HELP Advances Eight Health Measures

The Senate Health, Education, Labor, and Pensions (HELP) Committee advanced eight pieces of health legislation by voice vote last week, including:

  • the Ticks: Identify, Control, and Knockout (TICK) Act (S. 1657), to support efforts to combat Lyme disease and other tick-borne illnesses;
  • the Healthy Start Reauthorization Act (S. 2619), to reauthorize the Healthy Start program, improve access to care and reduce infant mortality rates;
  • the Title VIII Nursing Workforce Reauthorization Act (S. 1399), to reauthorize federal nursing workforce development programs;
  • the Lifespan Respite Care Reauthorization Act (S. 995), to extend support for state respite care programs that aid Americans caring for family members with special needs;
  • the Scarlett’s Sunshine on Sudden Unexpected Death Act (S.1130), to improve the understanding of unexpected sudden death in children;
  • the Promoting Physical Activity for Americans Act (S. 1608), to require the U.S. Department of Health and Human Services (HHS) to routinely update recommendations on exercise;
  • the United States Public Health Service Modernization Act (S. 2629), to allow the creation of a reserve of public health professionals to respond to national or public health emergencies; and
  • the Over-the-Counter Monograph Safety, Innovation, and Reform Act (S. 2740), to overhaul the regulation of over-the-counter drug, speed the FDA’s review of such products and create new user fees to support improvements to this process.

Senate Dems Fail to Overturn 1332 Waiver Guidance

Senate Democrats were unsuccessful in their attempt last week to use the Congressional Review Act to overturn the October 2018 White House guidance that permits the use of federal subsidies to pay for health insurance plans that do not comply with all of the Affordable Care Act’s (ACA) patient protections. S. J. Res. 52, the Overturn ACA Waiver Guidance, failed by a vote of 43-52, with Sen. Susan Collins (R-Maine) breaking with her GOP colleagues in support of the resolution from Senate Minority Leader Chuck Schumer (D-N.Y.). The vote was a largely symbolic attempt by Democrats to put Republicans on the record regarding their position on protections for individuals with pre-existing conditions. The White House and GOP lawmakers argue that the guidance supports efforts to increase the number of affordable health insurance options available. No state has yet to apply for an expanded Section 1332 waiver with the U.S. Department of Health and Human Services (HHS) that would take advantage of the guidance.

Cassidy, Hassan Pitch IDR Compromise in Push to Pass Surprising Billing Legislation

Sens. Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.) spoke about the possibility of including surprise billing legislation as a part of a year-end package during an event hosted by the Bipartisan Policy Center last week. Negotiations on a solution to protect patients from surprise medical bills have stalled amidst disagreements on how to resolve billing disputes between providers and payers. The legislation advanced by the Senate HELP Committee would base payments for out-of-network bills on the median rates for in-network providers, while the House Energy and Commerce Committee bill would allow an independent dispute resolution (IDR) process for claims above $1,250. Sen. Cassidy, who is supportive of adding an IDR process to the HELP bill, noted that one possible compromise could be to allow physicians to combine small out-of-network bills in order to meet the threshold for initiating the IDR process. IDR decisions would then be based on commercially reasonable rates rather than billed charges, in an attempt to prevent the inflation of provider prices. Such a policy could also address stakeholder concerns about the potential administrative costs of IDR for the significant number of smaller medical bills. Staff for HELP Chairman Lamar Alexander (R-Tenn.) noted the chairman’s concerns regarding the inflationary impact of IDR, as well as the importance of addressing air ambulance charges in the final surprise billing solution. Such a provision was not included in the House Energy and Commerce measure. Cassidy and Hassan, however, appeared optimistic about the chances of a surprise billing solution becoming law this year.

Durbin, Kennedy Request Opioid Quota Reduction

In a letter to the Drug Enforcement Administration (DEA), Sens. Dick Durbin (D-Ill.) and John Kennedy (R-La.) have requested that opioid quotas be meaningfully reduced from 2019 levels. The lawmakers argue that there is a “clear connection between the staggering volumes of painkillers approved for production and the current overdose epidemic.” The SUPPORT for Patients and Communities Act (P.L. 115-271) included a provision to strengthen the DEA’s statutory quota-setting authority. Durbin and Kennedy urge the agency to apply this new authority in order to prevent and limit opioid diversion.

E&C, Finance Democrats Pressure HHS On Rates of Uninsured Children

House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) and Senate Finance Committee Ranking Member Ron Wyden (D-Ore.) have written to HHS Secretary Alex Azar asking that the department take immediate action to reverse Medicaid and CHIP coverage declines amongst children. The lawmakers point to new data from the U.S. Census Bureau indicating an increase of 425,000 uninsured children between 2017 and 2018. They assert that “these historic coverage losses among children are the result of overly burdensome and faulty eligibility and renewal processes, diminished resources for outreach and enrollment assistance, and policies that instill fear and confusion among immigrant and mixed status families.”

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