THIS WEEK’S DOSE

• Congress Passes CR to Avert Government Shutdown: Congress passed another two-tiered continuing resolution (CR) to extend current government funding deadlines to March 8 and 22. Passage of the first appropriations package is expected next week.
• Senate Budget Committee Holds Hearing on Economic Impact of Restricting Reproductive Freedom: The hearing examined access to reproductive care as well as the economic impacts of restricting abortion.
• House Energy and Commerce Committee Holds Legislative Hearing on Rare Diseases: The hearing included discussion on legislative solutions to support patients living with rare diseases.
• President Releases EO to Protect Sensitive Personal Data: The executive order (EO) tasks several federal agencies with taking steps to further protect Americans’ data from being collected and sold to countries of concern.
• Administration Announces New Funding for Behavioral Health Services: The Substance Abuse and Mental Health Services Administration (SAMHSA) announced funding opportunities for grant programs supporting behavioral health services across the country.
• CMS Issues Medicare Prescription Payment Plan Guidance: The Centers for Medicare & Medicaid Services (CMS) issued the final version of the first part of a guidance document on the Medicare Prescription Payment Plan.

CONGRESS

Appropriations Update. As appropriators continue to finalize the 12 funding bills for fiscal year (FY) 2024 – which began on October 1, 2023 – a series of stopgap CRs have been needed to avoid a government shutdown. This week, leaders unveiled another CR to extend the two-tiered deadlines 1) from March 1 to March 8 and 2) from March 8 to March 22. The House passed the CR on February 29 by a vote of 320 to 99, and the Senate passed the CR by a vote of 77 to 13, averting a partial government shutdown yet again.

Next, appropriators are expected to release the first tranche of FY 2024 bills this weekend, and both bodies of Congress are expected to pass them next week. This package includes Agriculture-FDA, Military Construction-VA, Energy-Water and Transportation-HUD (whose deadlines have been extended to March 8), along with the Interior and Commerce-Justice-Science bills (which are part of the March 22 deadline batch). Anticipated legislation may include a limited healthcare package with the following likely inclusions:

• Healthcare extenders that have been riding with the previous stopgap spending bills, such as funding extensions for community health centers and special diabetes programs and prevention of cuts to Medicaid disproportionate share hospital funding
• Additional policies such as a partial alleviation of the Medicare physician payment cut, reauthorization of the SUPPORT Act, and pandemic preparedness

All of these policies are couched as extenders. New policies, such as those related to transparency, site neutral payments and pharmacy benefit manager reforms, apparently will not be included, as agreements were unable to be reached. Instead, those policies may be considered as part of another health package, which is anticipated after the election during a lame duck session that will be driven by the need for Congress to address Medicare coverage of telehealth and other year-end priorities.

Senate Budget Committee Holds Hearing on Economic Impact of Restricting Reproductive Freedom. The hearing included discussion on the economic impacts of restricting abortion and reproductive freedoms in the United States. Witnesses highlighted their personal experiences with abortions and the need for increased support for women and families. Multiple witnesses highlighted the negative economic impacts that abortion restrictions cause, including an increase in past-due debt and an increase in adverse credit reports. Democratic senators emphasized the need to protect abortion and reproductive care access. Republican senators focused on the morality of abortions and the need to support pregnant women.

House Energy and Commerce Committee Holds Legislative Hearing on Rare Diseases. The Health Subcommittee hearing included discussion on legislative solutions to support patients living with rare diseases. There was strong bipartisan support for H.R. 4758, the Accelerating Kids Access to Care Act, which would enable providers to enroll in state Medicaid programs other than their home state’s program without additional screening requirements. There was partisan support and opposition for H.R. 5539, Optimizing Research Progress Hope And New (ORPHAN) Cures Act, and H.R. 5547, Maintaining Investments in New Innovation (MINI) Act. Republicans noted these bills would increase research and access to treatments. Democrats noted these bills would amend the Inflation Reduction Act drug price negotiation program and would make rare disease treatments less affordable. More details on all of the bills considered can be found in this memo.

