Health Care Checkup
July 23, 2021
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Early this week, a procedural vote allowing the Senate to take up bipartisan infrastructure legislation failed on a party-line vote, with Democrats supporting and Republicans opposing. GOP Senators indicated that they needed more time to finalize the details of the legislation before they would agree to proceed, and it is likely that Senate Majority Leader Chuck Schumer (D-NY) will attempt next week to bring the bill back up for a vote. As the bipartisan group of Senators, led by Rob Portman (R-OH), Kyrsten Sinema (D-AZ) and others, struggles to finalize the infrastructure spending and find budgetary offsets for the nearly $600 billion package, it has been reported that the final deal could be paid for, in part, by delaying a Trump-era Medicare drug rebate rule. The rebate rule, which was finalized during the Trump Administration, sends drug rebates directly to consumers, eliminating rebates drug companies send to benefit managers in Medicare Part D. Delaying the rule would save the Medicare program money, which the group of Senators want to use to help pay for the infrastructure package.
On Monday, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would increase the penalty for hospitals that do not comply with the Hospital Price Transparency final rule, which went into effect on January 1, 2021. Under this final rule, hospitals must make their pricing clear and accessible to consumers online. CMS said that there have been complaints from consumers that hospitals are not complying with the rule, so CMS proposes to increase the penalty for hospitals that do not comply with it. CMS proposes to set a minimum fine of $300 per day for hospitals with 30 or fewer beds and $10 per bed per day for larger hospitals, with a max fine of $5,500 per day.
Also on Monday, the Secretary of the Department of Health and Human Services (HHS), Xavier Becerra, renewed the public health emergency (PHE), effective July 20. PHEs are renewable for 90 days at a time. Language of the renewal can be found here.
On Tuesday, the Senate Committee on Health, Education, Labor and Pensions (HELP) held a hearing on the current COVID-19 response. At the hearing, lawmakers questioned the witnesses on topics including COVID booster shots, guidance for students returning to school in the fall, and the nation’s stockpile of medical supplies. Dr. Walensky said that the highly contagious Delta variant is now the dominant strain in the U.S., accounting for 83% of all sequenced COVID-19 cases in the country. The witnesses all stressed the importance of the public getting vaccinated against the virus to help curb its spread. MCRT’s summary of the hearing can be found here.
On Thursday, the Missouri Supreme Court overturned a lower court decision that found the state’s voter-approved Medicaid expansion invalid. The ballot measure, which was approved by voters in August 2020, expanded Medicaid eligibility in Missouri to include an additional 275,000 low-income adults. However, the state refused to implement the expansion on grounds that it violated state law. The Missouri Supreme Court ruled unanimously that the ballot measure was not unconstitutional because it only requires that the state expand its Medicaid program under the Affordable Care Act and does not require the state legislature to appropriate money.
A new report released by the CDC found that life expectancy in the U.S. fell by a year and a half in 2020, making it the largest one-year decline since World War II. The CDC attributes the decline to deaths from COVID-19, along with increased rates of drug overdoses and homicides.
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What to Expect Next Week: On Tuesday, the Senate HELP Committee will hold a hearing titled, "The Path Forward: Building on Lessons Learned from the COVID-19 Pandemic." On Thursday, the House Energy and Commerce Subcommittee on Health will hold a hearing on advancing treatments and cures for neurodegenerative diseases. Also next week, final details of the Senate’s infrastructure package are expected to be released.
