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


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

Legislative Activity –

Introduced Legislation

  • On July 30, Rep. Maloney (D-NY) and 4 cosponsors introduced the Medicare Demonstration of Coverage for Low Vision Devices Act (H.R. 4129), which would provide for a Medicare demonstration project to evaluate the fiscal impact of covering low vision devices as durable medical equipment under Medicare Part B. Press release: https://bit.ly/2KkBSp1
  • On July 31, Sen. Udall (D-NM), Moran (R-KS), Tester (D-MT), Rounds (R-SD), and Smith (D-MN) introduced the Health Care Access for Urban Native Veterans Act (S. 2365), which would authorize urban Indian organizations to enter into arrangements for the sharing of medical services and facilities. Rep. Khanna (D-CA) introduced companion legislation in the House (H.R. 4153). Press release: http://bit.ly/2LZ21Nx Bill text: http://bit.ly/2LZFxfi
  • Also on July 31, Sens. Warner (D-VA) and Portman (R-OH) introduced the Commonsense Reporting Act of 2019 (S. 2366), which would streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy. Press release: http://bit.ly/2M1lpJs Summary: http://bit.ly/2M4i24v Bill text: http://bit.ly/2LYuItK
  • Also on July 31, Sen. Smith (D-MN), Murkowski (R-AK), Jones (D-AL), and Capito (R-WV) introduced the Rural MOMS Act (S. 2373), which would improve obstetric care in rural areas. Press release: https://bit.ly/2YCg8tO Bill summary: https://bit.ly/31alm1E
  • Also on July 31, Sens. Van Hollen (D-MD) and Scott (R-FL) introduced the We Protect American Investments in Drugs (PAID) Act of 2019 (S. 2387), which would ensure that the prices of drugs developed using federally funded research are set at reasonable levels. Press release: https://bit.ly/2KeNxHg Bill text: https://bit.ly/2LWzuIb
  • Also on July 31, Sen. Blackburn (R-TN), Sen. Durbin (D-IL), Cramer (R-ND), Jones (D-AL), and Murkowski (R-AK) introduced the Rural America Health Corps Act (S. 2406), which would enhance the National Health Services Corps to include a Rural Healthcare Corps to incentivize academic medical centers and health care graduates to rotate through underserved communities, and a range of sites would qualify for the program. Press release: https://bit.ly/2MBaoy0
  • Also on July 31, Sens. Blackburn (R-TN) and Cramer (R-ND) introduced the Telemedicine Across State Lines Act (S. 2408), which would establish a national telehealth program. Press release: https://bit.ly/2MBaoy0
  • Also on July 31, Sens. Blackburn (R-TN) and Murkowski (R-AL) introduced the Rural Health Innovation Act (S. 2411), which would establish a rural health center innovation awards program and a rural health department enhancement program. Press release: https://bit.ly/2MBaoy0
  • On August 1, Sens. Portman (R-OH), Brown (D-OH) and Casey (D-PA) introduced S. 2414, which would extend the Health Coverage Tax Credit. Press release: https://bit.ly/2OCvU8l
  • Also on August 1, Sen. Sasse (R-NE) introduced the Qualified Health Savings Account Distribution Act (S. 2440) which would expand permissible distributions from an employee’s health flexible spending account or health reimbursement arrangement to their health savings account. Press release: https://bit.ly/2KmiIiu Bill text: https://bit.ly/2GIyzHg
  • Also on August 1, Sen. Sasse (R-NE) introduced the Health Savings Expansion Act (S. 2441), which would allow individuals who are not enrolled in a high deductible health plan to have access to health savings accounts. Press release: https://bit.ly/2KmiIiu Bill Text: https://bit.ly/2YBG8K6
  • On August 2, Sens. Booker (D-NJ) and McSally (R-AZ) introduced the Humana Correctional Health Care Act (S. 2305), which would provide a consistent standard of health care to the incarcerated. Reps. Kuster (D-NH) and Norton-Holmes (D-DC) introduced companion legislation in the House (H.R. 4141). Press release: http://bit.ly/2M0Qqxl

ACA Policy and Implementation –

  • On July 30, CMS released updated federal standard renewal and product discontinuation notices and enforcement safe harbor for product discontinuation notices in connection with the open enrollment period for coverage in the individual market in the 2020 benefit year. Guidance: https://go.cms.gov/2OCbLzg
  • On August 1, Sen. Murphy (D-CT) and 19 senators sent a letter to HHS Secretary Azar and Treasury Secretary Mnuchin, requesting information to help states and Congress understand the potential consequences if the Texas vs. Azar lawsuit prevails in the courts. Press release: http://bit.ly/2M3imR1 Letter: http://bit.ly/2LXvA1K
  • On August 2, CMS released a set of frequently asked questions (FAQ) regarding the 2020 audit submission timeline for third-party auditor operational readiness reviews for the enhanced direct enrollment pathway. FAQ: https://go.cms.gov/2LZljlP

