December 5, 2022
This Week in Health Policy for December 5
This week (Dec. 5-9)
There are currently no health care hearings scheduled for the week of Dec. 5. Lawmakers in Congress will continue to work toward an agreement on a year-end spending bill and Georgia, on Tuesday (Dec. 6), will hold its Senate runoff election.
Last week (Nov. 28-Dec. 02)
Health Care Highlights
Health care part of year-end funding discussions. Congress returned to session this week following the Thanksgiving recess. Lawmakers have a packed agenda and are working toward an agreement on a bill to keep the federal government funded beyond the December 16 expiration of the current continuing resolution (CR). Congress is expected to pass another short-term CR before finalizing a year-end spending bill and it remains unclear if the year-end bill will take the form of an omnibus FY 2023 appropriations package or a longer CR. Health care is among the items being discussed as part of a year-end bill with negotiations active around telehealth, mental and behavioral health, provider payment cuts, pandemic response, maternal child health and preparedness, and more.
House leadership takes shape for 118th Congress. On Wednesday (Nov. 30), House Democrats elected Rep. Hakeem Jeffries (D-NY) to lead House Democrats in the 118th Congress. House Democratic leadership also will include Rep. Katherine Clark (D-MA) as Minority Whip and Rep. Pete Aguilar (D-CA) as Democratic caucus chairman. On Jan. 3, 2023, House Republicans will hold a formal vote on their leadership elections. Prior to the Thanksgiving break, Rep. Kevin McCarthy (R-CA) won the Republican nomination for House speaker.
New surprise billing lawsuit. On Wednesday (Nov. 30), the Texas Medical Association filed a third lawsuit challenging the Biden administration's rules for resolving payment disputes between providers and insurers covered under the No Surprises Act (NSA). The latest lawsuit alleges that the revised rule implementing the NSA, which took effect Oct. 25, would financially harm providers by deflating provider payments and skewing negotiations in favor of insurers.
ACA back in the courts. On Wednesday (Nov. 30), the American Medical Association and several other large health groups filed an amicus brief in a case challenging the Affordable Care Act's (ACA) requirement that insurers cover certain preventive care services at no out-of-pocket cost to the patient. The brief, which asks the judge not to implement a nationwide injunction on the provision, follows a ruling that determined the federal advisory board that makes recommendations on which preventive services should be covered does not have legal authority.
HHS issues long-awaited rule on 340B dispute resolution process. On Tuesday (Nov. 30), the Department of Health and Human Services (HHS) issued a proposed rule revising the 2020 final rule that created the 340B Administrative Dispute Resolution process for diversions, duplicate discounts, and overcharges. HHS said the rule proposed changes to better align the 340B dispute resolution process with statutory requirements in the ACA. HHS is accepting public comment on the rule through Jan. 30, 2023.
Medicare to engage pharma on drug price negotiations. Beginning Dec. 13, Medicare officials will host monthly, hour-long calls with drug manufacturers to solicit input and discuss implementation of the Inflation Reduction Act's Medicare drug price negotiation provisions.
HHS issues proposed rule on patient privacy for substance use disorders. On Monday (Nov. 28), HHS published a notice of proposed rulemaking to update privacy protections regarding health records for patients with substance use disorders to better facilitate care coordination and the exchange of patient records. The proposed rule, which is open for comment for 60 days, would implement provisions in the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
ICYMI: Health Care Highlights During the Thanksgiving Recess
White House's latest COVID-19 vaccine push. On Tuesday (Nov. 22), the Biden administration launched a six-week campaign to encourage Americans to get a COVID-19 vaccine or booster shot. The campaign includes $350 million for community health centers and $125 million for national organizations supporting older Americans and people with disabilities.The Biden administration used $475 million from the Provider Relief Fund to support the campaign as Congress has not authorized additional COVID-19 relief funding.
ACA Marketplace open enrollment update. On Tuesday (Nov. 22), the Centers for Medicare & Medicaid Services (CMS) announced nearly 3.4 million people selected a 2023 health plan through the ACA Marketplaces between Nov. 1 and Nov. 19, a 17% year-over-year increase. Open enrollment in the 33 states that use the federally facilitated Marketplace will remain open through Dec. 15. Open enrollment dates in the remaining states may vary. The data include only those who have selected a health plan. Individuals are not considered enrolled in a plan until they pay their first month's premium.
The Senate Health, Education, Labor & Pensions (HELP) Subcommittee on Children and Families held a hearing on "Caring for Our Kids: Supporting Mental Health in the Transition from High School to College." On Wednesday (Nov. 30), the Senate HELP Subcommittee on Children and Families held a hearing to discuss the mental and behavioral health needs of adolescents, particularly how to support those transitioning from high school to college. During the hearing, lawmakers and witnesses discussed ways to improve the individualized education program (IEP) process, the prior authorization process, and other hurdles that can prevent teens from accessing mental health care or treatment. In addition, witnesses discussed the importance of increasing mental health literacy and increasing access to mental health first aid and other education programs.
Reports, Studies, and Journals
Pandemic Response Accountability Committee: Insights on Telehealth Use and Program Integrity Risks Across Selected Health Care Programs During the Pandemic. The report, which provides an overview of potential integrity risks for federal programs that expanded telehealth during the pandemic, concluded that federal programs could take more steps to prevent fraud, waste, and abuse in telehealth, particularly related to billing practices.
Health Affairs: Higher COVID-19 Vaccination And Narrower Disparities In US Cities With Paid Sick Leave Compared To Those Without. The study found cities with paid sick leave policies experienced 17% higher COVID-19 vaccination coverage than cities that did not have paid sick leave policies. The authors found strong associations between paid sick leave and COVID-19 vaccination in the most socially vulnerable neighborhoods.
JAMA: Over-the-counter Hearing Aids: From Research to Policy to Practice. In this viewpoint, officials from the National Institutes of Health and the Food and Drug Administration describe the process of establishing a new category for over-the-counter hearing aids.