Health Care Checkup
December 4, 2020
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What Happened This Week
Funding for the federal government runs out on December 11. Congressional leaders are continuing to negotiate a spending package and have been trying to attach COVID relief aid onto the bill. On Tuesday, a bipartisan group of lawmakers introduced a $908 billion coronavirus aid package. The new package comes after months of partisan back-and-forth over the contents and price tag of an additional COVID relief deal. This bipartisan legislation was developed by Bill Cassidy (R-LA), Susan Collins (R-ME), Angus King (I-ME), Joe Manchin (D-WV), Mitt Romney (R-UT), and Mark Warner (D-VA.) The proposal includes $160 billion for state and local governments, $180 billion in aid for unemployed Americans, and approximately $300 billion in support for small businesses. Additionally, tens of billions of dollars would be devoted to education, agriculture, rental assistance, and pandemic-related health care priorities. President-elect Joe Biden and Democratic leaders Chuck Schumer (D-NY) and Nancy Pelosi (D-CA) announced their support for the bipartisan deal as a starting point for additional negotiations. However, Senate Majority Leader Mitch McConnell (R-KY) has been still trying to garner support for the $550 billion Senate GOP plan that has already failed twice this fall.
Also on Tuesday, The Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) convened to vote on which groups should be the first to receive the COVID-19 vaccine. Given that there will be a limited number of doses available initially, the committee discussed who should be prioritized when the vaccine is first made available. The ACIP, which is an independent group of vaccine recommendation experts, decided that health care workers and long-term care facility residents should be the first populations to receive the vaccine. The Committee’s recommendations are not binding, but states often look to this guidance.
Both Pfizer and Moderna have applied for emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA). The FDA currently has a meeting scheduled for December 10 with its Vaccines and Related Biological Products Advisory Committee (VRBPAC) to discuss Pfizer’s request for EUA.
Several congressional committee leaders were elected this week for the 117th Congress. Rep. Cathy McMorris Rodgers (R-WA) was tapped on Wednesday by the GOP to serve as the ranking member of the House Energy and Commerce Committee, making history as the first woman from either party to serve in this role. Rep. Rosa DeLauro (D-CT) was selected to be the next chair of the House Appropriations Committee, a position that will give her wide federal spending control. Additionally, Rep. Richard Neal (D-MA), the current chairman of the House Ways and Means Committee, was reelected for that same role.
President-elect Joe Biden formally announced the head members of his economic team. The nominees and appointees include field experts and those who have worked in prior Democratic administrations. The Biden-Harris transition team has not yet announced who the new administration’s health leaders will be, but an announcement on that front is likely to be made as early as next week. Various reports state that Biden’s top choices for Secretary of Health and Human Services have come down to New Mexico Governor Michelle Lujan Grisham, Rhode Island Governor Gina Raimondo, or former Surgeon General Vivek Murthy.
The Centers for Medicare and Medicaid Services (CMS) released its annual Physician Fee Schedule (PFS) final rule. The rule will increase Medicare reimbursements for physicians who primarily utilize office and outpatient visits to care for their patients and for those who invest time in managing their patients’ chronic conditions. However, there will be a decrease in Medicare reimbursement rates for providers who have less office billings.
On Wednesday, the Trump Administration finalized policies that aim to “give Medicare patients and their doctors greater choices to get care at a lower cost in an outpatient setting.” The Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule contains changes that include eliminating the inpatient only list, adding 11 procedures to the ASC covered procedures list (CPL), and reducing reimbursement rates to hospitals for 340B-acquired drugs.
On Thursday, The Department of Health and Human Services (HHS) announced its new plan and partnership to reduce maternal-related deaths and disparities in the U.S. The Action Plan provides an outline for “addressing risk factors before and during pregnancy, improving the quality of and access to maternity and postpartum care, and supporting a research agenda to fill gaps in current evidence.”
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What to Expect Next Week
Both the House and the Senate will be in session next week. Congress is poised to pass the National Defense Authorization Act (NDAA) for Fiscal Year 2021, despite President Trump’s veto threat. The President has said he will veto the NDAA if lawmakers do not include provisions eliminating legal protections for social media companies. However, lawmakers on both sides of the aisle agree such measures are unrelated to the annual defense bill. On Tuesday, President Trump is set to hold a “Vaccine Summit” at the White House with state, military, and scientific leaders. On Thursday, the Senate Commerce Committee will conduct a hearing to examine the logistics of transporting a Covid-19 vaccine throughout the country. Congress will also continue its sprint to complete legislation that would fund the federal government beyond the December 11 deadline. It remains to be seen whether COVID-19 relief will be tied to the bill.
