Health Care Checkup
May 17, 2024
THE BIG PICTURE: KEY CONGRESSIONAL & EXECUTIVE BRANCH DEVELOPMENTS
On Wednesday, the House passed two bipartisan health bills on children’s and maternal health under suspension of the rules: the Maternal and Child Health Stillbirth Prevention Act of 2023 and the Emergency Medical Services for Children Reauthorization Act of 2024.

On Thursday, the House Energy and Commerce Health Subcommittee held a markup on 23 bills but consolidated two into a third, for a total of 21 legislative pieces, all of which advanced out of the subcommittee. The legislation focused on extending access to telehealth services, helping children with rare diseases, and building on the Medicaid program, among other health priorities.

On Wednesday, as part of their ongoing work to address primary care challenges and reform physician payment models, Senators Bill Cassidy (R-LA) and Sheldon Whitehouse (D-RI) released a Request for Information (RFI) to accompany the introduction of the senators’ bipartisan Pay PCPs Act, legislation to better support and improve pay for high-quality primary care providers.

On Tuesday, the Department of Health and Human Services (HHS) announced the release of a national strategy, with recommendations developed by the Task Force on Maternal Mental Health, a subcommittee of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Advisory Committee for Women’s Services, to address the urgent public health crisis of maternal mental health and substance use issues.
What to Expect Next Week:

The House and Senate will hold multiple hearings on various health care topics.

On Wednesday, the House Energy and Commerce Committee will hold a hearing on FDA regulations of drugs, biologics, and devices. On Thursday, the House Budget Committee will hold a hearing on health care monopolies, and the Ways and Means Committee will hold a hearing on independent physician practices.

In the Senate, on Tuesday, the Judiciary Committee will hold a hearing on competition in the prescription drug market, and the HELP Committee will hold a hearing on food and medicine. The Senate HELP Committee will also hold a markup on Thursday on a variety of healthcare bills (see the full list of hearings and markups below for more information). 
DEEP DIVE
Congressional:

House Passes Two Health Bills Under Suspension of the Rules
On Wednesday, the House passed two bipartisan health bills on children’s and maternal health under suspension of the rules. The Maternal and Child Health Stillbirth Prevention Act of 2023 from Rep. Ashley Hinson (R-IA), passed in a 408-3 vote, would clarify that stillbirth prevention research is a permissible use of funds under the Maternal and Child Health Services Block Grant program. The Senate passed its companion bill (S. 2231) by unanimous consent in September. The Emergency Medical Services for Children Reauthorization Act of 2024 from Rep. Buddy Carter (R-GA), passed in a 399-13 vote, would reauthorize $24 million in grants annually for fiscal years 2025 to 2029 for the Emergency Medical Services for Children program, which supports pediatric care for severe trauma or illness. The Senate has not yet passed the companion bill (S. 3765).

House Energy and Commerce Committee Health Subcommittee Advanced 21 Health Bills
On Thursday, the House Energy and Commerce Health Subcommittee held a markup on 23 bills but consolidated two bills into a third, for a total of 21 legislative pieces, all of which advanced out of the subcommittee. The legislation focused on extending access to telehealth services, helping children with rare diseases, and building on the Medicaid program, among other health priorities. One bipartisan telehealth bill, the Telehealth Modernization Act of 2024, would extend telehealth flexibilities for Medicare beneficiaries for two years. The bill’s spending would be offset with a PBM policy in Medicare Part D that delinks compensation from the cost of drugs and a delay in phasing in Medicare laboratory test payment changes for an additional year. Another bill, the TELEMH Act of 2024, would make it easier to submit claims for mental health services furnished through telehealth. The push is part of a bipartisan focus on telehealth expansion. The House Ways and Means Committee advanced a similar bill earlier this month, the Preserving Telehealth, Hospital, and Ambulance Access Act. Other bills focused on rare diseases, such as an extension of priority review vouchers to encourage treatment for rare pediatric diseases, a change to the orphan drug exclusivity period for rare diseases, and an authorization of certain targeted clinical trials involving combinations of drugs to treat pediatric cancer. Read the bills included in the markup here.
 
