March 20, 2023
This Week in Health Policy for March 20
This Week (March 20-24)
Senate Health, Education, Labor and Pensions Committee will hold a hearing on "Taxpayers Paid Billions For It: So Why Would Moderna Consider Quadrupling the Price of the COVID Vaccine."
Senate Finance Committee will hold a hearing on "The President's Fiscal Year 2024 Health and Human Services Budget."
Senate Commerce, Science and Transportation Committee will hold a markup on "the Pharmacy Benefit Manager Transparency Act of 2023" and other legislation.
Senate Appropriations Labor, Health and Human Services, Education and Related Agencies Subcommittee will hold a hearing on "A Review of the President's FY2024 Funding Request and Budget Justification for the Department of Health and Human Services."
The Senate Committee on Veterans' Affairs will hold a member day on "Strengthening Methods of Recruitment and Retention for VA's Workforce."
The House Ways & Means Health Subcommittee will hold a hearing on "Why Health Care is Unaffordable: The Fallout of Democrats' Inflation on Patients and Small Businesses."
The House Appropriations Committee will hold a member day on "Agriculture, Rural Development, Food and Drug Administration, and Related Agencies."
The House Appropriations Committee will hold a public witness day on "Labor, Health and Human Services, Education, and Related Agencies."
Last Week (March 13-17)
Health Care Highlights
IRS publishes FAQ on nutrition and health spending accounts. On Friday (March 17), the Internal Revenue Services (IRS) published a frequently asked questions that clarifies expenses related to nutrition and nutrition counseling can be paid or reimbursed by a health savings account (HSA), health flexible spending arrangement (FSA), Archer medical savings account (Archer MSA) or health reimbursement arrangement (HRA) when they are used to treat a specific, physician-diagnosed disease.
CMS publishes first part B drugs subject to inflation rebates. On Wednesday (March 15), the Centers for Medicare and Medicaid Services (CMS) published a list of 27 drugs that will be subject to the Inflation Reduction Act's inflation rebate program. This January began the first quarterly period for which drug companies will be required to pay rebates for raising prices that outpace inflation on certain Part B drugs. CMS in 2025 will begin to send the first invoices to drug companies required to pay a rebate for the 2023 and 2024 rebates. CMS said Medicare beneficiaries could see lower co-insurance for the drugs between April 1 and June 30. President Biden touted the move in a speech during which he talked about other efforts his administration has taken to lower health care costs, including prescription drug costs, for patients.
CMS issues new guidance on drug price negotiation program. On Wednesday, CMS released initial guidance on how it will implement the Medicare Drug Price Negotiation Program for 2026, including the processes for selecting drugs for negotiation, the negotiation timeline, and processes for determining a final maximum fair price offer.
Two more drugmakers cap out-of-pocket insulin costs. This week, Sanofi and Novo Nordisk joined Eli Lilly in announcing plans to reduce out-of-pocket costs for certain insulin products for people with private insurance. Together, the three companies account for 80% of the insulin market. On Thursday (March 16), Sanofi said it will cap out-of-pocket costs for its most prescribed insulin product, Lantus, at $35 per month for people with private insurance, while Novo Nordisk said it will cut U.S. list prices for certain insulin products by up to 75%.
FTC action on social media advertising. On Thursday (March 16), the Federal Trade Commission (FTC) voted 4-0 to study deceptive advertising, including health care advertising, on social media and video streaming platforms.
VA to cover new Alzheimer's drug. On Monday (March 13), the Veterans Health Administration said it will cover Eisai's and Biogen's new Alzheimer's drug Leqembi, The move contrasts with Medicare's decision to limit coverage to patients enrolled in clinical trials or CMS-approved comparative studies.
Texas judge hears case challenging FDA approval process for Mifepristone. On Wednesday (March 15), U.S. District Judge Matthew Kacsmaryk heard oral arguments in a case that challenges the Food and Drug Administration's (FDA) approval of the abortion drug Mifepristone, saying the agency failed to adequately review the drug's safety before approval. Attorneys for the Biden administration defended the FDA's approval process and warned that a ruling in favor of the plaintiffs would disrupt access to reproductive health care and open the door to additional lawsuits challenging FDA approval of various drugs. The judge said he would issue a ruling as soon as possible.
