June 20, 2022
This Week in Health Policy for June 20
This Week (June 20-24)
The House Veterans' Affairs Subcommittee on Health will hold a hearing to markup several health care bills.
Last Week (June 13-17)
Health Care Highlights
Supreme Court sides with hospitals in 340B payment case. On Wednesday (June 15), the Supreme Court in a unanimous decision said the Department of Health and Human Services (HHS) did not have the authority to enact a 2018 payment change that cut drug reimbursements for hospitals that participate in the 340B drug discount program by nearly 30%. The justices said per the law, HHS must first conduct a survey of hospitals' acquisition costs, which the department did not do before enacting the cuts from 2018 through 2022. The case, which was remanded back to the lower courts, comes about a month before HHS is expected to release its annual payment rule that addresses the 340B rate cuts.
Senate Finance Committee unveils draft mental health bill. On Wednesday (June 15), Senate Finance Committee leaders released a discussion draft addressing children's mental health. The draft focuses largely on barriers to mental health care in the Medicaid program.
FDA advisers authorize Moderna and Pfizer vaccines for young children. On Friday (June 17), the Food and Drug Administration (FDA) granted emergency use authorizations (EUAs) for Moderna's COVID-19 vaccine for children ages 6 to 17, Moderna's COVID-19 vaccine for children 6 months to 5 years old, and Pfizer-BioNTech's COVID-19 vaccine for children 6 months to 4 years old. Advisers at the Centers for Disease Control and Prevention (CDC) will meet on Friday and Saturday (June 17-18) to determine whether or not to recommend the COVID-19 shots for young children, and the CDC Director must accept the recommendation before shots can start to be given.
MedPAC issues June 2022 report to Congress. On Wednesday (June 15), the Medicare Payment Advisory Commission (MedPAC) released its June 2022 report to Congress. The report offers recommendations on ways the Centers for Medicare and Medicaid can streamline the number of Medicare alternative care models, ways Congress can address high Medicare Part B drug prices, site neutral policies to align Medicare payments across care settings, new methods to make Medicare Advantage risk adjustment more accurate,and more.
MACPAC issues June 2022 report to Congress. On Wednesday (June 15), the Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2022 report to Congress. The report includes recommendations for enhanced oversight of Managed Care Directed Payments, including making directed payment information publicly available; recommendations to improve vaccine outreach and education to Medicaid and CHIP beneficiaries, as well as improved immunization information systems and funding to support; policies to support health IT adoption for Medicaid behavioral health providers; recommendations on how to address health equity with an emphasis on data collection and prioritization; and more.
Senators reach deal on bipartisan gun safety package. Last Sunday (June 12), a bipartisan group of 20 senators reached a deal on a "framework" for a gun-safety package. The framework has the support of congressional Democratic leadership, President Biden, and at least 10 Republican senators, but it differs greatly from the House-passed package and is still in the early stages. The framework, which has not yet been publicly released, includes:
OMB to review data collection standards on race and ethnicity. On Wednesday (June 15), the Office of Management and Budget (OMB) announced a formal review and process for revising standards for maintaining, collecting, and presenting federal data on race and ethnicity.
FTC ramps up enforcement in health care. This week, the Federal Trade Commission (FTC) published a new policy statement detailing its plans to examine rebates and other fees common in the prescription drug industry, taking a particular look at the role pharmacy benefit managers play. On Thursday (June 16) the FTC also released a statement praising the FTC's role in two health systems calling off plans to merge, saying, "This should be a lesson learned to hospital systems all over the country and their counsel: the FTC will not hesitate to take action in enforcing the antitrust laws to protect healthcare consumers who are faced with unlawful hospital consolidation."
AMA adopts new policies on gun violence, physician burnout, abortion. This week, the American Medical Association (AMA) adopted several new policies, including a policy on children's mental health and gun safety, recommending schools use "evidence-based and trauma-informed" approaches to inform students how to respond to active shooters; a policy on burnout that urges states to create "safe haven" health programs to help connect doctors to counseling and treatment; a policy urging the FDA to allow over-the-counter birth control; and an update to its abortion policy to seek legal protections for patients who go out of state for reproductive services, among other things.
Senate Health, Education, Labor, and Pensions (HELP) Committee markup of FDA User Fee Agreements and three public health bills. On Tuesday (June 14), the Senate HELP Committee advanced four health care bills to the full Senate, including legislation to reauthorize the FDA user fee agreements, the FDA Safety and Landmark Advancements Act (FDASLA). During the Senate markup, lawmakers debated 39 amendments to FDASLA, ultimately adopting 28 amendments, including several addressing the current infant formula shortage, new transparency requirements for the FDA, increasing generic drug competition, and allowing prescription drug importation from Canada. Lawmakers voted 15-7 to table a broader drug importation amendment from Sen. Bernie Sanders (D-VT) that would have allowed prescription drug importation from the United Kingdom and Canada, with the potential for additional countries over time.
House Committee on Energy and Commerce hearing on "Protecting America's Consumers: Bipartisan Legislation to Strengthen Data Privacy and Security." On Tuesday (June 14), the House Committee on Energy and Commerce held a hearing on "Protecting America's Consumers: Bipartisan Legislation to Strengthen Data Privacy and Security." During the hearing, there was unanimous agreement among members on the importance of enacting legislation that protects the privacy rights of all Americans, albeit with some concerns regarding unintended burden on small businesses. Primarily, this hearing discussed the recently introduced legislation, the American Data Privacy and Protection Act (ADPPA), a bipartisan and bicameral bill that aims to introduce a national standard for data privacy.
House Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies markup of FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Bill. On Wednesday (June 15), the House Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies advanced by voice vote a package that would increase FDA discretionary funding by $341 million for FY 2023. The bill includes a $77 million increase for food safety.
Reports, Studies, and Journals
HHS Office of Inspector General: Medicare and Beneficiaries Paid Substantially More to Provider-Based Facilities in Eight Selected States in Calendar Years 2010 Through 2017 Than They Paid to Freestanding Facilities in the Same States for the Same Type of Services. The report found Medicare could have saved $1.3 billion and beneficiaries could have saved $334 million, if the agency had paid physician claims in eight select states at the Physician Fee Schedule rate for freestanding facilities instead of the hospital outpatient department rate. While OIG acknowledges that CMS has taken steps to equalize payments between provider-based and freestanding facilities, it recommends the agency fully equalize payments for E/M services.
National Bureau of Economic Research: Vaccination Policy, Delayed Care, and Health Expenditures. The paper found COVID-19 vaccines reduced the likelihood of patients delaying or skipping medical care by 37%, particularly among children.
Urban Institute: Lowering the Age of Medicare Eligibility to 60. The report estimates that lowering the Medicare eligibility age to 60 would increase federal Medicare spending for adults ages 60 to 64 by $44.6 billion, after accounting for declines in federal spending on marketplace subsidies. The report estimated Medicare enrollment would increase by 5.1 million people ages 60 to 64.