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


 What’s Ahead: This Week

Hearings and Markups –

  • Tuesday, June 18
    • Senate HELP Committee, “Lower Health Care Costs Act of 2019.”
  • Wednesday, June 19
    • Senate Veterans’ Affairs Committee, “Harnessing the Power of Community: Leveraging Veteran Networks to Tackle Suicide.”
    • Senate Aging Committee, “The Complex Web of Prescription Drug Prices, Part III: Examining Agency Efforts to Further Competition and Increase Affordability.”
    • House Energy & Commerce Committee, Subcommittee on Oversight and Investigations, “Protecting Title X and Safeguarding Quality Family Planning Care.”
    • House Oversight & Reform Committee, “Medical Experts: Inadequate Federal Approach to Opioid Treatment and the Need to Expand Care.”
    • House Veterans’ Affairs Committee, Subcommittee on Health, “Mission Readiness: VA’s Emergency Response and Cache Program.”
  • Thursday, June 20
    • House Energy & Commerce Committee, Subcommittee on Health, “Strengthening Health Care in the U.S. Territories for Today and Into the Future.”
    • House Veterans’ Affairs Committee, “Hearing on H.R. 2943, H.R. 2942, H.R. 2676, H.R. 2677, H.R. 712, H.R. 1647, H.R. 3083, and H.R. 485.
    • House Agriculture Committee, Subcommittee on Nutrition, “The Potential Implications of Eliminating Broad-Based Categorical Eligibility for SNAP Households.”
    • House Oversight & Reform Committee, Subcommittee on Government Operations, “Ensuring Quality Health Care for Our Veterans.”

 Notable Policy Events –

  • Monday, June 17 – Wednesday, June 19
    • Global Health Care LLC, “National Bundled Payment Summit.” Additional information: https://bit.ly/31FA1Dc
  • Tuesday, June 18
  • Wednesday, June 19
    • Politico, “America’s Sky-High Drug Prices and the Role of Biosimilars.” Additional information: https://politi.co/2XEIQL7
    • American Consumer Institute’s Center for Citizen Research, “The Price of Progress: Drug Innovation, Access and Costs.” Additional information: https://bit.ly/2KmKyN9
  • Thursday, June 20
    • Information Technology and Innovation Foundation (ITIF), “The Cost of Cures: Drug Price Controls vs. Biopharmaceutical Innovation.” Additional information: https://bit.ly/2Qz3NnW

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

 Legislative Activity –

Committee Activity, Executive Actions, and Floor Votes:

  • On June 11, the House Education & Labor Committee favorably reported by a vote of 26-18 the amended Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309), which would direct the Department of Labor to promulgate an occupational safety and health standard that requires certain employers in the health care and social service sectors to develop and implement a comprehensive plan for protecting health care workers, social service workers, and other personnel from workplace violence. The bill has also been referred to the Ways & Means and Energy & Commerce Committees. Press release: https://bit.ly/2F8D64P Bill text: https://bit.ly/2RfpHgj
  • On June 12, the House began consideration of a package of fiscal year 2020 (FY2020) appropriations bills, including the Labor-HHS-Education bill (H.R. 2740). The bill would provide HHS with $99.4 billion in funding for FY2020. The House passed several amendments to the bill this week, including one to increase funding for ACA outreach and education and another that would lift the ban on establishing a national patient identifier. The House has yet to vote on the final bill. Press release: https://bit.ly/2KrIeVk List of amendments: http://bit.ly/2Xd1sVu Bill text: https://bit.ly/2Fm06h9

