Health Policy Update 2-6-17


What’s Ahead: This Week

Markups/Hearings

  • Monday, February 6
    • House Bipartisan Heroin Task Force, “Synthetic Opioids.”
  • Tuesday, February 7
    • House Small Business Committee, “Reimagining the Health Care Marketplace for America’s Small Businesses.”
    • House Energy & Commerce Committee, Subcommittee on Health, “Subcommittee Vote on H.R. 829 and H.R. 181.” Legislation to be voted on includes: the Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017 (H.R. 829), which would clarify the treatment of lottery winnings and other lump sum income for the purposes of Medicaid income eligibility; and the Close Annuity Loopholes in Medicaid Act (H.R. 181), which would count portions of income from annuities of a community spouse as income available to institutionalized spouses for Medicaid eligibility.

Notable Policy Events

  • Monday, February 6
    • Heritage Foundation, “Tax Reform in the New Congress.” Additional information: http://bit.ly/2lbdhJ4
  • Tuesday, February 7 – Thursday, February 9
    • National Rural Health Association. “Rural Health Policy Institute.” Additional information: http://bit.ly/2l11BZd
  • Tuesday, February 7
    • CMS, “Webinar: Beneficiary Engagement and Incentives: Shared Decision Making (SDM) Model – Application Process.” Additional information: http://bit.ly/2l1L5YW
    • Health Affairs, “The Work/Health Relationship.” Additional information: http://bit.ly/2l0ZzIW
  • Thursday, February 9
    • CMS, “Webinar: Beneficiary Engagement and Incentives: Direct Decision Support (DDS) Model – Application Process.” Additional information: http://bit.ly/2l1J6UI
    • Brookings Institution. “What Worked and What Didn’t in Obamacare Insurance Markets?” Additional information: http://brook.gs/2l13oNW
  • Friday, February 10
    • National Association of Health Care Management, “Engaging Medicaid Patients: Obstacles, Successes & the Impact of Medicaid Waivers.” Additional information: http://bit.ly/2l13vJm

Weekly Wrap Up: Notable Health Care Developments From Last Week

HHS Leadership

On February 1, Senate Finance Committee advanced the nomination of Rep. Price (R-GA) to serve as HHS Secretary by a vote of 14-0 under suspension of the Committee rules. Rep. Price’s Nomination now moves to the full Senate for consideration. Chairman Hatch’s Press release: http://bit.ly/2kCHFeV

Regulatory Policy – On February 3, White House Office of Management and Budget (OMB) released interim guidance on implementing President Trump’s Executive Order, “Reducing Regulation and Controlling Regulatory Costs.” Comments are due by February 10. Interim guidance: http://bit.ly/2jRP71a

Legislative Activity

  • On January 30, Reps. Jenkins (R-KS) and Loebsack (D-IA) introduced the Rural Hospital Regulatory Relief Act of 2017 (H.R. 741), which would permanently extend an enforcement moratorium on supervision requirements for outpatient therapeutic services provided in critical access hospitals and small, rural hospitals. Sens. Thune (R. SD) and Heitkamp (D-ND) introduced a companion bill in the Senate (S. 243). Rep. Jenkins’ Press release: http://bit.ly/2jRoRnE Thune’s Press release: http://bit.ly/2jRpU71
  • Also on January 30, Reps. Schrader (D-OR), Bilirakis (R-FL) and nine bipartisan cosponsors introduced the Lower Drug Costs Through Competition Act (H.R. 749), which would establish a new priority review voucher for generic drugs with no current competition. Press release: http://bit.ly/2jRv6aR
  • Also on January 30, Reps. Sensenbrenner (R-WI) and Crowley (D-NY) introduced the Ensuring Access to Quality Complex Rehabilitation Technology Act (H.R. 750), which would establish a Medicare benefit category for complex rehabilitation technology products. Press release: http://bit.ly/2jRm7GT
  • On January 31, the House passed by a voice vote the Medical Preparedness Allowable Use Act, which would make Department of Homeland Security grants available for enhancing medical preparedness and medical surge capacity in public health crises. The bill now moves to the Senate for consideration. Press release: http://bit.ly/2jRvlTB
  • Also on January 31, Reps. Lee (D-CA), Schakowsky (D-IL), Slaughter (D-NY), DeGette (D-CO) and 103 cosponsors introduced the Equal Access to Abortion Coverage in Health Insurance Act (EACH Woman Act) (H.R. 771), which would require the federal government to ensure coverage for abortion services in public and private insurance plans. Press release: http://bit.ly/2kCABP6
  • On February 1, Senate Finance Committee Ranking Member Wyden (D-OR) introduced the Protecting Medicare from Executive Action Act of 2017 (S.251), which would repeal the ACA’s provisions relating to the Independent Payment Advisory Board (IPAB). The next day, Senate Majority Whip Cornyn (R-TX) introduced a similar bill, the Protecting Seniors’ Access to Medicare Act (S. 260), and on February 3, Rep. Roe (R-TN) introduced a companion bill (H.R. 849) in the House. Sen. Wyden’s Press release: http://bit.ly/2kCJMzf Cornyn’s Press release: http://bit.ly/2l5tAE9 Rep. Roe’s Press release: http://bit.ly/2l1Ytwp
  • Also on February 1, Sens. Cardin (D-MD), Collins (R-ME), Casey (D-PA) and Heller (D-NV) introduced the Medicare Access to Rehabilitation Services Act (S. 253), which would repeal Medicare’s outpatient rehabilitation therapy caps. Rep. Paulsen (R-MN) and 46 bipartisan cosponsors introduced a companion bill in the House (H.R. 807). Sen. Cardin’s Press release: http://bit.ly/2kCqZUy Paulsen’s Press release: http://bit.ly/2kCxhDV
  • On February 2, Sens. Reed (D-RI), Capito (R-WV), Van Hollen (D-MD) and Isakson (R-GA) introduced the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act ­of 2017 (S. 292), which would expand opportunities for childhood cancer research, and improve efforts to identify and track childhood cancer incidences. Reps. McCaul (R-TX), Speier (D-CA), Kelly (R-PA), and Butterfield (D-NC) also introduced a companion bill in the House (H.R. 820). Sen. Reed’s Press release: http://bit.ly/2jRwfiN
  • Also on February 2, Senate Aging Committee Chair Collins (R-ME) and Sen. McCaskill (D-MO) introduced the Competition in Pharmaceuticals Act (S. 297), which would establish a clear timeframe for the Food and Drug Administration (FDA) to expedite the review of certain applications for generic drugs and would create a new generic priority review voucher. Press release: http://bit.ly/2jRrPIL Bill text: http://bit.ly/2jRpSfg
  • Also on February 2, Rep. Upton (R-MI) introduced the Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017 (H.R. 829), which would clarify the treatment of lottery winnings and other lump sum income for the purposes of Medicaid income eligibility. Press release: http://bit.ly/2jRuceM

