March 4, 2024 This Week in Health Policy for March 4 This Week (March 4 - 8) The House and Senate are both in session this week and lawmakers are expected to work to advance FY 2024 appropriations. There also is expected to be some health care activity in committees: House Committee on Oversight and Accountability will hold a hearing on "Examining the White House's Role in Pandemic Preparedness and Response."
Senate Budget Committee will hold a hearing on "How Primary Care Improves Health Care Efficiency."
The Senate Health, Education, Labor & Pensions Committee will hold a hearing on "The Older Americans Act: Supporting Efforts to Meet the Needs of Seniors."
The Senate Committee on Veterans' Affairs will hold a hearing on "Legislative Presentation of Disabled American Veterans."
Last Week (February 26 - March 1) Health Care Highlights Congress gets more time to resolve FY 2024 funding. On Thursday (February 29), Congress passed another two-step continuing resolution (CR) to avert a partial government shutdown. The latest CR extends deadlines for Military Construction-Veterans Affairs (VA); Agriculture, which includes funding for the FDA; Transportation-Housing and Urban Development (HUD); and Energy & Water appropriations set to expire March 1 to March 8, while deadlines for the Department of Health and Human Services (HHS) and the remaining appropriations bills are extended from March 8 to March 22. The House approved the Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) in a 320-99 vote, while the Senate voted 77-13 to approve the bill, after four amendment votes failed. With the new CR, the hope is for appropriators to soon release and pass the first tranche of FY 2024 appropriations bills. This package could include Military Construction-VA; Agriculture, which includes funding for the FDA; Transportation-HUD; and Energy & Water — and two additional bills, on Interior and Financial Services and General Government. Lawmakers will need more time to negotiate HHS and the remaining spending bills. Lawmakers also are still working out a limited health care package that could ride with appropriations legislation. Items on the table could include health care extenders like funding for community health centers and the special diabetes programs, as well as delaying cuts to Disproportionate Share Hospitals (DSH) and a partial remedy of the 3.4% Medicare physician fee cuts. Other long-debated proposals on pharmacy benefit manager reforms, transparency policies, SUPPORT Act provision reauthorization, and certain pandemic preparedness authorities could be pushed to later in the year or the lame-duck session when Congress also will face Medicare telehealth waiver expiration deadlines. CMS issues final guidance on Medicare prescription payment plan. On Thursday (February 29), the Centers for Medicare and Medicaid Services (CMS) issued final part one of the guidance implementing the Inflation Reduction Act's Medicare Prescription Payment Plan. The guidance focuses on the operational requirements for the program and includes several updates from the proposal, including requiring Part D sponsors and pharmacies to use a $600, single prescription POS threshold to identify enrollees likely to benefit. CMS originally sought input on a range between $400-$700. CMS released draft part 2 guidance on February 15 and is accepting comments on through March 16. Biden issues EO to protect Americans' data. On Wednesday (February 28), President Biden issued a new Executive Order to Protect Americans' Sensitive Personal Data. The EO includes some directives for departments and agencies to issue new regulations and standards to protect Americans' data, including health data. For example, the EO directs the Departments HHS, Defense, and the VA to help ensure that federal grants, contracts, and awards are not used to help "countries of concern" access Americans' sensitive health data, including via US-based companies. CDC issues new guidance for respiratory viruses. On Friday (March 1), the Centers for Disease Control and Prevention (CDC) updated its guidance on COVID-19 isolation, removing the 5-day isolation recommendation for those who test positive for COVID-19. Instead, CDC now advises people who test positive for COVID-19 to resume normal activities if their symptoms are mild and they've gone 24 hours without a fever, bringing those guidelines into alignment with other respiratory illnesses. Biden administration finalizes religious anti-discrimination rule. On Friday (March 1), nine federal agencies, including HHS, issued a final rule that prohibits religious organizations providing social services through federal grants or vouchers from withholding services from beneficiaries based on their religion. The rule also prohibits such organizations from requiring individuals receiving federally-backed services to participate in religious services. ARPA-H unveils AI-driven project to tackle rare diseases. On