Congressional leaders have made progress in their attempts to negotiate a coronavirus relief bill that they intend to combine with the fiscal year 2021 omnibus spending package. Lawmakers are expected to pass a one-week stopgap measure through December 18 to give negotiators more time, as a slew of issues still need to be ironed out. Legislative text for the bipartisan $908 billion coronavirus relief proposal floated last week is anticipated to be released “early this week,” according to Sen. Bill Cassidy (R-LA) who also said that President Trump indicated he will sign their proposal.
President-elect Biden also weighed in on relief talks, urging lawmakers and President Trump to “act now.” He said he was “encouraged” by the bipartisan $908 billion proposal offered by centrist senators and called on Congress to provide “more economic relief as a bridge through 2021 until both the pandemic and economic crises are over.”
The inclusion of a surprise billing policy in the relief bill was discussed in earnest by staff over the weekend. House Speaker Nancy Pelosi (D-CA) is very interested in including this policy in the relief bill, but Ways and Means Chairman Richard Neal (D-MA) would prefer to wait until next Congress in order to give President-elect Biden a policy victory. Proponents and opponents are weighing in with congressional leaders this week as the talks heat up.
In other transition-related news, Biden chose California Attorney General Xavier Becerra for Department of Health and Human Services (HHS) Secretary and Dr. Rochelle Walensky, an infectious-disease specialist at Massachusetts General Hospital, for the Director of the Centers for Disease Control and Prevention (CDC). Notably, Becerra is leading the defense of the Affordable Care Act before the Supreme Court in Texas v. Azar. Dr. Vivek Murthy was tapped to serve as Surgeon General, a role he held under the Obama administration.
As access to a COVID-19 vaccine nears, at least for a key segment of the U.S. population, additional funding for states to assist with vaccine distribution remains a bipartisan issue. The $908 billion bipartisan proposal includes $16 billion for vaccine development and distribution, as well as testing and contact tracing. Senate Majority Leader Mitch McConnell’s (R-KY) revised proposal provides $31 billion to support vaccine distribution, along with vaccine, therapeutic and diagnostic development, the Strategic National Stockpile, and grants to establish state stockpiles.
On Thursday (December 10), the Vaccines and Related Biological Products Advisory Committee will discuss emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine for individuals 16 years of age and older. Upon emergency use authorization by the Food and Drug Administration (FDA), which could occur shortly after the meeting, Pfizer’s vaccine could be distributed within 24 hours and administered to priority patients within days. Last week, Dr. Robert Redfield, Director of the CDC, signed off on interim recommendations approved by the Advisory Committee on Immunization Practices (ACIP) to offer the authorized COVID-19 vaccine to both (1) health care personnel and (2) residents of long-term care facilities in the initial phase of the vaccination program.
On the regulatory front, HHS has largely finished its annual payment update rulemaking cycle with the recent release of the CY 2021 Physician Fee Schedule (details) and Hospital Outpatient Prospective Payment Systems (details). However, a number of new rules have recently arrived at OMB for review, including a final rule on administrative dispute resolution for the 340B program, as well as a proposed rule regarding patient access to electronic health information. A final rule that would implement the Trump administration’s recent drug pricing executive order to offer insulin and injectable epinephrine at lower prices for patients visiting 340B facilities (details) has also arrived for review.
The Medicaid and CHIP Payment and Access Commission (MACPAC) convenes later this week (December 10 and 11) to resume discussions on improving health equity, extending postpartum coverage, and increasing access to behavioral health services for children and adolescents. Commissioners are also slated to discuss a draft recommendation relating to Medicaid estate recovery, the interim final rule affecting Medicaid provisions of the Families First Coronavirus Relief Act, and implications of the 2020 elections, among other topics.