POLICY BRIEFINGS

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Democrats Warn Against Fraud, Abuse in ACO REACH

Agroup of progressive Democrats have sent a letter to the Centers for Medicare and Medicaid Services (CMS) warning that the agency’s Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) model provides an opportunity for insurers and other health care companies with a history of defrauding the government to take further advantage of the Medicare program. The letter follows a preliminary review conducted by the Physicians for a National Health Program, which found that nine companies participating in the model face allegations of fraud and abuse in various other insurance programs but were still accepted into the global and professional direct contracting program in 2021. The lawmakers ask that CMS closely examine the participants in the ACO REACH program and take action to prevent those with histories of fraud and abuse from participating in the program in 2023.

Future of Select COVID Panel Unclear as Final Report Released

The House Oversight and Reform Select Subcommittee on the Coronavirus Crisis released its final report last week. They announced what could be the panel’s final hearing in anticipation of Republicans retaking the majority in the House of Representatives for the 118th congress. The report includes findings related to the Trump administration’s failure to recognize and prepare for the threat posed by the coronavirus in early 2020 resulting from inaccurate testing and insufficient personal protective equipment. The panel will convene a hearing titled “Preparing for and Preventing the Next Public Health Emergency: Lessons Learned from the Coronavirus” on Wednesday at 2:00 p.m. Republicans are still deciding whether to renew the select subcommittee during the 118th congress. Rep. Jim Jordan (R-Ohio) has expressed an interest in shifting the panel’s attention to the origins of COVID-19 and gain-of-function research funding decisions made by the National Institutes of Health. Ranking Member Steve Scalise (R-La.) has stated that this type of work could be completed by the broader Oversight Committee, but that no final decisions about the future of the select subcommittee have been made.

Walensky Voices Support for Public Health Data Bill

Director of the Centers for Disease Control and Prevention (CDC) Rochelle Walensky has lent her support for legislation to modernize the nation’s health data infrastructure. The Improving DATA in Public Health Act (S. 3913/H.R. 8481), introduced by Sen. Tim Kaine (D-Va.) and Rep. Lauren Underwood (D-Ill.), would establish uniform data standards for federal and local governments to use in the exchange of health data and provide funding for the development of data sharing best practices. Walensky stressed her agency’s current lack of authority to require data reporting during the Bloomberg American Health Summit last week and expressed frustration over how the speed with which states and localities shared real-time data during the COVID-19 and mpox outbreaks hampered the CDC’s ability to respond to the public health emergencies and make appropriate public health recommendations.

Longtime NIAID No. 2 to Serve as Acting Director

Transplant surgeon Hugh Auchincloss will serve as acting director of the National Institute of Allergy and Infectious Diseases (NIAID) when Anthony Fauci steps down from public service at the end of the month. Auchincloss has worked as the institute’s principal deputy director since 2006, overseeing NIAID’s strategic plan and leading an internal group to develop its initiatives. His current work centers on making NIAID’s clinical research infrastructure more flexible and accessible.

New Tool Launched to Determine App Compliance with Rules and Regulations

The U.S. Department of Health and Human Services’ Office for Civil Rights and Office of the National Coordinator for Health Information Technology, in conjunction with the Federal Trade Commission (FTC) and the FDA, have launched an updated interactive tool to help app developers and their software remain in compliance with federal regulations around data privacy, cybersecurity, and data sharing. “The burgeoning market for health apps holds promise for consumers, but only if – and this is a big if – app developers understand their legal obligations and honor those responsibilities,” Lesley Fair, senior attorney with the FTC, said in a blog post last week. The new Mobile Health App Interactive Tool aims to help industry members determine what federal laws and regulations might apply to their apps.

