Health Care Policy Update – Weekly Wrap-Up and What’s Ahead – June 19, 2017


What’s Ahead: This Week

Hearings/Markups –

  • Tuesday, June 20
    • Senate Appropriations Committee, Agriculture, Rural Development, Food and Drug Administration­­­, and Related Agencies Subcommittee, “Hearing to Review the FY2018 Budget Request for the Food and Drug Administration.
  • Wednesday, June 21
    • Senate Appropriations Committee, Military Construction and Veterans Affairs Subcommittee, “Hearing to Review the FY2018 and FY2019 Budget Requests for the U.S. Department of Veterans Affairs.”
  • Thursday, June 22
    • Senate Appropriations Committee, Labor, Health & Human Services, Education, and Related Agencies Subcommittee, “Hearing to Review the FY2018 Budget Request for the National Institutes of Health.”
    • House Veterans Affairs Committee, “FY 2018 Department of Veterans Affairs Budget Request for Veterans Health Administration.”
  • Friday, June 23
    • House Energy & Commerce Committee, Health Subcommittee, “Examining the Extension of Safety Net Health Programs.” 

Notable Policy Events –

  • Monday, June 19
    • Association of Schools and Programs of Public Health, “The Opioid Epidemic: Findings from Public Health Research Experts.” Additional information: http://bit.ly/2t1OWWI

Weekly Wrap Up: Notable Health Care Developments From Last Week

Legislative Activity –

  • On June 12, Warner (D-VA) and Isakson (R-GA) introduced the Patient Choice and Quality Care Act of 2017 (S. 1334), which would provide for advanced illness care coordination services for Medicare beneficiaries. Reps. Blumenauer (D-OR) and Roe (R-TN) introduced companion legislation in the House (H.R. 2797). Press release: http://bit.ly/2soAuv2
  • Also on June 12, Reps. Jenkins (R-KS) and Cleaver (D-MO) introduced the Medicare Access to Rural Anesthesiology Act (H.R. 2881) which would provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals. Press release: http://bit.ly/2sHp5q1
  • On June 13, the House passed by a vote of 368-55 the Veterans Affairs (VA) Accountability and Whistleblower Protection Act (S. 1094), which would improve the accountability of employees at the Department of Veterans Affairs. The bill now to the President for signature. Press releases: http://bit.ly/2taix0g and http://bit.ly/2taxwY3
  • Also on June 13, Senate HELP Committee Ranking Member Wyden (D-OR) introduced the Stopping the Pharmaceutical Industry from Keeping Drugs Expensive (SPIKE) Act (S. 1348) which would require drug manufacturers to publicly justify unnecessary price increases. Press release: http://bit.ly/2t1CN45 Summary: http://bit.ly/2t1PBHM Bill text: http://bit.ly/2t1QYq5
  • Also on June 13, Senate HELP Committee Ranking Member Wyden (D-OR) and Sens. Bennet (D-CO), Cardin (D-MD), Merkley (D-OR), and Whitehouse (D-RI) introduced the Reducing Existing Costs Associated with Pharmaceuticals for Seniors (RxCAP) Act (S. 1347), which would prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities. Press release: http://bit.ly/2t1CN45 Bill text: http://bit.ly/2t1BZMH
  • Also on June 13, Reps. Welch (D-VT) and Harper (R-GA) introduced the Closing Loopholes for Orphan Drugs Act (H.R. 2889) which would limit the orphan drug exclusion under the drug discount program under section 340B. Bill text: http://bit.ly/2sq84xG
  • On June 14, Sens. Baldwin (D-WI) and Portman (R-OH) introduced the Family-Based Care Services Act (S. 1357) which would provide a standard definition of therapeutic family care services in Medicaid. Press release: http://bit.ly/2sH1OEJ
  • On June 15, Sens. Grassley (R-IA) and Schatz (D-HI) introduced the Ensuring Access to General Surgery Act of 2017 (S. 1351), which would amend the Public Health Service Act with respect to the designation of general surgery shortage areas. Reps. Bucshon (R-IN) and Bera (D-CA) introduced companion legislation in the House (H.R. 2906). Press release: http://bit.ly/2sqbPmW Bill text: http://bit.ly/2sqbQHw
  • Also on June 15, Sens. Brown (D-OH), Gillibrand (D-NY), Franken (D-MN), Reed (D-RI), Hassan (D-NH), and Udall (D-NM) introduced the Stop Price Gouging Act (S. 1369) which would establish an excise tax on certain prescription drugs which have been subject to a price spike. Press release: http://bit.ly/2s9hX4G
  • Also on June 15, Reps. Napolitano (D-CA) and Katko (R-NY) reintroduced the Mental Health in Schools Act (H.R. 2913) which would revise and extend projects relating to children and violence to provide access to school-based comprehensive mental health programs. Sen. Franken (D-MN) introduced a companion bill (S. 1370) in the Senate. Press release: http://bit.ly/2rlHggW

