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


 What’s Ahead: This Week

 Hearings and Markups –

  • Tuesday, May 21
    • House Energy & Commerce Committee, Subcommittee on Health, “Improving Drug Pricing Transparency and Lowering Prices for American Consumers.”
    • House Ways & Means Committee, Subcommittee on Health, “Protecting Patients from Surprise Medical Bills.”
    • House Armed Services Committee, Subcommittee on Military Personnel and House Veterans’ Affairs Committee, “Military and Veteran Suicide: Understanding the Problem and Preparing for the Future.”
  • Wednesday, May 22
    • House Budget Committee, “Key Design Components and Considerations for Establishing a Single-Payer Health Care System.”
    • Senate Veterans Affairs Committee, “Pending Legislation.”
    • House Veterans Affairs Committee, Joint Subcommittee on Health and Technology and Modernization Oversight, “MISSION Critical: Caring for our Heroes.”
    • House Veterans Affairs Committee, Subcommittee on Oversight and Investigations, “Improving the Department of Veterans Affairs Effectiveness: Responding to Recommendations from Oversight Agencies.”

 Notable Policy Events –

  • Monday, May 20
    • Aspen Institute, “Breakthroughs in Brain Health, Immunity, and Wellness.” Additional information: https://bit.ly/2JknYoY
  • Tuesday, May 21
    • Kaiser Family Foundation (KFF) and John A. Hartford Foundation, “Inclusive Care at the End of Life: The LGBTQ+ Experience.” Additional information: https://bit.ly/2VC7FdH
  • Wednesday, May 22
    • Health IT Advisory Committee (HITAC), “Health IT Advisory Committee Meeting.” Additional information: http://bit.ly/2Embmtn

 

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

Legislative Activity –

 Committee Activity, Floor Votes, and Executive Action –

  • On May 16, the House passed by a vote of 234 to 183 the Strengthening Health Care and Lowering Prescription Drug Costs Act (H.R. 987), which is a package of several drug pricing bills – including the CREATES Act (H.R. 965), the BLOCKING Act (H.R. 938), and the Protecting Consumer Access to Generic Drug Prices Act (H.R. 1499) – with several ACA-related bills, including the State Allowance for a Variety of Exchanges Act (H.R. 1385), the Expand Navigators’ Resources for Outreach, Learning, and Longevity Act (H.R. 1386), and a bill that would vacate the Short-Term Limited Duration Insurance final rule. The bill now moves to the Senate for consideration. Press release: http://bit.ly/2WPZIht

