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


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

Legislative Activity –

Committee Activity, Executive Actions, and Floor Votes

  • On June 26, the Senate HELP Committee approved by a vote of 20-3 the Lower Health Care Costs Act of 2019 (S. 1895), which includes a number of provisions related to surprise billing, healthcare price transparency, drug pricing, and other healthcare topics. The Committee also approved the Emergency Medical Services for Children Reauthorization Act of 2019 (S. 1173) and the Poison Control Center Network Enhancement of 2019 (S. 1199). The bills now move to the full Senate for consideration. Press release: https://bit.ly/2XxjUbD
  • Also on June 26, the House Ways & Means Committee advanced five healthcare related bills: the Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 (H.R. 3417), the HEARTS and Rural Relief Act (H.R. 3429), the Improving Chronic Care Management Act (H.R. 3436), the Opioid Workforce Act of 2019 (H.R. 3414), and the Protecting Access to Information for Effective and Necessary Treatment (PATIENTS) Act of 2019 (H.R. 3439). The bills now move to the full House for consideration. Chair Neal’s opening remarks: https://bit.ly/2JbvYpz Bill texts: https://bit.ly/2x9hSQ7
  • On June 27, the Senate Judiciary Committee advanced a set of four bills aimed at addressing prescription drug costs, including: the Prescription Pricing for the People Act of 2019 (S. 1227), the PACED Act (S.440), Stop STALLING Act (S. 1224), and the Affordable Prescriptions for Patients Act of 2019 (S. 1416). The bills now move to the full Senate for consideration. Press release: https://bit.ly/2NghHgC
  • On June 28, the House passed by a voice vote S.2047, which provides a two-week extension of the Medicaid Community Mental Health Services demonstration program, providing funding through July 14. Having previously passed the Senate, the bill now moves to the President for signature. Bill text: https://bit.ly/2LpvVta

 Introduced Legislation

  • On June 24, Sen. Blumenthal (D-CT) introduced the Public Health Funding Restoration Act (S. 1944), which would fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system. Rep. Matsui (D-CA) introduced companion legislation in the House (H.R. 3447). Press release: https://bit.ly/31TdKSp
  • Also on June 24, Sens. Thune (R-SD) and Carper (D-DE) introduced the Chronic Disease Management Act (S. 1948), which would permit high deductible health plans to provide chronic disease prevention services to plan enrollees prior to satisfying their plan deductibles. Press release: https://bit.ly/2ZYbEPw
  • Also on June 24, Reps. Axne (D-IA) and Smith (R-NE) introduced H.R. 3431, which would provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and rural hospitals through 2021. Press release:  http://bit.ly/2ZXo223
  • Also on June 24, Rep. Beyer (D-VA) introduced the Protecting Access to Information for Effective and Necessary Treatment (PATIENT) Act (H.R. 3439), which would extend appropriations and transfers to the Patient-Centered Outcomes Research Trust Fund through FY2026 extends certain health insurance fees for such transfers. Press release: https://bit.ly/2X5VMs5 Bill text: https://bit.ly/31SuTvz
  • Also on June 24, House Energy & Commerce Committee, Subcommittee on Oversight and Investigations Chair DeGette (D-CO), Ranking Member Guthrie (R-KY, and Reps. Latta (R-OH) and Dingell (D-MI) introduced the Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2019 (H.R. 3443), which would clarify the regulatory framework with respect to certain nonprescription drugs that are marketed without an approved drug application. Press release: http://bit.ly/2ZXzydH Bill text: http://bit.ly/2ZZOBUa
  • On June 25, Reps. Sanchez (D-CA), Kelly (R-PA), and Schrader (D-OR) introduced the Community-Based Independence for Seniors Act (H.R. 3461), which would establish a community-based institutional special needs plan demonstration program to target home and community-based care to eligible Medicare beneficiaries. Press release: http://bit.ly/2ZUkMnW
  • Also on June 25, Reps. Trone (D-MD), Wild (D-PA), Joyce (R-PA), Shalala (D-FL) and Fitzpatrick (R-PA) introduced the Higher Education Mental Health Act of 2019 (H.R. 3489), which would authorize the Secretary of Education to establish an Advisory Commission on serving and supporting students with mental health disabilities in higher education institutions. Press release: https://bit.ly/2ZVD1tu  Bill text: https://bit.ly/2xiYyzP
  • Also on June 25, Sens. Stabenow (D-MI) and Collins (R-ME) introduced the Quality Care for Moms and Babies Act  (S. 1960), which would improve the quality, health outcomes, and value of maternity care under the Medicaid and CHIP programs by developing maternity care quality measures and supporting maternity care quality collaboratives. Press release: https://bit.ly/2FQTTtR
  • Also on June 25, Sens. Blackburn (R-TN), Cramer (R-ND), Daines (R-MT), Ernst (R-IA) and Hyde-Smith (R-MS) introduced the Protecting Life and Taxpayers Act (S. 1966), which would halt the use of taxpayer dollars to fund abortion services. Press release: https://bit.ly/2KJo0Hy
  • Also on June 25, Sens. Scott (R-SC) and Cardin (D-MD) introduced the Provide Accurate Information Directly (PAID) Act (S. 1989), which would provide for transparency of Medicare secondary payer reporting information. Press release: http://bit.ly/2ZZDmep
  • On June 26, Reps. Welch (D-VT) and Rooney (R-FL) introduced the End Price Gouging for Medications Act (H.R. 3523), which would require the Secretary of HHS to establish reference prices for prescription drugs for purposes of federal health programs. Sen. Merkley (D-MA) introduced companion legislation in the Senate (S. 1987). Press release: https://bit.ly/2FDYyPw Bill text: https://bit.ly/2KH0ElK
  • Also on June 26, Sens. Cramer (R-ND), Daines (R-MT), and Blackburn (R-TN) introduced the Patient Rights Act (S. 1993), which would restrict federal funding for health care entities that do not respect all human life and patient rights. Press release: https://bit.ly/2JpdQJd
  • Also on June 26, House Doctor’s Caucus Co-Chairs Roe (R-TN) and Ruiz (D-CA) introduced the Protecting People from Surprise Medical Bills Act (H.R. 3502) which would amend the Public Health Service Act to protect health care consumers from surprise billing practices. Press release: http://bit.ly/2ZZMAr4
  • On June 27, Reps. Norman (R-SC) and Palmer (R-AL) introduced the Ensuring Accurate and Complete Abortion Data Reporting Act of 2019 (H.R. 3580) which would improve the reporting of abortion data to the CDC. Press release: https://bit.ly/2XfPVp0
  • Also on June 27, Reps. Engel (D-NY) and King (R-NY) introduced the 21st Century Hospital Act (H.R. 3558), which would direct the Secretary of HHS to conduct a study assessing the level of investment needed to modernize hospitals in the United States. Press release: https://bit.ly/2NjFAns
  • Also on June 27, Reps. Ferguson (R-GA), Burgess (R-TX), Panetta (D-CA), and Kennedy (D-MA) introduced the Behavioral Intervention Guidelines (BIG) Act (H.R. 3539), which would direct the Secretary of HHS to develop best practices for the establishment and use of behavioral intervention teams at schools. Press release: https://bit.ly/2xgVGUh
  • Also on June 27, Reps. Rush (D-IL), Roe (R-TN), Chu (D-CA), and Dunn (R-FL) introduced the U.S. Preventive Services Task Force Transparency and Accountability Act (H.R. 3534), which would amend the Public Health Service Act to revise the operations of the United States Preventative Services Task Force. Press release: https://bit.ly/2ZYaxyX
  • Also on June 27, Sens. Smith (D-MN) and Cramer (R-ND) introduced the Emergency Access to Insulin Act (S. 2004), which amend the Public Health Service Act to establish insulin assistance programs. Press release: https://bit.ly/2xeWr03 Bill summary: https://bit.ly/2REKr1g Bill text: https://bit.ly/2RFJe9T

