Health Care Checkup
May 21, 2021
THE BIG PICTURE
On Tuesday, HHS announced that the Substance Abuse and Mental Health Services Administration (SAMHSA) is going to distribute $3 billion in American Rescue Plan (ARP) funding for its mental health and substance use block grant programs. The funding allocation is the largest aggregate amount to date for the programs.
 
HHS also announced that $14.2 million from the ARP will be made available to expand pediatric mental health care access by integrating telehealth services into pediatric primary care. The agency said that the funding will help to expand Pediatric Mental Health Care Access (PMHCA) programs into new regions across the country.
 
On Wednesday, the Senate Appropriations Labor, Health and Human Services (HHS) Subcommittee held a hearing on the Centers for Disease Control and Prevention’s (CDC) budget request for fiscal year (FY) 2022. The Director of the CDC, Rochelle Walensky testified at the hearing and urged that additional funding is needed for the CDC to build upon its public health efforts.
 
Also on Wednesday, the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights held a hearing that focused on the impact of hospital consolidation on the health care industry and on consumers. The Chair of the Subcommittee, Senator Amy Klobuchar (D-MN), said in her opening statement that there have been almost 1,600 hospital mergers in the last 20 years.
 
The House Oversight and Reform Committee held a hearing, titled “Unsustainable Drug Prices (Part III): Testimony from AbbVie CEO Richard Gonzalez.” The hearing delved into the pricing and business practices of the pharmaceutical company AbbVie Inc. Before the hearing, the Committee released a report, which detailed AbbVie’s repeated price gouging of Humira, an anti-inflammatory drug that now costs 470% more than when it initially hit the market.
 
The Senate Finance Committee has been evaluating which expanded telehealth policies from the pandemic should be made permanent for Medicare beneficiaries. During the pandemic, CMS temporarily approved Medicare to pay for telehealth services outside of rural areas and added more than 100 new telehealth services for beneficiaries. The agency also allowed for audio-only visits to be reimbursed and increased reimbursement rates for telehealth visits. On Wednesday, at a hearing to examine COVID-19 health care flexibilities, the Chairman of the Senate Finance Committee, Ron Wyden (D-OR), expressed support for making mental health services via telehealth available for all Medicare beneficiaries.
What to Expect Next Week: On Monday, the Senate will vote on President Joe Biden’s pick to lead CMS, Chiquita Brooks-LaSure. The vote will be the first of two needed to confirm Brooks-LaSure as the Administrator of CMS. On Wednesday, the Senate Appropriations Labor HHS Subcommittee will hold a hearing on the “National Institutes of Health’s FY22 Budget and the State of Medical Research.”
DEEP DIVE
HHS Announces that $3 Billion from American Rescue Plan Will be Allocated for SAMHSA Block Grants to Address the Mental Health Crisis in America

On Tuesday, HHS announced that the Substance Abuse and Mental Health Services Administration (SAMHSA) is going to distribute $3 billion in American Rescue Plan (ARP) funding for its mental health and substance use block grant programs. The funding allocation is the largest aggregate amount to date for the programs. The agency stated that the COVID-19 pandemic, along with the corresponding economic crisis, has been especially devastating for Black, American Indian, Alaska Native and Hispanic communities, which has contributed to increased levels of depression and anxiety. The CDC’s data shows that in June 2020, American adults reported elevated levels of “adverse mental health conditions, substance use, and suicidal ideation.” In response, HHS Secretary Xavier Becerra has established a new Behavioral Health Coordinating Council (BHCC) to target mental health and substance abuse disorders. The Acting Assistant Secretary for Mental Health and Substance Use, Tom Coderre, said, “Given the significant impact mental and substance use disorders can have on the lives of individuals, families and communities, the establishment of the BHCC provides a critical tool in addressing these issues in a collaborative and strategic way.” Funding allocations for the block grant programs can be viewed here and here.

$14.2 Million from American Rescue Plan Will Go Toward Pediatric Mental Health Care Access

On Thursday, HHS announced that $14.2 million from the ARP will be made available to expand pediatric mental health care access by integrating telehealth services into pediatric primary care. The agency said that the funding will help to expand Pediatric Mental Health Care Access (PMHCA) programs into new regions across the country. New teams of pediatric mental health experts will “provide teleconsultations, training, technical assistance and care coordination for pediatric primary care providers to diagnose, treat and refer children and youth with mental health conditions and substance use disorders.” HHS reports that only 20% of children with mental, emotional, or behavioral disorders receive care from a specialist.

Texas Plans to Submit Medicaid Waiver Extension Application
 
Texas plans to submit an application to the Centers for Medicare and Medicaid Services (CMS), seeking a 10-year extension of funding for its Medicaid 1115 waiver that is set to expire in October 2022. The waiver provides billions of dollars to Texas hospitals for uninsured patients’ care. The Trump Administration had granted an extension on the waiver in the waning days of former President Donald Trump’s presidency. However, the Biden Administration revoked that extension last month because it did not undergo the typical public notice and comment period. The state has since sued the Biden Administration over its decision to revoke the waiver extension. The waiver was originally granted to Texas in 2011 on a temporary basis as the state transitioned to an expanded Medicaid program under the Affordable Care Act (ACA). However, when the Supreme Court ruled in 2012 that states could not be forced to expand their Medicaid programs, Texas decided to not expand its Medicaid program and instead has relied on the waiver to care for uninsured Texans.
 