 Medicare –

  • On July 29, CMS released the proposed calendar year (CY) 2020 Physician Fee Schedule, which proposes changes to payment for evaluation and management services, care management services, and opioid treatment services, among others. Comments are due by September 27. Press release: https://go.cms.gov/2YaA23W Fact sheet: https://go.cms.gov/2OrQcS2 Proposed Rule: http://bit.ly/2OPGOb9
  • Also on July 29, CMS released the CY2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System proposed rules, which would enhance price transparency requirements, extend Part B 340B payment cuts, and encourage site neutrality, among other proposed changes. Comments are due by September 27. Press release: http://bit.ly/2Oz1YKo Fact sheet: https://go.cms.gov/2Ya7R4Z Proposed rule: http://bit.ly/2OzijyG
  • Also on July 29, CMS released the proposed CY2020 Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS), End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). Comments are due by September 27. Press release: https://go.cms.gov/2Oyq08j Fact sheet: https://go.cms.gov/2YiZNPH Proposed rule: http://bit.ly/2OxwR1G
  • On July 30, CMS announced that the average basic premium for Medicare Part D prescription drug plans is projected to decline to $30 in 2020, which is a 13.5 percent decrease from the basic premium rate in 2017. Press releases: https://go.cms.gov/2OIUeFQ and http://bit.ly/2Ozg0f7
  • Also on July 30, CMS released the final CY2020 Inpatient Psychiatric Facility (IPF) PPS and the IPF Quality Reporting Program. Fact sheet: https://go.cms.gov/2YlLf1t Final rule: http://bit.ly/2YkJ2DE
  • Also on July 30, U.S. Government Accountability Office (GAO) released a report finding that usability problems and incomplete information create challenges for beneficiaries comparing coverage options on the Medicare Plan Finder. Summary with link to report: http://bit.ly/2Yn7Fj5 House Ways & Means Committee Chair Neal statement: http://bit.ly/2Yng0Dp
  • Also on July 30, House Ways & Means Committee Chair Neal (D-MA) and Ranking Member Brady (R-TX) sent a letter to CMS requesting information regarding the agency’s efforts to address certain hospice failings. Press release: http://bit.ly/2Ymcjhd Letter: http://bit.ly/2YkmC5w
  • On July 31, CMs released the final payment and policy changes for Medicare Inpatient Rehabilitation Facilities (IRFs), Hospice Facilities, and Skilled Nursing Facilities. Fact sheets: https://go.cms.gov/2YgTHPH and https://go.cms.gov/2Yp4Kqc and https://go.cms.gov/2YeXtca Final rules: http://bit.ly/2Ym7Yur and http://bit.ly/2YhQrn7 and http://bit.ly/2YgTV9v
  • Also on July 31, GAO released a report on spending on and the use of billing codes for comprehensive care planning services, funding 13 codes are specifically dedicated for care planning and that spending on these 13 codes was $467 million in 2017. Summary with link to report: http://bit.ly/2YkEAVl
  • Also on July 31, CMS released Episode 5 of the Beyond the Policy Podcast, which is focused on its efforts to strengthen nursing home facility oversight. Podcast: https://go.cms.gov/2OvHh1M
  • On August 2, CMS released the final Inpatient PPS and Long-Term Care Hospital PPS rule, which updates payment policies and includes changes to the wage index and promoting interoperability. Press release: https://go.cms.gov/2M02DT4 Fact sheet: https://go.cms.gov/2M02oaC Final rule: http://bit.ly/2M0kk4K

 Medicaid –

  • On July 29, Federal District Court Judge Boasberg issued a decision that blocks the implementation of Medicaid work requirements in the state of New Hampshire, finding that CMS’ approval of the waiver request failed to meet the statutory purpose of the Medicaid program.
  • Also on July 29, CMS released a statement in response to reports that it chose not to approve Utah’s request to receive an enhanced match rate for a partial Medicaid expansion. Utah Governor Herbert has since released a statement outlining the next steps for the state. CMS Press release: https://go.cms.gov/2Oxy3lG Governor Herbert Statement: http://bit.ly/2Ow1bd5
  • On July 29, GAO released a report on state’ use and distribution of supplemental Medicaid payments to hospitals, finding that these payments covered 51 percent of the costs of uncompensated care at hospitals receiving payments nationwide. Summary with link to report: http://bit.ly/2YkJ9ih Senate Finance Committee Chair Grassley (R-IA) statement: http://bit.ly/2OznFdg
  • On August 2, CMS released an informational bulletin providing information on how heightened scrutiny will be applied to newly constructed presumptively institutional settings for home- and community-based services. Bulletin: http://bit.ly/2KsFG7w