Senate Finance Committee Holds Hearing on Rural Health Care
On Thursday, the Senate Finance Committee held a hearing discussing legislative policies to support rural health care. During the hearing, members expressed broad bipartisan support for supporting and strengthening rural healthcare through a variety of legislative options. Members spoke about the need to permanently extend telehealth flexibilities granted during the COVID-19 pandemic, update the Graduate Medical Education (GME) program in Medicare to ensure rural areas received adequate residency slots, bolster rural maternity care, and improve the recruitment and retention of the healthcare workforce. Read Mehlman’s hearing summary here.
 
Rep. Foxx & Sen. Cassidy Press for Information Following Change Healthcare Cyberattack
On Wednesday, Education and the Workforce Committee Chairwoman Virginia Foxx (R-NC) sent a letter to Acting Secretary of Labor Julie Su requesting additional information about the Employee Benefits Security Administration’s (EBSA) cybersecurity capabilities and procedures after a cybersecurity breach at Optum’s Change Healthcare unit exposed the threat cyber criminals pose to EBSA’s ability to protect workers’ information and employer-sponsored health insurance plans. Read the press release and letter here.

On Tuesday, Senator Bill Cassidy (R-LA), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, requested information from UnitedHealth Group (UHG) on its response to the February 21 cyberattack on UHG subsidiary Change Healthcare. In the letter Cassidy asked for answers from UHG on why it did not implement multifactor authentication or other agency recommendations that could have prevented the attack. Cassidy also requested information on how UHG is working with providers and other stakeholders to ensure all of its services are back online and patient care is not further impacted. Read the press release and letter here.

Cassidy, Whitehouse Introduce Legislation, Release RFI On Primary Care Provider Payment Reform
On Wednesday, as part of their ongoing work to address primary care challenges and reform physician payment models, Senators Bill Cassidy (R-LA) and Sheldon Whitehouse (D-RI) released a Request for Information (RFI) to accompany the introduction of the senators’ bipartisan Pay PCPs Act, legislation to better support and improve pay for high-quality primary care providers. The Senators’ accompanying RFI provides stakeholders the opportunity to comment on the bipartisan bill, which serves as a marker for legislation in the primary care space. Feedback can be submitted until July 15, 2024. Read the press release here.

Chairman Sanders Releases Report Exposing How Weight Loss Drugs Could Bankrupt American Health Care
On Wednesday, Sen. Bernie Sanders (I-VT), Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, released a report calling attention to the potential of weight loss drugs to bankrupt the American health care system. In the report, HELP Committee Majority Staff modeled how new weight loss drugs could impact prescription drug spending, even while taking into account estimated manufacturer discounts. The report stated that unless prices are substantially reduced, Wegovy and other weight loss drugs could “push Americans to spend $1 trillion per year on all prescription drugs.” Read the press release and report here.

Senators Urge VA to Step Up Accountability for Electronic Health Care Records
Late last week, Chairman Jon Tester (D-MT) and his Senate Veterans’ Affairs Committee colleagues. Senators Patty Murray (D-WA) and Sherrod Brown (D-OH) are calling on the Department of Veterans Affairs (VA) to push for stronger accountability provisions in its ongoing contract negotiations with Oracle Health on the Electronic Health Record Modernization (EHRM) program. The current contract is slated to expire on May 16, 2024. In the letter the senators asked VA Deputy Secretary Tanya Bradsher to "add additional accountability and oversight provisions to protect veterans and taxpayers" into the forthcoming deal, which will cover a one-year term. They wrote that while the current contract contains "several improved provisions" over the original agreement struck in 2018, "significant challenges remain" when it comes to contractor Oracle Cerner's performance. Read the press release and letter here. 

Notable Bills Introduced:

Reps. Steel, Schiff, Colleagues Introduce Bill to Stop Health Care Cyber Attacks
On Wednesday, Reps. Michelle Steel (R-CA), Adam Schiff (D-CA), Mariannette Miller-Meeks (R-IA), Pat Ryan (D-NY), Abigail Spanberger (D-VA), Chris Pappas (D-NH), and David Trone (D-MD) introduced the Strengthening Cybersecurity in Health Care Act. The bipartisan, bicameral bill will address the recent spike in cybersecurity attacks against American health care systems by requiring the U.S. Department of Health and Human Services (HHS) Inspector General to perform consistent evaluations of the Department’s cybersecurity systems and report its findings to Congress. The Senate companion bill is led by Senators Marco Rubio (R-FL) and Angus King (I-ME). Read the press release here and the bill here.
 
