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


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

Legislative Activity –

Committee Actions and Votes –

  • On November 19, the House Energy & Commerce Committee passed by a 28-24 vote the Reversing the Youth Tobacco Epidemic Act 0f 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 bill now moves to the full House for consideration. Press release: http://bit.ly/35lt1My Bill text: http://bit.ly/2J1zLqr
  • On November 20, the House Energy & Commerce Committee passed by voice vote the Maternal Health Quality Improvement Act of 2019 (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 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 House for consideration. Press release: http://bit.ly/339RhzX Press release: http://bit.ly/2qExMCd Bill texts: http://bit.ly/35AKktt and http://bit.ly/2qVYZjE
  • On November 21, President Trump signed into law the Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019 (H.R. 3055), which funds the government at fiscal year 2019 levels through December 20. The Senate passed the bill by a 74-20 vote and House passed the bill by a 231 to 192 vote. Press releases: http://bit.ly/338Aihd and http://bit.ly/2XF83WE
  • Also on November 21, the House passed by a 251-158 vote the Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309), which would direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan. The bill now moves to the Senate for consideration. Press release: http://bit.ly/35o0Ah9 Bill text: http://bit.ly/2QDlNj4

Introduced Legislation –

  • On November 18, Reps. Cicilline (D-RI), Collins (R-GA), Nadler (D-NY) and Sensenbrenner (R-WI) introduced the Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 (H.R. 5133), which would amend the Federal Trade Commission Act to prohibit anticompetitive behaviors by drug product manufacturers. Press release: http://bit.ly/2KyibL9
  • Also on November 18, Rep. Davids (D-KS) introduced the Insurance Accountability and Transparency Act (H.R. 5144), which would amend the Patient Protection and Affordable Care Act to require group health plans and health insurance coverage to have in place a process to self-audit information listed in publicly accessible provider directories of such plans and coverage. Press release: http://bit.ly/332Bh2B Bill text: http://bit.ly/37lIVZp
  • Also on November 18, Sens. Murkowski (R-AK) and Klobuchar (D-MN) introduced the Advancing FASD Research, Prevention, and Services Act of 2019 (S. 2879), which would reauthorize and extend the Fetal Alcohol Spectrum Disorders Prevention and Services program. Press release: http://bit.ly/35gF5Pl One-pager: http://bit.ly/2O2fC6r Bill text: http://bit.ly/2OnGb4M
  • Also on November 18, Sens. Sinema (D-AZ) and Murkowski (R-AK) introduced the Protecting Social Workers and Human Services Professionals from Workplace Violence Act (S. 2880), which would authorize the Secretary of Health and Human Services to award grants to States to provide safety measures to social workers, health workers, and human services professionals performing services placing such individuals in high-risk and potentially dangerous situations. Reps. Brownley (D-CA) and Stefanik (R-NY) introduced companion legislation in the House (H.R. 5138). Press release: http://bit.ly/2CWfVJD
  • Also on November 18, Sens. Cassidy (R-LA) and Rosen (D-NV) introduced the Stop Marketing And Revealing the Wearables And Trackers Consumer Health Data Act (S. 2885), which would prohibit the transfer or sale of certain consumer health information. Press release: http://bit.ly/33X8Vbj Bill text: http://bit.ly/2D01bJU