Mississippi’s Ballot Initiatives Halted by Court Ruling
 
Last week, the Supreme Court of Mississippi halted a proposed Mississippi ballot initiative to vote on the legalization of medical marijuana during the upcoming 2022 midterm elections. The Court held that the proposed medical marijuana referendum violated the state’s constitution, which says that no more than 20% of the signatures collected to place a new initiative on the ballot can be derived from a single congressional district. According to the Court, since Mississippi currently only has four congressional districts, it is impossible for the medical marijuana initiative to satisfy this constitutional requirement. The Court’s ruling also invalidated recent efforts of the Fairness Project to put Medicaid expansion to a statewide vote in 2022. The Fairness Project, an organization that has helped to expand Medicaid in traditionally Republican states, had recently begun a statewide campaign to get Medicaid expansion on the state’s ballot in 2022. These efforts would have expanded Medicaid coverage to an additional 200,000 Mississippi residents.
 
Senate Subcommittee Holds Hearing on CDC’s Budget Request for FY 2022
 
On Wednesday, the Senate Appropriations Labor, Health and Human Services (HHS) Subcommittee held a hearing on the Centers for Disease Control and Prevention’s (CDC) budget request for fiscal year (FY) 2022. The Director of the CDC, Rochelle Walensky testified at the hearing and urged that additional funding is needed for the CDC to build upon its public health efforts. The CDC’s budget request for FY 2022 is $8.7 billion, which is $1.6 billion more than the previous year. Walensky said that the additional funds will help to "[increase] focus on four critical areas: building public health infrastructure, reducing health disparities, using public health approaches to reduce violence, and defeating diseases and epidemics." Walensky also said that additional funding will help to end the coronavirus pandemic and prepare for the next public health emergency. Senators questioned Walensky on various topics, ranging from suicide prevention to the agency’s updated guidance on face masks. The Subcommittee’s Chairwoman, Patty Murray (D-WA), stated “These investments will help us finish strong when it comes to this pandemic, prepare for the next one, and make progress on other public health challenges.”
 
House Holds Hearing on ‘Unsustainable’ Drug Prices

On Tuesday, the House Oversight and Reform Committee held a hearing, titled “Unsustainable Drug Prices (Part III): Testimony from AbbVie CEO Richard Gonzalez.” The hearing delved into the pricing and business practices of the pharmaceutical company AbbVie Inc. Before the hearing, the Committee released a report, which detailed AbbVie’s repeated price gouging of Humira, an anti-inflammatory drug that now costs 470% more than when it initially hit the market. The report also found that between 2015 and 2018, senior executives’ bonuses were “tied directly to Humira net revenue.” The hearing also focused on the company’s continued price increases of its drug Imbruvica, which is used to treat cancer. Democrats are likely to use the report in their ongoing push for H.R. 3, the drug bill that would allow Medicare to negotiate directly with pharmaceutical companies to lower drug prices. A study on H.R. 3 came out on Thursday and found that the legislation would save employers an estimated $195 billion and employees an estimated $98 billion by 2030. MCRT’s summary of the hearing can be found here.

Senators Weigh Telehealth Policies from the Pandemic
 
The Senate Finance Committee has been evaluating which expanded telehealth policies from the pandemic should be made permanent for Medicare beneficiaries. During the pandemic, CMS temporarily approved Medicare to pay for telehealth services outside of rural areas and added more than 100 new telehealth services for beneficiaries. The agency also allowed for audio-only visits to be reimbursed and increased reimbursement rates for telehealth visits. On Wednesday, at a hearing to examine COVID-19 health care flexibilities, the Chairman of the Senate Finance Committee, Ron Wyden (D-OR), expressed support for making mental health services via telehealth available for all Medicare beneficiaries. Wyden said, “My view is that mental health service ought to be available for telehealth for everybody.” Ranking Member Mike Crapo (R-ID) also expressed support for extending telehealth services, but said, “it is important that we gather evidence of its impact on access, quality and cost.”
 
Senate Judiciary Subcommittee Holds Hearing on Hospital Consolidation
 
On Wednesday, the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights held a hearing that focused on the impact of hospital consolidation on the health care industry and on consumers. The Chair of the Subcommittee, Senator Amy Klobuchar (D-MN), said in her opening statement that there have been almost 1,600 hospital mergers in the last 20 years. Klobuchar explained that the purpose of the hearing was to examine the impact these mergers have had on health care costs and the treatment of patients. Some of the industry witnesses claimed that the hospital mergers have been negative for consumers due to substantial price increases. However, others asserted that hospital consolidation has been beneficial for consumers because they claim it has improved the quality of care. MCRT’s full summary of the hearing can be found here
SENATE HEARINGS AND EXECUTIVE SESSIONS
Senate Appropriations Committee - Hearing
Subcommittee on The Subcommittee on Labor, Health and Human Services, Education and Related Agencies: National Institutes of Health’s FY22 Budget and the State of Medical Research.
Wednesday, May 26 at 10:00 AM ET
                                  
Senate Health, Education, Labor and Pensions Committee - Hearing
Full Committee Hearing: Nominations of Rajesh Nayak for Assistant Secretary of Labor for Policy, Taryn Mackenzie Williams for Assistant Secretary of Labor for Disability Employment Policy, and Doug Parker for Assistant Secretary of Labor for Occupational Safety and Health
Thursday, May 27 at 10:00 AM ET
HOUSE HEARINGS AND EXECUTIVE SESSIONS
N/A
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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