Legislative Activity

House Committee on Energy and Commerce to Mark Up Health Legislation

The House Committee on Energy and Commerce has announced that it will hold a markup on Tuesday, July 28. Several health bills are on the agenda: H.R. 1344, the Early Hearing Detection and Intervention Act of 2015, which reauthorizes a program for early detection, diagnosis, and treatment regarding deaf and hard-of-hearing newborns, infants, and young children; H.R. 1462, the Protecting Our Infants Act of 2015, which seeks to reduce the rise of prenatal opioid abuse and neonatal abstinence syndrome through improving data and developing recommendations for prevention and treatment; H.R. 1725, the National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015, which amends and reauthorizes the controlled substance monitoring program under the Public Health Service Act; and H.R. 2820, the Stem Cell Therapeutic and Research Reauthorization Act of 2015, which reauthorizes the National Cord Blood Inventory program and the C.W. Bill Young Cell Transplantation Program.

Potential Senate Vote on Obamacare Repeal This Week

On Sunday, July 26, the Senate Republicans failed to attach an Affordable Care Act (ACA) repeal provision to the highway funding bill. The amendment fell on a partisan 49-43 vote, but eight senators were absent from the weekend proceedings. Sen. Mike Lee (R-UT) is expected to propose a procedural motion early this week that would allow approval of the Obamacare repeal provision with a simple majority vote.

House Committee on the Judiciary Announces Fall Hearings on Health Care Competition

On Thursday, July 23, House Committee on the Judiciary Chairman Bob Goodlatte (R-VA), Ranking Member John Conyers Jr. (D-MI), Subcommittee on Regulatory Reform, Commercial and Antitrust Law Chairman Tom Marino (R-PA), and Subcommittee on Regulatory Reform, Commercial and Antitrust Law Ranking Member Hank Johnson (D-GA) announced that the Committee plans to hold a series of hearings to explore competition in the U.S. health care marketplace. According to the Committee, the first hearing in September will consider the role the ACA has played in the consolidation of the industry. It will also examine any impacts on care accessibility and affordability for consumers. The second hearing will focus on consolidation within the industry, including the proposed mergers between Aetna and Humana and Anthem and Cigna.

Last week, Anthem Inc. agreed to purchase Cigna Corp. for $48.4 billion, which would create the largest health insurer in the country if the deal passes regulatory muster. Several weeks ago, Aetna Inc. agreed to buy Humana Inc. for $34 billion.

This Week’s Hearings:

• Tuesday, July 28: The House Committee on Ways and Means Subcommittee on Health will hold a hearing to discuss rural health care disparities created by Medicare regulations.

• Tuesday, July 28: The House Committee on Education and the Workforce will hold a hearing titled “Reviewing the Policies and Priorities of the U.S. Department of Health and Human Services.” The Honorable Sylvia Mathews Burwell is slated to testify.

• Tuesday, July 28: The House Committee on Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing titled “Continuing Concerns with the Federal Select Agent Program: Department of Defense Shipments of Live Anthrax.”

• Tuesday, July 28: The House Committee on the Judiciary Subcommittee on Crime, Terrorism, Homeland Security, and Investigations will hold a hearing titled “America’s Growing Heroin Epidemic.”

• Tuesday, July 28: The House Committee on Energy and Commerce will hold a markup to consider H.R. 985, Concrete Masonry Products Research, Education, and Promotion Act of 2015; H.R. 1344, Early Hearing Detection and Intervention Act of 2015; H.R. 1462, Protecting Our Infants Act of 2015; H.R. 1725, National All Schedules Prescription Electronic Reporting Authorization Act of 2015; H.R. 2820, Stem Cell Therapeutic and Research Reauthorization Act of 2015; and H.R. 3154, E-Warranty Act of 2015.

• Wednesday, July 29: The Senate Committee on Indian Affairs will hold a hearing titled “Examining the True Costs of Alcohol and Drug Abuse in Native Communities.”

• Thursday, July 30: The House Committee on Agriculture Subcommittee on Livestock and Foreign Agriculture will hold a hearing titled “Examination of Federal and State Response to Avian Influenza.”

• Friday, July 31: The Senate Special Committee on Aging will hold a field hearing in St. Louis, Missouri titled “Celebrating Medicare: Strengthening The Program For The Next 50 Years.”

Regulatory Activity

CMS Names Participants in Hospice Demonstration

On Monday, July 20, the Centers for Medicare and Medicaid Services (CMS) named the hospice providers that will be participating in the Medicare Care Choice Model, a demonstration which will allow Medicare and dually eligible beneficiaries to receive palliative care services from certain hospice providers while concurrently receiving curative care services. Current payment rules require Medicare and dually eligible beneficiaries to forego curative care in order to receive palliative care services offered by a hospice.

CMS has selected 140 Medicare-certified hospice centers to participate in this five year demonstration. Participating hospices will provide services that are currently available under the Medicare hospice benefit for routine home care and respite levels of care, but which cannot be separately billed under Medicare Parts A, B, and D. CMS will pay the hospices a per beneficiary monthly fee ranging from $200 to $400.

Medicare Trustees Release Annual Report

On Wednesday, July 22, the Boards of Trustees for Medicare released its annual report to Congress titled “2015 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and the Federal Supplementary Medical Insurance Trust Funds.” This mandated report addresses the financial operations and actuarial status of the Medicare trust funds.

Of note, the Board projects that, in the future, expenditures will increase at a somewhat faster pace than the overall economy. As a percentage of gross domestic product (GDP), expenditures are projected to increase from 3.5 percent in 2014 to 6.0 percent in 2089. The Trustees estimate that the Medicare Part A trust fund will be depleted in 2030, the same year stated in last year’s report. The Trustees recommend that Congress and the Executive Branch work together “with a sense of urgency” to address the depletion of the Medicare Part A trust fund, as well as the projected growth rate in Medicare Parts A, B, and D.

CMS Provides Guidance on State Innovation Waivers

On Wednesday, July 22, CMS released guidance on the section 1332 State Innovation Waiver. This waiver is designed to encourage states to pursue innovative strategies in ACA implementation, while ensuring that the basic protections of the ACA are retained. This guidance provides an overview and a list of frequently asked questions on the State Innovation Waiver application process. This guidance also provides the key elements to be included in an application and a description of the application review process.

State Innovation Waivers are slated to be available beginning on January 1, 2017. CMS will approve the waivers for five-year periods, and they may be renewed.

CMS Announces Expedited Review of Section 1115 Demonstrations

On Friday, July 24, CMS released an informational bulletin, which announced that the agency is establishing a “fast-track” process for federal review of proposed extensions to section 1115 Medicaid and Children’s Health Insurance Program (CHIP) demonstrations. Section 1115 demonstrations give states flexibility in designing and improving their CHIP and Medicaid programs.

This expedited review process will be available for states with existing section 1115 demonstrations that have “proven program outcomes,” have not made substantial program changes since the last extension cycle, and are not proposing “major or complex changes.” The informational bulletin provides a streamlined approach for section 1115(a) extensions and simplifications to section 1115(e) and section 1115(f) extensions.

CMS will provide states with further information roughly 18 months prior to the expiration of their current demonstration in order to assist the state in considering whether to use the new fast-track process.