October 30, 2023
This Week in Health Policy for October 30
This Week (Oct. 30 - Nov. 3)
Senate HELP Subcommittee on Employment and Workplace Safety will hold a hearing on “AI and the Future of Work: Moving Forward Together.”
Senate Veterans Affairs Committee will hold a hearing on “Foundation of Care: Examining Research at the Department of Veterans Affairs.”
Last Week (October 23 - 27)
Health Care Highlights
House Republicans elect Johnson as Speaker. On Wednesday (October 25), Rep. Mike Johnson (R-LA) was elected Speaker of the House with all 220 Republicans voting in support. Speaker Johnson was the fourth candidate for the position in a three-week process. He has set an ambitious schedule for regular-order consideration of appropriations bills with the Labor and Health and Human Services (HHS) and Education appropriations bill tentatively scheduled the week of November 13. Johnson’s plan includes a continuing resolution (CR) after November 17 that would end either January 15 or April 15 to avoid a year-end omnibus. Johnson was lesser known than other candidates prior to his ascension to the Speaker role, which was widely observed to have been a benefit in a chamber with many relatively new members, some with an aversion to the Washington establishment. Johnson favors more conservative health policy, previously chairing the 2019 Republican Study Commission, which proposed several health care policies, including raising Medicare’s eligibility age, transitioning Medicare to a “premium support” system, and expanding coverage options through direct primary care, as well as Association Health Plans and Short-term, Limited Duration Plans and more.
Biden administration issues No Surprises Act IDR proposed rule. On Friday (October 27), the departments of Health and Human Services, Labor and the Treasury issued a proposed rule to update the No Surprises Act’s independent dispute resolution (IDR) process. The rule, which will be open for public comment for 60 days, includes new information requirements for plans issuing the initial payment or payment denial notice, changes to the batching requirements for items and services, and changes throughout the IDR process, including the open negotiation period, the dispute eligibility review, and the payment and collection fees related to the process.
ONC publishes findings on data sharing. On Thursday (October 26), the Office of the National Coordinator for Health IT published a blog highlighting new data from the 2022 Health Information National Trends Survey that found about 60% of US residents are comfortable with health care providers sharing their social needs data with other providers.
HRSA issues reminder to hospital outpatient departments on 340B compliance. On Thursday (October 26), the Health Resources & Services Administration (HRSA) issued a Notice in the Federal Register to inform and remind stakeholders of the registration requirements for off-site, outpatient hospital facilities to participate in the 340B Drug Pricing Program.
NLRB publishes rule on joint-employer status. On Thursday (October 26), the National Labor Relations Board (NLRB) issued a final rule outlining a new standard for determining joint-employer status under the National Labor Relations Act, when separate organizations must bargain with a union jointly. Effective December 26, 2023, NLRB could consider an entity a joint employer of a group of employees if each entity has an employment relationship with the employees and they share or codetermine one or more essential terms and conditions of employment.
HHS, CISA issue cybersecurity guidance. On Wednesday (October 25), HHS and the Cybersecurity and Infrastructure Security Agency (CISA) released a cybersecurity tool kit to help health care entities protect against cyberattacks. Speaking with reporters, HHS Deputy Secretary Andrea Palm said the agency is considering “all our options” to protect sensitive personal information, including tying minimum cybersecurity requirements to payments under federal health programs.
CMS opens HealthCare.gov. On Wednesday (October 25), CMS opened HealthCare.gov for consumers to begin window shopping for 2024 qualified health plans (QHPs) ahead of the start of open enrollment on November 1. CMS said there are 210 total QHP issues for the 2024 open enrollment period, down from nine last year. According to CMS, pre-tax credit premiums for benchmark plans rose 4% over last year.
Hearings, Markups, and Other Committee Action
Senate HELP Committee held a field hearing in New Brunswick, NJ on “Overworked and Undervalued: Is the Severe Hospital Staffing Crisis Endangering the Well-Being of Patients and Nurses?” On Friday (October 27), the Senate HELP Committee held a field hearing focused on staffing challenges hospitals are facing and the impact on patient care. The Committee heard from a panel of witnesses representing nurses, nursing unions, health care staffing firms, academics, and hospitals.
House Energy & Commerce Health Subcommittee held a hearing on “Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care.” On Wednesday (October 25), the Subcommittee held a hearing focused on policies included in two recent CMS proposals: 1) the proposed minimum staffing ratios for registered nurses (RNs) and certified nurse aides (CNAs) at long-term care facilities, 2) the proposal to require home health agencies to pass through a minimum 80% of all Medicaid payments to the direct workforce. During the hearing, lawmakers heard from a panel of witnesses representing nursing home administrators, home health agency administrators, certified nurse aides, and consumer advocates. Republicans and their witnesses spoke in opposition of the rules’ top-down mandates while Democrats and their witnesses largely spoke in favor of the Biden administration’s effort to address staffing shortages among long-term care facilities and home health agencies.
Senate Finance Committee held a hearing on “Exploring Paid Leave: Policy, Practice, and Impact on the Workforce.” On Wednesday (October 25), the Committee held a hearing on paid leave, with lawmakers raising questions on the costs of such programs to businesses, the potential economic growth that would come from expanded paid leave policies, the value of “comprehensive paid leave, and the role of the federal government in setting paid leave policy. The Committee heard from a panel of witnesses representing employers, consumer advocates, research analysts, and small businesses.
Senate HELP Committee will hold an executive session on nominations for NIH and others. On Wednesday (October 25), the Committee advanced President Biden’s nomination of Monica Bertagnolli to head the National Institutes of Health to the Senate for a floor vote. Chair Bernie Sanders (I-VT) and five Republican members voted against the nomination.
The Senate Special Committee on Aging held a hearing on “Unlocking Hope: Access to Therapies for People with Rare, Progressive, and Serious Diseases.” On Thursday (October 26), the Special Committee held a hearing during which lawmakers heard testimony from a panel of witnesses representing providers and patients with rare diseases, as well as experts in medical ethics. During the hearing, lawmakers spoke about a recently introduced bipartisan bill, the Promising Pathway Act, that would allow the time-limited provisional approval of drugs intended to treat rare diseases.
Senate Veterans Affairs Committee held a hearing on “VA Accountability and Transparency: A Cornerstone of Quality Care and Benefits for Veterans.” On Wednesday (October 25), the Committee held a hearing focused on ways to hold the VA accountable for providing high-quality care to veterans. During the hearing, Chair Jon Tester (D-MT) discussed his bipartisan bill, the Leadership, Engagement, Accountability, and Development (LEAD) Act of 2023, to improve the Department’s ability to identify wrongdoing and hold leadership and employees accountable.
Reports, Studies, and Journals
HHS Office of Inspector General: CDC's Internal Control Weaknesses Led to Its Initial COVID-19 Test Kit Failure, but CDC Ultimately Created a Working Test Kit. The report found weaknesses in CDC’s internal control standards during the development of COVID-19 testing kits that may have led to early quality issues with the kits.
Government Accountability Office: Mental Health Services: State Should Collect Ongoing Feedback to Ensure Overseas Employees' Needs Are Being Met. The report recommends states collect ongoing feedback on mental health services to ensure they are meeting the needs of overseas workers.
Commonwealth Fund: Paying for It: How Health Care Costs and Medical Debt Are Making Americans Sicker and Poorer. A new affordability survey of U.S. adults found many Americans have inadequate coverage that results in delayed or forgone care.