 Individual Market and ACA Implementation –

  • On June 26, House Oversight Committee Chair Cummings (D-MD) sent a letter to Office of Management and Budget Director Vought requesting his testimony on the Administration’s stance on the Texas vs Azar ACA case. Press release: http://bit.ly/2ZOXXlN Letter: http://bit.ly/2ZTTnmm
  • On June 28, CMS released a summary report on permanent risk adjustment in transfers for the 2018 benefit year for issuers participating in the individual or small group markets. Report: https://go.cms.gov/2ZXQn8v

 Medicare and Medicaid –

  • On June 25, CMS Administrator Verma penned a blog post highlighting the agency’s actions to improve Medicaid program integrity and announced a number of future initiatives. Blog post: https://go.cms.gov/2Xzu4bE
  • On June 26, Senate Homeland Security and Governmental Affairs Chair Johnson (R-WI) sent a letter to CMS Administrator Verma requesting information on CMS’ steps to mitigate Medicaid fraud. Press release: http://bit.ly/2ZTqVRC  Letter: http://bit.ly/2XFE570
  • Also on June 26, CMS released the latest iteration of its Beyond the Policy Podcast, focused on key perspectives from attendees at the recent HIMSS Annual Conference. Podcast: https://go.cms.gov/2ZR4Enk
  • On June 27, House Energy & Commerce Committee Chair Pallone (D-NJ) sent a letter to HHS Secretary Azar arguing that the Department does not have the legal authority to implement a block grant or per capita cap on the Medicaid program. Press release: http://bit.ly/2ZUzfQV Letter:  http://bit.ly/2ZUzlrL
  • Also on June 27, CMS published a proposed rule and request for additional comment on proposed changes to the Medicare Advantage risk adjustment data validation (RADV) program and announced the release of additional material related to the RADV provisions of the November 1 MA Proposed Rule. Comments are due by August 28. Proposed rule: http://bit.ly/2ZQXHm9
  • On June 28, Senate Finance Committee Chair Grassley (R-IA) sent a letter to CMS providing recommendations on proposed guidance clarifying how CMS and state surveyors will evaluate the use of shared space, shared staff, and contracted services by hospitals that are co-located with other hospitals and health care providers under the Medicare program. Press release: http://bit.ly/301Lqvr Letter: http://bit.ly/2ZZ6x1w

