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.


House Passes MA Prior Authorization Legislation

On Wednesday, the House of Representatives passed the Improving Seniors’ Timely Access to Care Act (H.R. 3173), introduced by Rep. Suzan DelBene (D-Wash.), by voice vote. The Energy and Commerce Health Subcommittee had unanimously approved the measure earlier that day. The bill would require Medicare Advantage (MA) plans to establish an electronic prior authorization process. It also aims to improve transparency in the prior authorization process by requiring plans to make public data on prior authorization approval rates and response times. The Congressional Budget Office estimates that the bill will cost more than $16 billion over the next decade. Companion legislation (S. 3018) has been introduced in the Senate by Sen. Roger Marshall (R-Kansas) and currently has 40 bipartisan cosponsors.

Bera, Bucshon Introduce Bill to Protect Physicians from Medicare Pay Cuts

Reps. Ami Bera (D-Calif.) and Larry Bucshon (R-Ind.) introduced the Supporting Medicare Providers Act (H.R. 8800) last week. The bill seeks to hold providers harmless from the impending 4.42% cut to the Medicare Physician Fee Schedule conversion factor resulting from budget neutrality. In 2023, physicians face more than 8.42% in payment cuts, and this legislation would stop the 4.42% cut in Medicare payments providers will face on January 1st. The bill also includes a Sense of the Congress related to the need to pursue administrative and legislative actions to "ensure financial stability and predictability in the Medicare physician payment system; promote and reward value-based care innovation; and safeguard timely access to high-quality care by advancing health equity and reducing disparities."

Congress Approaches End of Fiscal Year Without Agreement

The Senate has begun drafting a continuing resolution (CR) to keep the government open beyond the end of the fiscal year on September 30. The stopgap spending bill currently under discussion would fund the federal government through December 16. Lawmakers are still debating what other measures should be attached to the CR, with a deal currently being held up over a proposal to streamline the energy permitting process. The White House continues to push for the inclusion of more money for the COVID-19 and monkeypox responses. Senate Republicans hope to include a clean five-year reauthorization of medical product user fees at the Food and Drug Administration (FDA) in the government funding bill. Other policy riders – such as an overhaul of the FDA’s diagnostic, dietary supplement, and cosmetic regulations – may be pushed for consideration in an end-of-the-year omnibus appropriations package; negotiations are ongoing.

E&C Health Subcommittee Advances Five Bills

The House Energy and Commerce Health Subcommittee advanced five pieces of legislation last week to improve health care delivery systems and increase access to care.

  • H.R. 3173, the Improving Seniors’ Timely Access to Care Act of 2021 was forwarded to the full committee by voice vote.
  • H.R. 3655, the Vaccine Injury Compensation Modernization Act of 2021 was forwarded to the full committee by voice vote.
  • H.R. 5141, the Maximizing Outcomes through Better Investments in Lifesaving Equipment for Health Care Act was forwarded to the full committee by a vote of 29-0.
  • H.R. 8163, the Improving Trauma Systems and Emergency Care Act was forwarded to the full committee by voice vote.
  • H.R. 6737, the Flint Registry Reauthorization Act was forwarded to the full committee by a vote of 16-12.

Ways and Means Report on Health Care System and Climate Change

The House Ways and Means Committee has released a new report examining the role of the U.S. health care system in the climate crisis. The Majority Staff Report explores the responses received from health systems, hospitals, dialysis companies, nursing homes, community health centers, and health care trade associations following a request for information issued by the panel in March 2022 about how they are addressing climate change and how they have been impacted by extreme weather events. A majority of respondents reported having experienced one such extreme weather event in the last five years. The report reflects a diversity of experiences in responding to carbon emissions and found that the health care sector is responsible for an estimated 10% of national greenhouse gas emissions. On September 15th, the committee held a hearing titled “Preparing America’s Health Care Infrastructure for the Climate Crisis.”

Hassan, Braun Encourage More Provider Training on Substance Use Disorders

Sens. Maggie Hassan (D-N.H.) and Mike Braun (R-Ind.) have sent a letter to the Accreditation Council for Graduate Medical Education (ACGME) asking the organization to update its requirements for training medical practitioners in the treatment of substance use disorders. Hassan and Braun are seeking to ensure that physicians-in-training are taught the skills necessary to address the current overdose epidemic. The lawmakers argue that the overdose crisis has persisted in part because of a lack of treatment providers. “Just one in five individuals with an opioid use disorder receives the treatment they need. As of 2019, fewer than 7% of all physicians prescribe buprenorphine for an opioid use disorder,” the letter states.

Senators Urge HHS to Strengthen HIPAA Privacy Rule

Agroup of 30 senators led by Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Patty Murray (D-Wash.) is asking the U.S. Department of Health and Human Services (HHS) to update Health Information Portability and Accountability Act (HIPAA) privacy protections to ban health care providers from sharing a patient’s abortion-related information with law enforcement. “To safeguard the privacy of women’s personal health care decisions and ensure patients feel safe seeking medical care, including reproductive health care, we urge you to quickly initiate the rulemaking process to strengthen privacy protections for reproductive health information,” the letter states. "In particular, HHS should update the HIPAA Privacy Rule to broadly restrict regulated entities from sharing individuals’ reproductive health information without explicit consent, particularly for law enforcement, civil, or criminal proceedings premised on the provision of abortion care."

Pascrell Asks HHS to Investigate HCA Healthcare’s Medicare Billing Practices

Chair of the House Ways and Means Subcommittee on Oversight Bill Pascrell (D-N.J.) is asking the U.S. Department of Health and Human Services to investigate possible Medicare fraud by the HCA Healthcare chain. “In light of reports that there may be misconduct and potentially the improper shifting of taxpayer dollars, I ask that HHS launch an investigation into the allegations leveled against HCA regarding its emergency department admissions practice.” Pascrell states that patients in HCA’s emergency rooms “may have been admitted for inpatient stays regardless of medical necessity.”

Bennet Urges Guidance on Medicaid Funding for School Mental Health Services

Sen. Michael Bennet (D-Colo.) is asking the Biden administration to update its guidance on Medicaid funding for school-based mental health care. “Updating federal guidance regarding Medicaid funding for services in school-based settings is long overdue and urgently needed to help address the youth mental and behavioral health crisis,” the letter states. The Bipartisan Safer Communities Act, passed earlier this year, instructed the Centers for Medicare and Medicaid Services to issue updated guidance for state Medicaid programs, local educational agencies, and school-based settings to implement and expand school-based health programs, including best practices for accessing Medicaid funding, identifying eligible providers, and utilizing telehealth to deliver mental and behavioral health services in schools.

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