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Senate Infrastructure Package Likely to Delay Trump-era Drug Rebate Rule
Earlier this week, a procedural vote allowing the Senate to take up bipartisan infrastructure legislation failed on a party-line vote, with Democrats supporting and Republicans opposing. GOP Senators indicated that they needed more time to finalize the details of the legislation before they would agree to proceed, and it is likely that Senate Majority Leader Chuck Schumer (D-NY) will attempt next week to bring the bill back up for a vote. As the bipartisan group of Senators, led by Rob Portman (R-OH), Kyrsten Sinema (D-AZ) and others, struggles to finalize the infrastructure spending and find budgetary offsets for the nearly $600 billion package, it has been reported that the final deal could be paid for, in part, by delaying a Trump-era Medicare drug rebate rule. The rebate rule, which was finalized during the Trump Administration, sends drug rebates directly to consumers, eliminating rebates drug companies send to benefit managers in Medicare Part D. Delaying the rule would save the Medicare program money, which the group of Senators want to use to help pay for the infrastructure package. Senator Joe Manchin (D-WV) confirmed the group’s plan to delay the rule on Thursday and said that, “the pay-fors are pretty much lined up.” However, negotiations are likely to continue into the weekend before final details are released next week.
Missouri Supreme Court Rules State’s Medicaid Expansion Via Ballot Initiative Valid
On Thursday, the Missouri Supreme Court overturned a lower court decision that found the state’s voter-approved Medicaid expansion invalid. The ballot measure, which was approved by voters in August 2020, expanded Medicaid eligibility in Missouri to include an additional 275,000 low-income adults. However, the state refused to implement the expansion on grounds that it violated state law. The state claimed that it was in violation of the state’s law because the ballot measure did not include a funding source for the expansion. The Missouri Supreme Court ruled unanimously that the ballot measure was not unconstitutional because it only requires that the state expand its Medicaid program under the Affordable Care Act and does not require the state legislature to appropriate money. While the state’s Supreme Court ruling was a win for proponents of Medicaid expansion in the state, it will still take time for the newly eligible Missourians to receive their Medicaid benefits, as the state has not yet finalized its enrollment process.
CMS Issues Proposed Rule to Increase Price Transparency and Access to Care
On Monday, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would increase the penalty for hospitals that do not comply with the Hospital Price Transparency final rule, which went into effect on January 1, 2021. Under this final rule, hospitals must make their pricing clear and accessible to consumers online. CMS said that there have been complaints from consumers that hospitals are not complying with the rule, so CMS proposes to increase the penalty for hospitals that do not comply with it. CMS proposes to set a minimum fine of $300 per day for hospitals with 30 or fewer beds and $10 per bed per day for larger hospitals, with a max fine of $5,500 per day. A full calendar year of noncompliance would result in a minimum total penalty of $109,500 per hospital, and the maximum total penalty would be $2,007,500 per hospital. Currently, hospitals face a fine of up to $300 per day for noncompliance. Also in the proposed rule, CMS is seeking comment on ways to make the reporting of health disparities “more comprehensive and actionable.” Additionally, the proposal seeks public comment to inform potential policies surrounding emergency hospitals in rural areas. CMS’s fact sheet on the rule can be found here.
HHS Secretary Renews Public Health Emergency Amid Ongoing COVID-19 Pandemic
This week, the Secretary of the Department of Health and Human Services (HHS), Xavier Becerra, renewed the public health emergency (PHE), effective July 20. PHEs are renewable for 90 days at a time. Language of the renewal can be found here.
Senate HELP Committee Holds Hearing with Biden Administration Health Officials
On Tuesday, the Senate Committee on Health, Education, Labor and Pensions (HELP) held a hearing on the current COVID-19 response. Witnesses at the hearing included Dr. Rochelle Walensky, the Director of the Centers for Disease Control and Prevention (CDC); Dr. Anthony Fauci the Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH); Dr. Janet Woodcock, the Acting Commissioner of the U.S. Food and Drug Administration (FDA); and Dawn O'Connell, the Assistant Secretary for Preparedness and Response. At the hearing, lawmakers questioned the witnesses on topics including COVID booster shots, guidance for students returning to school in the fall, and the nation’s stockpile of medical supplies. Dr. Walensky said that the highly contagious Delta variant is now the dominant strain in the U.S., accounting for 83% of all sequenced COVID-19 cases in the country. The witnesses all stressed the importance of the public getting vaccinated against the virus to help curb its spread. MCRT’s summary of the hearing can be found here.
