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 Judiciary Advances Supreme Court Nomination, Final Vote Expected Today

The Senate Judiciary Committee advanced the nomination of Amy Coney Barrett to the Supreme Court last Thursday. All 12 Republican panel members voted in favor of the nomination, with panel Democrats boycotting the vote in objection to what they have characterized as a rushed confirmation process. Democrats have conceded that they do not have the votes to defeat Barrett on the floor. Senate Majority Leader Mitch McConnell (R-Ky.) announced that the chamber will hold the final vote to confirm Barrett to the Supreme Court today. Sen. Susan Collins (R-Maine) is the only Republican who has said she will oppose Barrett’s confirmation, because she does not believe a nominee should be considered prior to the election.

Bipartisan Lawmakers Request Legislative Fix to Medicare Budget Neutrality

A bipartisan group of 229 House members sent a letter urging Speaker Nancy Pelosi (D-Calif.) and Minority Leader Kevin McCarthy (R-Calif.) to pass a fix preventing Medicare physician fee schedule cuts for certain medical specialties from going into effect. The letter expresses support for pay increases for office-based specialties, but urges the leaders to waive the budget neutrality requirement that would result in across-theboard pay cuts elsewhere to offset the increases. The lawmakers ask for a fix to be included in any upcoming legislation moving through the House in the absence of regulatory relief from the Centers for Medicare and Medicaid Services (CMS).

HHS Updates the PRF Reporting Requirements

On October 22, the U.S. Department of Health and Human Services (HHS) announced expanded eligibility for the Phase 3 General Distribution of the CARES Act Provider Relief Fund (PRF), along with revisions to the reporting requirements. With respect to the reporting requirements, as detailed in a separate memo, HHS described the rationale for the reporting requirement changes, noting that the “decision to prohibit most providers from using PRF payments to become more profitable than they were pre-pandemic, in order to conserve resources to allocate to providers who were less profitable, has generated significant attention and opposition from many stakeholders and Members of Congress. There is consensus among stakeholders and Members of Congress who have reached out to HHS that the PRF should allow a provider to apply PRF payments against all lost revenues without limitation. In consideration of this feedback, HHS has amended its reporting instructions to provide for the full applicability PRF distributions to lost revenues.” The revised reporting requirements state that “[r]ecipients may apply PRF payments toward lost revenue, up to the amount of the difference between their 2019 and 2020 actual patient care revenue.” This differs from the initial reporting requirements which focused on net profit but still retains the focus on comparing year over year.

As detailed within the application instructions, all providers receiving more than $10,000 are subject to key reporting requirements, with the first deadline for reporting February 15, 2021. For the updated reporting elements, visit here, along with a summary of those requirements here. In addition, as noted within the reporting requirements document, all providers that expend more than $750,000 in Federal funds (including PRF and the Paycheck Protection Program funds) will be subject to additional audit requirements. For additional information, visit the Reporting Requirements and Auditing page and read the Auditing and Reporting Requirements FAQs. More information related to this program can be found on the Provider Relief Fund website.

Azar Floats Plan to Oust FDA Commissioner Hahn

According to a recent Politico report, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar is floating a plan to oust Commissioner of Food and Drugs Stephen Hahn. The Food and Drug Administration (FDA) has been at odds with President Trump in recent weeks over the standards for authorizing an eventual COVID-19 vaccine. The standards, which Hahn unilaterally published after allowing the White House to review for only a few hours, would preclude vaccine availability prior to the election. Azar has reportedly discussed the possibility of seeking White House permission to remove Hahn and potentially appoint HHS testing czar Brett Giroir, FDA Principle Deputy Commissioner Amy Abernethy, or Center for Drug Evaluation and Research Director Janet Woodcock as acting commissioner. Hahn and Azar have also engaged in recent disputes over the HHS Secretary’s decision to eliminate the FDA’s regulatory authority over laboratory-developed tests (LDTs).

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