November 25, 2024 This Week in Health Policy for November 25 This Week (November 25 - 29) Congress will be in recess this week for the Thanksgiving Holiday. This Week in Health Policy will not publish during the recess and will resume December 6. Last Week (November 18 - 22) Health Care Highlights Congress activities in lame duck. This week, Congress continued to work toward its year-end deadlines, though no final agreements have been reached on any of the major priorities prior to the Thanksgiving recess. When Congress returns, they will need to address: A government funding bill, hurricane and disaster relief, the FARM bill, and the National Defense Authorization Act (NDAA). The House has passed five of the 12 annual appropriations bills and the Senate none, as the process to set long-term government funding through the end of the fiscal year (September 30, 2025) got caught up in the election and philosophical differences between House Republicans, who support spending cuts and policy riders, and Senate Democrats, who have sought a more bipartisan approach with Senate Republicans. House Speaker Mike Johnson (R-LA) this week said he may prefer a short-term rather than full-year measure. Leadership also is still determining whether and how to address expiring Medicare telehealth flexibilities, other health care extenders, including funding for community health centers, and mitigation for looming Medicare physician pay cuts. The Biosecure Act also remains on the negotiation table for the NDAA as lawmakers work to address member concerns over the scope of the bill and the entities named in the legislation. Congress continues preparations for 119th Congress. On Tuesday (November 19), House Democrats held leadership elections, re-electing Rep. Hakeem Jeffries (D-NY) as minority leader. Rep. Katherine Clark (D-MA) will serve as minority whip and Rep. Pete Aguilar (D-CA) will serve as caucus chair. The votes follow House and Senate Republican leadership elections last week, during which House Republicans re-elected Rep. Mike Johnson (R-LA) as House Speaker, Rep. Steve Scalise (R-LA) as Majority Leader and Rep. Tom Emmer (R-MN) as Majority Whip. In the Senate, Republicans elected Sen. John Thune (R-SD) as Senate Majority Leader, Sen. John Barrasso (R-WY) as Majority Whip, and Sen. Tom Cotton (R-AR) as Republican Conference Chair. Senate Democrats have not yet scheduled their leadership votes. Trump names new health nominees. On Tuesday (November 19), President-elect Trump announced he has selected Mehmet Oz, a physician and former TV show host, to lead the Centers for Medicare and Medicaid Services (CMS), and on Friday (November 22), Trump selected Janette Nesheiwat, a physician and Fox News contributor, to serve as US Surgeon General, Johns Hopkins surgeon Martin Makary to be FDA administrator, and Dave Weldon, a physician and former congressman from Florida, to lead the Centers for Disease Control and Prevention. In recent years, Makary has written papers and op-eds criticizing the FDA's rare disease drug program and the Medicare provider payment system. Trump on Friday also selected Rep. Lori Chavez-DeRemer (R-OR) to serve as Department of Labor Secretary and Scott Bessent, chief of the hedge fund Key Square Group, to lead to Department of Treasury. The news comes after Trump last week announced Robert F. Kennedy Jr. to serve as the Secretary of the Department of Health and Human Services. The HHS Secretary and CMS administrator must undergo two Senate confirmation committee hearings (Senate Finance Committee and Senate Health, Education, Labor, and Pensions Committee), and then be confirmed by the full Senate with a simple majority, 51, vote. While Kennedy's nomination has garnered some public pushback, Trump has indicated he may seek recess appointments, and House and Senate leaders have said that remains an option. The US Constitution empowers the President to make temporary appointments to vacant positions if the Senate is in recess and cannot hold confirmation votes. The Supreme Court in 2014 ruled that the President's recess authority may only be used if the Senate is in recess at least 10 days. The Senate typically holds "pro forma" sessions to prevent such an occurrence, meaning the Senate would have to vote to allow a 10-day recess in order for the appointments to occur. DOGE leaders share vision in op-ep. On Wednesday (November 20), Elon Musk and Vivek Ramaswamy, Trump's picks to head a new Department of Government Efficiency (DOGE), published a Wall Street Journal op-ed in which they cited an EPA-related Supreme Court ruling