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May 13, 2024

This Week in Health Policy for May 13

This Week (May 13 - 17)

Senate Finance Committee will hold a hearing on "Rural Health Care: Supporting Lives and Improving Communities."

  • Date: Thursday, May 16 at 10am ET
  • Witnesses: Keith Mueller, Gerhard Hartman Professor of Health Management and Policy, Director, Rural Policy Research Institute (RUPRI); Lori Rodefeld, Director of GME Development at the Wisconsin Residency Planning and Development Technical Assistance Center; Michael Topchik, Partner, Chartis Center for Rural Health; Jeremy Davis, President and CEO of Grande Ronde Hospital and Clinics
  • More information available here.

Senate Health, Education, Labor & Pensions Committee will hold a hearing on "Examining the Dental Care Crisis in America: How Can We Make Dental Care More Affordable and More Available?"

  • Date: Thursday, May 16 at 10am ET
  • More information available here.

House Committee on Oversight and Accountability will hold a hearing on "Overseeing the Overseers: A Hearing with NIH Deputy Director Lawrence Tabak."

  • Date: Thursday, May 16 at 9am ET
  • More information available here.

House Committee on Oversight and Accountability will hold a mark up on bills including the BIOSECURE Act

  • Date: Wednesday, May 15 at 10am ET
  • More information available here.

House Committee on Education & the Workforce will hold a hearing on "Examining the Policies and Priorities of the Department of Health and Human Services."

  • Date: Wednesday, May 15 at 10:15am ET
  • Witness: Xavier Becerra, Secretary, U.S. Department of Health and Human Services
  • More information available here.

Last Week (May 6 - 10)

Health Care Highlights

DOJ unveils new anti-trust task force focused on health care. On Thursday (May 9), the Department of Justice (DOJ) announced a new task force on Health Care Monopolies and Collusion tasked with guiding the DOJ's anti-trust division's enforcement strategy and policy approach in health care.

CMS extends Medicaid unwinding flexibilities. On Thursday (May 9), the Centers for Medicare & Medicaid Services(CMS) extended through June 30, 2025, waivers to help Medicaid beneficiaries retain coverage as states go through the Medicaid redetermination process. CMS noted that states were originally scheduled to finish their unwinding processes by June 2024, but many states will continue those processes beyond June.

CMS unveils mandatory kidney transplant payment model. On Wednesday (May 8), CMS released a proposed rule for the Increasing Organ Transplant Access Model, a new mandatory six-year payment model designed to test whether performance-based incentives or penalties for participating transplant hospitals would increase access to kidney transplants for patients with end-stage renal disease, maintain or improve care quality, improve equitable access to kidney transplants and lower Medicare expenditures. The model, which would launch January 1, 2025, is expected to include 90 non-pediatric transplant facilities conducting at least 11 kidney transplants during a three-year baseline period. Click here for a fact sheet.

FTC reaches $7.8M settlement with BetterHelp. On Monday (May 6), the Federal Trade Commission (FTC) announced online therapy firm BetterHelp has agreed to pay $7.8 million to settle FTC allegations that the company used and shared consumers' health data with third-party companies, including Facebook and Snapchat, for advertising. FTC initially announced the charges in March 2023.

Hearings, Markups, and Other Committee Activity

House Ways and Means Committee held a markup of telehealth and rural health access bills. On Wednesday (May 8), the Committee advanced six bills to extend Medicare telehealth flexibilities, extend the Acute Hospital Care at Home Program, and support access to care in rural areas, paid for in part by provisions to reform Pharmacy Benefit Manager (PBM) practices. The bills advanced were:

