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


 What’s Ahead: This Week

 Hearings and Markups –

  • Monday, April 29
    • House Veterans’ Affairs Committee, “Tragic Trends: Suicide Prevention Among Veterans.”
  • Tuesday, April 30
    • House Energy & Commerce Committee, Subcommittee on Health, “Prescription Drug Coverage in the Medicare Program.”
    • House Appropriations Committee, Subcommittee on Labor, HHS, Education, and Related Agencies, “Markup: FY2020 Labor, Health and Human Services, Education, and Related Agencies Subcommittee.”
    • House Rules Committee, “Legislative Hearing: H.R. 1384, Medicare for All Act of 2019.”
    • House Oversight & Reform Committee, Subcommittee on the Environment, “Climate Change, Part II: The Public Health Effects.”
    • House Veterans’ Affairs Committee, Subcommittee on Health, “Legislative Hearing: H.R. 100, Veterans Overmedication and Suicide Prevention Act of 2019; H.R. 712, VA Medicinal Cannabis Research Act of 2019; H.R. 1647, Veterans Equal Access Act; H.R. 2191, Veterans Cannabis Use for Safe Healing Act; GAO Suicide Prevention; VA Whole Health; and Suicide Notification.
  • Wednesday, May 1
    • House Appropriations Committee, Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, “Markup: FY2020 Military Construction, Veterans Affairs, and Related Agencies Subcommittee.”
  • Thursday, May 2
    • House Veterans’ Affairs Committee, Subcommittee on Health, “Cultural Barriers Impacting Women Veterans’ Access to Healthcare.”

 Notable Policy Events –

  • Monday, April 29
    • U.S. Chamber of Commerce, “Innovations Forum: Redesigning Wellness.” Additional information: https://bit.ly/2vhfp56
  • Tuesday, April 30
    • National Academy of Medicine, “Action Collaborative on Countering the U.S. Opioid Epidemic.” Additional information: http://bit.ly/2GJYnSz
    • Wall Street Journal, “WSJ Health Forum.” Additional information: http://bit.ly/2GHlOvF
  • Wednesday, May 1
    • Brookings Institution’s Braiding and Blending Working Group, “Braiding and Blending Funds to Promote Social Determinants of Health.” Additional information: https://brook.gs/2UDaXIe
  • Thursday, May 2
    • Government Executive and Google Cloud, “Federal Healthcare Day Forum: Technologies for Health Sciences.” Additional information: https://bit.ly/2Zv7peN

 

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

ACA and Individual Market –

  • On April 22, North Dakota Gov. Burgum (R) signed a bill establishing a statewide reinsurance program for the state’s individual health insurance market. Press release: https://bit.ly/2INYY8r
  • On April 23, CMS held a National Forum on State Relief and Empowerment Waivers to disseminate information on CMS’ approach to 1332 waivers, at which Administrator Verma delivered opening remarks. Transcript: https://go.cms.gov/2UBZTLd
  • On April 25, CMS released proposed updates to the 2018 benefit year risk adjustment data validation timeline. Notice: https://go.cms.gov/2DBGYKT

 Medicare and Medicaid –

  • On April 22, the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (“Medicare Trustees”) released their 2019 Annual Report, which indicates that current revenue is sufficient to pay full scheduled benefits until 2026 for Medicare’s Hospital Insurance program. Press release: https://go.cms.gov/2Dvblmk Report: https://go.cms.gov/2KZdxIP CMS Administrator Verma statement: https://go.cms.gov/2vmh09H HHS Secretary Azar statement: https://bit.ly/2DyBcts
  • Also on April 22, Senate Finance Committee Chair Grassley (R-IA) published an op-ed in the Des Moines Register on his intent to conduct oversight of the nursing home industry. Op-ed: https://bit.ly/2ZyliZq
  • On April 23, CMS released a proposed rule for the fiscal year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System (PPS), which alters the methodology behind which rural hospitals are paid. CMS also issued an RFI on the inclusion of more meaningful measures to combat the opioid epidemic and leveraging health IT effectively. Comments are due by June 24. Press release: https://go.cms.gov/2DsBcvi Fact sheet: https://go.cms.gov/2vjtRK4 Proposed rule and RFI: https://bit.ly/2vkvR4E House Ways & Means Committee Ranking Member Brady (R-TX) statement: https://bit.ly/2GG7Pay
  • On April 24, CMS sent a letter to State Medicaid Directors encouraging states to partner with the agency to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid, including through the Capitated Financial Alignment Model, the Managed Fee-for-Service Model, and a new option for State-Specific Models. Press release: https://go.cms.gov/2UDvgFg State Medicaid Director letter: https://bit.ly/2IExhQg Letter from Administrator Verma to Governors: https://bit.ly/2W6LJUe CMS Administrator Verma Health Affairs blog: https://bit.ly/2L0hX2i
  • On April 25, HHS Office of Inspector General (OIG) released an assessment of state programs within the national background check program for long-term care providers between 2013 and 2016, finding that of the background checks that 8 of the 10 states conducted, nearly 80,000 resulted in determinations of ineligibility for prospective employees. Summary with link to report: https://bit.ly/2IVYOvB
  • On April 26, CMS released a report assessing racial and ethnic differences in health care experiences and clinical care received in by beneficiaries enrolled in Medicare Advantage in 2017. FAQ: https://go.cms.gov/2DAviIx Report: https://go.cms.gov/2DzVDX4

