January 22, 2024
This Week in Health Policy for January 22
This Week (January 22 - 26)
The House will be in recess this week, while the Senate will be in session.
Last Week (January 15 - 19)
Health Care Highlights
Congress temporarily extends government funding with some health extenders. On Friday (January 19), President Biden signed into law a continuing resolution (CR) to temporarily extend government funding. The latest two-step CR funds the Military Construction-Veterans Affair; Agriculture, which includes the Food and Drug Administration (FDA); Transportation-HUD; and Energy & Water appropriations bills through March 1 and the remainder of appropriations, including those for the Health and Human Services (HHS) Department, through March 8. The bill includes some temporary health care extenders authorizing funding for certain pandemic preparedness services, community health centers, the National Health Service Corps and Teaching Health Center Graduate Medical Education until March 8. The bill also delays Medicaid Disproportionate Share Hospital cuts through March 8 and extends the physician payment work Geographic Practice Cost Indices floor. However, the bill leaves out several other health care program extenders and does not address the 3.4% cut to the Medicare Physician Fee Schedule conversion factor, which took effect on January 1. The focus is once again on how and whether a longer-term deal on spending can be reached before the latest deadlines and whether lawmakers can find bipartisan, bicameral policies to offset the expiring health care extenders.
CMS issues interoperability and prior authorization final rule. On Wednesday (January 17), the Centers for Medicare and Medicaid Services (CMS) issued the CMS Interoperability and Prior Authorization final rule (CMS-0057-F), aimed at improving the electronic exchange of health information and prior authorization processes. The rule requires certain insurers to implement three new APIs, adds new data to the existing Patient Access API, and establishes new standards for timely data sharing and prior authorization processes and decision-making. Most of the polices that require API development and enhancement have compliance dates in 2027 (one year later than proposed), while various operational and prior authorization process policies have compliance dates in 2026. Click here for a press release. Click here for a fact sheet. Click here for the final rule.
CMS announced new behavioral health payment model. On Thursday (January 18), CMS announced a new payment model, the Innovation in Behavioral Health (IBH) Model, that will launch in the Medicaid and Medicare programs to test approaches to better integrate physical, behavioral and health-related social services to improve patient outcomes and reduce emergency department use. CMS will select up to eight states, the District of Columbia, or US territories to run the models and community-based behavioral health organizations in selected areas will be able to apply to participate in both the Medicare and Medicaid payment models. The payment model, which will run for eight years, will launch this Fall with funding opportunities expected in the spring. Click here for a press release. Click here for a fact sheet. Click here for an FAQ.
TEFCA seeks feedback on documents to support greater HL7 FHIR® use. On Friday (January 19), the Trusted Exchange Framework and Common Agreement (TEFCA), as part of the Sequoia Project, released a bundle of new draft materials to support greater use of HL7 FHIR® and make other improvements to the framework. Stakeholders have through February 5th to provide feedback online. Stakeholders who wish to learn more can attend a three-part webinar series. Click here for the draft documents. Click here for the webinar registration.
Departments reopen comment period for IDR Operations proposed rule. On Wednesday (January 17), HHS, Labor and the Treasury departments announced they will reopen the public comment period for an October 2023 proposed rule to update the No Surprises Act independent dispute resolution (IDR) process for 14 days beginning January 22 to provide additional time for interested parties to comment.
ARPA-H announces program to increase care access in rural areas. On Tuesday (January 16), the Advanced Research Projects Agency for Health (ARPA-H) announced the Platform Accelerating Rural Access to Distributed & InteGrated Medical care (PARADIGM) program. The program aims to create a scalable multi-functional, electric vehicle platform that can provide hospital-level care in rural communities and settings with limited resources.
CMS releases Hospital Care at Home data. On Tuesday (January 16), CMS publicly released data on the Acute Hospital Care at Home initiative. The data, which is released through the Research and Data Assistance Center (ResDAC), covers collected from November 27, 2020, through March 30, 2023.
