March 6, 2023
This Week in Health Policy for March 6
This Week (March 6-10)
On Thursday (March 9), Congress is expected to receive President Biden’s FY 2024 budget request, which is a non-binding document that details the administration’s funding and policy goals for the next fiscal year.
House Committee on Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic will hold a hearing on “Investigating the Origins of COVID-19.”
House Committee on Oversight and Accountability Cybersecurity, Information Technology, and Government Innovation Subcommittee will hold a hearing on “Advances in AI: Are We Ready For a Tech Revolution?”
Senate Health, Education, Labor & Pensions Committee will hold a hearing on “Defending the Right of Workers to Organize Unions Free from Illegal Corporate Union-Busting”
Senate Committee on Veterans’ Affairs will hold a hearing to discuss the Nomination of Joshua D. Jacobs to be Under Secretary for Benefits, Department of Veterans Affairs
Last Week (February 27- March 3)
Health Care Highlights
CMS publishes new resources on PHE unwinding. This week, the Centers for Medicare and Medicaid Services (CMS) published several resources related to the public health emergency, which is set to expire on May 11. On Thursday (March 2), CMS published anticipated timelines for states to resume Medicaid redeterminations, with five states set to begin terminations in April. On Monday (February 27), CMS published a new fact sheet providing an overview of expected expiration dates for certain COVID-related waivers and flexibilities and the agency has continued to update resources on its coronavirus waivers and flexibilities landing page.
White House unveils COVID-19 antifraud proposal. On Thursday (March 2), President Biden unveiled a three-part proposal to combat pandemic-related fraud, particularly related to pandemic small business programs and unemployment benefits. The proposal seeks $1.6 billion to investigate and prosecute instances of fraud, invest in new programs to prevent fraud and identity theft, and support victims of fraud.
FTC pursues second settlement over consumer health data sharing. On Thursday (March 2), the Federal Trade Commission (FTC) announced it has proposed an order to ban the online counseling service BetterHelp from sharing consumers’ health data with third parties such as Facebook and Snapchat for advertising and requires the company obtain affirmative express consent before sharing any personal information to certain third parties. The proposed order also would require BetterHelp to pay $7.8 million to settle charges that it shared consumers’ health data with third parties for advertising between Aug. 1, 2017, and Dec. 31, 2020. In a statement, BetterHelp did not admit to wrongdoing. The latest enforcement action comes a month after FTC fined GoodRx Holdings $1.5 million for sharing users’ health data with advertisers and amid a debate in Congress over legislation to protect consumers’ online data.
Eli Lilly announces insulin price cut. On Wednesday (March 1), Eli Lilly announced plans to cut the list price of Humulin, its most commonly prescribed insulin product, by 70% in Q4 2023 and cap patients’ out-of-pocket costs for Eli Lilly insulin products at $35. President Biden in a statement praised the move and called on other pharmaceutical companies to follow Medicare’s and Eli Lilly’s footsteps and lower the cost of insulin for consumers.
Biden delivers speech on protecting access to affordable health care. On Tuesday (February 28), President Biden spoke at a recreation center in Virginia Beach, Virginia, about congressional Republicans’ proposals to “undermine the Affordable Care Act and cut Medicaid reimbursement.” In contrast, Biden said his administration is pushing policies to protect and expand access to health care through federal health care programs and the ACA’s exchanges.
House E&C members issue RFI ahead of PAHPA reauthorization. On Monday (February 27), House Energy and Commerce Committee Members Reps. Richard Hudson (R-NC) and Anna Eshoo (D-CA) issued a Request for Information (RFI) related to the upcoming reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA). The RFI asks stakeholders from the public and private sector to share thoughts on how to reauthorize and revise biodefense and pandemic preparedness programs under PAHPA. Responses are due by March 13, 2023.
CMS resumes IDR process. On Monday (February 27), certified independent dispute resolution (IDR) entities resumed issuing payment determinations for disputes involving items or services furnished before October 25, 2022. CMS directed certified IDR entities to continue holding payment determinations for disputes involving items or services after October 25, 2022, until the agency issues new guidance in light of a February 6 ruling in Texas, which vacated certain portions of the regulation informing the IDR process.
ICYMI: Health Care Highlights from the Week of Feb. 20-24
DEA proposes rule on telemedicine prescribing of controlled substances. On Friday (February 24), the Drug Enforcement Administration (DEA) issued proposed rules for prescribing controlled substances via telemedicine after the COVID-19 public health emergency expires on May 11. Under the proposed rule, providers can virtually write a 30-day prescription for non-narcotic Schedule III, IV, or V controlled substances and buprenorphine for opioid use disorder (OUD) treatment. However, the patient would need to be seen in person before any additional prescribing. DEA under the rule would require an initial in person visit for any Schedule II medication or a Schedule III-V narcotic medication with the exception of buprenorphine for opioid use disorder (OUD) treatment. DEA said the initial in-person exam could occur with a referring provider. The proposed rules, which are open for public comment for 30 days, have come under fire from telemedicine advocates who say they are overly restrictive and could disrupt patients’ care.
