Healthcare Policy Update 3-06-17


What’s Ahead: This Week

Hearings/Markups

  • Tuesday, March 7
    • House Veterans Affairs Committee, “Shaping the Future: Consolidating and Improving VA Community Care.”
  • Wednesday, March 8
    • Senate Appropriations Committee, Subcommittee on Labor, Health and Human Services and Related Agencies, “Savings Lives Through Medical Research.”
    • House Committee on Oversight & Government Reform, Subcommittees on Healthcare, Benefits and Administrative Rules and Government Operations, “Examining IRS Customer Service Challenges.”
  • Thursday, March 9
    • House Appropriations Committee, “Management Challenges at the Departments of Labor, Health and Human Services, and Education and the Social Security Administration: Views from the Inspectors General.”

Notable Policy Events

  • Monday, March 6
    • Center for Consumer Engagement in Health Innovation, “Too Much to Lose: Protecting Patients, Protecting Progress in Health Care.” Additional information: http://bit.ly/2mv7iPU
  • Monday, March 6 – Tuesday, March 7
    • Federation of American Hospitals, “Annual Public Policy Conference.” Additional information: http://bit.ly/2meedvC
  • Tuesday, March 7
    • Health Affairs, “Delivery System Innovation.” Additional information: http://bit.ly/2lAMp1R
    • University of Pennsylvania Leonard Davis Institute of Health Economics and Wharton Public Policy Institute, “Health Reform and the Future of the Individual Insurance Market: Weighing the Evidence.” Additional information: http://bit.ly/2medWJ7
  • Tuesday, March 7 – Wednesday, March 8
    • Department of Veterans Affairs (VA), “Meeting of the Health Care and Clinical Management Subcommittee and the Healthcare Informatics Subcommittee of the Health Services Research and Development Service Scientific Merit Review Board.” Additional information: http://bit.ly/2lAGxFC
  • Wednesday, March 8
    • HHS Office of the National Coordinator for Health IT (ONC), “Collaboration of the Health IT Policy and Standards Committees.” Additional information: http://bit.ly/2m4rDIJ
  • Wednesday, March 8 – Thursday, March 9
  • Thursday, March 9 – Friday, March 10
    • AHIP, “National Conference on the Individual and Small Group Markets.” Additional information: http://bit.ly/2m4n15q

Weekly Wrap Up: Notable Health Care Developments From Last Week

Joint Session of Congress

On February 28, President Trump spoke to a Joint Session of Congress, during which he described several key principles for ACA repeal and replace, including ensuring that Americans with pre-existing conditions have access to coverage; providing tax credits to help individuals afford coverage; expanding the use of health savings accounts; giving states greater flexibility on Medicaid; implementing reforms to lower the cost of insurance; and allowing insurers to sell health plans across state lines. White House Press release: http://bit.ly/2m4gyI0 Secretary Price Press release: http://bit.ly/2mCjNti

Administration

On March 2, Senate Finance Committee approved by a vote of 13-12 the nomination of Seema Verma to be the Administrator of CMS. Her nomination now moves to the full Senate for consideration. Senate Finance Committee Chair Hatch (R-UT) Press release: http://bit.ly/2mxy0HG