  • H.R. 8261, the "Preserving Telehealth, Hospital, and Ambulance Access Act." The bipartisan bill sponsored by Reps. David Schweikert (R-AZ) and Mike Thompson (D-CA) includes a two-year extension for Medicare telehealth flexibilities set to expire at the end of 2024, including those waiving geographic requirements and expanding originating sites to include the patient's home, expanding the types of practitioners who can be reimbursed by Medicare for telehealth services, allowing federally qualified health centers (FQHCs) and rural health clinics (RHCs) to provide telehealth services, allowing Medicare to reimburse for audio-only visits, and allowing hospice recertification via telehealth. The bill also would delay until January 1, 2027, in-person requirements for tele-mental health services, extend until January 1, 2027, flexibilities allowing FQHCs and RHCs to provide tele-mental health services, and extend until 2029 the Acute Hospital Care at Home program. The bill includes extenders the low-volume hospital adjustment, the Medicare dependent hospital program, and add-on payments for ambulance services. The bill seeks to partially offset the costs of the extensions by reforming PBM policies, phasing in changes to clinical laboratory payments over a longer period and extending adjustments to hospice pay to 2034. The bill's PBM reforms include a delinking provision, which would prohibit PBMs and affiliates from deriving any remuneration other than "bona fide service fees" for Part D drugs for plan years on or after January 1, 2027; new transparency requirements related to PBM pricing guarantees and cost performance evaluations; and reporting requirements for PBMs to plan sponsors and the HHS Secretary.
  • H.R. 7931, the "Preserving Emergency Access in Key Sites Act" (PEAKS Act). The bipartisan bill sponsored by Reps. Miller (R-WV) and Yadira Caraveo (D-CO) clarifies that Medicare will pay the critical access hospital (CAH) rate for CAH-owned ambulances located a 15-mile drive away in mountainous areas or areas accessible only by secondary roads (as opposed to the 35-mile drive requirement) and ensures that CAHs located in mountainous areas can retain their CAH status even if another hospital encroaches on the 15-mile threshold.
  • H.R. 8245, the "Rural Hospital Stabilization Act." The bill sponsored by Rep. Randy Feenstra (R-IA) would create a rural hospital stabilization pilot grant program at the Office of Rural Health Policy to award grants to rural hospitals and technical assistance providers to be used for minor renovations, care delivery training, hiring new staff or supplementing compensation for existing staff.
  • H.R. 8244, the "Ensuring Seniors' Access to Quality Care Act." The bipartisan bill sponsored by Reps. Ron Estes (R-KS) and Gerry Connolly (D-VA) would allow nursing homes to continue operating Certified Nurse Assistant/Aide (CNA) training programs if they incur certain fines unrelated to direct resident care.
  • H.R. 8235 the "Rural Physician Workforce Preservation Act." The bill sponsored by Rep. Greg Murphy (R-NC) would amend statute to ensure 10% of newly created graduate medical education (GME) slots go to rural teaching hospitals.
  • H.R. 8246, the "Second Chances for Rural Hospitals Act." The bill sponsored by Rep. Jodey Arrington (R-TX) expands CAH access to the rural emergency hospital (REH) designation by moving back the eligibility date for a closed CAH from December 27, 2020, to January 1, 2014.
  • More information available here.

Senate Budget Committee held a hearing on "Reducing Paperwork, Cutting Costs: Alleviating Administrative Burdens in Health Care." On Wednesday (May 8), the Committee held a hearing during which lawmakers and witnesses discussed ways to reduce administrative burdens in health care, including those tied to prior authorizations and duplicative or overlapping quality metrics. During the hearing, several lawmakers and witnesses discussed the potential for AI to help alleviate some of providers' administrative burdens and the need to address fraud and abuse in Medicare. During the hearing, Senator Roger Marshall (R-KS) announced he would soon re-introduce the "Improving Seniors' Timely Access to Care Act," a bipartisan bill to streamline Medicare Advantage (MA) prior authorization processes, noting that the Congressional Budget Officer (CBO) told lawmakers the bill's cost would be reduced from $16 billion to zero.

  • More information available here.

Senate Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies held a hearing on "A Review of the President's Fiscal Year 2025 Budget Request for the Food and Drug Administration." On Wednesday (May 8), the Subcommittee heard testimony from FDA Commissioner Robert Califf on the agency's FY 2025 budget request. During the hearing, Califf fielded questions on a range of topics including the use of AI and food safety amid the ongoing avian flu outbreak on dairy farms.

  • More information available here.

House Ways and Means Committee held a field hearing on "Empowering Native American and Rural Communities." On Friday (May 10), the Committee held a field hearing in Scottsdale, Arizona. The hearing included discussion of the health care provider shortage in rural areas and the lack of access to hospital and emergency care.

  • More information available here.

Reports, Studies, and Journals

Department of Treasury: 2024 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Fund. The report projects that the hospital insurance trust fund will remain solvent until 2036, which is five years longer than last year's report. The report attributes the extended insolvency date to several factors, including a policy change updating how medical education expenses are accounted for in MA rates, higher payroll tax income, and lower than projected 2023 expenditures.

Congressional Budget Office: Budgetary Outcomes Under Alternative Assumptions About Spending and Revenues. The report highlights the budgetary implications of alternative assumptions about future funding for discretionary programs, including permanently enacting the enhanced premium tax credits and changes related to the 2017 tax bill.

Food & Drug Administration: 2023 Office of New Drugs Annual Report: Breaking Barriers to Advance Public Health. The report shows that FDA's Office of New Drugs approved 55 new drugs in 2023, up from 37 new drugs in 2022. According to the report, about half of 2023 new drug approvals were for rare diseases.

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Contact Information

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Washington Council Ernst & Young