  • On November 19, Reps. Sewell (D-AL), McKinley (R-WV) and Brindisi (D-NY) introduced the Non-Opioids Prevent Addiction in the National Act (H.R. 5172), which would amend title XVIII of the Social Security Act to combat the opioid crisis by promoting access to non-opioid treatments in the hospital outpatient setting. Press release: http://bit.ly/342KVUk Bill text: http://bit.ly/35fuvb6
  • Also on November 19, Sens. Warner (D-VA), Cassidy (R-LA), Van Hollen (D-MD) and Capito (R-WV) introduced the Patient-Centered Outcomes Research Institute Reauthorization Act (S. 2897), which would reauthorize the Patient-Centered Outcomes Research Institute. Press release: http://bit.ly/2Oyc2Qo Bill text: http://bit.ly/32Zka1C
  • On November 20, Reps. Clark (D-MA) and Carter (R-GA) introduced the Birth Access Benefiting Improved Essential Facility Services Act (BABIES Act) (H.R. 5189), which would establish a Medicaid demonstration program to develop and advance innovative payment models for freestanding birth center services for women with a low-risk pregnancy. Press release: https://bit.ly/2KHOmrS
  • Also on November 20, Rep. Beyer (D-VA) introduced the Know Where to Go in An Emergency Act (H.R. 5192), which would require group health plans and health insurance issuers to include on any insurance card issued by such plan or issuer information on the nearest in-network hospital or urgent care facility. Press release: https://bit.ly/2rZ81ge Bill text: https://bit.ly/2OxZ4Cr
  • Also on November 20, Reps. Golden (D-ME) and Carter (R-GA) introduced the Patients’ Right to Know Their Medication Act of 2019 (H.R. 5198), which would require patient medical information to be included in the labeling of the prescription drugs. Press release: https://bit.ly/2pGo2aj Bill text: https://bit.ly/2XzhEhD
  • Also on November 20, Rep. Lujan (D-NM) and five cosponsors introduced the Expanding Capacity for Health Outcomes Act (H.R. 5199), which would expand the capacity to improve health outcomes and increase access to specialized care. Press release: https://bit.ly/2KJNy5D
  • Also on November 20, Rep. Rush (D-IL) and 15 cosponsors introduced the Prostate-Specific Antigen Screening for High-Risk Insured Men (PSA Screening for HIM) Act (H.R. 5200), which would require group health plans and health insurers offering group or individual health insurance coverage to provide coverage for prostate cancer screenings without the imposition of cost-sharing requirements. Press release: https://bit.ly/2qqJ25k
  • Also on November 20. Reps. Porter (D-CA), Courtney (D-CT) and Mucarsel-Powell (D-FL) introduced the Student Mental Health Rights Act (H.R. 5204), which would direct the Secretary of Education to study student mental health at institutions of higher education and to issue guidance on compliance with the ADA for mental health and substance use disorder policies of institutions of higher education. Press release: https://bit.ly/2QQdsc3
  • Also on November 20, Sens. Smith (D-MN) and Barrasso (R-WY) introduced the Strengthening Our Rural Health Workforce Act (S. 2902), which would help rural communities by ensuring Primary Care Training and Enhancement programs continue as well as improving recruitment of providers by funding area health centers. Press release: https://bit.ly/347KwzO Section-by-section: https://bit.ly/2OLU2Cv Summary: http://bit.ly/35mv7M8 Bill text: https://bit.ly/2O8IN7J
  • Also on November 20, Sens. Peters (D-MI) and Lankford (R-OK) introduced S. 2905, which would reduce the occurrence of diabetes in Medicare beneficiaries by extending coverage under Medicare for medical nutrition therapy services to beneficiaries with pre-diabetes or with risk factors for developing type 2 diabetes. Press release: https://bit.ly/35nCYZV