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Bipartisan COVID-19 Stimulus Deal Introduced, Could Help Bridge Differences Between GOP and Democratic Congressional Leaders
On Tuesday, a bipartisan group of lawmakers introduced a $908 billion coronavirus aid package. The new package comes after months of partisan back-and-forth over the contents and price tag of an additional COVID relief deal. This bipartisan legislation was developed by Bill Cassidy (R-LA), Susan Collins (R-ME), Angus King (I-ME), Joe Manchin (D-WV), Mitt Romney (R-UT), and Mark Warner (D-VA.) The proposal includes $160 billion for state and local governments, $180 billion in aid for unemployed Americans, and approximately $300 billion in support for small businesses. Additionally, tens of billions of dollars would be devoted to education, agriculture, rental assistance, and pandemic-related health care priorities. On Wednesday, Democratic leaders Chuck Schumer (D-NY) and Nancy Pelosi (D-CA) announced their support for the bipartisan deal as a starting point for additional negotiations, and stated that “[they] believe the bipartisan framework introduced by Senators yesterday should be used as the basis for immediate bipartisan, bicameral negotiations.” Senate Leader Mitch McConnell (R-KY) continues to push for a slimmer aid package, at this point, it is unclear whether he will support this bipartisan effort.
CDC Advisory Committee Convenes to Discuss COVID-19 Vaccine Distribution
On Tuesday, December 1, The Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) convened to vote on which groups should be the first to receive the COVID-19 vaccine. Given that there will be a limited number of doses available initially, the committee discussed who should be prioritized when the vaccine is first made available. The ACIP, which is an independent group of vaccine recommendation experts, decided that health care workers and long-term care facility residents should be the first populations to receive the vaccine. ACIP specified that the health care providers who should receive the highest priority are those who have direct contact with COVID-19 patients and those who cannot telework. The director of the National Center for Immunization and Respiratory Diseases at the CDC, Nancy Messonier, said that many states and local jurisdictions expect it will take about three weeks to vaccinate all their health care providers.
Both Pfizer and Moderna have applied for emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA). The FDA currently has a meeting scheduled for December 10 with its Vaccines and Related Biological Products Advisory Committee (VRBPAC) to discuss Pfizer’s request for EUA. The Advisory Committee is expected to meet December 17 to discuss the Moderna vaccine. The FDA has faced growing pressure from members of the Trump White House to expedite its review process and grant preliminary approval of Pfizer’s vaccine, but the FDA issued a statement on Monday defending its timeline. Specifically, the FDA asserted that “Completion of these reviews involves such things as ensuring that the manufacturing process and the controls on manufacturing are appropriate, checking statistical analyses performed to ensure that they were done properly, and doing additional analyses, as necessary, to look at the effect of the vaccine on subsets of individuals who might be at greater risk of adverse effect.” President Trump is set to hold a “Vaccine Summit” at the White House on December 8 with state, military, and scientific leaders.
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Key House Committees Elected Leaders for the 117th Congress
Several congressional committee leaders were elected this week for the 117th Congress. Rep. Cathy McMorris Rodgers (R-WA) was tapped on Wednesday by the GOP to serve as the ranking member of the House Energy and Commerce Committee, making history as the first woman from either party to serve in this role. McMorris Rodgers will fill the vacancy of retiring Rep. Greg Walden (R-OR). On Thursday, Rep. Rosa DeLauro (D-CT) was selected to be the next chair of the House Appropriations Committee, a position that will give her wide federal spending control. DeLauro will be filling the vacancy of Nita Lowey (D-NY), who is retiring. Also on Thursday, Rep. Richard Neal (D-MA), the current chairman of the House Ways and Means Committee, was reelected for that same role.
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President-Elect Biden Continues to Announce Members of His Administration
On Monday, President-elect Joe Biden formally announced the head members of his economic team. The nominees and appointees include field experts and those who have worked in prior Democratic administrations. Janet Yellen, who has been tapped to be the Secretary of the Treasury would be the first woman to fill that position. Additionally, Neera Tanden, who was nominated to be the director of the Office of Management and Budget, would be the first woman of color to hold that title. The Biden-Harris transition team has not yet announced who the new administration’s health leaders will be, but an announcement on that front is likely to be made as early as next week. Various reports state that Biden’s top choices for Secretary of Health and Human Services have come down to New Mexico Governor Michelle Lujan Grisham, Rhode Island Governor Gina Raimondo, or former Surgeon General Vivek Murthy. Announcements for other top health positions, such as the FDA commissioner and the administrator of CMS, will likely be announced weeks after the HHS secretary is announced, as the HHS secretary is expected have input into who should fill those positions. The full list of members of Biden’s economic team can be found here.