Senators Carper and Scott Introduce Bipartisan Legislation to Extend the Hospital at Home Waiver Program for Five Years
On Wednesday, Senators Tom Carper (D-DE) and Tim Scott (R-SC) introduced the Hospital Inpatient Services Modernization Act of 2024, bipartisan legislation that would extend the Centers for Medicare & Medicaid Services (CMS) Acute Hospital Care at Home waiver program for five years. The program is currently active in 37 states nationwide, including Delaware and South Carolina. It is set to expire on December 31, 2024. Read the press release here and the bill here.
 
Fitzpatrick, Panetta, Joyce, Tonko Introduce Bipartisan Bill to Safeguard Patient Access to High Quality Cancer Treatments
On Wednesday, Reps. Brian Fitzpatrick (R-PA), Jimmy Panetta (D-CA), John Joyce (R-PA), and Paul Tonko (D-NY) introduced the bipartisan Radiation Oncology Case Rate (ROCR) Value-Based Program Act of 2024 that would modernize Medicare reimbursement for radiation therapy. The legislation would safeguard access to high-quality cancer treatments for patients nationwide, improve patient outcomes, and reduce health disparities while generating savings for Medicare. Read the press release here and the bill here.
 
Rep. Ciscomani Leads Bipartisan, Bicameral Flagship Veterans Package
On Wednesday, Rep. Juan Ciscomani (R-AZ) introduced legislation alongside House Veterans’ Affairs Committee Chairman Mike Bost (R-IL), and Senate Veterans’ Affairs Committee Chairman Jon Tester (D-MT), and Ranking Member Jerry Moran (R-KS). The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (H.R. 8371) will be the flagship veterans’ package for the 118th Congress, similar to the 116th Congress’ Isakson and Roe Veterans Health Care and Benefits Improvement Act of 2020 (H.R. 7105). The legislation encompasses a number of bipartisan and bicameral proposals to reform and improve the delivery of healthcare, benefits, and services at the VA for veterans, their families, and their survivors. Read the press release here and the bill here.

Fischbach, Pence Introduce Congressional Review Act to Undo Nursing Home Staffing Mandate
On Tuesday, Reps. Michelle Fischbach (R-MN) and Greg Pence (R-IN) introduced a Congressional Review Act to overturn the Department of Health and Human Services (HHS) mandatory nursing staff ratio rule. The final rule requires all Medicare- and Medicaid-certified facilities to have 3.48 “hours per resident day " of total staffing as part of a White House push to improve nursing home care. Fischbach called the rule “half-baked” and stated she wants to develop policies that support recruitment and retention to solve the ongoing nursing shortage in this country. Read the press release here.

Reps. Kelly, Kim, Meuser, Schrier Introduce Legislation to Support Rural Maternal Health
On Monday, Reps. Robin Kelly (D-IL), Young Kim (R-CA), Dan Meuser (R-PA), and Kim Schrier (D-WA) introduced the bipartisan Rural Obstetrics Readiness Act to support rural health care facilities providing critical obstetric care. The Rural Obstetrics Readiness Act will support rural hospitals and doctors prepare to handle the obstetric emergencies by:
  • Directing the Health Resources and Services Administration’s Alliance for Innovation on Maternal Health to create an obstetric emergency training program for rural health care facilities that do not have a dedicated labor & delivery unit;
  • Establishing new federal grants for rural health care facilities to purchase necessary equipment to carry out obstetrics readiness training and response;
  • Creating a pilot program to support a statewide or regional network of obstetric and maternal health care teams that can provide urgent teleconsultation to rural facilities; and
  • Directing HHS to study maternity ward closures, regional patterns of patient transport, and models for regional partnerships for rural obstetric care.
Read the press release here and the bill here.

Executive Branch:

CMS Drops ‘Stacking’ Provision in Medicaid Drug Rebate Proposal
On Wednesday, the Centers for Medicare & Medicaid Services said it would not finalize a provision in the proposed rule that would have required companies to “stack” discounts and rebates throughout a transaction when reporting best prices for the Medicaid drug rebate program. CMS stated it will instead collect more information from manufacturers on their price calculation methodologies before pursuing changes through future rulemaking. Read the CMS fact sheet here.