  • Also on November 20, Sens. Hassan (D-NH) and Murkowski (R-AK) introduced the NUTRITION CARE Act (S. 2907), which would provide coverage of medical nutrition therapy services for individuals with eating disorders under the Medicare program. Press release: https://bit.ly/35lHfx2 Bill text: https://bit.ly/335qFjr
  • Also on November 20, Sens. Cassidy (R-LA) and Menendez (D-NJ) introduced the Seniors Prescription Drug Relief Act (S. 2911), which would provide a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs for covered part D drugs towards the annual out-of-pocket threshold during a month. Press release: http://bit.ly/2XNIB1f
  • On November 21, Reps. Arrington (R-TX), DelBene (D-WA), Marshall (R-KS) and Bera (D-CA) introduced the Accountable Care in Rural America Act (H.R. 5212), which would improve the benchmarking process for the Medicare Shared Savings Program. Press release: http://bit.ly/35rtdKe Bill text: http://bit.ly/2OzvXyp
  • Also on November 21, Rep. Schakowsky (D-IL) and 25 cosponsors introduced the Quality Care for Nursing Home Residents Act of 2019 (H.R. 5216) which would revise minimum nurse staffing requirements for skilled nursing facilities under the Medicare program and for nursing facilities under the Medicaid program. Sens. Blumenthal (D-CT), Klobuchar (D-MN) and Booker (D-NJ) introduced companion legislation in the Senate (S. 2943). Press release: http://bit.ly/2D4NHMW Section-by-section summary: http://bit.ly/2QLKV7d
  • Also on November 21, Reps. Bishop (R-NC), Budd (R-NC), Westerman (R-AR) and Smucker (R-PA) introduced the Increasing Health Coverage through HRAs Act (H.R. 5224), which would codify certain rules related to health reimbursement arrangements and other account-based group health plans. Press release: http://bit.ly/2rjgA5a
  • Also on November 21, Reps. Engel (D-NY), Upton (R-MI), Cox (D-CA) and King (R-NY) introduced the Elijah E. Cummings Family Asthma Act (H.R. 5230), which would amend the Public Health Service Act with regard to research on asthma. Press release: http://bit.ly/2QJ9CRU
  • Also on November 21, Reps. Fitzpatrick (R-PA), Kuster (D-NH) and Murphy (D-FL) introduced the Road to Recovery Act (H.R. 5232), which would remove barriers to access to residential substance use disorder treatment services under Medicaid and the Children’s Health Insurance Program (CHIP). Press release: http://bit.ly/2KKvcS9
  • Also on November 21, Rep. Houlahan (D-PA) and 11 bipartisan cosponsors introduced the Better and Robust Screening Today Act (H.R. 5238), which would include digital breast tomosynthesis as a primary and preventative health care service under the military health system and the TRICARE program. Sen. McSally (R-AZ) and 10 bipartisan cosponsors introduced companion legislation in the Senate (S. 2944). Press release: http://bit.ly/2OHcg8a Press release: http://bit.ly/2qsTfhF
  • Also on November 21, Rep. Joyce introduced the Prescription Drug Price Reporting Act (H.R. 5239), which would require reporting on prescription drug expenditures under group health plans and on prescription drug price changes. Press release: http://bit.ly/33hZJgC
  • Also on November 21, Rep. Pascrell (D-NJ) and six cosponsors introduced the Researching and Ending Disparities by Understanding and Creating Equity (REDUCE) Act (H.R. 5246), which would direct the Secretary of Health and Human Services to carry out a Health in All Policies Demonstration Project. Press release: http://bit.ly/2saDBb9
  • Also on November 21, Reps. Trone (D-MD), Thompson (R-PA), Kuster (D-NH) and Gurthrie (R-KY) introduced the Supporting Healthy Outcomes for Mothers and Infants Act of 2019 (H.R. 5249), which would support women, infants, and children impacted by substance use disorder. Press release: http://bit.ly/35ph34x

