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


 What’s Ahead: This Week

 

Hearings and Markups – 

  • Tuesday, November 19
    • House Energy & Commerce Committee, “Markup of 18 Bills.”
  • Wednesday, November 20
    • Senate HELP Committee, “Nomination of Stephen Hahn, MD, to serve as Commissioner of Food and Drugs.”
    • House Veterans’ Affairs Committee, Subcommittee on Technology Modernization, “Go-Live March 2020: The Status of Electronic Health Record Modernization Readiness.”
    • Senate Finance Committee, Subcommittee on Health Care, “Alzheimer’s Awareness: Barriers to Diagnosis, Treatment and Care Coordination.”

Notable Policy Events – 

  • Monday, November 18
    • Alliance for Health Policy, “Long-Term Care: Where Are We and What’s Next?” Additional information: http://bit.ly/33GWJvj
    • Trust for America’s Health, “The State of Obesity: Better Policies for a Healthier America.” Additional information: http://bit.ly/37cyJSH
  • Thursday, November 21
    • Politico, “The Future of Primary Care.” Additional information: https://politi.co/2rTlTJ3
    • Committee for a Responsible Federal Budget, “Opportunities for Lowering Health Care Costs.” Additional information: http://bit.ly/2KpP0Ka

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

Legislative Activity –

Committee Actions and Votes –

  • On November 12, the House passed by a 399 – 11 vote the Deborah Sampson Act (H.R. 3224), which wouldprovide for increased access to Department of Veterans Affairs medical care for women veterans.. The bill now moves to the Senate for consideration. Press release: http://bit.ly/370rj4Z Bill text: http://bit.ly/2qO2WHe
  • Also on November 12, the House passed by voice vote the Reducing High Risk to Veterans and Veterans Services Act (H.R. 4477), which would direct the Secretary of Veterans Affairs to submit to Congress a plan to address certain high risk areas identified by the Comptroller General of the United States regarding the Department of Veterans Affairs in the 2019 High-Risk List of the Government Accountability Office. The bill now moves to the Senate for consideration. Press release: http://bit.ly/32Knei2 Bill text: http://bit.ly/2QqEvuj
  • Also on November 12, the House passed by voice vote the VA Overpayment Accountability Act (H.R. 4360), which would improve the due process accorded veterans with respect to recovery of overpayments made by the Department and other amounts owed by veterans to the United States, to improve the processing of veterans benefits by the Department of Veterans Affairs. The bill now moves to the Senate for consideration. Press release: http://bit.ly/2COObGU Bill text: http://bit.ly/2Xkfx16
  • On November 13, the House Energy & Commerce Committee, Subcommittee on Health passed three bills by voice vote: the Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339), which would amend the Federal Food, Drug, and Cosmetic Act with respect to the sale and marketing of tobacco products; the Maternal Health Quality Improvement Act (H.R. 4995), which would amend the Public Health Service Act to improve obstetric care and maternal health outcomes; and the Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 (H.R. 4996), which would provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals. The bills now move to the full Committee for consideration. Press release: http://bit.ly/2OgizPD Bill text: http://bit.ly/2J1zLqr and http://bit.ly/2qVYZjE

