Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Senate Recesses, Congress to Return After November Midterm Elections

The Senate adjourned on Thursday and is not scheduled to return until November 13. This gives senators up for re-election more than three weeks to campaign before the midterm elections on November 6. Lawmakers reached a deal on dozens of the President’s nominees before leaving town. During the lame-duck session, legislators hope to tackle the farm bill, expiring tax breaks, criminal justice reform, reauthorization of the Violence Against Women Act, and the Jobs Act 3.0. Short-term funding for several federal agencies, including the Food and Drug Administration and the Department of Homeland Security, expires on December 7. One key remaining topic will be the amount of funds for the construction of a wall along the U.S.-Mexico border. The lame-duck agenda also includes a vote on recommendations from the Joint Select Committee on Budget and Appropriations Reform.

Senate Rejects Effort to Overturn Insurance Regulation

Senate Democrats failed to reverse a regulation from the Trump administration that will expand the availability of short-term, limited duration health plans that do not have to comply with consumer protections of the Affordable Care Act (ACA). Democrats had attempted to use the Congressional Review Act, which allows for regulations to be overturned with a simple majority. Sen. Tammy Baldwin (D-Wis.) sponsored the resolution (S.J.Res. 63) and obtained the 49 signatures necessary to file a discharge petition and force a vote. The resolution was rejected by a 50-50 vote, with Sen. Susan Collins (R-Maine) voting with Democrats in support of overturning the short-term insurance plan regulation. Democrats characterize the plans as junk insurance because they are not required to cover pre-existing conditions or follow other ACA regulations. The administration and congressional Republicans argue that the rule, which became effective earlier this month, expands access to less expensive insurance coverage options.

Lawmakers Request CMS Guidance on Use of Prior Authorization in MA

More than 100 members of the House of Representatives have written to Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), asking the agency to issue guidance dissuading Medicare Advantage (MA) plans from using prior authorization. The letter was signed by 55 Republicans and 48 Democrats. The lawmakers warn CMS that burdensome and often unnecessary prior authorization requirements may be preventing beneficiaries from receiving the care they need. They urge CMS to increase transparency around utilization management practices, streamline the prior authorization process, and report on CMS’ oversight of prior authorization in MA.

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