What’s Ahead: This Week

 Notable Policy Events –

  • Wednesday, April 24
    • Health Affairs, “Health and Housing Needs for U.S. Seniors in the ‘Middle Market.’” Additional information: https://bit.ly/2Gfxk18
  • Thursday, April 25
    • Kaiser Family Foundation (KFF) and Center for Strategic and International Studies (CSIS) Global Health Policy Center, “The Future of Global Health Financing: Hope vs. Reality in the Push for Universal Health Coverage.” Additional information: https://bit.ly/2XhGyRv
    • Alliance for Health Policy (AHP), “News Conference: Medicare for All and Other Policy Options to Expand Public Coverage.” Additional information: https://conta.cc/2UMgTDq
  • Friday, April 26
    • National Academies of Science, Engineering and Medicine (NASEM), “Investing in Interventions that Address Non-Medical Health-Related Social Needs.” Additional information: http://bit.ly/2DoIJuU


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

 Legislative Activity –

 Committee Activity and Executive Action:

  • On April 18, the President signed into law the Medicaid Services Investment and Accountability Act of 2019 (H.R. 1839), which will modify Medicaid authorities by imposing penalties on manufacturers that misclassify drugs, expand a state option for health homes for children with complex medical conditions, extend and provide additional funding for the Medicaid Money Follows the Person (MFP) demonstration, and modify other Medicaid funding and billing provisions. Press release: https://bit.ly/2DmbI2A Bill text: https://bit.ly/2Pk2lFt

Introduced Legislation:

  • On April 15, Sen. Durbin (D-IL) and Reps. Foster (D-IL) and Underwood (D-IL) announced their intent to introduce the American Cures Act and the American Innovation Act, which would create a mandatory fund to provide steady funding for research at the country’s top research agencies. Press release: https://bit.ly/2GvBPG2
  • Also on April 15, Senate Finance Committee Chair Grassley (R-IA) and 18 cosponsors announced their intent to introduce legislation to help ensure that the Administration’s association health plan rule remains intact. Press release: https://bit.ly/2IuTqQP
  • On April 18, House Energy & Commerce Committee Chair Pallone (D-NJ) and Rep. Shalala (D-FL) introduced the Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339), which, among other things, would raise the minimum age for purchasing tobacco products to 21 years. Press release: https://bit.ly/2IEbHKR Bill text: https://bit.ly/2VfQSfe
  • Also on April 18, Rep. Rose (D-NY) introduced H.R. 2340, which would direct the VA Secretary to provide Congress notice of any suicide or attempted suicide of veterans in a VA facility. Press release: https://bit.ly/2KLjUPU

ACA and Individual Market –

  • On April 18, CMS released the final annual Notice of Benefit and Payment Parameters for the 2020 benefit year. The final notice reduces HealthCare.gov user fees for plans and encourages the use of lower-cost generic drugs. Press release: https://go.cms.gov/2XsSzng Fact sheet: https://go.cms.gov/2INSrua Final rule: https://bit.ly/2GmEDUK
  • Also on April 18, CMS issued the Final 2020 Letter to Issuers in the Federally Facilitated Exchanges (FFE) and the Key Dates Charts for the 2019 Calendar Year. Letter to Issuers: https://go.cms.gov/2Up8EIJ Key Dates Charts: https://go.cms.gov/2VV22TV
  • Also on April 18, Congressional Budget Office (CBO) released four new products explaining how its new health insurance simulation model, HISIM2, generates estimates of health insurance coverage and premiums for the population under age 65. Summary with link to products: https://bit.ly/2GozLyq

 Medicare and Medicaid –

  • On April 15, U.S. Government Accountability Office (GAO) released a report recommending CMS address gaps in federal oversight of nursing home abuse investigations that have persisted in Oregon for at least 15 years. Summary with link to report: https://bit.ly/2Xh71OW
  • Also on April 15, CMS Administrator Verma posted a blog on the importance of ensuring safety and quality in America’s nursing homes and steps that CMS is taking to achieve that goal. Blog: https://go.cms.gov/2IGnmIO
  • On April 16, HHS released an issue brief on transitions of care and service use among Medicare beneficiaries in inpatient psychiatric facilities (IPFs), highlighting the characteristics of Medicare beneficiaries who use IPFs and types of care utilized before and after IPF stays. Summary with link to report: https://bit.ly/2GuwCOP
  • On April 17, CMS issued a proposed rule to update Medicare payment policies for facilities under the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) and the Inpatient Rehabilitation Quality Reporting Program (IRF QRP) for fiscal year (FY) 2020. Comments are due by June 17. Fact sheet: https://go.cms.gov/2VOhbq8 Proposed rule: https://bit.ly/2UrJ7i2
  • On April 18, CMS issued a proposed rule to update payment policies and rates for facilities under the Inpatient Psychiatric Facilities (IPF) PPS and the IPF Quality Reporting (IPFQR) Program for FY 2020. Comments are due by June 17. Fact sheet: https://go.cms.gov/2L4xVIT Proposed rule: https://bit.ly/2Va0xnz
  • On April 19, CMS issued proposed rules to update the 2020 Medicare payment policies and the quality program for for skilled nursing facilities (SNF) and updates to the payment rates, wage index, and cap amount for hospice facilities. Comments are due for both proposed rules by June 18. SNF Fact Sheet: https://go.cms.gov/2UNIvbn Hospice Fact Sheet: https://go.cms.gov/2UKGFbr SNF Proposed Rule: http://bit.ly/2UQkGzV Hospice Proposed Rule: http://bit.ly/2UO593x

