McDermott Health Policy update
This week’s dose
Congress is no closer to passing additional COVID-19 funds, and without them some programs are running out of funds. While the House of Representatives was on recess, the Senate focused on hearings to confirm Supreme Court nominee Ketanji Brown Jackson.
Concerns about the launch of the suicide hotline. On March 23, the Senate Committee on Health, Education, Labor and Pensions held a Listen, titled “Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, Emerging Issues,” where senators discussed the mental health impact of the pandemic and federal programs and partnerships to provide solutions. The witness list included testimony from officials from the Substance Abuse and Mental Health Administration (SAMHSA), the Health Resources and Services Administration and the National Institutes of Health.
At the hearing, senators expressed concern about the operational readiness of the National Suicide Prevention Lifeline, which switched to its new number 988 in July. Witnesses also shared lawmakers’ concerns that an additional infusion of federal funds will be needed to ensure infrastructure readiness and bolster the behavioral health staff who will staff the hotline. The federal government has invested $282 million in mental health crisis infrastructure, and only two states have not applied for funding.
President’s budget coming soon. President Biden is expected to release his much-anticipated 2023 budget proposal on Monday, March 28. The budget will highlight the government’s funding and policy priorities and provide economic forecasts that take into account rising inflation. The President’s budget signals some policy initiatives that the administration has the authority to implement, but most recommendations require either legislative approval or funding from Congress.
The status of the additional COVID funding. The Biden administration is halting the reimbursement program, which pays for treatment, testing and vaccines for COVID-19 for the uninsured, due to a lack of funding. The federal government has spent more than $20 billion over the past two years to help the uninsured get these benefits.
The government earlier this month pushed for an additional $22.5 billion in COVID aid to be included in the omnibus spending bill. Congress reduced this to $15.6 billion, but then removed those funds from the final bill due to disagreements over funding mechanisms for COVID relief. Democrats continue to work on a standalone COVID funding bill, but those negotiations continue as they work to reach an agreement on the amount of funding and required payments — both of which are required to reach 60 votes in the Senate.
Amid these negotiations, the Centers for Disease Control and Prevention is warning of a doubling in the prevalence of the new omicron subvariant BA.2 in the past two weeks, and the government is weighing whether to offer a potential fourth dose of the coronavirus vaccine to older and immunocompromised adults is required. White House coronavirus coordinator Jeff Zients has indicated that the administration does not have the resources to buy a fourth dose without additional funds from Congress.
Air Ambulance Surprise Billing Case Updates. There are a number of court cases pending to challenge the surprise federal accounting rules. Most focus on whether the Biden administration followed the text of the No Surprises Act in implementing the independent dispute resolution (IDR) process and directed arbitrators how to consider legal factors in decision-making. Plaintiffs in the cases have argued, among other things, that the rules violate the law because the rules and accompanying guidance require IDR arbitrators to give particular weight to the qualifying payment amount when resolving payment disputes between providers and payers.
On February 23, the US District Court for the Eastern District of Texas ruled in favor of the Texas Medical Association in its lawsuit challenging portions of the regulations. On March 22, Judge Richard Leon of the US District Court for the District of Columbia heard hearings in surprise billing cases brought by the Association of Air Medical Services and the American Medical Association and American Hospital Association. As a next step, the parties in the case were asked to submit additional briefs.
Judge Leon pressed the government on whether to appeal the Texas Medical Association’s case. The government said it has not yet decided whether to appeal.
The US Occupational Safety and Health Administration (OSHA) on March 22nd announced a limited reopening of the comment period for the COVID-19 Emergency Healthcare Standard originally published on June 21, 2022. Additionally, OSHA intends to hold a public hearing on the COVID-19 Prevention Guideline for Healthcare Stakeholders on April 27 before finalizing the rule.
The Centers for Medicare & Medicaid on March 21st brought out Templates and resources for two state reporting requirements to help CMS and states oversee enrollment and renewal efforts as states resume routine Medicaid after the public health emergency ends.
The Department of Health and Human Services through HRSA announced on March 22 that it will distribute $413 million in Provider Relief Fund (PRF) Phase 4 payments to more than 3,600 providers impacted by the COVID-19 pandemic. HRSA is working to complete the PRF distributions as no additional funding is on the cards from Congress.
On March 23, the Senate Special Committee on Aging held a Listen entitled “An Economy That Cares: The Importance of Home-Based Services,” where the committee discussed the need to enact funding for home and community-based services and home care workers.
The House Ways and Means Committee held a Republican Assembly on Cures and Coverage: A Chilling Precedent for Patients to discuss how new restrictions on FDA-approved drugs are barring access and treatment for Americans with Alzheimer’s.
The House Energy and Commerce Committee announced that the Health Subcommittee will hold a Listen on March 30 for the reauthorization of the Medical Devices Fees Act.
The House Ways & Means Committee problematic a Request for Information (RFI) asking twelve health systems for input on their work and operational policies to address climate change and how the federal government can support these initiatives. There is evidence that the RFI may be sent to more entities over time.
Health policy breakroom podcast
Twelve years ago this week, the Affordable Care Act (ACA) became law in the country and millions of Americans gained affordable coverage as a result. Since 2010, the ACA has endured multiple legislative challenges and court appeals. Debbie Curtis and Rodney Whitlock have both been active on both sides of the aisle while curating the ACA legislation and share their experiences in the drafting of this legislation as well as the outlook on what is needed to support and strengthen the ACA for future generations.
Next week’s diagnosis
Both the House and Senate will meet next week, just two weeks before the chamber break for spring break. Stakeholders will review the President’s budget to understand key policy priorities.