 Introduced Legislation

  • On June 10, Reps. Porter (D-CA), Norcross (D-NJ), and Bilirakis (R-FL) introduced the Mental Health Parity Compliance Act (H.R. 3165), which would require health plans and insurers to conduct in-depth analyses to ensure that plans are compliant and would direct the Secretaries of both HHS and Department of Labor to request these analyses if there are patient complaints that the plans are not compliant. Press release: https://bit.ly/2Ii4EqG
  • Also on June 10, Senate Aging Committee Ranking Member Casey (D-PA) and Sens. Brown (D-OH), Blumenthal (D-CT), Harris (D-CA), and Gillibrand (D-NY) introduced the Disaster Relief Medicaid Act (DRMA) (S. 1754), which would provide Medicaid assistance to individuals and families affected by a disaster or emergency. Reps. Langevin (D-RI) and Shalala (D-FL) introduced companion legislation in the House (H.R. 3215). Press release: https://bit.ly/2IbDcdP Bill text: https://bit.ly/2WI6hXv
  • Also on June 10, Sen. Collins (R-ME) and 21 bipartisan cosponsors introduced the Reach Every Mother and Child Act (S. 1766), which would require the Administration to implement a strategy to achieve the goal of ending preventing maternal, newborn, and child deaths by 2030. Press release: https://bit.ly/31yfT5F Bill text: https://bit.ly/2F4IQN2
  • Also on June 10, Sens. Durbin (D-IL), Duckworth (D-IL), Capito (R-WV), and Murkowski (R-AK) introduced the Resilience Investment, Support, and Expansion (RISE) from Trauma Act (S. 1770), which would help to build the trauma informed workforce and increase resources for communities to support children who have experienced trauma. Reps. Davis (D-IL) and Gallagher (R-WI) also introduced companion legislation in the House (H.R. 3180). Press release: https://bit.ly/2RajXEq
  • On June 11, Reps. Langevin (D-RI), Smith (R-NJ), and Shalala (D-FL) introduced the Real Emergency Access for Aging and Disability Inclusion (REAADI) for Disasters Act (H.R. 3208), which would support the development of preparedness, response, recovery and mitigation plans that are inclusive of seniors and people with disabilities. Senate Aging Committee Chair Collins (R-ME) and Ranking Member Casey (D-PA) introduced companion legislation in the Senate (S. 1755). Press release: https://bit.ly/2WI6hXv Bill text: https://bit.ly/2RaTIhl
  • Also on June 11, Sen. Sanders (I-VT) and 7 cosponsors introduced the Territories Health Equity Act of 2019 (S. 1773), which would eliminate the cap on annual federal Medicaid spending for the U.S. territories, increase the federal matching rate for territories’ Medicaid expenditures, and update the territories’ Medicare hospital reimbursements and prescription drug coverage. Rep. Plaskett (D-VI) and 37 cosponsors introduced companion legislation in the House (H.R. 1354). Press release: https://bit.ly/2WDMX8C Section-by-section: https://bit.ly/2KhgHGK Bill text: https://bit.ly/2IdpRC0
  • Also on June 11, Sen. Hassan (D-NH) and 5 bipartisan cosponsors introduced the Fair and Accurate Medicaid Pricing (AMP) Act of 2019 (S. 1785), which would exclude authorized generic drugs from calculation of the average manufacturer price for purposes of the Medicaid drug rebate program. Rep. Kennedy (D-MA) introduced companion legislation in the House (H.R. 3276). Press release: https://bit.ly/2MNNZPT
  • On June 12, Reps. Marshall (R-KS), Welch (D-VT), Carter (R-GA), and Gonzalez (D-TX) introduced the Pharmacy Benefit Manager Accountability Study Act of 2019 (H.R. 3223), which would require the Comptroller General to study the role PBMs play in the pharmaceutical supply chain and to provide Congress with appropriate policy recommendations. Press release: http://bit.ly/2XfWC9X
  • Also on June 12, Rep. Brownley (D-CA) introduced the Women Veterans Equal Access to Quality Care Act (H.R. 3224), which would provide for increased access to Department of Veterans Affairs medical care for women veterans. Press release: http://bit.ly/2XfjXZr
  • Also on June 12, Rep. Carter (R-GA) and 7 bipartisan cosponsors introduced the VA Telemedicine Clarification Act (H.R. 3228), which would authorize health professional trainees at VA medical facilities to provide treatment via telemedicine. Press release: https://bit.ly/2KOgpqn
  • Also on June 12, Sens. Kaine (D-VA), Isakson (R-GA), and King (I-ME) introduced the Saving Lives Through Better Data Act (S. 1793), which would establish a grant program for the purpose of public health data system modernization. Press release: https://bit.ly/31vi9L9 Bill text: https://bit.ly/2IebjC3
  • Also on June 12, Sen. Smith (D-MN) and 14 cosponsors introduced the Affordable Medications Act (S. 1801), which would require pharmaceutical companies to disclose how much money is going toward research and development, as well as toward executive pay and marketing. The bill would also end the restriction that prevents the Medicare program from negotiating prices in Part D. Press release: https://bit.ly/2If5X9S Section-by-section: https://bit.ly/2WGrD2F
  • Also on June 12, Sens. Scott (R-SC) and Jones (D-AL) introduced the Better Tools for Healthy Living Act (S. 1805), which would require the HHS Secretary to develop a guide on evidence-based strategies for building and maintaining effective obesity prevention and control programs. Press release: https://bit.ly/2Rhlh8z
  • On June 13, Rep. Harder (D-CA) introduced the No Health Care No Raise Act (H.R. 3271), which would prohibit cost of living adjustments in pay rates for members of Congress unless the HHS Secretary certifies that all citizens of the U.S. are enrolled in health insurance coverage that provides a package of benefits that is at least as comprehensive as the essential health benefits package described in the ACA. Press release: https://bit.ly/2KVq7HH
  • Also on June 13, Rep. Hastings (D-FL) and 6 cosponsors introduced the Services for Ending Long-Term Homelessness Act (H.R. 3272), which would establish a grant program to place in permanent supportive housing and provide supportive services to individuals who have physical or mental health conditions or SUD and are chronically homeless or at risk of becoming so. Press release: https://bit.ly/2MOvICd Bill text: https://bit.ly/31qLlmm
  • Also on June 13, Sens. Klobuchar (D-MN) and Murkowski (R-AK) introduced the Protecting Personal Health Data Act (S. 1842), which would require the HHS Secretary to promulgate  privacy regulations for new health technologies such as apps, wearables, and direct-to-consumer genetic testing kits that are not regulated by existing laws. Press release: https://bit.ly/2IMDJCj
  • Also on June 13, Senate HELP Committee Ranking Member Murray (D-WA) and 27 Democratic cosponsors introduced the Affordability is Access Act (AAA) (S. 1847), which would require group health plans and group or individual health insurance coverage to provide coverage for over-the-counter contraceptives. Reps. Pressley (D-MA), Ocasio-Cortez (D-NY), Hill (D-CA), and Bera (D-CA) introduced companion legislation in the House (H.R. 3296). Press release: https://bit.ly/2WL17tP Bill text: https://bit.ly/2ZuciE7
  • Also on June 13, Sens. Collins (R-ME) and Manchin (D-WV) introduced the Premium Reduction Act of 2019 (S. 1868), which would provide support to states to establish invisible high-risk pool or reinsurance programs. Press release: https://bit.ly/2MPNg0z Section-by-section: https://bit.ly/2XVelAo

