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


  What’s Ahead: This Week

 Hearings and Markups –

  • Tuesday, March 26
    • Senate HELP Committee, “Implementing the 21st Century Cures Act: Making Electronic Health Information Available to Patients and Providers.”
    • Senate Veterans Affairs Committee, “Fiscal Year 2020 Budget for Veterans Programs and Fiscal Year 2021 Advance Appropriations Request.”
    • House Budget Committee, “Department of Health and Human Services FY 2020 Budget.”
    • House Appropriations Committee, Subcommittee on Agriculture, Rural Development, FDA, and Related Agencies, “Member Day.”
    • House Veterans’ Affairs Committee, Subcommittee on Disability Assistance and Memorial Affairs, “Legislative Hearing: H.R. 1200, the Veterans Compensation Cost-of-Living Adjustment Act of 2019; H.R. 1199, the VA Website Accessibility Act of 2019; H.R. 1126, the Honoring Veterans’ Families Act.”
  • Wednesday, March 27
    • House Appropriations Committee, Subcommittee on Labor, HHS, Education, and Related Agencies, “Member Day.”
    • House Appropriations Committee, Subcommittee on MilCon-VA, “Veterans Affairs FY 2020 Budget.”

 Notable Policy Events –

  • Tuesday, March 26
    • CQ Roll Call, “Health Care Decoded: Previewing Health Care Legislation in 2019.” Additional information: https://bit.ly/2OdrKzO
    • Bipartisan Policy Center (BPC), “Tracking Federal Funding to Combat the Opioid Crisis.” Additional information: https://bit.ly/2OfbJcM
  • Wednesday, March 27 – Thursday, March 28
  • Thursday, March 28

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

 Legislative Activity –

  • On March 18, House Veterans’ Affairs Committee Ranking Member Roe (R-TN) and Rep. Levin (D-CA) introduced the Vet Center Eligibility Expansion Act (H.R. 1812), which would allow members of the National Guard, Reserve, and Coast Guard who are not currently eligible to access care at Vet Centers. Press release: https://bit.ly/2U19T4x
  • Also on March 18, Rep. Gibbs (R-OH) and 10 cosponsors introduced the Help Ensure Responders Overdosing Emerge Safely (HEROES) Act (H.R. 1823), which would add naloxone to the list of approved equipment and resources for purchase through the federal Fire Prevention and Safety Grants program and the COPS grants programs. Press release: https://bit.ly/2CvCh4L Bill text: https://bit.ly/2Hu8MEA
  • Also on March 18, Reps. Butterfield (D-NC) and Bilirakis (R-FL) introduced H. Res. 242, which would affirm the importance of the Orphan Drug Act and recognize the need to continue supporting research and development for rare diseases. Resolution text: https://bit.ly/2TPGbjy
  • On March 21, Congressional Diabetes Caucus Co-Chairs Reed (R-NY) and DeGette (D-CO) and 4 bipartisan cosponsors introduced H.R. 1840, which would seek to increase patients’ use of diabetes self-management trainings by making more classes available in more locations and making them free for Medicare beneficiaries. Press release: https://bit.ly/2FtUwJZ
  • Also on March 21, Reps. Kuster (D-NH) and Mullin (R-OK) introduced the Analyzing and Leveraging Existing Rx Transactions (ALERT) Act of 2019 (H.R. 1845), which would establish the Prescription Safety Alert System with respect to covered drug products. Press release: http://bit.ly/2FyMsaL                                                                         

Fiscal Year (FY) 2020 Budget –

ACA and Individual Market –

  • On March 19, CMS released the 2020 Final Actuarial Value Methodology and Calculator. Methodology: https://go.cms.gov/2WkTIwF Calculator: https://go.cms.gov/2YgLYx8
  • On March 21, U.S. Government Accountability Office (GAO) released a report showing that enrollment remains concentrated among few issuers in the private health insurance market, including in the Exchanges. The three largest companies held 80 percent or more of the market in at least 37 states. Summary with link to report: https://bit.ly/2Wf3MHp

Medicare and Medicaid –

  • On March 18, CMS released an informational bulletin outlining state data reporting and quality requirements for the Transformed-Medicaid Statistical Information System (T-MSIS), which helps ensure monitoring and oversight of the Medicaid and CHIP programs. Bulletin: https://bit.ly/2Cvvw37
  • On March 21, Senate Finance Committee Chair Grassley (R-IA) and Ranking Member Wyden (D-OR) penned a letter to HHS Office of Inspector General (OIG) and CMS Administrator Verma regarding physician-owned distributorships’ (PODs) potential failure to disclose physician ownership interests and related payments as required by the Physician Payment Sunshine Act. Press release: https://bit.ly/2Jwvhe8 Letter: https://bit.ly/2JABIN8
  • On March 22, CMS released new guidance on state implementation of the 2014 home and community-based services (HCBS) regulation. Press release: https://go.cms.gov/2FzdTkV Guidance: http://bit.ly/2Fx5bU4