 New Payment and Delivery System Models –

  • On August 1, CMS announced that it is discontinuing the Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration (MAQI) due to low participation. The model was intended to help providers use their MA participation to exempt from the Quality Payment Program requirements. Model homepage: http://bit.ly/2L8gnKl
  • Also on August 1, CMS announced that the list of Stage 1 Participants for its Artificial Intelligence Health Outcomes Challenge will be released in October 2019. Model homepage: http://bit.ly/2FubMkk
  • On August 2, CMS announced an extension the of the Letter of Intent submission deadline from August 2 to August 5 due to technical difficulties. Information: http://bit.ly/2VZaod5

 Drug and Medical Device Policy –

  • On July 30, House Energy & Commerce Committee Chair Pallone (D-NJ), Ranking Member Walden (R-OR), Oversight and Investigations Chair Diana DeGette (D-CO), Oversight and Investigations Ranking Member Brett Guthrie (R-KY), Health Subcommittee Chairwoman Anna G. Eshoo (D-CA), and Health Subcommittee Ranking Member Michael C. Burgess, M.D. (R-TX) sent a letter to Food and Drug Administration (FDA) Acting Commissioner Sharpless requesting briefings on the potential threat to the U.S. supply of heparin. Press release: http://bit.ly/2Yp8yI0 Letter: http://bit.ly/2Yp8GY0
  • On July 31, HHS announced a new Action Plan to Lay the Foundation for the Safe Importation of Certain Prescription Drugs via forthcoming Notice of Proposed Rulemaking and draft guidance documents. Press releases: http://bit.ly/2OAEcOb Action Plan: http://bit.ly/2OAMAgt Senate HELP Committee Chair Alexander (R-TN) statement: http://bit.ly/2OzaGs4

 Mental Health and Substance Use Disorder Policy –

  • On July 29, Sens. Durbin (D-IL) and Kennedy (R-LA) sent a letter to the Drug Enforcement Administration urging it to apply its new authorities to prevent and limit the pharmaceutical industry’s high opioid production levels. Press release: http://bit.ly/2OyYsiW  Letter: http://bit.ly/2OxqZp7

Health IT –

  • On July 30, CMS Administrator Verma spoke at the Blue Button Developer Conference, and outlined her priorities for the Medicare program and for enabling patient access to data. Remarks: https://go.cms.gov/2YmmsKI
  • Also on July 30, CMS announced a new update to MyHealthEData, Data at the Point of Care (DPC), which will allow providers to access claims data for their patients across the continuum of care. Press release: https://go.cms.gov/2YkepOr DPC Website: http://bit.ly/2Yg5VrM
  • Also on July 30, Senate Finance Committee Ranking Member Wyden (D-OR), and Sen. Hoeven (R-ND) led a bipartisan group of eight Senators in a letter to the Federal Communications Commission (FCC) expressing concern with the FCC’s proposed Rural Health Care Program, specifically citing obstacles that could limit rural Americans’ access to high quality care by preventing health care providers from participating in the program. On August 1, the FCC voted to approve the program. Press release: http://bit.ly/2OzKSvJ Letter: http://bit.ly/2OCBpDW FCC Press release: http://bit.ly/2OzvZJO

Veterans Health –

  • On July 29, VA announced that it had completed the transfer of 23.5 million health records to a Cerner Corp. data center, setting the stage for the records to the process in support of the VA’s and DoD’s common EHR solution. Press release: http://bit.ly/2YlK9mi
  • On July 31, VA, in partnership with DeepMind Health, published results on the development of an artificial intelligence system that can forecast a deadly kidney disease in advance. Press release: http://bit.ly/2YkODK4
  • On August 1, VA announced upcoming awards of more than $400 million in grants to help veterans who are homeless or at risk of homelessness. Press release: http://bit.ly/2M23LW0
  • On August 2, GAO released a report identifying opportunities for the VA to enhance its oversight and provide more comprehensive information on its website for nursing home care. Summary with link to report: http://bit.ly/2M3hVGn
  • Also on August 2, VA announced that it has cured more than 100,000 veterans of chronic hepatitis C infection. Press release: http://bit.ly/2LXufrK

Misc. –

  • On July 31, Ways & Means Committee Chair Neal (D-MA) and Ranking Member Brady (R-TX) sent a letter to Department of Transportation Secretary Chao urging her to comply with congressional requirements and convene the Air Ambulance and Patient Billing Advisory Committee. Press release: http://bit.ly/2Yl9NrD Letter: http://bit.ly/2Ymc31K
  • On August 1, House Energy & Commerce Committee Chair Pallone (D-NJ), Education and Labor Committee Chair Scott (D-VA), Oversight and Reform Committee Chair Cummings (D-MD), and Senate HELP Committee Ranking Member Murray (D-WA) sent a letter to HHS Secretary Azar requesting information regarding HHS’ recent ‘refusal of care rule.’ Press release: http://bit.ly/2OvZzQz Letter: http://bit.ly/2OzoToS