Legislative Activity

  • On February 27, Senate Aging Committee Chair Collins (R-ME) and Sen. Cardin (D-MD) introduced the Home Health Care Planning Improvement Act (S. 445), which would ensure more timely access to home health services for Medicare beneficiates under the Medicare program by allowing physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives to order home health services. Press release: http://bit.ly/2mvbXl3
  • Also on February 27, Sens. Bennet (D-CO), Rubio (R-FL), Van Hollen (D-MD), and Gardner (R-CO) introduced the Research to Accelerate Cures and Equity (RACE) for Children Act (S. 456), which would establish a program to increase the development of new drugs to treat pediatric cancers. Reps. McCaul (R-TX), Butterfield (D-NC) and Duffy (R-WI) introduced a companion bill in the House (H.R. 1231). Press releases from Sen. Bennet and Rep. McCaul: http://bit.ly/2lAQ2Vp and http://bit.ly/2lANMgO
  • Also on February 27, Reps. Bilirakis (R-FL) Butterfield (D-NC) and McCaul (R-TX) introduced the Orphan Product Extensions Now accelerating Cures and Treatments (OPEN) Act (H.R. 1223), which would authorize an extension of exclusivity periods for certain drugs that are approved for a new indication for a rare disease or condition. Press release: http://bit.ly/2mveFHn
  • On February 28, Senate Majority Whip Cornyn (R-TX) and Sen. Carper (D-DE) introduced the Cancer Care Payment Reform Act (S. 463), which would establish a national Oncology Medical Home Demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency. Press release: http://bit.ly/2lATrUe
  • Also on February 28, Sens. Markey (D-MA), Portman (R-OH), Bennet (R-DO) and Cornyn (R-TX) introduced the Independence at Home Act of 2017 (S. 464), which would provide for a permanent Independence at Home medical practice program under the Medicare program. Press release: http://bit.ly/2m4mlx5 Bill text: http://bit.ly/2mCj5w0
  • Also on February 28, Sens. Sanders (I-VT), Booker (D-NJ), and Casey (D-PA) introduced the Affordable and Safe Prescription Drug Importation Act (S. 469), which would allow for the importation of affordable and safe drugs by wholesale distributors, pharmacies, and individuals. Reps. Cummings (D-MD) and Doggett (D-TX) introduced a companion bill in the House (H.R. 1245). Press release: http://bit.ly/2mv0zpg. Bill summary: http://bit.ly/2mvpV6D Bill text: http://bit.ly/2mveL1n
  • Also on February 28, Sen. Rubio (R-FL) introduced the Territory Health Insurance Tax Relief Act of 2017 (S. 476), which would exempt health insurers of residents of the U.S. territories from the annual fee on health insurance providers. Reps. Curbelo (R-FL) and Velazquez (D-NY) introduced a companion bill in the House (H.R. 1246). Press release: http://bit.ly/2mvdUxF Bill text: http://bit.ly/2mva8o7
  • Also on February 28, Rep. Lobiondo (R-NJ) introduced the Veterans Health ID Act (H.R. 1254), which would direct the Secretary of the VA to carry out a pilot program under which eligible veterans may elect to receive hospital care and medical services at non-VA facilities. Press release: http://bit.ly/2lB1UGT
  • On March 1, Sens. Thune (R-SD), Murphy (D-CT), Capito (R-WV) and Donnelly (D-IN) introduced the Personal Health Investment Today (PHIT) Act (S. 482), which would treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care. Reps. Smith (R-MO) and Kind (D-WI) and 11 bipartisan cosponsors introduced a companion bill in the House (H.R. 1267). Press release: http://bit.ly/2m4tYn4
  • Also on March 1, Reps. Jenkins (R-KS) Thompson (D-CA) and Marshall (R-KS) introduced the Medicare Patient Access to Hospice Act (H.R. 1284), which would provide for the recognition of attending physician assistants as attending physicians to serve hospice patients. Press release: http://bit.ly/2mCgTVm
  • On March 2, Sen. Manchin (D-WV) and nine Democratic cosponsors introduced the Budgeting for Opioid Addiction Treatment (LifeBOAT) Act (S. 523), which would establish a stewardship fee on the production and importation on opioid pain relievers. Press release: http://bit.ly/2mCgn9H Fact sheet: http://bit.ly/2mCfPAM
  • Also on March 2, Sens. Blumenthal (D-CT), Baldwin (D-WI), and 39 Democratic cosponsors introduced the Women’s Health Protection Act (S. 510), which would protect a woman’s right and ability to determine whether and when to bear a child or end a pregnancy by limiting restrictions on the provision of abortion services. Reps. Chu (D-CA), Fudge (D-OH), Frankel (D-FL) and 99 Democratic cosponsors introduced companion legislation in the House (H.R. 1322). Sen. Blumenthal and Rep. Chu Press releases: http://bit.ly/2msVVrg and http://bit.ly/2mta2gt
  • Also on March 2, Rep. Collins (R-GA) and seven bipartisan cosponsors introduced the Prescription Drug Price Transparency Act (H.R. 1316), which would provide for pharmacy benefits manager standards under the Medicare prescription drug program and the Medicare Advantage program to further transparency of payment methodologies to pharmacies. Press release: http://bit.ly/2mCfZrT

ACA Repeal

  • On February 27, Rep. Kennedy (D-MA) introduced a Resolution of Inquiry (H.R. 154), requesting that the President and the Secretary of HHS transmit certain information to the House relating to plans to repeal or replace the ACA. Press release: http://bit.ly/2lLPb3B
  • On February 28, Sens. Carper (D-DE), Cardin (D-MD), Brown (D-OH), Markey (D-MA), and Blumenthal (D-CT) wrote a letter to President Trump expressing concern over the Executive Order directing the Secretaries of HHS and other federal agencies to take all available efforts to undermine the ACA, and requesting that the President retract the Executive Order and reduce any unnecessary disruption to the healthcare system. Letter: http://bit.ly/2mtdZl2
  • On March 1, House Energy & Commerce Ranking Member Pallone and Oversight and Government Reform Ranking Member Cummings (D-MD) issued a district-by-district report summarizing the progress made under the ACA and the potential effects of repealing the law. Press release: http://bit.ly/2mCbRrF Report: http://bit.ly/2mC12Gi
  • On March 2, House Energy & Commerce Democrats sent a letter to Energy & Commerce Chair Walden (R-OR) requesting that the text of any ACA repeal bill be posted for public viewing at least 30 days before a markup is held in the Energy & Commerce Committee. Press release: http://bit.ly/2m4nogj Letter: http://bit.ly/2m4wZ6X
  • Also on March 2, House Ways & Means Committee Democrats sent a letter to Ways & Means Chair Brady (R-TX) urging him to refrain from holding a full committee markup of any legislation to replace the ACA without conducting hearings or obtaining scores from the Congressional Budget Office or the Joint Committee on Taxation. Press release with text of letter: http://bit.ly/2mydwyK