Hearings, Markups, and Other Committee Action
Senate Homeland Security and Governmental Affairs Committee held a hearing on "Examining the Cybersecurity Risks to the Healthcare Sector." On Thursday (March 16), the Committee held a hearing examining the health care industry's cybersecurity risks. Committee members heard testimony from Scott Dresen, Chief Information Security Officer for Corewell Health; Kate Pierce, Senior Virtual Information Security Officer at Fortified Health Security; Greg Garcia, Executive Director of Cybersecurity at Healthcare and Public Health Sector Coordinating Council; and Stirling Martin, Senior Vice President and Chief Privacy and Security Officer at Epic Systems. During the hearing, Committee members and witnesses raised concerns about the increasing cybersecurity threat impacting the health care industry and discussed ways to support the health care system and protect against cyberattacks.
Senate HELP Committee issues RFI on PAHPA Reauthorization. On Wednesday (March 15), the Senate HELP Committee issued a request for information on the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA). The RFI seeks feedback on changes Congress could make to improve existing HHS programs' efficiency and effectiveness; gaps in the PAHPA framework and HHS' capabilities; and steps Congress would take to improve partnerships with states and localities, community-based organizations, and the private sector on preparedness activities. The Committee is accepting comments through March 29.
Senate Budget Committee held a hearing on "The President's Fiscal Year 2024 Budget Proposal." On Wednesday (March 15), the Committee held a hearing to discuss President Biden's FY 2024 budget proposal. During the hearing, Office of Management and Budget Director Shalanda Young defended the Biden's budget and debated the impact of the budget's tax increases and investments in Medicare and other health care programs with Republican members. Ultimately, Young said the White House was committed with working with Congress to determine appropriate funding levels for FY 2024.
Senate Committee on Veterans' Affairs held a hearing on "Examining the Future Path of VA's Electronic Health Record Modernization Program." On Wednesday (March 15), the Committee held a hearing that examined the implementation of the VA's Oracle Cerner EHR system and reports that the EHR implementation has caused "catastrophic harm" to veterans, including four incidents that resulted in patients dying. During the hearing, lawmakers heard from several Biden administration representatives, including Neil Evans, Acting Program Executive Director of the VA's Electronic Health Record Modernization Integration Office; Carol Harris of the Government Accountability Office; and Mike Sicilia, Executive Vice President of Oracle Global Industries.
Senate Committee on Environment & Public Works held a hearing on "Implementing IIJA: Perspectives on The Drinking Water and Wastewater Infrastructure Act." On Wednesday (March 15), the Committee held a hearing on the implementation of the drinking water and wastewater investments and authorizations in the Bipartisan Infrastructure Law. During the hearing, lawmakers discussed the Biden administration's recent proposal to limit the amount of PFOA and PFOS that can be in drinking water to four parts per trillion and require drinking water systems. Lawmakers heard testimony from Environmental Protection Agency Office of Water Assistant Administrator Radhika Fox, as well as Philadelphia Water Department head Randy Hayman, National Association of Clean Water Agencies President Thomas Sigmund, and West Virginia Department of Environmental Protection Division of Water and Waste Management Director Katheryn Emery.
Reports, Studies, and Journals
Medicare Payment Advisory Commission (MedPAC): March 2023 Report to the Congress: Medicare Payment Policy. In its March 2023 report to Congress, MedPAC recommends increasing physician payment by 1.45% and creating a non-budget neutral add-on payment of 15% for primary care physicians and 5% for other physicians who treat low-income patients. The report also discusses Medicare Advantage plan trends and issues related to risk adjustment and coding intensity, trends related to Medicare Part D, the impact of the COVID-19 pandemic on Medicare, and more.
The Medicaid and CHIP Payment and Access Commission (MACPAC): March 2023 Report to Congress on Medicaid and CHIP. The report includes chapters on Medicaid race and ethnicity data collection, nursing facility payment data collection and transparency, drug coverage policies and Medicaid disproportionate share hospital allotments to states to pay hospitals that treat a high portion of Medicaid and other low-income patients.
Government Accountability Office: Additional Coordination Is Needed for Assessing Risks in the Improper Payment Estimation Process for Advance Premium Tax Credits. The report examined methods five states and the federal government use to ensure ineligible people do not receive premium tax credits for exchange plans and recommends ways states and the federal government could improve verification processes.
Department of Health and Human Services: Inflation Reduction Act Research Series: Medicare Part D Enrollee Savings from Elimination of Vaccine Cost-Sharing. The report from HHS' Office of the Assistant Secretary for Planning and Evaluation estimates each Medicare Part D enrollee would have saved $70 on vaccine cost-sharing if the Inflation Reduction Act has been in effect in 2021.
Centers for Disease Control and Prevention (CDC): Maternal Mortality Rates in the United States, 2021. The latest CDC data show the U.S. maternal mortality rate rose from 23.8 deaths per 100,000 live births in 2020 to 32.9 deaths per 100,000 live births in 2021. The data also show the maternal mortality rate for Black women was nearly three times the rate for white women.