and the Loper Bright ruling that overturned the Chevron doctrine that generally required federal courts to defer to agency interpretations of ambiguous statutory provisions. They wrote, "DOGE will work with legal experts embedded in government agencies, aided by advanced technology, to apply these rulings to federal regulations enacted by such agencies. DOGE will present this list of regulations to President Trump, who can, by executive action, immediately pause the enforcement of those regulations and initiate the process for review and rescission." The op-ed also discussed a potential reduction in the federal agency workforce — an action that RFK Jr. has cited has a priority at the National Institutes of Health. Senate Bipartisan Cybersecurity Working Group introduces new bill. On Friday (November 22), the working group, which includes Sens. Bill Cassidy (R-LA), Mark Warner (D-VA), John Cornyn (R-TX), and Maggie Hassan (D-NH), introduced the Health Care Cybersecurity and Resiliency Act of 2024. The bill would provide grants to health entities to support cyberattack prevention and response, require HHS to issue best practices for rural health clinics, improve coordination between HHS and the Cybersecurity and Infrastructure Security Agency, and require HHS to develop and implement a cybersecurity incident response plan. Click here for the bill text. Click here for the section-by-section. CMS publishes national enrollment snapshot. On Friday (November 22), CMS announced that 496,000 new consumers have signed up for a health plan sold through the Affordable Care Act's exchanges since the start of the open enrollment period on November 1. CMS said more than 2.5 million consumers have re-selected in exchange coverage, with total sign ups just over 3 million people. Click here for a fact sheet. CMS publishes guidance on Medicaid substance use disorder coverage and MLR policies. On Tuesday (November 19), CMS published guidance that addresses permanent required coverage of medications to treat opioid use disorder and a permanent state plan option for coverage for individuals who have a substance use disorder and reside in an institution for mental disease. The guidance also addresses the permanent medical loss ratio (MLR) remittance policy. The policies are all required under the Consolidated Appropriations Act, 2024. CMS publishes guide for Medicaid redetermination compliance. On Friday (November 14), CMS published guidance outlining how it will examine state Medicaid agencies compliance with Medicaid redetermination rules and the types of unwinding strategies states are permitted to use. HRSA launches public awareness campaign for maternal mental health hotline. On Friday (November 14), the Health Resources and Services Administration (HRSA) launched a nationwide campaign to raise public awareness of the National Maternal Mental Health Hotline involving pharmacies, grocery stores, hospitals, and other organizations. Hearings, Markups, and Other Committee Activity Senate Judiciary Committee held a markup on patent reforms. On Thursday (November 21), the Committee voted 11-10 to advance the PREVAIL Act (S. 2220), which raises the threshold for patent challenges; requires patents to be challenged before the Patent Trial and Appeal Board or through the courts, instead of both; and more. Sens. Seldon Whitehouse (D-RI), Alex Padilla (D-CA), and Jon Ossoff (D-GA) split from their party to vote no, while Sens. Lindsey Graham (R-SC), Thom Tillis (R-NC), and Marsha Blackburn (R-TN) split from their party to vote yes.
House Appropriations Labor-HHS Subcommittee held a hearing on the National Institutes of Health. On Tuesday (November 19), the Subcommittee heard testimony from NIH Director Monica M. Bertagnolli during which she spoke of NIH's plans to focus more on gene therapies for rare diseases and sought to defend NIH, saying it "concentrates on science, not on politics."
Reports, Studies, and Journals Government Accountability Office: Private Health Insurance: Market Concentration Generally Increased from 2011 through 2022. The report found that market concentration increased from 2011 through 2022 across the individual, small group, and large group markets. GAO did not make any recommendations. CMS: Comprehensive Medicaid Integrity Plan for Fiscal Years 2024—2028. The plan outlines CMS initiatives to combat fraud, waste, and abuse in Medicaid and the Children's Health Insurance Program, including managed care oversight, data sharing and collaboration, and other program integrity efforts.
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