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.


Federal Funding Extended through Dec. 23

Congress passed a continuing resolution (CR) to avoid a government shutdown and provide more time to negotiate a comprehensive spending plan last week. The stopgap measure funds the federal government at current levels through December 23. Appropriations leadership have reached a bipartisan, bicameral deal on a framework for a year-end omnibus spending package. While official details have yet to be released, it has been reported that the bill will include domestic funding levels similar to those requested by the White House and a $76 billion increase in defense funding. According to Senate Appropriations Committee Ranking Member Richard Shelby (R-Ala.), an “agreement in principle” has been reached on a top-line allocation for health care. The Senate is expected to begin debate on the approximately $1.7 trillion fiscal year 2023 spending bill as early as Monday evening. The House of Representatives could vote on the bill as soon as Thursday.

Negotiations continue related to what other measures could be attached to the must-pass spending package before the 117th congress adjourns for the year. Two letters were sent to congressional leadership from different groups of lawmakers last week regarding the looming Medicare physician reimbursement cuts. The first, spearheaded by Reps. Susan Wild (D-Pa.) and Mariannette Miller-Meeks (R-Iowa) and signed by 115 bipartisan legislators, requests that the cuts – a 4% PAYGO cut and a 4.47% cut to the Medicare conversion factor - be stopped entirely as they are in addition to the 2% Medicare sequestration cut, which resumed on July 1. Regarding spending offsets, the Wild-Miller- Meeks letter explicitly states opposition “to paying for preventing these cuts with additional provider cuts.” Another letter from the House GOP Doctors Caucus requests support for policies to address impending Medicare payment cuts in legislation moving before the end of the year. Legislation (S. 5194) from Sen. John Kennedy (R-La.) to avert the impending Medicare physician reimbursement cuts failed to pass the Senate by unanimous consent last week. Finance Committee Chair Ron Wyden (D-Ore.) objected to passing the bill which bypassed the committee process, stating that his panel is already working on a plan to stop the cuts and that standalone passage of a reimbursement fix would jeopardize the larger package of health care policies set to be included in year-end legislation.

Legislation to Help Address Maternal Mortality Advances

The Senate passed the Data Mapping to Save Moms’ Lives Act (S. 198) last week. The bill requires the Federal Communications Commission to create maps showing where poor maternal health outcomes and gaps in broadband service coincide. It will now be sent to President Joe Biden’s desk for his signature.

Defense Authorization Sent to Presidentís Desk

The Senate passed the National Defense Authorization Act (NDAA) last week. The legislation includes $45 billion more than requested by the White House and repeals the military’s COVID-19 vaccine mandate. The latest national defense authorization is a $76 billion increase over fiscal year (FY) 2022’s $781.8 billion in spending and provides the Pentagon with 30 days to undo its COVID-19 vaccine mandate. The NDAA will now be sent to President Joe Biden’s desk to be signed into law.

2023 Senate Calendar Available

Majority Leader Chuck Schumer (D-N.Y.) released the Senate’s calendar for 2023 last week. The chamber will convene for 34 work weeks next year, with a scheduled five-week summer recess. The Senate is scheduled to convene for the first day of the 118th Congress on January 3 to swear in the seven new senators elect and will return to session on January 23. The combined calendar for the House of Representatives and Senate can be found here.

House Intelligence Panel Releases COVID-19 Reports

Democrats on the House Permanent Select Committee on Intelligence released a new report last week examining the early response to the COVID-19 pandemic. The lawmakers conclude that the intelligence community relied too much on public data related to the virus rather than gathering clandestine information. The report criticizes intelligence agencies for their lack of focus on tracking biological threats and continued failure to prioritize biological threats since the start of the COVID-19 pandemic. Republicans on the panel released their own report, which considers the role of the intelligence community in determining the origins of COVID-19 and questions why the potential link between the virus and China’s work on biological weapons has not been addressed. The report is an unclassified summary of information which Republicans plan to fully declassify during the next congress.

