It has been a busy week in Washington. On Wednesday, after more than a year of negotiations, Senate Majority Leader Chuck Schumer (D-NY) and Senator Joe Manchin (D-WV) announced that they had struck a deal on a new reconciliation package that would make significant climate and health investments. The Inflation Reduction Act of 2022 would fight inflation, lower energy costs, increase cleaner production, and reduce carbon emissions by roughly 40 percent by 2030. The bill would also extend the enhanced Affordable Care Act tax subsidies through 2025. Additionally, the legislation would allow Medicare to negotiate prescription drug prices and cap out-of-pocket costs to $2,000 per year. No new taxes would be imposed on families making $400,000 or less and there would be no new taxes on small businesses. Instead, the Senators aim to close tax loopholes, enforce the tax code, and “make [the] biggest corporations and ultra-wealthy pay their fair share.” Summaries of the tax, prescription drug, and climate change provisions can be found here, here, and here. Further, a one-pager on the legislation can be found here.

On Thursday, the Senate released its nearly $1.7 trillion fiscal year 2023 appropriations package. The Labor HHS portion of the package includes, among other provisions, $350 million for a new Reproductive Healthcare Access Fund to help women who live in states with restricted access to abortion receive care, $512 million for the Title X-Family Planning program, $496 million for the Maternal Mortality Initiative, $9.1 billion for the Substance Use and Mental Health Services Administration (SAMHSA), $600 million to strengthen the nation’s public health infrastructure, and $48 billion for the National Institutes of Health (NIH). The package also includes a $21 billion emergency supplemental funding bill to provide the necessary resources to address the ongoing COVID-19 pandemic. A topline summary of all 12 bills can be found here. Links to the legislative text, explanatory statement, and summary for each of the FY 2023 appropriations bills can be found here.

Late Wednesday, the House passed the bipartisan Advancing Telehealth Beyond COVID–19 Act of 2021 in a vote of 416-12. The bill, which was introduced by Representatives Liz Cheney (R-WY) and Debbie Dingell (D-MI), would extend telehealth policies implemented during the COVID-19 pandemic through December 31, 2024. Specifically, the legislation would allow a two-year extension of Medicare originating site flexibilities, an extended list of practitioners eligible to furnish telehealth services, Medicare reimbursement of telehealth services provided by practitioners working for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs), and audio-only telehealth services.

Also on Wednesday, the House Ways and Means Committee held a markup for H.R. 8487, the Improving Seniors’ Timely Access to Care Act of 2022. This legislation would shorten the time frame for Medicare Advantage plans to make prior authorization decisions and would make the prior authorization process fully electronic. At the markup, the Committee adopted Chairman Richard Neal’s (D-MA) substitute amendment. The bill will now move to the House floor for a full vote. Mehlman Castagnetti’s summary of the markup can be found here.

On Thursday, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI), seeking public comment on the Medicare Advantage program. CMS is looking for input on the best ways to ensure that people with Medicare receive more “equitable, high quality, and person-centered care that is affordable and sustainable.” Dr. Meena Seshamani, CMS Deputy Administrator and Director of the Center for Medicare said, “We see a huge opportunity for partnership with as many stakeholders as possible to better understand how care innovations are changing outcomes and costs and how Medicare Advantage is working for enrollees.” The RFI can be accessed here.

On Friday, the Biden Administration announced two new actions to improve school-based mental health services. Beginning next week, the Administration will award the first of nearly $300 million through the FY 2022 omnibus agreement to expand access to mental health services in schools. Additionally, the Administration sent a letter to  Governors across the country, highlighting the federal resources that are available to states and schools to invest in mental health services for students. Additional information can be found here.

After more than a year of negotiations, Senate Majority Leader Chuck Schumer (D-NY) and Senator Joe Manchin (D-WV) announced that they had struck a deal on a new reconciliation package that would make significant climate and health investments. The Inflation Reduction Act of 2022 would fight inflation, lower energy costs, increase cleaner production, and reduce carbon emissions by roughly 40 percent by 2030. The bill would also extend the enhanced Affordable Care Act tax subsidies through 2025. Additionally, the legislation would allow Medicare to negotiate prescription drug prices and cap out-of-pocket costs to $2,000 per year. No new taxes would be imposed on families making $400,000 or less and there would be no new taxes on small businesses. Instead, the Senators aim to close tax loopholes, enforce the tax code, and “make [the] biggest corporations and ultra-wealthy pay their fair share.” Summaries of the tax, prescription drug, and climate change provisions can be found here, here, and here. Further, a one-pager on the legislation can be found here.

On Thursday, the Senate released its nearly $1.7 trillion fiscal year 2023 appropriations package. The Labor HHS portion of the package includes, among other provisions, $350 million for a new Reproductive Healthcare Access Fund to help women who live in states with restricted access to abortion receive care, $512 million for the Title X-Family Planning program, $496 million for the Maternal Mortality Initiative, $9.1 billion for the Substance Use and Mental Health Services Administration (SAMHSA), $600 million to strengthen the nation’s public health infrastructure, and $48 billion for the National Institutes of Health (NIH). The package also includes a $21 billion emergency supplemental funding bill to provide the necessary resources to address the ongoing COVID-19 pandemic. A topline summary of all 12 bills can be found here. Links to the legislative text, explanatory statement, and summary for each of the FY 2023 appropriations bills can be found here.

