This Week in Washington: House Energy and Commerce Committee marks up 13 healthcare bills; House Energy and Commerce Committee Subcommittee on Health holds hearing on CMMI; CMS announces it will recalculate MA Star Ratings.
House
The House is in district work week.
House Energy and Commerce Committee Marks Up 13 Healthcare Bills
On June 12, the House Energy and Commerce Committee marked up and reported out of committee 13 healthcare bills concerning maternal health, lung cancer research and Medicare and Medicaid fraud prevention. The committee did not mark up the Telehealth Modernization Act, which would extend telehealth flexibilities for two years because it is waiting for a Congressional Budget Office score.
The bills are:
H.R. 6020, Honor Our Living Donors Act: Eliminates consideration of the income of organ recipients in providing reimbursement of expenses to donating individuals.
H.R. 455, To amend the Controlled Substances Act to fix a technical error in the definitions: Amends the Controlled Substances Act to fix a technical error in the definitions.
H.R. 5012, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2023:
Allows the Department of Health and Human Services (HHS) to award grants for data collection and reporting related to stillbirths and requires HHS to issue guidelines and educational materials regarding proper training and processes for the collection of stillbirth data. The bill also requires HHS to establish a perinatal pathology fellowship program within an existing training program.
H.R. 4534, Women and Lung Cancer Research and Preventive Services Act of 2023: Requires the HHS Secretary and Secretaries of Defense and Veterans Affairs, to conduct an interagency review to evaluate the status of and identify opportunities related to research on women and lung cancer.
H.R. 7213, Autism Collaboration, Accountability, Research, Education and Support (CARES) Act of 2024: Enhances activities of the National Institutes of Health with respect to research on autism spectrum disorder and reauthorizes programs relating to autism.
H.R. 8084, LIVE Beneficiaries Act: Requires states to verify certain eligibility criteria for individuals enrolled for medical assistance quarterly.
H.R. 8089, Medicare and Medicaid Fraud Prevention Act of 2024: Requires certain additional provider screening under the Medicaid program.
H.R. 8111, To amend Title XIX of the Social Security Act to ensure the reliability of address information provided under the Medicaid program: Ensures the reliability of address information provided under the Medicaid program.
H.R. 8112, To amend Title XIX of the Social Security Act to further require certain additional provider screening under the Medicaid program: Requires certain additional provider screening under the Medicaid program.
H.R. 4758, Accelerating Kids’ Access to Care Act: Streamlines enrollment under the Medicaid program of certain providers across state lines.
H.R. 5526, Seniors’ Access to Critical Medications Act: Makes permanent a waiver issued by the Centers for Medicare and Medicaid Services that allows Medicare patients to receive medications by mail and allows family members or caregivers to obtain medications on a patient’s behalf.
H.R. 6033, Supporting Patient Education and Knowledge (SPEAK) Act of 2023: Requires the HHS Secretary to establish a task force to improve access to healthcare information technology for non-English speakers.
H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024: Establishes a Medicare incident to modifier for mental health services furnished through telehealth.
For more information, click here.
House Energy and Commerce Committee Chairman Releases Discussion Framework for Potential NIH Reforms
On June 14, the House Energy and Commerce Committee Chairman Cathy McMorris Rodgers (R-WA) released a framework that outlines current challenges facing the National Institutes of Health (NIH) and recommendations for reform proposed by Republican committee members. The proposed reforms intend to:
- Increase accountability, integration and agility of the NIH’s leadership and mission;
- Clarify NIH funding mechanisms and ensure they reflect congressional intent; and
- Enhance NIH grant research to protect against national security risks and ensure it remains independent, innovative, responsive and transparent.
The committee is requesting public comment on the framework. Comments are due by Aug. 16.
In addition, the committee released an interim staff report outlining findings of an investigation into a monkeypox research project planned and/or conducted at the National Institute of Allergy and Infectious Diseases.
For more information on the NIH framework, click here.
For more information on the MPXV report, click here.
House Appropriations Committee Agriculture, Rural Development, FDA and Related Agencies Subcommittee Marks Up FY2025 Agriculture-FDA Funding Bill
On June 11, the House Appropriations Committee Agriculture, Rural Development, Food and Drug Administration and Related Agencies Subcommittee marked up and reported out of committee the fiscal year (FY) 2025 Agriculture-FDA-Rural Development funding bill. It was reported out of committee without amendments.
The bill would provide the FDA with $6.75 billion in FY2025, $22 million less than FY2024 and below top-line funding levels agreed to during debt ceiling negotiations held between the former Speaker and President. The full committee is expected to mark up the bill next month.
For more information, click here.