Matsui to Co-Chair Rare Disease Caucus

Rep. Doris Matsui (D-Calif.) will serve as co-chair of the Rare Disease Congressional Caucus for the 118th congress. She will replace the retiring Rep. G.K. Butterfield (D-N.C.) and join current co-chairs Rep. Gus Bilirakis (R-Fla.) and Sens. Amy Klobuchar (D-Minn.) and Roger Wicker (R-Miss.). Matsui is a champion of the BENEFIT Act (H.R. 4472) and the Access to Rare Indications Act (H.R. 6160). Her TRANSPLANT Act was successfully signed into law last year.

Mike Braun (R-IN) to Exit Senate in 2024

Sen. Mike Braun (R-Ind.) announced that he will not seek reelection to the Senate in 2024 and will instead run for governor of Indiana. Rep. Jim Banks (R-Ind.) has already stated that he is “strongly considering running” for Braun’s seat in the Senate. Braun currently serves as a member of the Appropriations Committee and the Health, Education, Labor, and Pensions Committee.

Virginia to Hold Special Election Feb. 21

The state of Virginia will hold a special election on February 21 to fill the vacancy left by the death of Rep. Donald McEachin (D) last month. State Rep. Lamont Bagby (D) and state Sen. Jennifer McClellan (D) have already filed statements of candidacy with the Federal Election Commission. The Democratic primary will be held this Tuesday, December 20. The Democratic nominee is favored to win the 4th congressional district seat.

GAO Explores Persistent PEPFAR Staffing Challenges

The Government Accountability Office (GAO) published a new report last week on the President’s Emergency Plan for AIDS Relief (PEPFAR) which found that while coordination between the State Department and officials implementing the program globally has improved, longstanding staffing shortages remain a problem. GAO reports that 70% of the Office of the U.S. Global AIDS Coordinator and Health Diplomacy headquarters positions are open, and approximately 90% of overseas positions are filled on an “acting” basis. PEPFAR has spent more than $100 billion combating HIV/AIDS across the world since its creation in 2003.

SAMHSA Proposes to Make Permanent COVID-Era Addiction Treatment Flexibilities

The Biden administration released a new proposed regulation last week to make permanent the substance use disorder (SUD) treatment flexibilities instituted in response to the COVID-19 pandemic. The rule would maintain patients’ expanded access to SUD treatment medications by allowing doctors to continue to initiate treatment with buprenorphine via telehealth and allowing certain patients to maintain weeks’ worth of doses of methadone in their homes. The proposal would also eliminate the requirement that doctors who prescribe buprenorphine submit a report to the Substance Abuse and Mental Health Services Administration each year and do away with the requirement that patients must be addicted to opioids for a full year before beginning treatment at a methadone clinic. Public comments on the proposed regulatory changes are due February 14, 2023.

HHS Proposes to Strengthen MA Consumer Protections

The Biden administration has proposed new consumer protections that would safeguard seniors from deceptive marketing practices by Medicare Advantage (MA) plans. The Centers for Medicare and Medicaid Services (CMS) proposes to prohibit ads that do not mention a specific plan name as well as ads that use words and imagery that may be misleading, confusing, or misrepresentative of the plan. CMS also proposes to codify guidance protecting people with Medicare or exploring Medicare coverage from misleading marketing and ensure they are not pressured into enrolling into plans that may not best meet their needs. Further, the agency proposes to strengthen the role of plans in monitoring agent and broker activity. Senate Special Aging Committee Chair Bob Casey (D-Pa.) and Senate Finance Committee Chair Ron Wyden (D-Ore.) praised the proposed regulations. The lawmakers led a letter last month urging the White House to enact such consumer protections, and Sen. Wyden has released a report detailing the tactics used by insurance companies, brokers, and third-party marketing companies to enroll seniors in health care plans.

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