Late Wednesday, the House passed the bipartisan Advancing Telehealth Beyond COVID–19 Act of 2021 in a vote of 416-12. The bill, which was introduced by Representatives Liz Cheney (R-WY) and Debbie Dingell (D-MI), would extend telehealth policies implemented during the COVID-19 pandemic through December 31, 2024. Specifically, the legislation would allow a two-year extension of Medicare originating site flexibilities, an extended list of practitioners eligible to furnish telehealth services, Medicare reimbursement of telehealth services provided by practitioners working for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs), and audio-only telehealth services. Currently, pandemic-related telehealth flexibilities are slated to expire five months after the public health emergency (PHE) ends. The PHE has been in effect since January 27, 2020 and has been renewed ever since; the latest extension is effective through October 13, 2022. Additional information on the telehealth legislation passed by the House can be found here.

On Wednesday, the House Ways and Means Committee held a markup for H.R. 8487, the Improving Seniors’ Timely Access to Care Act of 2022. This legislation would shorten the time frame for Medicare Advantage plans to make prior authorization decisions and would make the prior authorization process fully electronic. At the markup, the Committee adopted Chairman Richard Neal’s (D-MA) substitute amendment. The bill will now move to the House floor for a full vote. Mehlman Castagnetti’s summary of the markup can be found here.

The Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI), seeking public comment on the Medicare Advantage program. CMS is looking for input on the best ways to ensure that people with Medicare receive more “equitable, high quality, and person-centered care that is affordable and sustainable.” Dr. Meena Seshamani, CMS Deputy Administrator and Director of the Center for Medicare said, “We see a huge opportunity for partnership with as many stakeholders as possible to better understand how care innovations are changing outcomes and costs and how Medicare Advantage is working for enrollees.” The RFI can be accessed here.

The Departments of Health and Human Services, Labor, and Treasury issued guidance to “make clear that contraceptive coverage is guaranteed at no additional cost under the Affordable Care Act no matter where someone lives or works.” Labor Secretary Marty Walsh warned that if plans and issuers do not comply with the law, the Administration  “will take enforcement action to ensure that participants receive this coverage.” The ACA guarantees coverage of free birth control and contraceptive counseling, for all individuals, no matter what state they reside in.

On Monday, the Department of Health and Human Services (HHS) issued a proposed rule that implements Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in certain health programs. A prior version of the rule enacted by the Trump Administration “limited its scope and power to cover fewer programs and services.” The Biden Administration’s proposal seeks to strengthen and restore civil rights protections for patients that were stripped in the prior rule. Specifically, the Trump Administration’s rule eliminated gender identity and pregnancy termination from the definition of sex discrimination. The new proposal reinstates protections on the basis of gender identity and sexual orientation, and makes it clear that discrimination on the basis of sex includes discrimination on the basis of pregnancy termination. The proposed rule also interprets Medicare Part B as federal financial assistance. The press release can be found here, and the fact sheet can be found here.

On Friday, the Biden Administration announced two new actions to improve school-based mental health services. Beginning next week, the Administration will award the first of nearly $300 million through the FY 2022 omnibus agreement to expand access to mental health services in schools. Additionally, the Administration sent a letter to  Governors across the country, highlighting the federal resources that are available to states and schools to invest in mental health services for students. Additional information can be found here.

This week, the Biden Administration made several noteworthy steps toward its goal of improving the nation’s maternal health outcomes. On Tuesday, the Centers for Medicare and Medicaid Services (CMS) released its “Maternity Care Action Plan,” which will take a coordinated approach to improve health outcomes for mothers during the pregnancy, childbirth, and the postpartum period. The plan includes efforts to enhance data collection, improve access to care and, expand the maternity care workforce.

CMS also approved Medicaid and Children’s Health Insurance Program (CHIP) coverage extensions for the 12-month postpartum period in Connecticut, Massachusetts, and Kansas. These three states are the latest to receive coverage extensions from 60 days to 12 months after pregnancy. States that received coverage extensions earlier in the year include: California; Florida; Illinois; Kentucky; Louisiana; Maine; Michigan; Minnesota; New Jersey; New Mexico; Oregon; South Carolina; Tennessee; Virginia; Washington state; and Washington, D.C.

Also this week, the Department of Health and Human Services (HHS) invested $8.5 million in programs designed to improve maternal health outcomes for women disproportionately impacted by pregnancy-related deaths and complications. Additional information on this funding can be found here. 

Full Committee Hearing: "A System in Need of Repair: Addressing Organizational Failures of the U.S.’s Organ Procurement and Transplantation Network."

Wednesday, August 3 at 2:30 PM ET

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