 Payment and Delivery System Reform –

  • On March 20, CMS posted the third annual report for Round 2 model test awards in the State Innovation Models (SIM) initiative. Report: https://bit.ly/2Fk7N6q
  • Also on March 20, CMS posted the second annual report for Phase Two of the Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents. Report: https://bit.ly/2TZSidj Findings at-a-glance: https://bit.ly/2TohrtM

 Drug and Medical Device Prices and Regulation –

  • On March 18, Congressional Budget Office (CBO) released a report on prices for and spending on specialty drugs in Medicare Part D and Medicaid, which showed that in 2015, brand-name specialty drugs accounted for roughly 30 percent of net prescription drug spending in Part D and Medicaid but accounted for only about 1 percent of all prescriptions dispensed in each program. Summary with link to report: https://bit.ly/2UORi9b
  • Also on March 18, House Energy & Commerce Committee Chair Pallone (D-NJ) released a list of drug pricing bills he plans to move through the Committee this Congress, including the CREATES Act of 2019, the FAST Generics Act of 2019, and the BLOCKING Act of 2019. Press release: https://bit.ly/2UNHGv7
  • On March 19, FDA posted a warning letter to Nutra Pharma Corp. for illegally marketing unapproved products labeled as homeopathic with claims about their ability to treat addiction and chronic pain. Press release: https://bit.ly/2TNsAcI
  • Also on March 19, Centers for Disease Control and Prevention (CDC) released a report on strategies used by adults aged 18 to 64 to reduce their prescription drug costs in 2017, finding that cost reduction strategies were commonly practiced among those who were uninsured. Summary with link to report: https://bit.ly/2CndOyr

 Substance Use and Mental Health –

  • On March 19, HHS released three requests for evidence and data on opioid treatment for common pain, non-opioid pharmacologic treatments for chronic pain, and non-invasive nonpharmacologic treatment for chronic pain. Comments are due by April 18. Requests: http://bit.ly/2FyPVWP and http://bit.ly/2Fzffw1 and http://bit.ly/2FwA8Yt
  • On March 20, HHS released an additional $487 million to supplement first-year funding through its State Opioid Response (SOR) grant program. Press release: https://bit.ly/2CuC8Ph
  • On March 21, CDC released a report finding that drug overdose deaths involving fentanyl increased from 1,663 in 2011 to 18,355 in 2016. Report: http://bit.ly/2Fv0qdC
  • Also on March 21, House Oversight Committee Chair Cummings (D-MD) and Rep. DeSaulnier (D-CA) sent a letter to Purdue Pharma CEO Craig Landau requesting documents relating to reports that members of the Sackler family sought to drive up sales of OxyContin while simultaneously expanding the market for medications to treat addiction. Press release: https://bit.ly/2Wf9byb Letter: https://bit.ly/2ULThuB
  • On March 22, HHS released a report on the experiences of community health centers in caring for people with opioid use disorder and preventing HIV and hepatitis C. Summary with link to report: http://bit.ly/2FrVpRS

 Veterans and Military Health –

  • On March 18, Department of Veterans Affairs (VA) announced that it is on track to eliminate the hepatitis C virus (HCV) in all veterans willing and able to be treated within as few as two months. The Office of Inspector General (OIG) also released a report reviewing HCV care within the Veterans Health Administration. Press release: https://bit.ly/2OlKBsQ OIG report: https://bit.ly/2OiFOIu
  • Also on March 18, ProPublica published an independent review performed by the U.S. Digital Service which highlighted that VA’s Community Care eligibility determination software tool is flawed and could disrupt the care of 75,000 veterans per day. In response, House Veterans Affairs Committee Chair Takano (D-CA) pledged to hold a hearing to learn more from VA. Article: https://bit.ly/2uoF9fs HVAC Chair Takano statement: https://bit.ly/2Tq9CDX
  • On March 20, VA and Department of Defense (DOD) announced a joint biannual conference that will address suicide within the military and veteran communities. The conference is scheduled for August 26 – 29, 2019.  Press release: http://bit.ly/2Fo0pqT

 Misc. –

  • On March 19, Senate HELP Committee Democratic members signed on to a letter to Chair Alexander (R-TN) and Ranking Member Murray (D-WA) requesting a hearing to assess the impacts of HHS’ recently released rule regarding the Title X Family Planning Program. Press release: https://bit.ly/2Yi1Uzd Letter: https://bit.ly/2OjjVsC
  • On March 20, GAO released a report showing that, according to available data, about two-thirds of air ambulance transports for patients with private insurance were out-of-network and almost all consumer complaints reviewed involved balance bills of over $10,000. Summary with link to report: https://bit.ly/2Tq9Mv8
  • On March 21, HHS awarded over $100 million in grant funding through its Healthy Start initiative to improve pregnancy outcomes and reduce infant mortality. Press release: https://bit.ly/2HJulQV