Wednesday (February 28), the Advanced Research Projects Agency for Health (ARPA-H) announced a new project, the ML/AI-Aided Therapeutic Repurposing In eXtended uses (MATRIX) project, that aims to build a machine learning platform to accelerate the development of treatments for rare diseases that lack existing therapies. HHS announces new initiatives to improve behavioral health access. On Monday (February 26), the Substance Abuse and Mental Health Services Administration (SAMHSA), announced $36.9 million in grant funding opportunities for programs supporting behavioral health services. In addition, CMS released new guidance to state Medicaid directors expanding the pool of behavioral health care providers eligible for enhanced Medicaid dollars to include marriage and family therapists as well as mental health counselors. The guidance also allows federal funds to be used to support Nurse Advice Lined available to Medicaid beneficiaries. ICYMI: Health Care Highlights from the Recess ARPA-H unveils project to accelerate women's health research. On February 21, ARPA-H announced a new $100 million funding initiative, the ARPA-H Sprint for Women's Health, to improve investment in research and development into women's health. ARPA-H will announce specific topics as part of a new request for solutions funding opportunities. Senate HELP Committee releases white paper on HIPAA modernization: On February 21, Senate Health, Education, Labor & Pensions (HELP) Committee Ranking Member Bill Cassidy (R-LA), released a white paper that explores legislative proposals to improve privacy protections for Americans' health data. The proposals fall into three categories: 1) Updates to the existing Health Insurance Portability and Accountability Act (HIPAA) framework; 2) Health data in areas where regulation may be unclear, including intake services, the removal of health data from HIPAA, patient-generated wellness data, sensor-generated data and direct-to-consumer-collected genetic data; and 3) Data outside of HIPAA. The white paper follows an RFI issued in September 2023 seeking feedback on ways to safeguard Americans' health data. House creates bipartisan AI task force: On February 20, House Speaker Mike Johnson (R-LA) and Democratic Leader Hakeem Jeffries (D-NY) announced a task force to explore legislative solutions to ensure the US continues to lead the world in AI innovation while considering guardrails that may be appropriate. The task force consists of 24 members representing key committees of jurisdiction, with 12 appointed by each party leader. Hearings, Markups, and Other Committee Activity House Energy and Commerce Subcommittee on Health held a hearing on "Legislative Proposals To Support Patients With Rare Diseases." On Thursday (February 29), the Subcommittee held a hearing on increasing access to care for patients with rare diseases. During the hearing, lawmakers heard from a panel of witnesses representing academics, rare disease patient advocates, and rare disease providers. Witnesses and lawmakers discussed 18 bills aimed at helping patients with rare diseases, including measures to expand the number of orphan drugs exempted from the Inflation Reduction Act's (IRAs) Medicare Drug Price Negotiation Program, create a safe harbor in the CMS anti-kickback statute for some forms of gene therapy patient assistance, and renew the FDA's pediatric priority review voucher program.
Senate Budget Committee held a hearing on "No Rights to Speak of: The Economic Harms of Restricting Reproductive Freedom." On Wednesday (February 28), the Committee held a hearing on the economic impacts of restricting access to abortion and other reproductive care. The Committee heard testimony from witnesses representing patient advocates, providers, and academics.
Reports, Studies, and Journals Health Affairs: TennCare Disenrollment Led To Increased Eviction Filings And Evictions In Tennessee Relative To Other Southern States. The study looked at eviction outcomes after a large, mandatory Medicaid disenrollment in Tennessee in 2005 and found a 27.6% increase in the average annual number of eviction filings at the county level from 2005 to 2009 and a 24.5% increase in the average annual number of completed evictions at the county level during that same period. CMS: National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Reports. The report, which includes an assessment of nearly 500 quality measures across 26 programs, found that many measures had worse than expected performance in 2020 and 2021. Government Accountability Office: Maternal Health: HHS Should Improve Assessment of Efforts to Address Worsening Outcomes. The report found that maternal mortality and other adverse outcomes associated with pregnancy or childbirth worsened in 2020 and 2021, compared with 2018 and 2019. Disparities in maternal health outcomes persisted during the pandemic for certain groups.
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