHS announced $11 million in funding to 120 school-based health centers to increase access to mental health, substance use, and childhood obesity treatment. Press release: https://bit.ly/2G3U8TM

 Misc. –

  • On January 30, HHS released key indicators from the National Health and Aging Trends Study (NHATS) with respect to community-dwelling older adults with dementia and their caregivers. Abstract with link to report: https://bit.ly/2GfyECN