New Report from CDC Finds that Life Expectancy Took Biggest Hit in Decades in 2020
A new report released by the CDC found that life expectancy in the U.S. fell by a year and a half in 2020, making it the largest one-year decline since World War II. The CDC attributes the decline to deaths from COVID-19, along with increased rates of drug overdoses and homicides. According to the report, the Hispanic population experienced the largest decline in life expectancy between 2019 and 2020, from 81.8 to 78.8 years. The non-Hispanic black population saw the second largest decline from 74.7 to 71.8, and the non-Hispanic white population life expectancy declined from 78.8 to 77.6 years.
New Report Finds High Out-of-Pocket Charges for COVID Testing
A new report released by America’s Health Insurance Plans (AHIP) found that the amount of out-of-network providers charging at least 50% more than the commercial market for COVID-19 tests has doubled since early in the pandemic. According to AHIP, the average cost of a COVID test on the commercial market is $130, whereas some out-of-network providers have charged more than $390. The report also found that 27% of COVID-19 tests in March 2021 were administered out of network, which is a 6% increase since the beginning of pandemic. More information can be found here.
Radiation Oncology Community Urges Biden Administration to Halt Proposed Medicare Payment Cuts
The American Society for Radiation Oncology (ASTRO) has expressed much opposition to CMS’s recent proposed Medicare Physician Fee Schedule for calendar year 2022. Under the proposal, radiation oncologists would see a 5% payment cut. ASTRO also criticized CMS’s 2022 hospital outpatient payment proposed rule, which would make changes to the Radiation Oncology Model. These changes include paying providers the same site-neutral payment rate for 90-day care episodes. In a statement, Thomas Eichler, Chair of ASTRO, stated, “By proposing to cut high-value radiation treatments by as much as 22% and proceeding with more than $160 million in reductions under the Radiation Oncology Model, CMS is jeopardizing the ability of the nation’s radiation therapy professionals to continue to provide essential care for their patients now and in the future.” ASTRO called on President Joe Biden to “immediately intervene” on CMS’s two proposed rules.
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SENATE HEARINGS AND EXECUTIVE SESSIONS |
Senate Health, Education, Labor and Pensions Committee - Hearing
Full Committee Hearing: "The Path Forward: Building on Lessons Learned from the COVID-19 Pandemic."
Tuesday, July 27 at 10:00 AM ET
Senate Foreign Relations Committee - Hearing
Subcommittee on Africa and Global Health Policy Hearing: "U.S. Trade and Investment in Africa."
Wednesday, July 28 at 2:30 PM ET
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HOUSE HEARINGS AND EXECUTIVE SESSIONS |
House Committee on Veterans' Affairs - Hearing
Subcommittee on Health Hearing: Aging in Place: Examining Veterans' Access to Home and Community Based Services
Tuesday, July 27 at 10:00 AM ET
House Select Subcommittee on the Coronavirus Crisis - Hearing
Select Subcommittee on the Coronavirus Crisis Hearing: Hybrid Hearing on "Oversight of Pandemic Evictions: Assessing Abuses by Corporate Landlords and Federal Efforts to Keep Americans in Their Homes"
Tuesday, July 27 at 10:30 AM ET
House Committee on Natural Resources - Hearing
House Committee on Natural Resources Hearing: FC/OIA Oversight Hearing on "The President's FY22 Budget Priority for the Territories: Medicaid, SSI, and SNAP Parity."
Wednesday, July 28 at 1:00 PM ET
House Committee on Transportation and Infrastructure - Hearing
House Committee on Transportation and Infrastructure Hearing: "Assessing the Federal Government's COVID-19 Relief and Response Efforts and its Impact."
Thursday, July 29 at 11:00 AM ET
House Committee on Energy and Commerce - Hearing
Subcommittee on Health Hearing: "The Path Forward: Advancing Treatments and Cures for Neurodegenerative Diseases"
Thursday, July 29 at 11:00 AM ET
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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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