House passes HR 6918, the "Supporting Pregnant and Parenting Women and Families Act." On Thursday (January 18), the House voted 214-208, along party lines, to pass a bill that would block the Biden administration's proposed rule that targets Temporary Assistance for Needy Families (TANF) funds for pregnancy prevention programming and restricts states from funding programs, including through entities sometimes known as crisis pregnancy centers or pregnancy resource centers, that primarily provide pregnancy counseling to women only after they become pregnant. The bill is unlikely to be taken up in the Democrat-controlled Senate.
Supreme Court hears oral arguments in case challenging agency authority . On Wednesday (January 17), the Supreme Court heard oral arguments in cases that seek to overturn the "Chevron deference," in which the courts defer to federal agencies' interpretation of statute where the plain meaning is not entirely clear. While the cases focus on federal oversight of herring fishing, health and legal experts say it overturning the 1984 Chevron ruling could impact federal health regulations.
Hearings, Markups, and Other Committee Action
Senate HELP Committee to vote on drugmaker CEO subpoenas. On Thursday (January 18), Senate HELP Committee Chair Bernie Sanders (I-VT) announced that the panel on January 31 will hold a vote on whether to issue subpoenas for the CEOs of Johnson & Johnson and Merck to provide testimony about why drug prices are higher in the United States than other comparable countries. This comes after Committee Democrats invited the CEOs of Johnson & Johnson, Merck, and Bristol Myers Squibb to testify at a hearing.
House Energy and Commerce Committee appoints new subcommittee chair. On Thursday (January 18), Chair Cathy McMorris Rodgers (R-WA) announced that Rep. Buddy Carter (R-GA) will serve as Chair of the Environment, Manufacturing, and Critical Materials Subcommittee, replacing Rep. Bill Johnson (R-OH), who is scheduled to retire from Congress later this month.
House Ways & Means Committee held a markup of the Tax Relief for American Families and Workers Act. On Friday (January 19), the committee advanced in a 40-3 vote the $78 billion Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) proposed by Chairman Jason Smith (R-MO) with Senate Finance Committee Chairman Ron Wyden (D-OR), addressing TCJA pre-cliffs and the Child Tax Credit (CTC) plus the United States-Taiwan Expedited Double-Tax Relief Act, disaster relief, affordable housing provisions, provisions to extend a tax deduction for domestic research and development, and more.
Senate Health, Education, Labor, and Pensions Committee held a hearing on "Addressing Long COVID: Advancing Research and Improving Patient Care." On Thursday (January 18), the committee held a hearing during which committee members largely agreed there should be more federal investment in long COVID treatment and diagnosis research, as well as preventive measures. The committee heard testimony from two panels: a panel of patients who shared their firsthand accounts of dealing with long COVID symptoms and a panel of doctors and academics.
House Budget Committee held a markup of Bills HR 5779, HR 6952, and HR 6957. On Thursday (January 18), the House Budget Committee advanced a bill (HR 5779), which creates a 16-member bipartisan commission tasked with tacking the nation's fiscal issues, including looming Medicare Trust Fund insolvency. The bill advanced with the support of all committee Republicans and three committee Democrats, Reps. Earl Blumenauer (D-OR), Scott Peters (D-CA) and Jimmy Panetta (D-CA).
Reports, Studies, and Journals
Government Accountability Office: Public Health Preparedness: HHS Emergency Agency Needs to Strengthen Workforce Planning. The report outlines four recommendations to help the Administration for Strategic Preparedness and Response address workforce planning problems, including setting specific goals and performance measures for the in-house hiring office it is creating.
Kaiser Family Foundation: What Are the Implications of the Recent Elimination of the Medicaid Prescription Drug Rebate Cap? The report examines the impact of the American Rescue Plan's provision to eliminate the cap on the total amount of rebates that drugmakers could provide to the federal government under the Medicaid Drug Rebate program.
Health Affairs. Enrollment Trends In Self-Funded Employer-Sponsored Insurance, 2015 And 2021. The study found that enrollment in self-funded employer-sponsored coverage grew from 55% in 2015 to 60% in 2021.