 Payment and Delivery System Reform –

  • On April 15, CMS released a Medicare Accountable Care Organization (ACO) Care Coordination Toolkit, which highlights innovative strategies Medicare ACOs are using to enact care coordination to improve population health and earn shared savings. Toolkit: https://bit.ly/2UoOkqJ

 Drug and Medical Device Prices and Regulation –

  • On April 17, House Oversight & Reform Committee Chair Cummings (D-MD) penned a letter to Ranking Member Jordan (R-OH), criticizing the Ranking Member’s April 5 letter to 12 drug companies, which urged them not to cooperate with the Committee’s drug pricing investigation. Press release: https://bit.ly/2DjmDK7 Letter: https://bit.ly/2IpoPEn
  • Also on April 17, FDA posted a statement on its efforts to advance the development of biologics. Statement: http://bit.ly/2GlAHUk

 Substance Use and Mental Health –

  • On April 17, HHS Office of Inspector General (OIG) announced the outcome of the largest ever prescription opioid law enforcement operation, charging 60 individuals for their alleged participation in the illegal prescribing and distributing of over 350,000 prescriptions and over 32 million pills. Press release: https://bit.ly/2IEP7Sk
  • Also on April 17, HHS OIG released a report on concerns about opioid use in Medicare Part D in the Appalachian region. OIG found that 36 percent of Part D beneficiaries in five states in the Appalachian region received a prescription opioid in 2017 and almost 49,000 beneficiaries in these states received high amounts of opioids, exceeding levels Centers for Disease Control and Prevention (CDC) recommends avoiding. Summary with link to report: https://bit.ly/2DnKfgG
  • On April 18, National Institutes of Health (NIH) selected four research sites for the HEALing Communities Study in four states highly affected by the opioid crisis. The initiative aims to reduce opioid overdose deaths by 40 percent over three years in selected communities. Press release: https://bit.ly/2IteCGZ
  • On April 19, FDA announced the approval of the first generic naloxone nasal spray to treat opioid overdose. Press release: http://bit.ly/2Go3CqJ

 Veterans and Military Health –

  • On April 16, Department of Veterans Affairs (VA) issued a statement reminding veterans that it offers all veterans same-day access to emergency mental health care at any VA health facility across the country. Press release: https://bit.ly/2Um5aql

 Health IT –

  • On April 16, HHS Office of the National Coordinator for Health IT (ONC) released an issue brief on hospitals’ use of electronic health records (EHR) data between 2015 and 2017, which found that 94 percent of hospitals used their EHR data to perform hospital processes that inform clinical practice, and EHR data is most community used by hospitals to support quality improvement, monitor patient safety, and measure organization performance. Issue brief: https://bit.ly/2ZtPCoi
  • On April 19, ONC and CMS issued 30-day extensions on the comment periods for their respective proposed rules pertaining to interoperability and patient access to health information. Comments are now due by June 3. Press release: https://bit.ly/2IIdiPB ONC extension: https://bit.ly/2Dnwmzn CMS extension: https://bit.ly/2PmfyO2
  • Also on April 19, HHS issued for public comment Draft 2 of the Trusted Exchange Framework and Common Agreement (TEFCA) that will support the full, network-to-network exchange of health information nationally. The Department also released a notice of funding opportunity (NOFO) to engage a nonprofit, industry-based organization that will advance nationwide interoperability. Applications for the funding opportunity are due by June 17. Press release: https://bit.ly/2Gmr3Rj ONC blog: https://bit.ly/2IHeW4c TEFCA Draft 2: https://bit.ly/2PnNb1W Funding opportunity: https://bit.ly/2UKLVM8
  • Also on April 19, HHS OIG issued a report reviewing the Department’s compliance with the Federal Information Security Modernization Act of 2014 for FY 2018. OIG found that the Department is continuing to implement changes to strengthen its enterprise-wide information security program. Summary with link to report: https://bit.ly/2Xm8vHC

 Misc. –

  • On April 16, HHS announced a 3-year, $6 million project designed to increase patient participation in cardiac rehabilitation after cardiovascular events such as heart attacks, heart failure, angioplasty, or heart surgery. Press release: https://bit.ly/2IHkyeO
  • On April 19, HHS announced a funding opportunity for projects that would broadly disseminate patient-centered outcomes research findings into practice through clinical decision support systems. Press release: http://bit.ly/2GhDk9u Funding announcement: http://bit.ly/2GoPxJP