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.


Ketanji Brown Jackson Confirmed as Supreme Court Justice

The Senate voted 53 to 47 to confirm Ketanji Brown Jackson to the Supreme Court. All 50 Senate Democrats, along with Republican Sens. Susan Collins (R-Maine), Lisa Murkowski (R-Alaska), and Mitt Romney (R-Utah), voted in support of her confirmation. Jackson will be the first Black woman justice on the Supreme Court when she replaces Justice Stephen Breyer who will retire at the end of the court’s current term. Her confirmation leaves the ideological balance on the nation’s high court unchanged. Jackson is a 51-year-old appellate court judge who also served on the U.S. District Court, as a federal public defender, and as vice-chair of the U.S. Sentencing Commission. Many of the Republican lawmakers who voted against Jackson cited their concerns about her being a potential activist judge.

Congress Leaves for Recess Without Passing Additional COVID Relief

Lawmakers have left Capitol Hill for a two-week recess without passing any additional coronavirus relief. While a bipartisan agreement was reached early last week on a $10 billion measure – a fraction of the White House’s initial $30 billion request – a dispute over the President’s decision to end Title 42 caused the deal to fall apart. Title 42 is the policy allowing the administration to expel migrants and asylum seekers if it is in the interest of public health. The COVID-19 funding agreement would have provided the administration with $5 billion to purchase therapeutics and antivirals, $4.75 billion that could be used for a wider range of purchases, and $750 million for research on future COVID-19 vaccines and therapeutics, repurposing unspent funds from prior pandemic relief efforts. Leadership will resume negotiations when Congress returns after recess, with lawmakers already discussing the need for follow-up legislation containing funding for global pandemic response. The administration has warned that the agreed- upon $10 billion in aid will not last through October.

Wyden Continues Investigation into Rx Tax Practices

Senate Finance Committee Chair Ron Wyden (D-Ore.) is continuing his investigation into the finances of pharmaceutical manufacturers. In his latest letter, sent to Merck, Wyden asserts that the company has minimized profits in the United States while reporting substantial foreign profits to avoid paying U.S. corporate income taxes. The letter requests detailed information on the company’s tax practices, overseas operations, and entities that hold the intellectual property for medications by April 15.

VA Requests Change to Health Funding Process

During a hearing before the House Appropriations Military Construction-VA Subcommittee last week, Secretary of Veterans Affairs Denis McDonough stated his support for negotiating money for veterans’ health programs separately from the toplines guiding defense and non-defense discretionary funding each year. President Joe Biden’s fiscal year 2023 budget request broke out an allocation for veterans’ health, apart from its non-defense budget proposal. The White House called for $813 billion in defense funds, $650 billion in nondefense discretionary funds, and $119 billion for Veterans Affairs medical care. Senate Appropriations Committee Ranking Member Richard Shelby (R-Ala.) raised concerns that this change could put spending on veterans’ health on an upward trajectory.

Upton, Gibbs Announce Plans to Retire

Rep. Fred Upton (R-Mich.) announced his plans to retire last week. Upton was first elected to the House of Representatives in 1986. He is the third most senior Republican in the 117th Congress and the former chair of the Energy and Commerce Committee. Upton has stated that his proudest accomplishment during his time in Congress was the 2016 passage of the 21st Century Cures Act. Under his redrawn congressional district, Upton would have faced Rep. Bill Huizenga (R-Mich.) in this year’s primary. Huizenga has been endorsed by former President Donald Trump. Rep. Bob Gibbs (R-Ohio) also announced that he will retire at the end of his term, citing the redistricting process happening in his state. Gibbs would have faced a primary challenge against a candidate also endorsed by Trump. Gibbs was first elected to the House of Representatives in 2010 and currently serves on the Oversight and Reform Committee.

New Breakthrough COVID Cases Hit Capitol Hill, Administration

House Speaker Nancy Pelosi (D-Calif.) has tested positive for COVID-19. Pelosi is asymptomatic but is quarantining consistent with the Centers for Disease Control and Prevention guidance. While Pelosi spent time with President Joe Biden in the days leading up to her positive test, the White House has not qualified the President as a close contact of the House Speaker. Sen. Susan Collins (R-Maine) also tested positive for COVID last week. She is experiencing mild symptoms and will isolate herself while working remotely. Several other administration officials have tested positive in recent days, including Attorney General Merrick Garland, Commerce Secretary Gina Raimondo, and Agriculture Secretary Tom Vilsack. Vice President Kamala Harris’s communications director Jamal Simmons recently contracted COVID-19 as well, and the Vice President is considered a close contact.

NCIís Sharpless to Step Down

National Cancer Institute (NCI) Director Ned Sharpless will step down at the end of this month after nearly five years at the helm of the agency. Sharpless’ departure follows President Joe Biden’s recent announcement of plans to reignite the Cancer Moonshot initiative – with a goal to cut the cancer death rate in half in 25 years. “Working at the National Cancer Institute has been the highlight of my career, and I am honored to have had the chance to serve my country in this role, alongside so many talented scientists and administrators,” Dr. Sharpless said. “I leave this job knowing that the talent and passion present at NCI, across the Biden-Harris Administration, and throughout the cancer research community will continue to fuel tremendous progress for people with cancer in the years ahead.” NCI Principal Deputy Director Douglas Lowy will serve as NCI’s acting director for the third time starting April 30. Lowey previously held this title between April 2015 and October 2017 and again between April 2019 and October 2019. NCI is the only institute leader within the National Institutes of Health (NIH) that requires a presidential appointment. The White House also has yet to pick a nominee for NIH director following Francis Collins’ departure in December.

WH Proposes to Further Delay RO Model

The Biden administration has proposed to further delay the start and performance period of the Radiation Oncology (RO) Model. The model would bundle payments for 90-day radiation treatment episodes provided to patients regardless of setting. It aims to remove incentives to provide radiation therapy in settings with higher reimbursement rates. The model is estimated to save the Medicare program $230 million over five years. The Radiation Oncology Model and performance period was originally scheduled to begin on January 1, 2021 and end on December 31, 2025. The start date was pushed back six months to July 1, 2021, due to the COVID-19 public health emergency. The Protecting Medicare and American Farmers from Sequester Cuts Act, which was enacted late last year, prohibited the implementation of the model before January 1, 2023. Under the latest proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) last week, the start date and model performance period would be established by future rulemaking. CMS stated its plans to provide at least six months’ notice from the announcement of a proposed start date and the actual start date for the model.

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