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CMS Releases Physician Fee Schedule for Calendar Year 2021
The Centers for Medicare and Medicaid Services (CMS) released its annual Physician Fee Schedule (PFS) final rule on Tuesday. The rule will increase Medicare reimbursements for physicians who primarily utilize office and outpatient visits to care for their patients and for those who invest time in managing their patients’ chronic conditions. However, there will be a decrease in Medicare reimbursement rates for providers who have less office billings. CMS attributes these rate reductions to budget neutrality adjustments set forth in the Medicare Act, which require increases in program payments to be offset by cutbacks elsewhere. These changes to the PFS will increase Medicare reimbursements by 16% for endocrinology, by 15% for rheumatology, and by 14% for hematology/oncology, by 13% for family practice, by 9% for allergy/immunology, by 7% for obstetrics/gynecology, and by 6% for pediatrics. Medicare reimbursements will decrease, however, by 10% for radiology, by 9% for physical/occupational therapy, by 8% for both anesthesiology and cardiac surgery, by 7% for critical care, by 6% for general surgery, and by 4% for infectious disease. The rule also expands the telehealth services covered by Medicare. The final rule adds 60 additional covered telehealth services, all of which will be made permanent in rural areas, even after the COVID-19 pandemic ends. However, Congress will need to pass legislation for Medicare to cover these additional services in urban areas once the pandemic ends. More details on the final rule can be found in the fact sheet here.
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CMS Finalizes Policies to Provide Medicare Beneficiaries with Additional Choices around Surgery
On Wednesday, November 2, the Trump Administration finalized policies that aim to “give Medicare patients and their doctors greater choices to get care at a lower cost in an outpatient setting.” The Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule contains changes that include eliminating the inpatient only list, adding 11 procedures to the ASC covered procedures list (CPL), and reducing reimbursement rates to hospitals for 340B-acquired drugs. Over a three-year-period, CMS will phase out the current inpatient list, which contains roughly 1,700 procedures that Medicare will only pay for if they are performed in a hospital inpatient setting. CMS plans to eliminate this list due to its stated belief that the list restricts patient choice. In addition to adding 11 procedures to the CPL, CMS has revised the criteria used to add covered surgical procedures to the CPL. Based on these new criteria, 267 additional surgical procedures will be added to the CPL beginning in the year 2021. Additional information on the final rule can be found here.
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HHS Announces New Plan and Partnership in Effort to Reduce U.S. Pregnancy-related Deaths and Disparities
On Thursday, December 3, The Department of Health and Human Services (HHS) announced its new plan and partnership to reduce maternal-related deaths and disparities in the U.S. The Action Plan provides an outline for “addressing risk factors before and during pregnancy, improving the quality of and access to maternity and postpartum care, and supporting a research agenda to fill gaps in current evidence.” Three specific goals within the plan are to reduce the maternal mortality rate by 50%, reduce low-risk cesarean deliveries by 25%, and achieve blood pressure control in 80% of women of reproductive age with hypertension. HHS also announced its new public-private partnership with the March of Dimes to “address the disparity gap in maternal health outcomes for black women through the implementation of evidence-based best practices to improve healthcare quality in hospital settings.” Roughly 700 women die each year in the U.S. due to pregnancy-related complications. Additionally, more than 25,000 women suffer unintended outcomes of labor and delivery annually that carry long-term impacts for their health. HHS’s new plan and partnership aims to turn these statistics around.
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SENATE HEARINGS AND EXECUTIVE SESSIONS |
WHAT: Senate Homeland Security and Governmental Affairs Committee Hearing: "Early Outpatient Treatment: An Essential Part of a COVID-19 Solution, Part II."
WHEN: Tuesday, December 8 at 10:00 AM
WHAT: Senate Veterans' Affairs Committee Hearing: VA’s Response to COVID-19 across the VA Enterprise
WHEN: Wednesday, December 9 at 10:00 AM
WHAT: Senate Commerce, Science and Transportation, Subcommittee on Transportation and Safety Hearing: "The Logistics of Transporting a COVID-19 Vaccine."
WHEN: Thursday, December 10 at 9:30 AM
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HOUSE HEARINGS AND EXECUTIVE SESSIONS |
WHAT: House Committee on Appropriations, Subcommittee on the Departments of Labor, Health and Human Services, Education, and Related Agencies Hearing: The Impact on Women Seeking an Abortion but are Denied Because of an Inability to Pay
WHEN: Tuesday, December 8 at 10:00 AM
WHAT: House Committee on Veterans' Affairs, Subcommittee on Economic Opportunity Hearing: Identifying Congressional and Administration Priorities for the Next Congress: How we can support our Veterans through and after COVID-19
WHEN: Tuesday, December 8 at 10:00 AM
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ADMINISTRATION ANNOUNCEMENTS |
Centers for Medicare & Medicaid Services
Food and Drug Administration
Guidance Documents from the Centers for Disease Control and Prevention
National Institutes of Health
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Washington, DC 20005
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