Introduced Legislation –

  • On November 12, Reps. Huffman (D-CA), Case (D-HI) and Grothman (R-WI) introduced the Recruiting in Underserved Rural Areas and Localities for Veterans (RURAL Veterans) Act (H.R. 5032), which would direct the Secretary of Veterans Affairs to establish a rural recruitment office within the Department of Veterans Affairs to recruit health care professionals. Press release: http://bit.ly/2NJBseR
  • Also on November 12, Rep. Byrne (R-AL) introduced the Full Choice for Veterans Act (H.R. 5033), which would expand the eligibility of veterans for hospital care and medical services provided by non-Department of Veterans Affairs medical providers under the Veterans Choice Program. Press release: http://bit.ly/2rzqm3h
  • Also on November 12, Rep. Pappas (D-NH) and 97 cosponsors introduced the Put Patients First Act (H.R. 5036), which would prohibit the Secretary of Health and Human Services from taking any action to implement, enforce, or otherwise give effect to the final rule, entitled “Protecting Statutory Conscience Rights in Health Care; Delegations of Authority.” Sen. Murray (D-WA) and 29 cosponsors introduced companion legislation in the Senate (S. 2836). Press release: http://bit.ly/33L6BUM
  • Also on November 12, Rep. Lipinski (D-IL) introduced the Life-Sustaining Prescription Drug Price Relief Act of 2019 (H.R. 5039), which would lower the prices of excessively costly life-sustaining prescription drugs under part D of the Medicare program by requiring the Secretary of Health and Human Services to negotiate their prices. Press release: http://bit.ly/2QnHC5S
  • On November 13, Reps. Panetta (D-CA) and Taylor (R-TX) introduced the Veterans Earned Transportation (Vets ETA) Act (H.R. 5074), which would make permanent the authority of the Secretary of Veterans Affairs to provide transportation to and from Department of Veterans Affairs facilities in connection with vocational rehabilitation or counseling. Press release: http://bit.ly/356QQry
  • Also on November 13, Rep. Porter (D-CA) and 5 bipartisan cosponsors introduced the Fair Access for Individuals to Receive Leave Act (H.R. 5075), which would amend the Family and Medical Leave Act of 1993, to repeal certain limits on leave for a married individuals employed by the same employer. Sens. Ernst (R-IA), Sinema (D-AZ), Lee (R-UT) and Smith (D-MN) introduced companion legislation in the senate. Press release: http://bit.ly/2XglhbU Press release: http://bit.ly/2NPO5F0 Bill text: http://bit.ly/2CSKakt
  • Also on November 13, Reps. Shalala (D-FL), Buschon (R-IN), Kuster (D-NH) and Roe (R-TN) introduced the Senior Immunization Act of 2019 (H. R. 5076), which would provide information regarding vaccines for seniors as part of the Medicare & You handbook and to ensure that the treatment of cost sharing for vaccines under Medicare part D is consistent with the treatment of vaccines under Medicare part B. Press release: http://bit.ly/2Oe9tCY Bill text: http://bit.ly/2qXxIx8
  • On November 14, Reps. Peterson (D-MN) and Tipton (R-CO) introduced the Rural Hospital Frontier Workforce Fairness Act (H.R. 5103), which would extend the floor on the area wage index under the inpatient prospective payment system to certain sole community hospitals. Press release: http://bit.ly/2OebhvT
  • Also on November 14, Sens. Smith (D-MN) and five bipartisan cosponsors introduced the Insulin Affordability Data Collection Act (S. 2855), which would require the Secretary to conduct a study and issue a report on the affordability of insulin. Press release: http://bit.ly/2pkSw1e
  • Also on November 14, Sen. Lankford (R-OK) and 12 Republican cosponsors introduced the Patient Access to Higher Quality Health Care Act (S. 2860), which would repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Press release: http://bit.ly/2XfsbhK
  • On November 15, Sens. Booker (D-NJ), Sanders (I-VT) and Harris (D-CA) introduced The Prescription Drug Affordability and Access Act Press release: http://bit.ly/2qSE9Sq

Individual Market and ACA Implementation –

  • On November 13, CMS announced that 754,967 individuals selected plans on the federal health insurance exchange during the second week of this year’s open enrollment period. Fact sheet: https://go.cms.gov/2Otri1d

Medicare –

  • On November 12, HHS Office of Inspector General (OIG) found that Medicare made $640,452 in overpayments to physicians for chronic care management services during fiscal years 2015 and 2016. Summary with link to report: http://bit.ly/2qOkO4w
  • On November 14, U.S. Government Accountability Office (GAO) released a report recommending that CMS require surveyors to use information, such as hospices’ quality of care data, to help better identify potential care issues and strengthen CMS oversight of hospice providers. Summary with link to report: http://bit.ly/2rOeZoq
  • Also on November 14, GAO released a report finding gaps that limit CMS’ oversight of nursing homes and that better oversight is needed to protect residents from abuse in nursing homes. Summary with link to report: http://bit.ly/2CYFxpr

Medicaid –

  • On November 12, CMS gave remarks during the National Association of Medicaid Directors (NAMD) Annual Meeting on the state of the Medicaid program and CMS’ Medicaid policy priorities, including program integrity and providing states with certain flexibilities to administer their programs. Remarks: https://go.cms.gov/2XchLPJ
  • Also on November 12, CMS issued the proposed Medicaid Fiscal Accountability Rule to strengthen the fiscal integrity of the Medicaid program and help ensure that state supplemental payments and financing arrangements are transparent and value-driven. Comments are due by January 17. Press release: https://go.cms.gov/36W2040 Fact sheet: https://go.cms.gov/2X5sdZx Proposed rule: http://bit.ly/34Yd0fE
  • Also on November 12, GAO released a report recommending that CMS ensure state implementation of Medicaid provider screening and enrollment requirements. Summary with link to report: http://bit.ly/2qTvb76
  • On November 14, CMS posted an informational bulletin on the Medicare-Medicaid integration and unified appeals and grievance requirements for state Medicaid agency contracts with Medicare Advantage dual eligible special needs plans (D-SNPs) for Contract Year 2021. Bulletin: http://bit.ly/2KpRmZI
  • Also on November 14, CMS posted an informational bulletin with further guidance on modifications to third party liability in Medicaid and CHIP enacted in the Bipartisan Budget Act (BBA) of 2018 and changes to Medicaid provisions passed in April 2019. Bulletin: http://bit.ly/33SX2TE

Prescription Drug and Medical Device Policy –

  • On November 14, GAO released a report finding that drug companies’ views of risk evaluation and mitigation strategies for drugs with serious safety concerns differed. Summary with link to report: http://bit.ly/2OfIk2z
  • Also on November 14, FDA issued a warning letter on potentially unsafe drugs produced by foreign manufacturers found to have serious violations of federal law. Press release: http://bit.ly/379XGOH