ADMINISTRATION

CMS Issues Medicare Prescription Payment Plan Guidance. CMS released a final guidance document related to the implementation of a provision within the Inflation Reduction Act. Specifically, CMS issued the final version of the first part of a guidance document on the Medicare Prescription Payment Plan.

Under the Medicare Prescription Payment Plan, Medicare Part D enrollees beginning in 2025 will have option to pay out-of-pocket prescription drug costs in the form of capped monthly payments instead of all at once at the pharmacy. Part one of the guidance focuses on the operational requirements for the program.

Draft part 2 guidance was released on February 15 and focuses on Part D enrollee education, outreach, and communications for the program. Comments on the draft Part 2 guidance are due on March 16, 2024.

For more details on the final guidance document released today, read the fact sheet here.

President Releases EO on Sensitive Personal Data. The EO tasks several federal agencies, including the US Department of Health and Human Services (HHS), with taking steps to further protect Americans’ data from being collected and sold to countries of concern. It focuses on alleviating significant privacy and national security risks. The data in question includes personal and sensitive information, including genomic data, biometric data, personal health data, geolocation data, financial data, and certain kinds of personally identifiable information. Here is a fact sheet from the White House.

Administration Announces New Funding for Behavioral Health Services. SAMHSA announced $36.9 million in notices of funding opportunities for grant programs supporting behavioral health services across the country. CMS issued guidance that allows states to expand the pool of behavioral healthcare providers eligible for enhanced federal Medicaid funding to include Masters of Social Work and other master’s-level behavioral healthcare providers, such as marriage and family therapists and mental health counselors. The guidance also allows states to claim federal dollars for nurse advice lines, which HHS notes are an important tool to support ongoing access to care, particularly in rural areas.

QUICK HITS

• Change Healthcare Announces Ransomware Attack. Change Healthcare, a healthcare technology company that is a business unit of Optum and owned by UnitedHealth Group, announced on February 21, 2024, that it was experiencing enterprise-wide connectivity issues and service application interruptions. This attack has disrupted operations at pharmacies and health systems across the country that rely on Change Healthcare tools for healthcare payment and revenue cycle management. Learn more about actionable next steps for impacted Change Healthcare customers by reading McDermott’s On the Subject.
• HHS Announces Multi-Pronged Effort to Strengthen Direct Care Workforce. The Administration for Community Living (ACL) Direct Care Workforce (DCW) Strategies Center announced several new initiatives and resources to address the shortage of professionals who provide services to older adults and people with disabilities. To showcase these efforts, ACL officially launched the DCW Strategies Center website and will be hosting a series of informational and technical webinars.
• CMS Announces Release of 2024 Impact Assessment Report. CMS conducted an assessment of all its quality measures (nearly 500 measures in 26 different programs). The report finds that a relatively large proportion of measures had worse than expected performance during 2020 and 2021. Read the report here.
• CMS Holds AHEAD Model NOFO Office Hours. During the webinar, officials spoke about the new Model Overlaps Fact Sheet and answered questions about the All-Payer Health Equity Advancements and Development (AHEAD) Model Notice of Funding Opportunity (NOFO) ahead of the March 18, 2024, application deadline.
• CMS Holds Transforming Maternal Health (TMaH) Model Webinar. The model aims to reduce disparities in access and treatment and to improve outcomes and experiences for mothers and their newborns, while also reducing overall program expenditures. Only state Medicaid agencies (SMAs) can apply to the notice of funding opportunity, which will be released by spring 2024. The application will be due by summer 2024, and the model is projected to run for 10 years, starting in January 2025. Slides and a transcript will be available on the website.
• CMS Holds IBH Model Webinar. The Innovation in Behavioral Health (IBH) model is designed to improve care quality and health outcomes and to support behavioral health practices. The model’s care delivery framework will consist of care integration, care management, and health equity. The NOFO will be released between late spring and early summer 2024, and the eight selected states will be notified by fall 2024. Additional resources on the model can be found here.

NEXT WEEK’S DIAGNOSIS

The House and Senate are scheduled to be in session next week. There is potential for healthcare activity in both bodies as part of consideration of the first of the FY 24 appropriation bills and at the committee level, including a Senate Budget Committee hearing on primary care and a Senate Health, Education, Labor & Pensions Committee hearing on the Older Americans Act.