Individual Market and ACA Implementation –

  • On November 20, CMS announced that 737,352 individuals selected plans on the federal health insurance exchange during the third week of this year’s open enrollment period, for a cumulative total of 1,669,401. Fact sheet: https://go.cms.gov/34eOBSO
  • Also on November 20, Sens. Shaheen (D-NH), Stabenow (D-MI) and 23 senators sent a letter to CMS Deputy Administrator and Director Pate and Acting Inspector General Chiedi requesting information regarding the increased promotion of short-term, limited-duration insurance plans to consumers seeking coverage on the federal health insurance marketplaces. Press release: http://bit.ly/2qtaBuO Letter: http://bit.ly/2XNkIXD
  • On November 21, Senate HELP Committee Ranking Member Murray (D-WA), Senate Finance Committee Ranking Member Wyden (D-OR), House Energy & Commerce Committee Chair Pallone (D-NJ), House Ways & Means Committee Chair Neal (D-MA) and House Education & Labor Committee Chair Scott (D-VA) sent a letter to HHS Secretary Azar and CMS Administrator Verma urging them to address any technical failures with HealthCare.gov and ensure the website is fully functional throughout open enrollment period. Press release: http://bit.ly/348fM1E Letter: http://bit.ly/37nbHsq

Medicare –

  • On November 18, CMS has announced its estimates of the 2019 improper payment rates for Medicare Fee-For-Service (FFS), Medicare Part C, and Medicare Part D; Medicaid; and the Children’s Health Insurance Program (CHIP) improper payments. Fact sheet: https://go.cms.gov/2KBZjv6
  • Also on November 18, HHS and the American Society of Nephrology announced the launch of a $1.5 million phase 2 prize competition of KidneyX, which seeks breakthrough solutions to redesign dialysis. Applications are due by January 31. Press release: http://bit.ly/37ny9lq
  • On November 19, CMS announced that the Medicare FFS improper payment rate declined more than $7 billion from FY 2017-2019 and is the lowest since FY 2010. Press release: https://go.cms.gov/2OuvvS5
  • On November 21, HHS Office of Inspector General (OIG) determined that registered nurses did not always visit Medicare beneficiaries’ homes at least once every 14 days to assess the quality of care and services provided by hospice aids, failing to comply Federal Medicare requirements. Summary with link to report: http://bit.ly/2KMZ2pb

Medicaid –

  • On November 19, CMS posted an information bulletin on the updates to the 2020 Child and Adult Core Health Care Quality Measurement Sets. For the 2020 update, CMCS will add two measures to the Adult Core set, which will allow CMS and states to expand the measurement of quality of care for adults in Medicaid for long-term services and supports (LTSS) and behavioral health. Bulletin: http://bit.ly/2XxTtA3 Child Core Set: http://bit.ly/2qBt9sJ Adult Core Set: http://bit.ly/2XNu0CZ
  • Also on November 19, North Carolina announced that managed care implementation and open enrollment for NC Medicaid will not go live on February 1, 2020 due to a budget impasse. Press release: http://bit.ly/2O6yAst
  • On November 20, Tennessee submitted to CMS an application for a section 1115 waiver that would convert the federal share of its Medicaid funding relating to providing its core medical services to its core population to a block grant. Waiver: http://bit.ly/2KDxCBO
  • On November 21, CMS posted an interim final rule with comment that would further delay the inclusion of U.S. Territories in the definitions of “States” and “United States” for Medicaid reimbursement for covered outpatient drugs. Comments are due by January 24. Rule: http://bit.ly/37rfm8G
  • On November 22, several legal aid groups filed suit to block Medicaid work requirements in Michigan. Michigan is the fifth state where advocates have sued HHS over work requirement rules. Suit: http://bit.ly/2OLyHcf

New Payment and Delivery System Models –

  • On November 22, CMS posted materials from the Comprehensive Kidney Care Contracting Model Options introduction webinar. Materials: http://bit.ly/2rgQmk1

Prescription Drug and Medical Device Policy –

  • On November 19, House Energy & Commerce Committee Ranking Member Walden (R-OR) and Rep. Crenshaw (R-TX) posted a video series describing H.R. 3’s potential impact on the development and delivery of new cures. Press release: http://bit.ly/2OtxRke
  • Also on November 19, HHS OIG released a report comparing average sales prices (ASP) and average manufacturer prices (AMP), finding that in the second quarter of 2019, 11 drug codes had ASPs that exceeded AMPs by at least five percent in the second quarter of 2019. Summary with link to report: http://bit.ly/2KD2vGB
  • On November 21, Rep. Kelly (R-PA) sent a letter to President Trump requesting help addressing insulin affordability. Press release: http://bit.ly/338MpLu Letter: http://bit.ly/2qBM5HO

