December 12, 2022
This Week in Health Policy for December 12
This week (Dec. 12-16)
There are currently no health care hearings scheduled for the week of December 12. Lawmakers in Congress will continue to work toward an agreement on a year-end spending bill and the Senate is expected to take up the National Defense Authorization Act.
Last week (Dec. 05-09)
Health Care Highlights
Health care remains part of year-end funding discussions. Health care items are still expected to ride along with any government funding legislation as lawmakers face a series of deadlines for provider payment cuts, Medicare extenders, telehealth flexibilities, and more. But the exact size and form of the government funding bill will take remains uncertain. A bipartisan agreement on topline spending numbers for an omnibus appropriations bill remains elusive with a week to go before current government funding runs out on December 16. A week-long continuing resolution (CR) through December 23 seems possible as negotiations continue. Some Republicans are pushing for a CR into early 2023 when they will have more influence with GOP control of the House, while House Democrats continue to cite a year-long CR as a fallback option.
Senate majority leadership takes shape: In the Senate, Democrats re-elected Senator Chuck Schumer (D-NY) as Majority Leader, Senator Dick Durbin (D-IL) as Whip, and made Senator Patty Murray (D-WA) President Pro Tempore. The major change to the current leadership slate was adding Senator Brian Schatz (D-HI) as deputy conference secretary, replacing Murray on the leadership team. Senator Raphael Warnock (D-GA) won the December 6 runoff, however the size of Senate Democrats' majority is now uncertain after Sen. Kyrsten Sinema (D-AZ) told CNN she is leaving the Democratic party and registering as an Independent.
House committee leadership changes: On Wednesday (Dec. 7), the House Republicans' steering committee met to decide on committee chairmanships for their new majority, but a decision on chairman of the Ways and Means Committee may not be determined until after the January 3 House vote for the next Speaker. Meanwhile, on Tuesday (Dec. 6), House Democrats elected Rep. Brendan Boyle (D-PA) ranking member on the Budget Committee, replacing retiring Chairman John Yarmuth (D-KY). The committee's chairmanship is uncertain, though Rep. Jason Smith (R-MO) could have the inside track if he does not win the Ways and Means job.
White House launches national opioid overdose tracker. On Thursday (Dec. 8), the White House launched a national dashboard to track nonfatal opioid overdoses. The dashboard, which the White House hopes can be used to support policy decisions and resource allocations, is based on ambulance data from all 50 states and the District of Columbia.
CMS issues prior authorization and interoperability proposed rule. On Tuesday (Dec. 6), the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule, "Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, etc." The rule includes new requirements for certain insurers, as well as performance measures for providers to improve electronic health care data exchange between providers and insurers and streamline the prior authorization process for items and services. CMS estimated the proposed rule would indirectly save health care providers $15 billion over 10 years — and sources say it could significantly reduce the projected cost of the House-passed, bipartisan Improving Seniors' Timely Access to Care Act (H.R. 3173), which the Congressional Budget Office previously estimated to be $16 billion.
House passes health care bills. The House this week advanced several pieces of health care legislation:
Colorado submits drug importation plan. On Monday (Dec. 5), Colorado became the fourth state to submit a plan to FDA to import Canadian drugs. However, FDA has yet to take action on similar state requests. Florida recently filed a lawsuit to spur action on its November 2020 plan to import drugs from Canada. Drug importation is likely to be a topic of discussion at the Senate Health, Education, Labor and Pensions (HELP) Committee next year as it is strongly supported by Sen. Bernie Sanders (I-VT) who is expected to chair the committee.
CMS delays enforcement of good faith estimate convening provider requirement. On Friday (Dec. 2), the Centers for Medicare & Medicaid Services delayed until further notice enforcement of the surprise billing rule requirement that good faith estimates (GFEs) for uninsured or self-pay patients include cost estimates from co-providers and co-facilities. This requirement was set to take effect Jan. 1, 2023, but the agency is exercising enforcement discretion to give providers more time to make the necessary technical and process changes. HHS is encouraging states, which are the primary enforcers of this requirement, to also delay enforcement. HHS will issue additional rulemaking in the future that provides a prospective applicability date for the requirement.
'Mpox' public health emergency to end. On Friday (Dec. 2), HHS Secretary Xavier Becerra issued a statement saying the department is not expected to renew the public health emergency declared in response to the "mpox" outbreak "given the low number of cases today." The "mpox" PHE is currently slated to expire on Jan. 31.
Senators unveil discussion draft on mental health parity amidst year-end discussions. On Thursday (Dec. 1), the Senate Finance Committee released a mental health parity discussion draft that includes policies to improve provider directories in Medicare Advantage, Medicaid managed care plans, and state Medicaid program. The discussion draft marks the fifth and final mental health focused draft that the committee hopes will be the starting point for larger mental health reform. The Committee previously has released discussion drafts on telehealth, youth mental health, workforce, and physical and mental health integration.Currently, congressional leaders are discussing which bipartisan mental health provisions could ride along with a year-end package.
The House Veterans' Affairs Committee held a hearing on "Fulfilling Our Pact: Ensuring Effective Implementation of Toxic Exposure Legislation." On Wednesday (Dec. 7), the House Veterans' Affairs Committee held a hearing to understand the barriers and opportunities to implementing the Honoring Our PACT Act passed over the summer. During the hearing, committee members heard from several representatives of the Department of Veterans Affairs on the best ways to educate veterans about the new benefits included in the bill and ways to implement the bill's provisions.
Reports, Studies, and Journals
Robert Wood Johnson Foundation: Centering Equity in the Nation's Public Health System. The report recommends the Centers for Disease Control and Prevention take a holistic approach to incorporating equity across its operations, foster trust among communities experiencing health inequities, collect health outcomes data for those impacted by discrimination, and more.
HHS' Office of Inspector General (OIG): Fall 2022 Semiannual Report to Congress. The report highlights OIG's activities related to identifying significant risks, problems, abuses, deficiencies, remedies, and investigative outcomes within HHS that were disclosed from April 1 through September 30, 2022.
Reagan-Udall Foundation: Operational Evaluation of the FDA Human Foods Program. The report, which was commissioned by the FDA in response to the infant formula crisis, found the organization's culture, structure, and governance model pose obstacles to the program's effectiveness.