ACA Implementation

On March 3, U.S. Treasury Inspector General for Tax Administration (TIGTA) released a report finding that the federal government paid out $112 million in 2014 to individuals who may not have been eligible to receive advanced payments of premium tax credits under the ACA. Report: http://bit.ly/2mt7tLr

Medicare

On February 28, Rep. Guthrie (R-KY) led a letter cosigned by 261 bipartisan House members to CMS Acting Administrator Conway expressing strong support for the Medicare Advantage program and asking that CMS continue to implement policies that preserve and strengthen the program as it finalizes policies in its 2018 Notice and Draft Call Letter. Press release: http://bit.ly/2lLR3cF Letter: http://bit.ly/2lLMgYB

Medicaid

On February 27, CMS published a blog post and RFI that seek input on the design of a draft model concept focused on improving the health of children and youth covered by Medicaid and CHIP through the integration of health care and health-related social services. Comments are due by March 28. Blog post and RFI: http://bit.ly/2bVHGlJ and http://bit.ly/2m4mC35

New Payment and Delivery Models

  • On March 2, CMS announced a deadline extension for Letters of Intent (LOI) and Request for Applications (RFA) for the Shared Decision Making Model. LOIs and Applications are now due by March 20. LOI and RFA: http://bit.ly/2mCm8Es and http://bit.ly/2mCgUZh
  • On March 3, CMS released a Request for Applications (RFA) and Letter of Intent (LOI) for organizations interested in applying to the Next Generation Accountable care Organization (ACO) Model for 2018. LOIs are due by May 4, Applications are due May 18. LOI and RFA: http://bit.ly/2kgYe0f and http://bit.ly/2kgTZS0 

Health IT

  • On February 27, U.S. Government Accountability Office (GAO) released a report finding that HHS has failed to measure the effectiveness of its efforts to promote the use of electronic health records (EHRs) in post-acute settings and lacks a plan to meet its goal of increasing the proportion of post-acute providers electronically exchanging health information. Summary with link to report: http://bit.ly/2m4ImvT
  • On March 1, HHS Office of the Inspector General (OIG) released a report reviewing HHS’ compliance with the Federal Information Security Modernization Act (FISMA) of 2014 for FY 2016, finding although HHS has made improvements in comparison to the prior year’s review, opportunities to strengthen the overall information security program exist. Summary with link to report: http://bit.ly/2m4xr5e

Substance Abuse and Mental Health

  • On February 28, Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it is accepting applications for the Services Grant Program for Residential Treatment for Pregnant and Postpartum Women, which would expand comprehensive treatment, prevention and recovery support services for women and their children in residential substance use disorder treatment facilities. Press release: http://bit.ly/2m9L0Ct
  • On March 3, SAMHSA announced that it is accepting applications for up to $47.5 million in grants over the next five years to support the development of and/or expansion of community infrastructures that integrate behavioral health treatment and services for substance abuse. Press release: http://bit.ly/2m4Nccs 

Misc.

  • On February 27, GAO released a report finding that some Veterans Health Administration (VHA) facilities did not follow all required inspection procedures, recommending that the VHA should take further action to ensure medical facilities’ controlled substance programs meet requirements. Summary with link to report: http://bit.ly/2muqqO2
  • Also on February 27, HHS released a report finding that from 2000 through 2014, the percentage of the uninsured or privately insured non-elderly with an out-of-pocket payment decreased from 95.6% to 91.5% and 90.0%, respectively. Report: http://bit.ly/2lAd3HU
  • On February 28, House Committee on Energy & Commerce Chair Walden (R-OR) and Oversight and Investigations Subcommittee Chair Murphy (R-PA) sent a letter to the Centers for Disease Control and Prevention (CDC) urging them to continue their oversight efforts in examining the agency’s Laboratory Response Network, which was established to boost federal preparedness for bioterrorism. Press release: http://bit.ly/2mv2FW7 Letter: http://bit.ly/2mv86V7
  • Also on February 28, CDC released a report on ambulatory surgery data from hospitals and ambulatory surgery centers in 2010, finding variation between females and males and among different age ranges. Report: http://bit.ly/2m9Qflq
  • Also on February 28, National Institutes of Health (NIH) published a study finding that youth with type 2 diabetes develop complications more often than their type 1 peers. Report: http://bit.ly/2mB9Wkd
  • On March 1, Senate HELP Committee Ranking Member Murray, and Sens. Cortez Mastro (D-NV) and Blumenthal (D-CT) sent a letter to Senate Majority Leader McConnell (R-KY) urging him to “protect the health and wellbeing of millions of women” by committing to not bring to the Senate floor a bill passed by the House seeking to overturn Title X health center. Press release: http://bit.ly/2lAKf2d Letter: http://bit.ly/2lApXpG
  • Also on March 1, CDC released a report finding that in 2015, nearly 17% of adults aged 18-64 with multiple chronic conditions delayed or chose not to obtain needed medical care in the last year due to cost. Report: http://bit.ly/2lLN3sx
  • On March 2, HHS released a final rule delaying the effective date of a 340B Final Rule originally published in January, which sets forth the calculation of the 340B ceiling price and the application civil monetary penalties. The effective date from delayed from March 6 until March 21. Final rule: http://bit.ly/2lLHV7J