Health Care Checkup
May 27, 2022
THE BIG PICTURE
This week, nineteen students and two teachers were tragically killed in a mass shooting at Robb Elementary School in Uvalde, Texas. This was the second-deadliest school shooting on record in the United States. In the aftermath of the shooting, Congress has been working to put together new gun-control laws. Senator Chris Murphy (D-CT) has been leading the charge in the Senate and met this week with a group of Senators to discuss a national “red flag” law and an enhanced background check system for gun sales. Most Senate Democrats support some form of gun control legislation; the challenge will be finding enough Republicans for a compromise that can overcome the 60 vote threshold needed to overcome a filibuster. A red flag law would allow for law enforcement to seize firearms from individuals a court deems dangerous. Congress is out of session for the next week on Memorial Day recess, but it is expected that talks will continue remotely over the break and resume in earnest when Congress returns.

On Friday, Senate Health, Education, Labor and Pensions (HELP) Committee Chair Senator Patty Murray (D-WA), and Ranking Member Senator Richard Burr (R-NC), introduced the FDA Safety and Landmark Advancements (FDASLA) Act—legislation that would reauthorize the Food and Drug Administration’s (FDA) prescription drug, generic drug, biosimilar, and medical device user fee agreements. The introduced legislation updates a discussion draft released last week. It is anticipated that the Committee will consider the legislation in Executive Session during the first- or second week following recess. The section-by-section summary can be found here, the bill text here and here, and a redline of the discussion draft here.

On Thursday, the Senate Finance Committee released a discussion draft for telehealth policies that would: remove Medicare’s in-person visit requirement for tele-mental health services, establish benefit transparency for mental health care services delivered via telehealth to inform Medicare beneficiaries how and when they can access telehealth, preserve access to audio-only mental health coverage in Medicare when necessary and appropriate, direct Medicare and Medicaid to promote and support provider use of telehealth, and incentivize states to use their CHIP programs to establish local solutions to serve behavioral health needs in schools, including through telehealth.

Additionally, earlier in the week, Representatives Dan Kildee (D-MI), Brad Wenstrup (R-OH), John Joyce (R-PA), and Lisa Blunt Rochester (D-DE) introduced legislation to expand the ability of renal dialysis facilities to serve as originating sites for telehealth services under the Medicare program. Originating site refers to the physical location of the patient during telehealth visits. Currently, Section 1834(m) of the Social Security Act restricts the delivery of telehealth services to certain physical locations, such as physician offices and hospitals.
 
On Wednesday, the Centers for Medicare & Medicaid Services (CMS) announced that California, Florida, Kentucky, and Oregon will extend Medicaid and Children’s Health Insurance Program (CHIP) coverage for the 12-month postpartum period. CMS estimates that this expansion of coverage will reach an additional 126,000 families. 42% of all births in the nation are covered by Medicaid. Additional information can be found here
What to Expect Next Week: The House and Senate will not be in session next week. Both chambers will return the week of June 6.
DEEP DIVE
New Bipartisan Telehealth Proposals Emerge in Congress
On Thursday, the Senate Finance Committee released a discussion draft for telehealth policies that would: remove Medicare’s in-person visit requirement for tele-mental health services, establish benefit transparency for mental health care services delivered via telehealth to inform Medicare beneficiaries how and when they can access telehealth, preserve access to audio-only mental health coverage in Medicare when necessary and appropriate, direct Medicare and Medicaid to promote and support provider use of telehealth, and incentivize states to use their CHIP programs to establish local solutions to serve behavioral health needs in schools, including through telehealth.

Additionally, earlier in the week, Representatives Dan Kildee (D-MI), Brad Wenstrup (R-OH), John Joyce (R-PA), and Lisa Blunt Rochester (D-DE) introduced legislation to expand the ability of renal dialysis facilities to serve as originating sites for telehealth services under the Medicare program. Originating site refers to the physical location of the patient during telehealth visits. Currently, Section 1834(m) of the Social Security Act restricts the delivery of telehealth services to certain physical locations, such as physician offices and hospitals.
 
Senate HELP Leaders Release FDA User Fee Discussion Draft
On Friday, Senate Health, Education, Labor and Pensions (HELP) Committee Chairwoman Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC) introduced the FDA Safety and Landmark Advancements (FDASLA) Act—legislation that would reauthorize the Food and Drug Administration’s (FDA) prescription drug, generic drug, biosimilar, and medical device user fee agreements. The legislation also includes provisions to “strengthen oversight of cosmetics and dietary supplements, modernize the regulation of diagnostic tests, bring more competition to the market, and prepare the FDA for the next generation of medical products to benefit Americans.” The section-by-section summary can be found here, the bill text here and here, and a redline of the discussion draft here.

House Democrats Urge the Extension of ARP Tax Credits in Upcoming Reconciliation Legislation, as Senate Democrats Call on Leaders to Address Drug Pricing through Reconciliation
Democrats, led by Rep. Lauren Underwood (D-IL) are urging Majority Leader Chuck Schumer (D-NY) and Speaker Nancy Pelosi (D-CA) to make the enhanced Affordable Care Act (ACA) premium tax credits from the American Rescue Plan (ARP) permanent. The members said that “monthly premiums for Marketplace plans have decreased by $50 per person on average,” saving families “an average of $2,400 on their annual premiums.” They also said that reconciliation is a “once-in-a-generation opportunity to extend coverage to millions of low-income people in states that have refused to expand Medicaid under the ACA.” Currently, the enhanced ACA tax credits are set to expire on December 31, 2022.

Over in the Senate, nearly 20 Democrats wrote a letter to Leader Schumer (D-NY) and Finance Chairman Ron Wyden (D-OR), requesting that the duo “move a reconciliation bill as soon as possible that will provide meaningful relief to those who rely on life-saving prescription drugs.” The Senators urged the leaders to pass a bill that limits the cost of insulin at $35 per month, caps out of pocket costs for Medicare Part D at $2,000 per year, penalizes drug corporations that raise prices faster than the rate of inflation, and grants Medicare the authority to negotiate the prices of certain drugs. The full letter can be found here.

California, Florida, Kentucky, and Oregon Expand Medicaid and CHIP Coverage to 12-Month Postpartum Period
On Wednesday, the Centers for Medicare & Medicaid Services (CMS) announced that California, Florida, Kentucky, and Oregon will extend Medicaid and Children’s Health Insurance Program (CHIP) coverage for the 12-month postpartum period. CMS estimates that this expansion of coverage will reach an additional 126,000 families. 42% of all births in the nation are covered by Medicaid. Additional information can be found here.
 
FDA Secures 2 Million Cans of U.K. Baby Formula, First Shipments to Arrive in June
The U.S. Food and Drug Administration (FDA) announced that beginning in June, 2 million cans of infant formula are expected to “land on U.S. store shelves” from a U.K. formula brand, Kendamil. The news comes amid the severe formula shortage the U.S. is facing. The FDA said that it will “continue to dedicate all available resources to help ensure that infant formula products remain available for use in the U.S.” As a reminder, last week Congress passed the Access to Baby Formula Act, which will authorize the U.S. Department of Agriculture (USDA) to waive baby formula contract requirements during emergencies, disasters, and supply chain disruptions affecting participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
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