Summary
This week, the House may vote on legislation to delay several Medicare payment cuts that would take effect on January 1, 2022. The bill may include:
- Extending the temporary 3.75 percent increase to the physician fee schedule;
- Delaying cuts as large as 15 percent to clinical laboratory tests; and
- Extending the moratorium on 2 percent Medicare sequester.
The House is also scheduled to vote on the fiscal year (FY) 2022 National Defense Authorization Act (NDAA) and separate legislation to address the looming debt limit. Treasury Secretary Janet Yellen estimates the U.S. could reach its debt limit on December 15. Senate Majority Leader Chuck Schumer (D-NY) and Senate Minority Leader Mitch McConnell (R-KY) are considering adding language to raise the debt limit to NDAA, though it faces an uphill battle in the House. Whether enough Senate Republicans will support the approach is unclear.
The House is also scheduled to vote on a slew of mostly bipartisan health-related bills:
- Accelerating Access to Critical Therapies for ALS Act (H.R. 3537)
- SHINE for Autumn Act of 2021 (H.R. 5487)
- Early Hearing Detection and Intervention Act of 2021 (H.R. 5561)
- Improving the Health of Children Act (H.R. 5551)
- Cardiovascular Advances in Research and Opportunities Legacy Act (H.R. 1193)
- Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667)
- Allied Health Workforce Diversity Act of 2021 (H.R. 3320)
- Oral Health Literacy and Awareness Act of 2021 (H.R. 4555)
- Opioid Prescription Verification Act of 2021 (H.R. 2355), Republican support only
- Synthetic Opioid Danger Awareness Act (H.R. 2364), Democratic support only
- Supporting the Foundation for the National Institutes of Health and the Reagan-Udall Foundation for the Food and Drug Administration Act (H.R. 3743), Democratic support only
- CARING for Social Determinants Act of 2021 (H.R. 3894)
Build Back Better Act
As for the Build Back Better Act (BBBA, H.R. 5376, WHG summary), the Senate parliamentarian will examine the health-related provisions this week – including prescription drug pricing, ACA premium tax credits, and Medicare and Medicaid coverage expansions. President Biden will deliver remarks at 2:00pm EST on how BBBA would lower the cost of prescription drugs. Collectively, BBBA includes measures that would:
- Authorize the Department of Health and Human Services (HHS) to negotiate the cost of single-source Part B and Par D drugs without competition directly with drug manufacturers;
- Impose penalties on drug manufacturers if they increase prices faster than the rate of inflation;
- Redesign the Medicare Part D benefit to lower out-of-pocket costs for beneficiaries and offset greater financial liability onto insurers and manufacturers; and
- Repeal the Trump Administration’s “rebate rule.”
The legislation also addresses cost-sharing for certain insulin products and would increase oversight over pharmacy benefit manager (PBM) services.
Continuing Resolution
Last Friday, President Biden signed another continuing resolution (P.L. 117-70) into law, extending FY 2021 funding levels through February 18, 2022. The stopgap measure also included nutrition-related provisions:
- Allows the Food and Nutrition Service to continue providing a larger cash value for fruits and vegetables in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food package through the second quarter of FY 2022.
- Extends waiver authority that allows residents in Supportive Living Facilities to receive Supplemental Nutrition Assistance Program (SNAP) benefits.
MACPAC
Later this week, the Medicaid and CHIP Payment and Access Commission (MACPAC) will convene to discuss various topics, including:
- Transparency and oversight of state directed payment arrangements, which may include value-based purchasing models, multi-payer or Medicaid-specific delivery system reform or performance improvement initiatives, or fee schedule requirements for provider reimbursement;
- Policy options for Money Follows the Person (MFP) qualified residence criteria (MFP increase the use of home and community-based services (HCBS) and reduces the use of institutionally-based services. The program is currently authorized through September 30, 2023 and BBBA would make it permanent.);
- How to monitor access to care among Medicaid beneficiaries. A panel of experts, including Karen Llanos, Director, Medicaid Innovation Accelerator Program, Centers for Medicare & Medicaid Services will provide recommendations;
- Options to strengthen integration of behavioral health services through health information technology;
- Applying a health equity lens to Medicaid; and
- Addressing nursing facility staffing issues with state policy levers.
MedPAC
The Medicare Payment Advisory Commission (MedPAC) will also meet later this week to discuss payment adequacy and updates for the Medicare fee-for-service (FFS) payment systems.