POLICY BRIEFINGS

Ways and Means Advances Private Equity, Hospice Legislation


During its markup last week, the House Ways and Means Committee also passed legislation to increase transparency among private equity firms that invest in medical care providers. The Transparency in Health Care Investments Act of 2020 (H.R. 5825), which was passed by voice vote, would require reporting to the Internal Revenue Service (IRS) separately from annual tax returns certain information with respect to health care providers in which private equity has a financial interest. Such returns would then be made publicly available. Chairman Richard Neal (D-Mass.) argued that this legislation would enable policy makers and regulators to better understand private equity’s impact on the health care system. Republicans on the panel, however, expressed opposition to the bill, asserting that it would be an abuse of the tax code. Ranking Member Kevin Brady (R-Texas) suggested that the Committee instead examine the impact of consolidation and acquisition of health care parties by all investors, private or non-profit.

Ways and Means also advanced the Helping Our Senior Population in Comfort Environments (HOSPICE) Act (H.R. 5821) by voice vote. The bill would provide HHS and the Centers for Medicare and Medicaid Services (CMS) with additional authorities to penalize low-performing Medicare hospice providers. CMS would be permitted to fine hospices $10,000 for each day they do not meet Medicare program requirements. The agency could also appoint temporary management of, suspend payments to, or terminate the Medicare certification of providers that do not meet program quality requirements. State agencies and accreditation organizations would be required to complete quality surveys of hospices no less than every two years, and submit the results to HHS to be published online. States would also be required to maintain a toll-free hotline for individuals to report hospice abuse and neglect. The bill is a response to a recent report from the HHS Office of the Inspector General finding that between 2012 and 2016 more than 80 percent of hospices had at least one deficiency leading to beneficiary harm. CBO estimates that the bill would save $181 million over 10 years.


Grassley Remains Optimistic on Fate of Drug Pricing Bill


Senate Finance Chairman Chuck Grassley (R-Iowa) has been meeting with Senate Republicans up for reelection this year hoping to drum up support for the bipartisan drug pricing measure (S. 2543) advanced out of his committee last year. Grassley has said that he needs at least 25 Republican co-sponsors to get the Prescription Drug Pricing Reduction Act to the Senate floor. So far, 11 Republicans, including Grassley, are on the record in support of the legislation. Sen. Grassley plans to file an updated version of the drug pricing bill that he introduced with Ranking Member Ron Wyden (D-Ore.) in the near future. He has previously discussed adding a provision to overhaul the prescription drug rebate system. Senate Majority Leader Mitch McConnell (R-Ky.) recently said that there remained internal divisions on the issue of prescription drug pricing within his caucus and that he is not sure whether any related legislation could pass the Senate this year. Sen. McConnell stated that the May 22 deadline to fund various health care programs would provide another opportunity for discussions on proposed drug pricing policies.


Lawmakers Raise Concerns About Organ Procurement, Transplant Oversight


A bipartisan group of senators are raising questions about the adequacy of patient safety standards at the U.S. Organ Procurement and Transplantation Network (OPTN). Senate Finance Committee Chairman Chuck Grassley (R-Iowa), Ranking Member Ron Wyden (D-Ore.), Sen. Todd Young (R-Ind.), and Sen. Ben Cardin (D-Md.) sent a letter requesting information and data to the United Network for Organ Sharing (UNOS), which has been contracted by Congress to oversee the OPTN. Their letter cites numerous inspector general audits and news reports finding that thousands of available organs go unused and describing organ procurement organizations’ (OPO) use of questionable financial practices. The lawmakers ask for details about the organ procurement and transplant process, including: legally required periodic performance reviews of OPOs, audits of OPOS that suggest Medicare was billed for unallowable expenditures, data released to OPOs identified as ‘underperforming’ or not in good standing over the last year, data related to delayed, mishandled, or damaged organs over the last ten years, data related to the number of organs not recovered or not transplanted over the last ten years, and information relating to the financial improprieties or conflicts of interest of OPOs over the last ten years. The letter requests a response by March 1.


Azar Asked to Reimburse Local Governments for Coronavirus Respons


A bipartisan group of 17 senators are asking HHS Secretary Alex Azar to establish guidelines for state and local governments to be reimbursed for costs incurred in response to the coronavirus outbreak. The lawmakers assert that state and local public health agencies are depleting their resources in support of federal virus monitoring and quarantines, and that federal support will be necessary for them to continue their response efforts.


Upcoming Congressional Hearings and Markups


House Energy and Commerce Subcommittee on Health hearing on President Trump’s budget request for HHS and its agencies for fiscal year (FY) 2021 and the ongoing coronavirus outbreak; time and place TBD; February 26

House Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Member Day; 10:00 a.m., 2362-A Rayburn Bldg.; March 3



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