ACA Repeal and Replacement Activity –

  • On June 13 and 15, the House voted to advance a series of bills that are being framed as part of the “third phase” of the repeal and replace strategy. The Verify First Act (H.R. 2581) passed by a vote of 238-134, and would require the provision of social security numbers as a condition of receiving the health insurance premium tax credit; the VETERAN Act (H.R. 2372) passed by a voice vote and would clarify the rules relating to veteran health insurance and eligibility for the premium tax credit; and the Broader Options for Americans Act (H.R. 2579) passed by a vote of 267-144 and would allow the premium tax credit to be used for unsubsidized COBRA coverage. The bills now move to the Senate for consideration. Press releases: http://bit.ly/2t1T0WY and http://bit.ly/2tacN6G
  • On June 14, Sens. Carper (D-DE), Kaine (D-VA), Shaheen (D-NH), Nelson (D-FL), Hassan (D-NH) and Cardin (D-MD) introduced the Individual Health Insurance Marketplace Improvement Act (S. 1354), which would establish an individual market reinsurance fund to provide funding for state individual market stabilization reinsurance programs. Press release: http://bit.ly/2sxAJnwBill text: http://bit.ly/2sxOgvs
  • Also on June 14, Ranking Members of the Senate Finance and HELP Committees, and House Energy & Commerce and Ways & Means Committees sent a letter to the Government Accountability Office (GAO) Comptroller describing their concern with the use of HHS communications to promote ACA repeal legislation and requesting that GAO review HHS communications for compliance with appropriations laws. Press release: http://bit.ly/2syao8OLetter: http://bit.ly/2sxQICf
  • On June 15, Senate Minority Leader Schumer (D-NY) and 39 cosponsors introduced the No Hearing, No Vote Act of 2017 (S. 1376) which would ensure that all fast-tracked reconciliation bills are subject to a committee hearing. Press release: http://bit.ly/2spTnL5 Bill text: http://bit.ly/2sxLrKS
  • On June 16, Govs. Kasich (R-OH), Hickenlooper (D-CO), Bullock (D-MT), Baker (R-MA), Sandoval (R-NV), Wolf (D-PA), and Bel Edwards (D-LA) sent a letter to Senate Majority Leader McConnell (R-KY) and Minority Leader Schumer (D-NY) urging Congress “to focus on improving our nation’s private health insurance system” and noting that H.R. 1628 fails to meet that goal. Press release: http://bit.ly/2tbJlx8 Letter: http://bit.ly/2tbKcy1

ACA Implementation –

  • On June 12, CMS released two reports on health care marketplace enrollment. The first report found that as of March 15 the total effectuated enrollment in the ACA Marketplaces for 2017 is 10.3 million, a decrease from the 12.2 million that had selected a plan by the end of Open Enrollment. The second report describes exit survey data from consumers who canceled or terminated their coverage, noting that cost and affordability were large factors. Press release: http://go.cms.gov/2sxxxZa Effectuated Enrollment Report: http://bit.ly/2sxtdJe Trends Report: http://bit.ly/2sxmJu5
  • On June 13, On Tuesday, CMS Office of the Actuary released a report on AHCA, projecting that the bill would leave 13 million more Americans uninsured over the next decade, and would reduce federal spending by $328 billion. Report: http://go.cms.gov/2sxHndA
  • Also on June 13, Iowa released a proposal to help stabilize its insurance Marketplace, which would set up a new health plan with standardized benefits, a reinsurance program to offset costs from expensive patients, and premium subsidies. It will require $352 million in additional federal funding and needs HHS approval to be implemented. Proposal: http://bit.ly/2sxYSdR
  • On June 15, CMS released a county-by-county projection of health insurer Marketplace participation for the 2018 plan year as of June 9, finding that there are likely to be 47 ‘bare’ counties with no issuer participation next year. CMS Press release: http://go.cms.gov/2sy4jcI Map: http://bit.ly/2sxQHOn

