July 24, 2023
This Week in Health Policy for July 24
This Week (July 24 - 28)
The Senate Finance Committee will hold a markup on PBM legislation.
The Senate Health, Education, Labor & Pensions Committee will hold a markup of “The Primary Care and Health Workforce Expansion Act.”
The Joint Economic Committee will hold a hearing on “The Economic Impact of Diabetes.”
The Senate Appropriations Committee will hold a markup of Fiscal Year 2024 Defense, Interior and Environment, Labor, Health and Human Services, Education, and Homeland Security Appropriations Acts.
The House Energy and Commerce Oversight and Investigations Subcommittee will hold a hearing, “Stopping The Exploitation Of Migrant Children: Oversight Of HHS' Office Of Refugee Resettlement.”
Senate Veterans’ Affairs Committee will hold a hearing, “Implementing the PACT Act: One Year Later.”
House Veterans’ Affairs Committee will hold a markup on pending legislation.
Last Week (July 17 - 21)
Health Care Highlights
FTC, HHS raise privacy and security concerns over online trackers. On Thursday (July 20), the Federal Trade Commission (FTC) and HHS’ Office for Civil Rights sent letters to 130 hospital systems and telehealth providers warning that online tracking technologies integrated into their websites or mobile apps could pose privacy or security risks. They noted that many online tracking tools collect data when users visit a website and, in some cases, may sell or share that data with third parties.
FTC walks back former policy statements on PBMs. On Thursday (July 20), the FTC issued a statement that warns against relying on nine advocacy letters published or issued between 2004 and 2014 that opposed proposals to increase regulatory oversight and transparency of pharmacy benefit managers (PBMs). The Commission indicated it may re-evaluate those materials after its current inquiry into PBMs is complete.
CMS halts Medicaid redeterminations in several states. On Wednesday (July 19), CMS administrator Chiquita Brooks-LaSure said the agency has paused Medicaid redeterminations in 12 states to address errors and ensure compliance with federal requirements.
DOJ, FTC publish draft merger guidelines. On Wednesday (July 19), the Justice Department and the FTC published a draft update to existing merger guidelines, outlining 13 proposed guidelines that the agencies may use when considering whether a merger, including health care industry mergers, run afoul of antitrust laws.
J&J sues over Drug Price Negotiation Program. On Tuesday (July 18), Johnson & Johnson became the latest drugmaker to sue CMS to halt Medicare’s drug price negotiations established under the Inflation Reduction Act. Johnson & Johnson, which owns the pharmaceutical company Janssen said the drug price negotiation process is unconstitutional and would force Janssen to remove all its drugs from Medicare and Medicaid programs. Merck, Bristol Myers Squibb, and Astellas, as well as PhRMA and the U.S. Chamber of Commerce also have filed lawsuits over the program.
Hearings, Markups, and Other Committee Action
The Senate Health, Education, Labor & Pensions Committee held a markup of the Pandemic and All-Hazards Preparedness and Response Act. On Thursday (July 20), the Committee advanced an amended bill (S. 2333) to reauthorize the Pandemic and All-Hazards Preparedness and Response Act (PAHPA). The amended bill includes news measures to address drug shortages, address the Strategic National Stockpile, and create a new FDA team to approve medical countermeasures to emerging pathogens.
The Senate Finance Health Care Subcommittee held a hearing, “The Cost of Inaction and the Urgent Need to Reform the U.S. Transplant System.” On Thursday (July 20), the Subcommittee held a hearing on ways to modernize the U.S. transplant system. The Subcommittee heard from a panel of experts representing providers, patient advocates, and organ procurement organizations who discussed ways to modernize the U.S. transplant system, including reforms included in the Securing the U.S. Organ Procurement and Transplantation Network Act (S. 1668).
The House Energy and Commerce Committee held a markup of health care legislation. On Wednesday (July 19), the Committee advanced 15 bills on a range of health care topics. Similar to last week’s Health Subcommittee markup, much of the hearing debate focused on the House-version of PAHPA reauthorization, which does not have bipartisan support. There was also partisan debate over the Children’s Hospital Graduate Medical Education (GME) Support Reauthorization Act of 2023’s provision to ban certain gender-affirming care procedures from being performed at GME-supported Children’s Hospitals. The committee advanced several bipartisan bills to reauthorize health care and research programs on pediatric cancer, premature birth, maternal mortality, sickle cell disease and heritable blood disorder research, the dental workforce, substance use disorder, and the firefighter cancer registry. There was also bipartisan support for a bill to clarify Medicaid’s authority to leverage direct primary care and other models to improve primary care. A bill to allow employers to offer stand-alone coverage of telehealth-only services to certain employees advanced with support from all Republicans and one Democrat, Rep. Angie Craig (D-MN).
The House Committee on Small Business held a hearing on, “Burdensome Red Tape: Overregulation in Health Care and the Impact on Small Businesses.” On Wednesday (July 19), the Committee held a hearing to discuss the impact of overregulation on independent physician practices. During the hearing, committee members and witnesses spoke in favor of easing the regulatory burden on physicians — including streamlining quality metrics, the prior authorization process, and the No Surprises Act’s independent dispute resolution process — as a way to address consolidation in health care.
The House Energy and Commerce Health Subcommittee held a hearing, “Innovation Saves Lives: Evaluating Medicare Coverage Pathways For Innovative Drugs, Medical Devices, And Technology.” On Tuesday (July 18), the Subcommittee held a hearing on medical innovations. During the hearing, several Republican members spoke critically about the impact over regulation can have on medical innovations and criticized CMS’ recent proposed plan for the transitional coverage for breakthrough devices. Throughout the hearing, lawmakers also spoke critically about CMS’ coverage of Alzheimer’s disease treatments.
House Veterans Affairs Subcommittee on Health held a markup of health care bills. On Tuesday (July 18), the Subcommittee advanced several bills aimed at improving veterans’ health care, including bills to increase veterans’ access to long-term care, establish new suicide prevention programs, and more.
House Committee on Oversight and Accountability held a hearing, “Why Expanding Medicaid to DACA Recipients Will Exacerbate the Border Crisis.” On Tuesday (July 18), the Committee held a hearing on HHS’ proposal to expand Deferred Action for Childhood Arrivals (DACA) recipients’ access to health care through federal health care programs, including Medicaid. The Committee heard testimony from Ellen Montz, CMS deputy administrator and director of the Center for Consumer Information and Insurance Oversight.
Reports, Studies, and Journals
HHS Office of Inspector General: High Rates of Prior Authorization Denials by Some Plans and Limited State Oversight Raise Concerns About Access to Care in Medicaid Managed Care. The report sought to determine whether Medicaid managed care organizations (MCOs) inappropriately delayed or denied care for Medicaid enrollees. The report found MCOs included in the review denied one-in-eight prior authorization requests in 2019 and details recommendations states should take to improve access to care.
Health Affairs: State Funding For Substance Use Disorder Treatment Declined In The Wake Of Medicaid Expansion. The study found state funding for substance use disorder treatment and prevention varied across states in 2019, with funding declining in Medicaid expansion states relative to non-expansion states.
Government Accountability Office: Fiscal Year 2024 Performance Plan. The report highlights GAOs past activities and details the GAOs strategic plans and objectives for FY 2024, which include “programs and financing to serve the health needs of an aging and diverse population.”