Health Data and IT –

  • On November 18, House Energy & Commerce Committee Chair Pallone (D-NJ), Health Subcommittee Chair Eshoo (D-CA), Oversight & Investigations Subcommittee Chair DeGette (D-CO) and Consumer Protection & Commerce Subcommittee Chair Schakowsky (D-IL) sent letters to Ascension and Google requesting briefings on Ascension and Google’s health data sharing arrangement and the steps the organizations are taking to protect the privacy and security of patients’ data. Press release: http://bit.ly/35iK8P7 Letters: http://bit.ly/2pztNq4 and http://bit.ly/2Xyagmy
  • Also on November 18, Senate Commerce Committee Ranking Member Cantwell (D-WA), Senate Judiciary Committee Ranking Member Feinstein (D-CA), Senate Banking, Housing, and Urban Affairs Ranking Member Brown (D-OH), and Senate HELP Committee Ranking Member Murray (D-WA) released a privacy and data protection framework for comprehensive privacy legislation, which includes establishing data safeguards, invigorating competition, strengthening consumer and civil rights and imposing real accountability. Press release: http://bit.ly/33b5Djp Framework: http://bit.ly/34cRPq4
  • On November 22, Reps. DeGette (D-CO) and Upton (R-MI) released their initial vision and request for comments for Cures 2.0 legislation, which will aim to improve care delivery and modernize coverage and access to life-saving cures, and digital health. Comments are due by December 16. Press release: http://bit.ly/2KM1goR Document: http://bit.ly/2KMBikX

Veterans and Military Health –

  • On November 21, VA OIG found that Veterans Health Administration (VHA) did not effectively manage appeals of non-VA care claims and needs to improve appeals management including by identifying and processing existing appeals, ensuring incoming appeals go to facilities that will process them, providing staff clear policies and procedures and ensure appropriate access and use of the appeals system of record for employees. Summary with link to report: http://bit.ly/33bcwBh
  • Also on November 21, U.S. Government Accountability Office (GAO) released a report with recommendations to improve future TRICARE managed care support contract transitions including that DOD improve the specificity of its transition guidance and have subject matter experts review oversight requirements. Summary with link to report: http://bit.ly/2DaiQyx
  • On November 22, VA announced that more than 900,000 Veterans used VA telehealth services in fiscal year (FY) 2019, a 17 percent increase over the prior fiscal year. Press release: http://bit.ly/35ujIu6

Mental Health and Substance Use Policy –

  • On November 19, Federal Communications Commission Chair Pai proposed to formally designate ‘988’ as a new, nationwide phone number for a suicide prevention and mental health hotline. Press release: http://bit.ly/2rmxlMP

Public Health –

  • On November 21, CDC released findings from a new study, which found significant declines in obesity among young children enrolled in food assistance programs in 41 U.S. states and territories. Press release: http://bit.ly/2DajkER
  • Also on November 21, HHS Secretary Azar hosted a bipartisan rural health roundtable with members of Congress. Topics discussed included work already being done by the Department including revisions to the Medicare Wage Index, reduction of regulatory burdens, addressing maternal mortality and morbidity and the opioid crisis, as well as including a focus on preventing disease, creating sustainable models for financing, using technology and innovation to improve patient access, and building the next generation of rural health providers. Press release: http://bit.ly/2XNzy0h
  • Also on November 21, CMS Administrator Verma posted a blog on CMS’ steps to-date and future plans to help improve rural health. Blog post: https://go.cms.gov/2QMiQN9

Miscellaneous –

  • On November 18, HHS OIG released its 2019 Top Management & Performance Challenges Facing HHS, which highlights concerns with ensuring the financial integrity of HHS programs, delivering value, quality, and improved outcomes in Medicare and Medicaid, protecting the health and safety of HHS beneficiaries, safeguarding public health, harnessing data to improve health and well-being of individuals and working across government to provide better service to HHS beneficiaries. Summary with link to report: http://bit.ly/37lk1sM
  • On November 19, Sens. Warren (D-MA), Brown (D-OH) and Rep. Pocan (D-WI) sent letters to four private equity firms investigating the role of private equity in declining quality of nursing home care. Press release: http://bit.ly/2OzNI0x Letters: http://bit.ly/2KN0YxN