 Payment and Delivery System Reform –

  • On June 27, CMS released the second annual evaluation report and associated materials for the Comprehensive Care for Joint Replacement (CJR) demonstration. Findings: http://bit.ly/2ZTnrP2 Report: http://bit.ly/2ZSOWId

 Drug and Medical Device Prices and Regulation –

  • On June 25, Senate HELP Committee Ranking Member Murray (D-WA) and Sen. Warren (D-MA) sent a letter to FDA Acting Commissioner Sharpless questioning the FDA’s plans with respect to approval standards for medical devices. Press release: http://bit.ly/300oblt Letter: http://bit.ly/300og8L
  • On June 26, CMS announced it had approved Louisiana’s state plan amendment for supplemental rebate agreements that use a modified subscription model for Hepatitis C therapies in Medicaid. Press release: https://go.cms.gov/2ZLN7No

 Substance Use and Mental Health –

  • On June 24, HHS released a literature review on housing options for recovery for individuals with opioid use disorder. Report: http://bit.ly/2ZQI1iL
  • On June 25, CMS announced a Notice of Funding Opportunity for state Medicaid agencies to apply for planning grants that will aid in the treatment and recovery of substance use disorders. Applications are due by August 9. Press release: https://go.cms.gov/2ZN5yBc NOFO: http://bit.ly/2ZYE8bP
  • Also on June 25, House Energy & Commerce Committee Chair Pallone (D-NJ), Ranking Member Walden (R-OR), Health subcommittee Chair Eshoo (D-CA), Ranking Member Burgess (R-TX), Oversight & Investigations Subcommittee Chair DeGette (D-CO) and Ranking Member Guthrie (R-KY) sent a letter to FDA Acting Commissioner Sharpless requesting briefings on the agency’s actions to address the opioid epidemic. Press release: http://bit.ly/2ZSReqN Letter: http://bit.ly/2ZW4V8B
  • On June 28, CMS announced the approval of two additional 1115 waivers in Minnesota and Nebraska that would increase access to treatment for opioid use disorder and other substance use disorders by waiving the IMD exclusion. Press release: https://go.cms.gov/2ZVCt6E

Health Data and IT –

  • On June 26, HHS Office of Civil Rights released a set of new frequently asked questions that clarify how HIPAA permits health plans to share protected health information to promote care coordination and continuity of care. Press release: http://bit.ly/2ZShv8Q FAQ: http://bit.ly/2ZYzquJ
  • Also on June 26, U.S. Government Accountability Office (GAO) released a set of recommendations intended to strengthen federal agencies’ acquisition and cybersecurity efforts, which includes information specific to HHS. Summary with link to report: http://bit.ly/2ZYFCCV

 Veterans and Military Health –

  • On June 25, Department of Veterans Affairs (VA) released its fiscal year 2018 performance metrics for the Veterans Crisis Line, finding that program has improved it ability to provide fast, effective assistance to Veterans. Press release: http://bit.ly/2ZVKGaT
  • Also on June 25, the VA announced its plans to reduce rates for Servicemembers’ Group life Insurance. Press release: http://bit.ly/2ZQDTPV
  • On June 26, VA announced a partnership with the Corporation for National and Community Services to engage Senior Corps volunteers in support of the Choose Home initiative, which enables older veterans to receive needed homemaker and daily living supports at home. Press release: http://bit.ly/2ZLR0ls
  • On June 27, VA announced a partnership with Verizon to provide all veterans who are Verizon customers unlimited access to the VA Video Connect telehealth app. Press release: http://bit.ly/2ZNf872

 Misc. –

  • On June 24, President Trump announced an Executive Order that aims to improve healthcare price transparency by requiring hospitals and plans to provide more information to patients on out-of-pocket costs, tasking the federal government with releasing additional data, and expanding the benefits of Health Savings Accounts and other similar tax-advantaged tools. HHS and CMS Press releases: http://bit.ly/2ZSxQKA and https://go.cms.gov/2ZSz4pa Fact sheet: http://bit.ly/2ZSO6ex Executive Order: http://bit.ly/2ZQTcbf
  • Also on June 24, GAO released a report finding that to help rural older adults age independently and in place, HHS should provide greater support to rural service providers by centralizing access to and promoting the awareness of promising practices or other useful information. Summary with link to report: http://bit.ly/2ZQC19R
  • On June 25, HHS updated its list of designated primary care, mental health, and dental health professional shortage areas. List: http://bit.ly/2ZRVzL5
  • On June 27, HHS announced the award of $1 million in Ryan White HIV/AIDS program grants to counties to strengthen efforts to end the HIV epidemic in the U.S. Press release: http://bit.ly/2ZQB2qb
  • Also on June 27, Centers for Disease Control and Prevention released data finding that less than 30 percent of individuals considered most at risk of contracting HIV were tested in the previous year. Data: http://bit.ly/2ZT7VCu