ACA Repeal

On February 3, Sen. Baldwin (D-WI) and 22 Democratic Senators wrote a letter to President Trump warning that repealing the ACA could hurt efforts to combat the opioid epidemic. Press release: http://bit.ly/2l1LSt2 Letter: http://bit.ly/2l1NenN 

Marketplaces

  • On January 30, House Energy & Commerce Committee Ranking Member Pallone (D-NJ), House Ways & Means Ranking Member Neal (D-MA), and Education and the Workforce Ranking Member Scott (D-VA) sent a letter to HHS Acting Secretary Cochran requesting details on the Trump Administration’s decision to halt advertising and outreach ahead of the end of the 2017 Open Enrollment Period. The next day, Senate HELP Committee Ranking Member Murray (D-WA) and Sen. Warren (D-MA) sent a letter to the HHS Office of the Inspector General requesting an investigation by the HHS Office of the Inspector General into the Department’s decision to halt advertising and outreach in the final days of the 2017 Open Enrollment period. Ranking Member Pallone’s Press release and letter: http://bit.ly/2l1O040 and http://bit.ly/2l1LtH8 Ranking Member Murray’s Press release and letter: http://bit.ly/2l1Lhr9 and http://bit.ly/2l1Ri7q
  • On January 31, U.S. Government Accountability Office (GAO) released a report summarizing three previously released reports on the early impact of the ACA, which focused on market concentration, plan availability and premiums, and enrollee experiences. Summary with link to report: http://bit.ly/2jRDSGc
  • On February 3, CMS released an updated Open Enrollment Snapshot, showing that as of January 31 – the end of this year’s Open Enrollment – 9.2 million individuals had signed up for 2017 coverage through Healthcare.gov. Fact sheet: http://go.cms.gov/2l1Db1R

New Payment and Delivery Models

On February 1, CMS posted an updated list of hospitals participating in the Comprehensive Care for Joint Replacement Model. Link to downloadable list: http://bit.ly/2cb62Yx

Medicare

On February 1, CMS released the 2018 Medicare Advantage and Part D Advance Notice and Draft Call Letter, which proposed an average 0.25% payment increase for Medicare Advantage plans. The Call Letter also proposed requiring Part D plans to implement formulary safe guards to prevent opioid overdoses. Comments are due by March 3. Press release: http://go.cms.gov/2l1I2QR Fact sheet: http://go.cms.gov/2l1Ey0q Notice: http://go.cms.gov/2l1o6gO

Medicaid

  • On January 31, Indiana Governor Holcomb submitted an application to CMS to extend the current version of the Health Indiana Plan, currently set to expire on January 31, 2018, until January 31, 2021. Press release: http://bit.ly/2l1Imz0 Letter from Governor Holcomb: http://bit.ly/2l1Nl2F Waiver Application: http://bit.ly/2l1Iqii
  • Also on January 31, GAO released a report highlighting four ongoing Medicaid program integrity issues, including enrollment verification, oversight of Medicaid managed care, provider eligibility, and coordination between Medicaid and the Marketplaces. Summary with link to report: http://bit.ly/2jRNXTe

Misc.

  • On January 30, Joint Committee on Taxation released estimates of federal tax expenditures for fiscal years 2016-2020. The Committee estimates that from 2016 to 2020, the tax exclusion for employer-sponsored health insurance is set to cost the federal government roughly $863 billion in lost revenue, while the ACA’s tax subsidies are set to cost $326.6 billion. Report: http://bit.ly/2l1ROCs
  • On February 1, HHS announced a new opportunity to apply for up to $500,000 in a Cooperative Agreements for the Historically Black Colleges and Universities Center for Excellence in Behavioral Health. Applications are due by March 24. Press release: http://bit.ly/2l1sooq
  • Also on February 1, National Institutes of Health announced a new funding opportunity of up to $5 million per year over the next three years for organizations to perform outreach and help recruit volunteers for the Precision Medicine Initiative. Applications are due by March 24. Press release: http://bit.ly/2l5zULW
  • Also on February 1, HHS announced a Health Insurance Portability and Accountability Act (HIPAA) civil money penalty against Children’s Medical Center of Dallas based on its impermissible disclosure of unsecured electronics protected health information. Press release: http://bit.ly/2l1GXIz