House Energy and Commerce Committee Subcommittee on Health Holds Hearing on CMMI
On June 13, the House Energy and Commerce Committee Subcommittee on Health held a hearing to discuss value-based care, the challenges facing the Centers for Medicare and Medicaid Innovation (CMMI) and steps Congress can take to alleviate them. Members questioned why CMMI acitivites increased spending despite initial projections showing they would reduce spending. Witnesses were:
- Elizabeth Fowler, Ph.D., J.D., Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation
For more information, click here.
Senate
The Senate is in session except for June 19.
Senate Finance Committee Holds Hearing on Youth Residential Treatment Facilities
On June 12, the Senate Finance Committee held a hearing to discuss youth residential treatment facilities and ways to improve care services they provide. During the hearing, Chairman Ron Wyden (D-OR) announced that he will introduce legislation to increase the oversight, enforcement and health and safety standards of residential treatment facilities (RTFs) and to support community-based services investments.
The chairman’s remarks come after committee staff released a report that outlines findings of an investigation led by the Senate Finance and Health, Education, Labor and Pensions Committees concerning systemic abuse in provider-operated youth RTFs. The report found that:
- Children suffer sexual, physical and emotional abuse in RTFs and face unsanitary and unsafe conditions;
- Children do not get specialized mental and behavioral health treatment advertised by RTF providers;
- Restraint and seclusion are used by RTF staff as punishment;
- RTFs employ unqualified and inadequately trained staff and fail to plan for children’s discharge to the community for ongoing care; and
- State and federal oversight authorities fail to effectively identify and address harm to children in RTFs.
For more information on the hearing, click here.
For more information on the staff report, click here.
MedPAC Releases June 2024 Report to Congress
On June 13, the Medicare Payment Advisory Commission released its June 2024 Report to Congress on Medicare Payment Policy. The report outlines recommendations to improve Medicare payment systems, address Medicare program issues and facilitate the delivery of healthcare services. The six-chapter report focuses on:
- Approaches for updating clinician payments and incentivizing participation in alternative payment models;
- Provider networks and prior authorization in Medicare Advantage;
- Assessing data sources for measuring healthcare utilization by Medicare Advantage enrollees;
- Paying for software technologies in Medicare;
- Considering ways to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and
- Medicare’s Acute Hospital Care at Home program.
For more information, click here.
MACPAC Releases June 2024 Report to Congress
On June 11, the Medicaid and Children’s Health Insurance Program (CHIP) Payment and Access Commission released its June 2024 Report to Congress on Medicaid and CHIP. The report outlines recommendations that aim to:
- Increase transparency in Medicaid and State CHIP financing;
- Improve state tools to optimize state Medicaid agency contracts; and
- Enhance enrollment trends in Medicare Savings Programs and demographic data collection in Medicaid.
For more information, click here.
Improving Seniors’ Timely Access to Care Act Introduced
On June 12, Sens. Marshall (R-KS), Sinema (I-AZ), Thune (R-SD) and Brown (D-OH) introduced the Improving Seniors’ Timely Access to Care Act. The legislation would:
- Establish an electronic prior authorization process for Medicare Advantage (MA) plans, including a standardization for transactions and clinical attachments;
- Increase transparency around MA prior authorization use and requirements;
- Clarify Department of Health and Human Services’ (HHS) authority to establish timeframes for e-prior authorizations;
- Expand beneficiary protections to improve enrollee experiences and outcomes; and
- Require HHS to report to Congress on program integrity efforts.
A companion bill was introduced in the House by Reps. DelBene (D-OR), Kelly (R-PA), Bucshon (R-IN) and Bera (D-CA).
For more information, click here.
Corporate Crimes Against Health Care Act of 2024 Introduced
On June 11, Sens. Warren (D-MA) and Markey (D-MA) introduced the Corporate Crimes Against Health Care Act of 2024. The legislation aims to prevent exploitative private equity practices among healthcare entities and would:
- Hold corporate and private equity executives criminally liable if their actions contribute to a triggering event that results in the death or injury of a patient;
- Grant state attorneys general and the Department of Justice the ability to seize all compensation of private equity and company executives within a 10-year period, if an acquired healthcare firm experiences serious, avoidable financial difficulties;
- Prohibit payments from federal healthcare programs to entities that sell assets or use assets as collateral for a loan with a real estate investment trust;
- Require healthcare providers receiving federal funding to publicly report mergers, acquisitions, changes in ownership and financial data, including debt and debt-to-earnings ratios; and
- Mandate a Department of Health and Human Services Office of Inspector General Report to Congress on the harms of healthcare corporatization.
For more information, click here.
Read more on healthcare policy in McGuireWoods Consulting’s Washington Healthcare Update.