Medicare –

  • On June 15, Medicare Payment Advisory Committee (MedPAC) released its June 2017 Report to Congress, which reviews issues affecting the Medicare program as well as broader changes in health care delivery and the market for health care services. The report includes recommendations on the new merit-based incentive program, the Part B drug payment system, and the post-acute payment system, among others. Press release: http://bit.ly/2sq4xj5 Fact sheet: http://bit.ly/2spPzcY Report: http://bit.ly/2sHBytM

Medicaid –

  • On June 15, Rep. Yarmuth (D-KY) sent a letter to HHS Secretary Price requesting an update on the statue of Kentucky Governor Bevin’s Section 1115 Medicaid Waiver request. Press release: http://bit.ly/2taq6nG Letter: http://bit.ly/2taq6UI
  • Also on June 15, Medicaid and CHIP Payment Access Commission (MACPAC) released its June 2017 Report to Congress, which provides recommendations on mandatory and optional benefits and eligibility categories, the opioid epidemic, and program integrity in Medicaid Managed Care. Press release: http://bit.ly/2spXXsN Report: http://bit.ly/2rELOOR

New Payment and Delivery System Reform Models –

  • On June 13, CMS published materials from a June 8 webinar about beneficiary assignment and financial methodologies in the Medicare-Medicaid Accountable Care Organization Model. Webinar Materials: http://bit.ly/2tvyWM7

Health IT –

  • On June 12, HHS Office of Inspector General (OIG) published a report finding that CMS paid hundreds of millions in electronic health record incentive payments to eligible providers that did not comply with federal meaningful use requirements. Summary with link to report: http://bit.ly/2ronSzK
  • On June 15, FDA Commissioner Scott Gottlieb announced a new Digital Health Innovation Plan that will include a novel, post-market approach to regulation of medical devices.  Blog Post: http://bit.ly/2rvQvPR

Veterans Health –

  • On June 14, GAO published a report on the VA’s pharmacy system capabilities, finding that the VA is limited in its ability to interoperate with private providers, provide additional clinical decision support, and effectively track medications that could impact veterans’ patient safety. Summary with link to report: http://bit.ly/2roqa27

Mental Health and Substance Abuse –

  • On June 12, Substance Abuse and Mental Health Services Administration (SAMHSA) published a report providing an overview of the state of the nation’s behavioral health system. Press release: http://bit.ly/2roGwYz
  • On June 13, Food and Drug Administration (FDA) Commissioner Gottlieb announced new steps to help address the opioid addiction crisis, including through the formation of a steering committee to examine additional regulatory and policy actions to combat the crisis. Statement: http://bit.ly/2sXzJ9n
  • Also on June 13, SAMHSA announced the award of $72.5 million in grants to 8 states through the Expansion and Sustainability of the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances Program, also known as Children’s Mental Health Initiative (CMHI). Press release: http://bit.ly/2sHGtL3
  • On June 15, SAMHSA published a report examining the availability of supported employment in specialty mental health treatment facilities in the United States and whether they offer vocational rehabilitation services. Press release: http://bit.ly/2sHpXLh
  • On June 16, CMS released guidance and a request for comments regarding mental health and substance use disorder parity implementation as impacted by the 21st Century Cures Act. CMS also released a form to request documentation from an employer-sponsored health plan or an insurer concerning treatment limitations that may affect mental health or substance use disorder benefits. Comments are due by September 13. Guidance: http://go.cms.gov/2tbp0bx Form: http://go.cms.gov/2tbPgm8 

Misc. –

  • On June 15, the Centers for Disease Control and Prevention (CDC) published results from the 2016 National Youth Tobacco Survey, finding that youth tobacco product use, including e-cigarettes, dropped between 2015 and 2016. Press release: http://bit.ly/2trizQR
  • On June 14, CMS released a report on health care spending by state from 1991-2014, finding that per capita health spending in Medicaid expansion and non-expansion states grew at similar rates. Press release: http://go.cms.gov/2stKdPL