CMS publishes rule to revise Medicare DSH payment calculations. On Friday (February 24), CMS issued a proposed rule outlining updates to how it calculates the Medicaid fraction of a hospital’s disproportionate patient percentage. The rule is open for public comment until May 1.
CMS will not revisit coverage decision for new Alzheimer's treatments. On Wednesday (February 22), CMS said it will not change its policy to only cover new Alzheimer's treatments designed to remove amyloid plaques from the brain approved through the Food and Drug Administration's standard process. CMS’ statement came in response to a request from the Alzheimer's Association, which asked CMS to expand coverage.
CMS proposed rule on nursing home ownership data reporting. On Friday (February 17), the Federal Trade Commission announced plans to create an Office of Technology (OT) to increase the Commission’s technological expertise and strengthen and support law enforcement investigations and other non-enforcement actions. The move follows President Biden’s call in the State of the Union for the government to better protect consumer data, including sensitive health data.
Hearings, Markups, and Other Committee Action
Senate Health, Education, Labor and Pensions Committee hearing on "Community Health Centers: Saving Lives, Saving Money." On Thursday (March 2), the Committee heard testimony from a panel of community health advocates, industry leaders, and academics, who urged Committee members to reauthorize the Community Health Center (CHC) Trust Fund and make additional investments in CHCs and primary care. Committee members also heard from a representative from the Government Accountability Office (GAO) who provided an overview of CHCs’ revenue streams, funding levels, and service lines.
House Energy & Commerce Committee Subcommittee on Innovation, Data, and Commerce hearing on “Promoting U.S. Innovation and Individual Liberty through a National Standard for Data Privacy.” On Wednesday (March 1), the Subcommittee held a hearing to discuss whether Congress should pass legislation that would establish a national privacy and data security standard.
House Judiciary Committee’s Crime and Federal Government Surveillance Subcommittee hearing on "The Fentanyl Crisis in America: Inaction is No Longer an Option." On Wednesday (March 1), the Subcommittee heard testimony from health care providers, advocates, academics, and a former Drug Enforcement Administration special agent on the impact of fentanyl and policies to prevent fentanyl from entering the country.
House Committee on Oversight and Accountability launches investigation into Pharmacy Benefit Managers’ Role in Rising Health Care Costs. On Wednesday (March 1), the Committee launched an investigation to learn how pharmacy benefit managers’ (PBM) practices impact patient care and costs. Chair James Comer (R-KY) sent letters to the Office of Personnel Management (OPM), CMS, and the Defense Health Agency (DHA) requesting documents and communications related to PBMs and federal health care programs. Chair Comer also sent letters to CVS Caremark, Express Scripts, and OptumRx requesting documents, communications, and information related to their practices.
House Financial Services Committee markup on data privacy and pandemic preparedness bills. On Tuesday (February 28), the Committee held its first markup of the 118th Congress, approving Chair Patrick McHenry’s (R-NC) financial data privacy bill along party lines, along with two bills to expand the president’s powers to secure critical medical supplies during health emergencies and a bill that would require the Government Accountability Office to conduct a study on illicit financing related to synthetic drug trafficking.
House Committee on Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic roundtable on "Preparing For the Future By Learning From the Past: Examining COVID Policy Decisions." On Tuesday (February 28), the Select Subcommittee held a roundtable discussion during which lawmakers heard from a panel of doctors and discussed ways to learn from the COVID-19 pandemic to prepare for future pandemics.
House Committee on Veterans' Affairs hearing on "Building an Accountable VA: Applying Lessons Learned to Drive Future Success." On Tuesday (February 28), the Committee heard testimony from a panel of federal representatives on the ways to improve the VA health system and veterans’ care.
Reports, Studies, and Journals
Government Accountability Office: Health Centers: Trends in Revenue and Grants Supported by the Community Health Center Fund. In the report, GAO highlights trends in community health centers’ revenue streams, funding levels, and service lines.
Health Affairs: Dental Services Use: Medicare Beneficiaries Experience Immediate And Long-Term Reductions After Enrollment. The study examined trends in dental utilization and outcomes before and after adults turned 65 and became Medicare eligible and recommended expanding traditional Medicare to include dental coverage to prevent negative outcomes.
BMJ: Inequities in surgical outcomes by race and sex in the United States: retrospective cohort study. The research found black men had higher 30-day mortality rates compared with white men, white women, and black women. The authors said the findings highlight a need to better understand the unique challenges of black men who require surgery.