 Introduced Legislation –

  • On May 13, Senate Finance Committee Chair Grassley (R-IA), Senate HELP Committee Chair Alexander (R-TN), Sen. King (I-ME), and Sen. Durbin (D-IL) introduced S. 1437, which would require that direct-to-consumer advertisements for prescription drugs and biological products include truthful and non-misleading pricing information. Press release: https://bit.ly/2Humd5g
  • On May 14, Rep. Harder (D-CA) introduced the Supporting the Health and Safety of Law Enforcement Act (H.R. 2696), which would provide for the establishment of a pilot program to provide grants to community mental health centers for the placement of social workers with law enforcement agencies. Press release: http://bit.ly/2EmJ5CW
  • Also on May 14, Reps. Horn (D-OK) and Gonzalez (R-OH) introduced the Law Enforcement Training or Mental Health Act of 2019 (H.R. 2698), which would provide grants to state, local, territorial, and tribal law enforcement agencies to obtain behavioral health crisis response training for law enforcement officers. Sen. Inhofe (R-OK) introduced companion legislation in the Senate (S. 1464). Press release: https://bit.ly/2JG6zGx
  • Also on May 14, House Energy & Commerce Health Subcommittee Ranking Member Burgess (R-TX) and 29 cosponsors introduced the Lowering Prescription Drug Costs and Extending Community Health Centers and Other Public Health Priorities Act (H.R. 2700), which would aim to incentivize low-cost drug options and generic competition and provide extensions for community health centers and the National Health Service Corps. Press release: https://bit.ly/2VqR33x Bill text: https://bit.ly/2VsIpS6
  • Also on May 14, Rep. Green (R-TN) and 5 Republican cosponsors introduced the Medicaid Improvement and State Flexibility Act (H.R. 2715), which would authorize states to begin pilot programs giving Medicaid recipients a “swipe card” with funds on it designated for medical purchases. Press release: https://bit.ly/2WJ86zn
  • Also on May 14, Reps. Stanton (D-AZ) and McAdams (D-UT) introduced the Lessening Addiction by Enhancing Labeling (LABEL) Act (H.R. 2732), which would require warning labels on addictive prescription painkillers. Sen. Markey (D-MA) introduced companion legislation in the Senate (S. 1449). Press release: https://bit.ly/2VqTnro
  • Also on May 14, Rep. Trahan (D-MA) introduced the Safe Prescribing of Controlled Substances Act (H.R. 2734), which would require certain practitioners authorized to prescribe controlled substances to complete continuing education. Sen. Markey (D-MA) introduced companion legislation in the Senate (S. 1448). Press release: https://bit.ly/2EcCsCS Bill text: https://bit.ly/2VXihmP
  • Also on May 14, Sens. Booker (D-NJ) and Menendez (D-NJ) introduced the Access to Infertility Treatment and Care Act (S. 1461), which would require health insurance coverage for the treatment of infertility. Press release: http://bit.ly/2WYB4eM
  • Also on May 14, House Energy & Commerce Committee Chair Pallone (D-NJ) and Ranking Member Walden (R-OR) released a draft bill to address surprise medical costs, called the “No Surprises Act. Draft bill: http://bit.ly/2EiR5od
  • On May 15, House Energy & Commerce Democrats introduced the Leading Infrastructure for Tomorrow’s America Act (LIST America Act) (H.R. 2741), which would provide significant funding to improve health infrastructure, including $100 million to establish a community-based care infrastructure program. Press release: http://bit.ly/2WPLihn Section-by-section: http://bit.ly/2WSJbcK  Bill text: http://bit.ly/2WPLjlr
  • Also on May 15, Reps. Moore (D-WI), Haaland (D-NM), and Dingell (D-MI) introduced the Mamas First Act (H.R. 2751), which would provide coverage under the Medicaid program for services provided by doulas and midwives. Press release: http://bit.ly/2WRE1O6
  • Also on May 15, Rep. Allred (D-TX) introduced the VA Newborn Emergency Treatment Act (H.R. 2752), which would authorize the Secretary of Veterans Affairs to furnish medically necessary transportation for newborn children of certain women veterans. Press release: http://bit.ly/2WORh6b
  • Also on May 15, Rep. Cunningham (D-SC) introduced the Creating Lower Cost Alternatives for Your Prescription Drugs (CLAY) Act (H.R. 2757), which would provide for adjustments to the Medicare part D cost-sharing reductions for low-income individuals. Press release: http://bit.ly/2WPb4SN