Biden-Harris Administration Announces Maternal Mental Health Task Force’s National Strategy to Improve Maternal Mental Health Care
On Tuesday, the Department of Health and Human Services (HHS) announced the release of a national strategy, with recommendations developed by the Task Force on Maternal Mental Health, a subcommittee of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Advisory Committee for Women’s Services, to address the urgent public health crisis of maternal mental health and substance use issues. The Report to Congress and accompanying National Strategy to Improve Maternal Mental Health Care are part of broader federal efforts to address women’s overall health, and maternal health in particular, across the nation. Read the press release here.
 
HHS Suspends Funding and Proposes Formal Debarment of EcoHealth Alliance
On Wednesday, HHS announced they have suspended federal grants to EcoHealth Alliance, which worked with the Wuhan Institute of Virology on experiments involving coronaviruses. HHS stated it would halt grants and propose to debar the alliance from future federal funding for failing to comply with agency rules designed to oversee grantees’ work. Select Subcommittee on the Coronavirus Pandemic Chairman Brad Wenstrup (R-OH) praised the move and has proposed a criminal investigation of the alliance's president, Peter Daszak. EcoHealth has 30 days to appeal. Read Wenstrup’s press release and HHS notice of suspension here.
 
USDA, HHS Announce New Steps Aimed at Preventing Avian Flu from Spreading to Humans
Late last week, the Agriculture and Health and Human Services departments announced additional steps to mitigate the H5N1 avian flu among cattle producers, with the USDA announcing it will provide up to $2,000 a month for dairy producers to supply personal protective equipment or outerwear uniform laundering to employees to protect the potential spread from animals to humans. HHS also announced that it will provide $101 million in new funding through the Centers for Disease Control and Prevention and Food and Drug Administration to test, prevent and treat avian flu. Of the new funding, $8 million will be dedicated to determining if the current candidate vaccine viruses would be effective and develop new vaccines if necessary. Read the fact sheet here. 
CONGRESSIONAL HEARINGS & EVENTS
House & Senate Hearings and Markups:

House:

House Committee on Appropriations, Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies – Hearing
“Nutritious Foods in the Supplemental Nutrition Assistance Program (SNAP)”
Wednesday, May 22, at 10:00 AM
 
House Committee on Energy and Commerce, Subcommittee on Health - Hearing
“Check Up: Examining FDA Regulation of Drugs, Biologics, and Devices”
Wednesday, May 22, at 10:30 AM
 
House Ways and Means Committee - Hearing
“The Collapse of Private Practice: Examining the Challenges Facing Independent Medicine”
Thursday, May 23, at 9:00 AM
 
House Committee on the Budget - Hearing
“Breaking Up Health Care Monopolies: Examining the Budgetary Effects of Health Care Consolidation”  
Thursday, May 23, at 10:00 AM

Senate:

Senate Judiciary Committee - Hearing
“Hearings to examine competition in the prescription drug market, focusing on ensuring affordable and accessible medications.”
Tuesday, May 21, at 10:00 AM
 
Senate Health, Education, Labor, and Pensions, Subcommittee on Primary Health and Retirement Security – Hearing
“To examine feeding a healthier America, focusing on current efforts and potential opportunities for Food is Medicine.”
Tuesday, May 21, at 2:30 PM
 
Senate Health, Education, Labor, and Pensions Committee – Markup
“To consider S.3679, to reauthorize the Dr. Lorna Breen Health Care Provider Protection Act, S.3765, to amend the Public Health Service Act to reauthorize the Emergency Medical Services for Children program, S.4351, to amend the Public Health Service Act to reauthorize certain poison control programs, S.3775, to amend the Public Health Service Act to reauthorize the BOLD Infrastructure for Alzheimer's Act, S.4325, to amend the Public Health Service Act to reauthorize the program relating to lifespan respite care, S.3757, to reauthorize the congenital heart disease research, surveillance, and awareness program of the Centers for Disease Control and Prevention, S.4045, to require a study on public health impacts as a consequence of the February 3, 2023, train derailment in East Palestine, Ohio, the nomination of Stephen H. Ravas, of Maryland, to be Inspector General, Corporation for National and Community Service, and other pending calendar business.”
Thursday, May 23, at 10:00 AM 
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