 Individual Market and ACA Implementation –

  • On June 13, HHS, Department of Labor (DOL), and the Treasury Department issued a final regulation that will allow employers, beginning in January 2020, to use individual coverage health reimbursement arrangements (HRAs) to provide employees with tax-preferred funds to pay for the cost of health coverage through the individual market. Press release: https://bit.ly/2WEcvTj CMS Administrator Verma statement: https://go.cms.gov/2KkYcBo FAQ: https://bit.ly/2KjgAui Final rule: https://bit.ly/2Kn8CjU
  • On June 14, House Energy & Commerce Committee Chair Pallone (D-NJ), Ways & Means Committee Chair Neal (D-MA), and Education and Labor Committee Chair Scott (D-VA) penned a letter to HHS Secretary Azar raising questions over a newly unveiled memo that includes internal analysis on the potential impacts of some the Administration’s proposed policy changes to the ACA. Press release: https://bit.ly/2XfEIEf Letter: https://bit.ly/2KpXfYH

 Medicare and Medicaid –

  • On June 10, Senate Finance Committee Chair Grassley (R-IA) and Sen. Rubio (R-FL) penned a letter to HHS Acting Inspector General Chiedi requesting oversight on potential CMS payments made to U.S. entities with partnerships to companies with ties to the Chinese government. Press release: https://bit.ly/2I6oxRk Bill text: https://bit.ly/2F9QdTr
  • On June 12, CMS approved Washington State’s plan amendment proposal to allow supplemental rebates involving a “subscription” model for prescription drug payment in Medicaid. Press release: https://go.cms.gov/2X9J3Zr
  • Also on June 12, HHS Office of Inspector General (OIG) published a report finding that CMS could use Medicare data to identify instances of potential abuse or neglect. Summary with link to report: https://bit.ly/2RerIZY
  • Also on June 12, HHS OIG published a report finding that incidents of potential abuse and neglect at skilled nursing facilities (SNFs) were not always reported and investigated. Summary with link to report: https://bit.ly/2KNbG8e
  • On June 13, CMS published an FAQ document on advanced planning documents (APD) for system development associated with 1115 demonstrations. FAQ: https://bit.ly/2IEhiyZ
  • On June 14, Medicare Payment Advisory Commission (MedPAC) released its June 2019 Report to the Congress, highlighting MedPAC’s recommendations on beneficiary enrollment in Medicare, restructuring Part D for the era of specialty drugs, and issues in Medicare beneficiaries’ access to primary care, among other topics. Press release: https://bit.ly/2XImHvq Fact sheet: https://bit.ly/2IK2TkT Report: https://bit.ly/31yfRe7
  • Also on June 14, Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2019 Report to the Congress, highlighting MACPAC’s recommendations on next steps in improving Medicaid prescription drug policy, treatment of third-party payments in the definition of Medicaid shortfall, and improving the effectiveness of Medicaid program integrity, among other topics. Press release: https://bit.ly/2MOgnS6 Report: https://bit.ly/2KkPS4o

 Payment and Delivery System Reform –

  • On June 12, CMS revised its public announcement of the Artificial Intelligence (AI) Health Outcomes Challenge to reflect updates regarding participation, prizes, judging, and dates. Official public notice: https://bit.ly/2MO2xiB