Upcoming Congressional Hearings and Markups

Senate Agriculture, Nutrition, and Forestry Subcommittee on Food and Nutrition, Specialty Crops, Organics, and Research hearing “Food as Medicine: Current Efforts and Potential Opportunities;” 10:00 a.m.; December 13

House Veterans’ Affairs Committee hearing “Review of the Role of VA’s Fourth Mission and Pandemic Response;” 2:00 p.m., December 13

House Veterans’ Affairs Subcommittee on Health hearing “Reviewing the Program of Comprehensive Assistance for Family Caregivers;” 10:00 a.m., December 14

House Veterans’ Affairs Subcommittees on Oversight and Investigations and Technology Modernization joint hearing “Protecting the Privacy of Veterans’ Data;” 1:00 p.m., December 14

House Oversight and Reform Select Subcommittee on the Coronavirus Crisis hearing “Preparing for and Preventing the Next Public Health Emergency: Lessons Learned from the Coronavirus Crisis;” 2:00 p.m., December 14

Recently Introduced Health Legislation

H.R.9404 — To amend the Public Health Service Act to prohibit the Secretary of Health and Human Services from placing any vaccine for COVID-19 on the child and adolescent immunization schedule unless the Secretary has posted on the public website of the Centers for Disease Control and Prevention all clinical data in the possession of the Department of Health and Human Services relating to the safety and efficacy of such vaccine, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

S.5181 — A bill to direct the Secretary of Veterans Affairs to make certain improvements relating to mental health and suicide prevention outreach to minority veterans and American Indian and Alaska Native veterans, and for other purposes; Sponsor: Tester, Jon [Sen.-D-MT]; Committees: Senate - Veterans’ Affairs

H.R.9424 — To amend the Public Health Service Act to authorize grants for graduate medical education partnerships in States with a low ratio of medical residents relative to the general population; Sponsor: Castor, Kathy [Rep.-D-FL-14]; Committees: House - Energy and Commerce

H.R.9427 — To amend title XVIII of the Social Security Act to permanently extend certain in-home cardiopulmonary rehabilitation flexibilities established in response to COVID-19, and for other purposes; Sponsor: Joyce, John [Rep.-R- PA-13]; Committees: House - Energy and Commerce; Ways and Means

S.5194 — A bill to amend title XVIII of the Social Security Act to extend certain increases in payments for physicians services under the Medicare program through 2023; Sponsor: Kennedy, John [Sen.-R-LA]; Committees: Senate – Finance

S.Res.863 — A resolution designating November 2022 as “National Lung Cancer Awareness Month” and expressing support for early detection and treatment of lung cancer; Sponsor: Smith, Tina [Sen.-D-MN]; Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent.

S.Res.868 — A resolution expressing support for the designation of September 2022 as “Sickle Cell Disease Awareness Month” in order to educate communities across the United States about sickle cell disease and the need for research, early detection methods, effective treatments, and preventative care programs with respect to complications from sickle cell disease and conditions related to sickle cell disease; Sponsor: Scott, Tim [Sen.-R-SC]; Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent.

S.5212 — A bill to amend titles XVIII and XIX of the Social Security Act and the Bipartisan Budget Act of 2018 to increase access to services provided by advanced practice registered nurses under the Medicare and Medicaid programs, and for other purposes; Sponsor: Merkley, Jeff [Sen.-D-OR]; Committees: Senate – Finance

H.Res.1514 — Raising awareness for the cancer chordoma; Sponsor: Johnson, Henry C. “Hank,” Jr. [Rep.-D-GA-4]; Committees: House - Energy and Commerce

H.R.9475 — To direct the Secretary of Health and Human Services, in consultation of the Secretary of Education, to conduct a study on the impact of COVID-19 on the mental health of education professionals, to direct the Secretary of Education to award grants to implement or improve health and wellness programs for education professionals, and for other purposes; Sponsor: Kirkpatrick, Ann [Rep.-D-AZ-2]; Committees: House - Education and Labor; Energy and Commerce

H.R.9476 — To protect against seasonal and pandemic influenza, and for other purposes; Sponsor: Larsen, Rick [Rep.-D- WA-2]; Committees: House - Energy and Commerce; Budget; Financial Services

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