  • Also on May 15, Reps. Pascrell (D-NJ) and Kinzinger (R-IL) introduced the Huntington’s Disease Parity Act (H.R. 2770), which would waiver the 24-month waiting period for Medicare eligibility for individuals disabled by Huntington’s Disease. Sens. Cassidy (R-LA) and Gillibrand (D-NY) introduced companion legislation in the Senate (S. 1476). Press release: http://bit.ly/2WNFq8c
  • Also on May 15, Reps. McMorris Rodgers (R-WA) and Loebsack (D-IA) introduced the Protecting Home Oxygen & Medical Equipment (HOME) Access Act of 2019 (H.R. 2771), which would direct the Secretary of HHS to revise regulations with respect to payment rates for durable medical equipment under the Medicare program. Press release: http://bit.ly/2WNCBE1
  • ALso on May 15, Reps. Schneider (D-IL) and Stefanik (R-NY) introduced the Primary Care Patient Protection Act of 2019 (H.R. 2774), which would require coverage without a deductible of certain primary care services by high deductible health plans. Press release: http://bit.ly/2EjEL7s
  • Also on May 15, Reps. Wasserman Schultz (D-FL) and Brooks (R-IN) introduced the Protecting Access to Lifesaving Screenings (PALS) Act (H.R. 2777), which would protect coverage for screening mammography. Press release: http://bit.ly/2EfDb6h
  • also on May 15, Rep. Watson Coleman (D-NJ) introduced the Healthy Maternal and Obstetric Medicine (Health MOM) Act (H.R. 2778), which would amend title XXVII of the Public Health Service Act to provide for a special enrollment period for pregnant women. Sens. Brown (D-OH) and Smith (D-MN) introduced companion legislation in the Senate (S. 1481). Press release: http://bit.ly/2Ehoi3p
  • Also on May 15, Senate Finance Committee Ranking Member Wyden (D-OR) introduced the Health care Price Check Act of 2019 (S. 1497), which would improve cost and quality transparency under the Medicare program. Press release: http://bit.ly/2ErGoA7 Summary: http://bit.ly/2ErGAPR Bill text: http://bit.ly/2WS1w9A
  • On May 16, Reps. Schakowsky (D-IL) and Burgess (R-TX) introduced the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 (H.R. 2781), which would reauthorize certain programs relating to the health professions workforce. Press release: http://bit.ly/2EfXL6S  Summary: http://bit.ly/2Egi8Rl
  • Also on May 16, Reps. Walorski (R-IN), Lipinski (D-IL), Kelly (R-PA), and Peterson (D-MN) introduced the Employee Flexibility Act (H.R. 2782), which would repeal the 30-hour threshold for classification as a full-time employee for the purposes of the employer mandate in the ACA and replace it with 40 hours. Sens. Young (R-IN), Manchin (D-WV), Barrasso (R-WY), and Sinema (D-AZ) introduced companion legislation in the Senate (S. 1510). Press release: http://bit.ly/2EiTWh3
  • Also on May 16, Reps. Smith (R-NE), Sewell (D-AL), McMorris Rodgers (R-WA) and Loebsack (D-IA) introduced the Rural Health Clinic Modernization Act (H.R. 2788), which would modernize provisions relating to rural health clinics under Medicare. Press release: http://bit.ly/2EhwJvC
  • Also on May 16, Rep. DeGette (D-CO) introduced the Physical Therapist Workforce and Patient Access Act (H.R. 2802), which would amend the Public Health Service Act to provider for the participation of physical therapists in the National Health Service Corps Loan Repayment Program. Press release: http://bit.ly/2Eh7s4R
  • Also on May 16, Sens. Hirono (D-HI) and Booker (D-NJ) introduced the Youth Access to Sexual Health Services (YASHS) Act (S. 1530), which would authorize the Secretary of HHS to award grants to support the access of marginalized youth to sexual health services. Press release: http://bit.ly/2Ef2p4U
  • Also on May 16, Sens. Cassidy (R-LA), Bennet (D-CO), Young (R-IN), Hassan (D-NH), Murkowski (R-AK) and Carper (D-DE) introduced the STOP Surprise Medical Bills Act (S. 1531), which would provide protections for health insurance consumers from surprise billing. Press release: http://bit.ly/2WVg3la Section-by-section: http://bit.ly/2WPO5Hn Bill text: http://bit.ly/2WQk4am
  • Also on May 16, Sens. Blackburn (R-TN) and Braun (R-IN) introduced the Pharmacy Benefit Managers Accountability Study Act of 2019 (S. 1532), which would require the Government Accountability Office to study the role pharmaceutical benefit managers play in the pharmaceutical supply chain and provide Congress with appropriate policy recommendations. Press release: http://bit.ly/2ErSqcL
  • On May 17, Reps. Sherrill (D-NJ) and Upton (R-MI) introduced the Family-to-Family Reauthorization Act of 2019 (H.R. 2822), which would provide for an extension of funding for family-to-family health information centers. Press release: http://bit.ly/2WVuHZo

