7.16.18 – 7.20.18 Health Wrap Up
Please find below a summary of the latest major health policy developments in Washington this week. Please let us know if you have any questions.
BUDGET AND APPROPRIATIONS
The House on Thursday passed another appropriations package that includes the FY19 Interior-Environment and the Financial Services bills. With Thursday's vote, the House has now cleared six of their 12 annual spending bills. The Senate to date has cleared a three bill minibus (Energy and Water, Military Construction-Veterans Affairs, and Legislative Branch) and could take up the recently passed House bills as soon as next week, substituting the Senate Appropriations Committee passed versions and adding the Agriculture and Transportation-HUD bills to make up a four bill package. We also understand that the Senate could consider the Defense bill, coupled with the Labor HHS bill, the week of July 30.
It is still likely, however, that a continuing resolution will be needed before the end of the fiscal year. While the House and Senate have already begun hashing out the details between the three spending bills that were approved in an earlier minibus, a conference committee has been stuck because both parties can't agree on how to pay for a funding shortfall for a veterans health program. In addition, while the Senate has indicated that that will cancel much of the August recess, the House is planning to leave in early August for its monthlong break and will have just three weeks in session before the September 30 deadline.
MENTAL HEALTH & SUBSTANCE USE
On July 19, the House Energy and Commerce Committee Health Subcommittee held a hearing on the status of implementation of the mental health reforms that were included in the 21st Century Cures Act. Dr. Elinore McCance-Katz, Assistant Secretary of Health and Human Services (HHS) for Mental Health and Substance Abuse, was the only witness. A summary of the hearing is attached.
Oversight Hearing on Substance Use Treatment Facilities
On July 24, the House Energy and Commerce Committee Oversight and Investigations Subcommittee will be holding a hearing entitled, “Examining Advertising and Marketing Practices Within the Substance Use Treatment Industry.” Witnesses will include:
- Jason Brian, Founder, Redwood Recovery Solutions and TreatmentCalls.com
- Michael Cartwright, Chairman and CEO, American Addiction Centers
- Mark Mishek, President and CEO, Hazelden Betty Ford Foundation
- Robert Niznik, CEO, Addiction Recovery Now and Niznik Behavioral Health
- Dr. Kenneth Stoller, Director, Johns Hopkins Hospital Broadway Center for Addiction
- Marvin Ventrell, Executive Director, National Association of Addiction Treatment Providers
On Tuesday, the House Ways and Means Committee Health Subcommittee held a hearing on reforms to the Stark law. A summary of the hearing is attached.
On Wednesday, the House Energy and Commerce Committee passed the “Pandemic and All-Hazards Preparedness and Advancing Innovation Act” by voice vote. The bill was one of the most bipartisan efforts in health matters of the committee in the 115th Congress. The bill reauthorizes a number of programs for man-made and natural biomedical threats. Among the key features of the five-year authorization bill are:
- Streamlines the administrative procedures before and during incidents.
- Improves coordination activities with HHS and CDC in working, training, and exercising with state and local public health entities.
- Authorizes $162 million annually for the Hospital Preparedness Program to train health care providers and purchase necessary equipment.
- Authorizes $610 million for the Strategic National Stockpile of medical countermeasures to procure new doses for potential threats.
- Reforms the Biomedical Advanced Research and Development Authority, and provides $536 million annually to develop new medical countermeasures for which there is no commercial market.
The bill is likely to go to the House floor as early as next week. The Senate is preparing its own bipartisan bill. Some form of the PAHPA will be signed into law prior to the end of the fiscal year in September.
HSA/FSA REFORMS AND LOWER PREMIUM PLANS
Next week, the House will consider three health related bills coming from the Ways and Means Committee. Two of the bills are consolidations of five smaller bills which passed the committee last week. For expediency, House Republican leadership has packaged them together.
- Protecting Medical Innovation Act repeals the 2.3% medical device tax imposed as part of the Affordable Care Act beginning in 2020.
- Increasing Access to Lower Premium Plans and Expanding Health Savings Account Act
- HR 6199: Allows over-the-counter drugs to be treated as a qualified medical expense for FSA/HSAs.
- HR 6301: Provides that a high deductible health plan is permitted to provide certain services up to a dollar threshold without meeting the plan’s minimum deductible
- HR 6305: Allows immunizations, physical exams, over-the-counter drugs, and vision/hearing screenings as eligible medical expenses.
- HR 6312: Allows gym memberships and sporting protective equipment as eligible medical expenses.
- HR 6317: Allows direct primary care service arrangements as allowable costs under HSAs.
- Restoring Access to Medication and Modernizing Health Savings Accounts Act
- HR 6306: Increases maximum contribution to an HSA related to a high-deductible plan to reflect the minimum deductible ($6600 for self)
- HR 6309: Allows Medicare eligible individuals to enroll in an HSA.
- HR 6311: Designates copper plans as qualified health plans under the ACA.
- HR 6313: Allows dollars remaining in an FSA at the end of a year to be carried forward to the next year.
- HR 6314: Treats silver and bronze plans under the ACA as high-deductible plans eligible for HSAs.
On Thursday, HHS Secretary Alex Azar announced the formation of a working group under FDA to examine how to safely import foreign-made prescription drugs. Currently the importation of foreign-made drugs is prohibited by law. The working group has two key guard rails which limit the scope of their discussions. First, they may only consider such importation in instances of “a dramatic price increase” from one manufacturer, and second, the drug must not be protected by patents or other exclusivities. What precisely constitutes “dramatic price increase” remains an open question.
At this point, it is too early to say if the working group’s efforts will culminate in a proposed rulemaking or any other official action. Trump administration officials claim this is one of the key efforts to drive down costs. Some organizations who generally support drug reimportation say this working group is a step toward recognizing foreign labs are safe, and eventually may open the market to greater foreign supply. Some critics, however, believe the working group’s narrow scope and will not result in lower prescription drug costs and is a political gesture.
|Katie Weyforth Vanlandingham
Van Scoyoc Associates
800 Maine Ave SW
Washington, DC 20024