 Drug and Medical Device Prices and Regulation –

  • On June 13, Senate Budget Committee Ranking Member Sanders (I-VT) and House Oversight Committee Chair Cummings (D-MD) sent a letter to U.S. Attorney General Barr to urge him to investigate 20 generic drug manufacturers for allegedly engaging in a multi-billion dollar price-fixing conspiracy in violation of federal antitrust law. Press release: https://bit.ly/2IfO62h Letter: https://bit.ly/31uZUWh
  • Also on June 13, HHS issued a funding opportunity for projects that would broadly disseminate patient-centered outcomes research findings into practice through clinical decision support systems. Funding announcement: https://bit.ly/2Fa3V8W
  • Also on June 13, House Energy & Commerce Committee Chair Pallone (D-NJ) and Ranking Member Walden (R-OR), Health Subcommittee Chair Eshoo (D-CA) and Ranking Member Burgess (R-TX), and Oversight and Investigations Subcommittee Chair DeGette (D-CO) and Ranking Member Guthrie (R-KY) penned letters to Department of Homeland Security (DHS), FDA, Office of National Drug Control Policy (ONDCP), and United States Postal Service (USPS) requesting briefings on the illicit flow of fentanyl into American communities as part of the Committee’s ongoing investigation into the public health threat posed by the deadly synthetic opioid. Press release with links to letters: https://bit.ly/2XLgjn6
  • Also on June 13, Congressional Progressive Caucus Co-Chairs Pocan (D-WI) and Jayapal (D-WA) penned letters to CEOs of six pharmaceutical companies inviting them to participating in a forum on the rising cost of prescription drugs and the need for reforms to lower prices for patients. Press release with letter text: https://bit.ly/2F8Qsy2

 Substance Use and Mental Health –

  • On June 11, Food and Drug Administration (FDA) finalized guidance for premarket tobacco product applications for electronic nicotine delivery systems as part of the agency’s commitment to continuing oversight of e-cigarettes. Press release: https://bit.ly/2R77Cks
  • Also on June 11, Centers for Disease Control and Prevention (CDC) released an issue brief finding that more than half of people who misuse prescription opioids also binge drink. Press release: https://bit.ly/2ZrqQEz

Health Data and IT –

  • On June 10, CMS Administrator Verma delivered remarks at the American Medical Association’s Annual Meeting of the House of Delegates, in which she highlighted the agency’s efforts to reduce physicians’ administrative burden and promote interoperability. Transcript: https://go.cms.gov/2IdIcP9

 Veterans and Military Health –

  • On June 10, Department of Veterans Affairs (VA) announced plans to implement a new policy restricting smoking by patients, visitors, volunteers, contractors, and vendors at its health care facilities by October 2019. Press release: https://bit.ly/2FjCGsL
  • On June 11, House Veterans’ Affairs Committee Ranking Member Roe (R-TN) issued a statement praising the launch of the VA MISSION Act’s Community Care Program. Press release: https://bit.ly/2wQOaiD
  • On June 12, VA announced that nine of the Department’s programs were recognized for innovations in federal health IT. Press release: https://bit.ly/2wUuyde
  • Also on June 12, U.S. Government Accountability Office (GAO) published a report estimating resources needed to provide community care for veterans. GAO found that VA’s budget documents show estimates of $17.8 billion for this care by fiscal year 2021. Summary with link to report: https://bit.ly/2RdtOti
  • Also on June 12, GAO published a report finding that improvements are needed for tracking coordination of specialty care referrals for TRICARE Prime beneficiaries. Summary with link to report: https://bit.ly/2WE0fXI
  • On June 13, VA OIG released a report on VA’s administration of the Transformation Twenty-One Total Technology Next Generation Contract, which was awarded between March and August 2016 and has a total maximum value of $22.3 billion. While OIG identified no violations of federal and VA acquisition regulations, the audit team found oversight weaknesses that, if not corrected, could increase the likelihood of VA conducting business with contractors unable to provide services according to contract requirements. Summary with link to report: https://bit.ly/2XNOOt1

 Misc. –

  • On June 10, CMS Administrator Verma published a blog highlighting the agency’s efforts in reducing providers’ administrative burden and how that reduction can be associated with increased quality of care. Blog: https://go.cms.gov/2wSjvBy
  • On June 11, U.S. Preventive Services Task Force (USPSTF) issued final recommendation statements on HIV screening and prevention, stating that clinicians should screen for HIV in everyone ages 15 to 65 years and all pregnant people and that clinicians should offer pre-exposure prophylaxis (PrEP) to people at high risk of HIV. Final recommendation: https://bit.ly/2KMAGfN