 ACA and Individual Market –

  • On May 14, House Energy & Commerce Committee Chair Pallone (D-NJ), Education and Labor Committee Chair Scott (D-VA), Ways & Means Committee Chair Neal (D-MA), Judiciary Committee Chair Nadler (D-NY), and Oversight and Reform Committee Chair Cummings (D-MD) penned letters to the White House and the Department of Justice requesting information regarding the Trump Administration’s decision not to defend the ACA in court. Press release: https://bit.ly/2HxqTY6 Letter to White House: https://bit.ly/30mPyHd Letter to DOJ: https://bit.ly/2JGkITZ
  • On May 16, Rep. Blunt Rochester (D-DE) sent a letter to HHS Secretary Azar and CMS Administrator Verma requesting that HHS and CMS release all ACA marketing and outreach studies and data. Press release with text of letter: http://bit.ly/2WLbt8O

 Medicare and Medicaid –

  • On May 13, Reps. Engel (D-NY) and Olson (R-TX) led a group of 300 members of Congress in a letter to House Speaker Pelosi (D-CA) and Minority Leader McCarthy (R-CA) requesting a delay of the Medicaid Disproportionate Share Hospital (DSH) cuts, which are scheduled to begin on October 1. Press release with text of letter: http://bit.ly/2WPb3OQ
  • On May 15, CMS posted an FAQ document on Medicaid opportunities for enhanced match for certain prescription drug monitoring program expenditures. FAQ: https://bit.ly/2YskwvO
  • Also on May 15, CMS released an informational bulletin for Medicaid managed care plans clarifying its guidance with respect to the how plans should treat rebates and price concessions when calculating the medical loss ratio. Press release: https://go.cms.gov/2WQisNQ  CIB: http://bit.ly/2WP5Gza
  • Also on May 15, HHS released a report assessing the out-of-pocket affordability of long-term services and supports (LTSS), finding that people with little wealth disproportionately receive LTSS and most older people with LTSS needs have little wealth. Report: http://bit.ly/2WYoqvW
  • On May 16, CMS released the final Medicare Advantage and Part D drug pricing rule, which is intended to ensure that patients have greater transparency into the cost of prescription drugs in Part D and also enable MA plans to negotiate better prices for physician-administered medicines. Press release: https://go.cms.gov/2WSLNHA Fact sheet: https://go.cms.gov/2WTey6Q  Final rule: http://bit.ly/2WQiEg2
  • On May 17, CMS released technical assistance questions and answers on the Serious Mental Illness and Seriously Emotional Disturbance demonstration opportunity described in an November 2018 State Medicaid Director letter. FAQ: http://bit.ly/2WWC577
  • Also on May 17, U.S. Government Accountability Office (GAO) released a report finding several deficiencies with CMS’ current process for reviewing and approving section 1115 demonstrations recommending increased transparency. Summary with link to report: http://bit.ly/2WLvvQI

 Payment and Delivery System Reform –

  • On May 14, CMS released the 2018 Year in Review document for the Comprehensive Primary Care Plus (CPC+) model. Document: https://bit.ly/2VDcFyx
  • Also on May 14, CMS released new and updated benchmark methodology documents and waiver information for the Next Generation ACO model. Model website: https://bit.ly/1YfzOws
  • On May 15, CMS released an updated frequently asked questions document for the Integrated Care for Kids (InCK) model. FAQ: http://bit.ly/2FDwIpa

 Drug and Medical Device Prices and Regulation –

  • On May 13, Food and Drug Administration (FDA) Center for Drug Evaluation and Research Director Woodcock posted a blog noting that safety, efficacy, and quality remain the agency’s top priorities as it continues to work to expand access to generic drugs. Blog: https://bit.ly/30gnQMm
  • Also on May 13, HHS published current estimates of supply and utilization of immune globulin (IG) products. The report examined IG market dynamics and the potential health consequences of IG access problems. Summary with link to report: https://bit.ly/30ju2TX
  • On May 15, HHS Office of Inspector General (OIG) released a report comparing average sales prices and average manufacturer prices of drugs in the fourth quarter of 2018 for Medicare Part B. HHS OIG found that 10 drug codes met CMS’ price substitution criteria, which were submitted to CMS for review. Summary with link to report: https://bit.ly/2LJFQeT
  • On May 17, HHS Senior Advisor to the Secretary for Drug Pricing Reform O’Brien penned a blog post outlining reasons why HHS chose to finalize a rule requiring pharmaceutical manufactures to include the price of certain products in their direct-to-consumer advertisements. Blog post: http://bit.ly/2WP4onO

 Substance Use and Mental Health –

  • On May 13, HHS awarded $24 million in grants to 120 rural organizations as part of the second round of its Rural Communities Opioid Response Program (RCORP) planning grants. Press release: https://bit.ly/2LUIApA
  • On May 14, HHS announced the creation of an interdepartmental substance use disorders coordinating committee, which will identify areas of improved coordination related to SUD research, services, supports, and prevention activities across all relevant federal agencies. Nominations are due by June 14. Press release: https://bit.ly/2JI5xK7 Committee charter: https://bit.ly/2W9nkQS

Veterans and Military Health –

  • On May 13, Department of Veterans Affairs (VA) announced a partnership with Virta Health to explore an innovative program focused on improving the health of individuals with type II diabetes. Press release: https://bit.ly/2E8jopq
  • Also on May 13, VA announced that its voluntary research genetics program has reached 750,000 veteran partners. Press release: https://bit.ly/2Q6xFri
  • On May 15, VA Office of Inspector General (OIG) released a report reviewing the deferrals in the Veterans Benefits Management System (VBMS). Within the three-month review period, OIG found that an estimated 23,200 unwarranted deferrals occurred. Summary with link to report: https://bit.ly/2W6losu
  • On May 16, VA announced the launch of a new community-focused public health model to prevent veteran suicide. Press release: http://bit.ly/2WRzkDY

 Misc. –

  • On May 13, HHS OIG released a report showing that the department met many requirements of the Improper Payments Information Act of 2002, but did not fully comply for FY 2018. Summary with link to report: https://bit.ly/2VnqYT3
  • On May 16, HHS announced a new project focused on understanding how local, state, faith-based and nonprofit human service programs and organizations can create and use social capital to increase employment, reduce poverty, ad improve child and family wellbeing. Summary: http://bit.ly/2WS4vPk