 Payment and Delivery System Reform –

  • On April 22, CMS announced the Primary Cares Initiative which includes the rollout of two new Medicare value-based care models – Primary Care First (PCF) and Direct Contracting (DC). Both models allow physicians to take on risk at varying levels for their Medicare patient population and engage in advanced primary care practices. Press release: https://go.cms.gov/2Dqnusw  PCF fact sheet: https://go.cms.gov/2vgJAcN DC fact sheet: https://go.cms.gov/2GzethC
  • Also on April 22, CMS posted the first annual report for the Comprehensive Primary Care Plus (CPC+) model. Practices that began CPC+ in 2017 served more than 15 million patients and nearly all practices reported that the model improved quality of care. Findings at-a-glance: https://bit.ly/2PrAYZR Report: https://bit.ly/2W5IKvc
  • On April 24, CMS posted a request for applications (RFA) for the Bundled Payments for Care Improvement (BPCI) Advanced Model Year 3 (CY 2020). Applicant resources: https://bit.ly/2W1c7yF
  • On April 25, CMS Administrator Verma delivered remarks to the National Association of ACOs (NAACOS) Spring 2019 Conference and highlighted the agency’s efforts to grow the Pathways to Success program. Transcript: https://go.cms.gov/2W1JrFI
  • On April 26, CMS released the 2018 CMS Innovation Center Report to Congress, the fourth annual report on the Innovation Center’s activities. Report: http://bit.ly/2DySSoY

 Drug and Medical Device Prices and Regulation –

  • On April 23, Food and Drug Administration (FDA) Regulatory Affairs Associate Commissioner Plaisier issued a statement on the agency’s new steps to strengthen the process of initiating voluntary recalls. Press release: https://bit.ly/2KWLGZV

 Substance Use and Mental Health –

  • On April 24, HHS released a fact sheet on the Administration’s progress in combating the opioid crisis, which notes that individuals continue to gain access to medication-assisted treatment (MAT) and provisional overdose death counts are beginning to decline. Fact sheet: https://bit.ly/2PvRsjR
  • Also on April 24, Centers for Disease Control and Prevention (CDC) issued a statement advising against misapplication of the Guideline for Prescribing Opioids for Chronic Pain. Press release: https://bit.ly/2DKdsTB
  • On April 25, FDA announced the launch of a public education campaign to encourage the safe removal of unused opioid pain medicines from homes. Press release: https://bit.ly/2IWfzag
  • On April 26, HHS released a Notice of Funding Opportunity for a new Rural Communities Opioid Response Program (RCORP) called RCORP-Medication-Assisted Treatment Expansion. Applications are due by June 10. Press release: http://bit.ly/2DyVIuc

 Health Data and Health IT –

  • On April 24, Senate Finance Committee Chair Grassley (R-IA) posted a letter from CMS describing its Meaningful Use program integrity efforts. Letter: http://bit.ly/2UZHhtQ
  • On April 26, HHS released a notice of enforcement discretion noting that it is exercising its discretion in how it applies HHS regulations concerning the assessment of civil monetary penalties under HIPAA, as amended by HITECH. Notice: http://bit.ly/2UZHfCd

Veterans and Military Health –

  • On April 22, Department of Veterans Affairs (VA) released a statement noting that the Department’s implementation of the MISSION Act’s Community Care provisions is still on track for June 6. Press release: https://bit.ly/2vhjsyk
  • Also on April 22, U.S. Government Accountability Office (GAO) issued a report recommending that actions are needed to strengthen oversight and coordination of health care for American Indian and Alaska Native veterans. Summary with link to report: https://bit.ly/2IUateq
  • On April 23, VA announced that it has added a text messaging feature to the Women Veterans Call Center, allowing users to use text, call, or chat to learn about resources that are available to them. Press release: https://bit.ly/2VlxLke
  • On April 24, VA Secretary Wilkie issued a statement praising VA’s model path to ending opioid addiction following the President’s remarks at a summit addressing the nation’s drug crisis. Press release: https://bit.ly/2Dzab9z
  • On April 26, VA published a Code of Integrity, which sets the ethical standards and obligations of every employee in the Veterans Health Administration. Press release: http://bit.ly/2DA34gN Code of Integrity: http://bit.ly/2DCdMU2

 Misc. –

  • On April 22, CDC released the findings of a survey which showed that about half of workplaces offer health and wellness programs and most worksite health programs focus on physical activity, nutrition, and stress management. Press release: https://bit.ly/2J0IKsP
  • On April 24, CDC announced that measles cases in the United States have reached their highest levels since the disease was eliminated in 2000. Press release: https://bit.ly/2ZAzPUw Secretary Azar statement: https://bit.ly/2UUxMMh
  • Also on April 24, bipartisan Energy & Commerce Committee leaders sent letters to six federal agencies – AHRQ, CDC, CMS, HRSA, HIS, and OASH – requesting briefings on efforts to address the rate of maternal morbidity and mortality in the United States. Press release with links to letters: https://bit.ly/2UJq2YU
  • On April 26, CMS Office of Minority Health Director James penned a blog post on ways that organizations can identify and address social determinants of health. Blog post: https://go.cms.gov/2DwpgZ9
  • Also on April 26, HHS Deputy Secretary Hargan penned a blog post highlighting some of the resources HHS makes available to provide assistance and to empower those returning from incarceration. Blog post: http://bit.ly/2UZGV6u