Health Data and IT –

  • On November 12, HHS Office of the National Coordinator for Health IT (ONC) posted a blog highlighting three global health IT takeaways from ONC’s 3rd interoperability forum. Blog post: http://bit.ly/2O4IVUO
  • On November 13, Sens. Klobuchar (D-MN) and Murkowski (R-AK) sent a letter to HHS Secretary Azar urging him to examine the collaboration between Google and Ascension Health System over privacy concerns. Press release: http://bit.ly/2XjNaje Letter: http://bit.ly/35aiyU3
  • Also on November 13, Rep. Matsui (D-CA) sent a letter to Google requesting information about Google’s plans to protect sensitive health information of current and future FitBit customers. Press release with letter: http://bit.ly/32MOxZb
  • On November 14, FDA posted a blog on the FDA’s work on balancing patient engagement and awareness with medical device cybersecurity. Blog post: http://bit.ly/32S7o54
  • On November 15, CMS finalized the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) Policy Changes: Hospital Price Transparency Requirements rule, which would increase price transparency of hospital standard charges. Press releases: https://go.cms.gov/2OjuThU and http://bit.ly/32PqrNn Fact sheet: https://go.cms.gov/2Ofnoc6 Final rule: http://bit.ly/32UH8GZ
  • Also on November 15, CMS issued a proposed rule on Transparency in Coverage, which would require most group health plans, including self-insured plans, and health insurance issuers to disclose price and cost-sharing information to participants, beneficiaries, and enrollees. Comments are due by January 27. Press releases: https://go.cms.gov/2OjuThU and http://bit.ly/32PqrNn Fact sheet: https://go.cms.gov/2po1zi7 Proposed rule: http://bit.ly/2QoTULE
  • Also on November 15, Sen. Warner (D-VA) sent a letter to HHS Secretary Azar urging him to include in the agency’s final interoperability and patient access rule clear standards and defined controls to accessing patient data in order to address the potential for misuse of new interoperability features. Press release: http://bit.ly/32RdVNb Letter: http://bit.ly/33UgDms

Veterans and Military Health –

  • On November 13, VA and the U.S. Chamber of Commerce Foundation launched an effort to prioritize mental health and emotional wellbeing in America’s workplace. Press release: http://bit.ly/2OmleHN
  • On November 14, GAO released a report finding that VA and other federal agencies continue to face several IT security challenges and needs to address challenges including safeguarding its sensitive information by implementing information security controls, addressing known vulnerabilities, accurately identifying critical cybersecurity staffing needs and managing risks in its IT supply chain. Summary with link to report: http://bit.ly/32P1X70
  • On November 15, VA renewed a partnership with Y-USA to expand whole-health services that promote the health and well-being of Veteran communities. Press release: http://bit.ly/2QtGM81
  • Also on November 15, VA announced a regional implementation of a new medical device to help reduce diabetic limb loss. Press release: http://bit.ly/2QmT3Lf

Public Health –

  • On November 12, GAO released a report finding that several CDC-funded studies on addressing obesity lowered body mass index for low-income children. Summary with link to report: http://bit.ly/2Qiv1Rp
  • On November 13, Senate Homeland Security & Governmental Affairs Committee Chair Johnson (R-WI) sent a letter to President Trump about anticipated e-cigarette restrictions and restrictions on safer alternatives to smoking. Press release: http://bit.ly/2CNyYFT
  • On November 14, FDA announced the expansion of their collaboration with Scholastic to launch the first middle school e-cigarette prevention resource and new resources for high schools. http://bit.ly/2XkuFvq
  • Also on November 14, CDC announced the updated number of confirmed and probable injury cases and deaths associated with e-cigarette product use to 2,172 injury cases and 42 deaths. Press release: http://bit.ly/353jCt0
  • Also on November 14, CDC announced that cigarette smoking among U.S. adults has reached an all-time low of 13.7% in 2018. Press release: http://bit.ly/2NUjgPP
  • Also on November 14, Energy & Commerce Committee Chair Pallone (D-NJ) sent a letter to FDA Acting Commissioner Giroir to investigate allegations that JUUL Labs, Inc. knowingly distributed approximately one million contaminated mint-flavored e-cigarette pods for consumer use. Press release: http://bit.ly/2qSzT5p Letter: http://bit.ly/2NRqeoI
  • On November 15, Ways & Means Committee Chair Neal (D-MA) and Ranking Member Brady (R-TX) announced a Request for Information (RFI) soliciting input that will inform the Rural and Underserved Communities Health Task Force as if works to develop bipartisan legislation to improve health care outcomes within underserved communities. Submissions are due by November 29. Press release: http://bit.ly/2CM1Pur Press release: http://bit.ly/2CJv29g RFI: http://bit.ly/2NRJcvt
  • Also on November 15, Sen. Warren (D-MA), Rep. Rochester (D-DE) and eight Senate and House members sent a letter to HHS Secretary Azar and CMS Administrator Verma requesting information about HHS’ use of alternate payment models to reduce maternal mortality and improve the delivery of maternal health care. Press release: http://bit.ly/2pqZ8va Letter: http://bit.ly/2qVXfH9