Summary
In the last week before August recess, both the House and Senate are trying to make progress on several legislative fronts including moving a workforce bill in Senate HELP, PBM Legislation in the Senate Finance Committee, Senate Appropriations bills, and potentially a health care package in the House Ways and Means Committee. Additionally, H.R. 2544, Securing the U.S. Organ Procurement and Transplantation Network Act is expected to go to the floor this week. The floor vote follows a hearing last Thursday in the Senate Finance Committee that featured this legislation (summary).
Legislative Activity
On Wednesday, the Senate HELP Committee is poised to take up Chairman Sander’s sweeping $20 billion workforce bill (summary/press release/section by section /text) that would reauthorize the Community Health Center Fund, the National Health Service Corps (NHSC), Teaching Health Center Graduate Medical Education (THCGME), as well as fund an additional 10,000 Medicare Graduate Medical Education slots, and fund programs aimed at increasing the nursing, dental, and behavioral workforce. Senator Sanders’ bill follows the introduction of HELP Committee Ranking Member Bill Cassidy’s own bill, which is a much slimmer bill that mirrors legislation the House Energy & Commerce Committee unanimously passed in May as part of the PATIENT Act. The two parties are very far apart in their approach to reauthorize legislation that is set to expire on September 30.
On Thursday the Senate Finance Committee will be the next Congressional Committee to markup pharmacy benefit manager legislation (summary). The Senate HELP Committee, Senate Commerce Committee, the House Education and the Workforce Committee, and the House Energy & Commerce Committee have all passed up their own legislation focused on increasing transparency of prescription drug costs and rebates and PBM practices. The House Ways and Means Committee could potentially unveil their own health focused package this week, that would include PBM reform, and quickly move it through the Committee. Ultimately all these bills will likely be combined into a single health package, including the workforce and PAHPA reauthorization bills. Timing and likelihood of enactment, however, remains undetermined.
Appropriations Markups continue this week as well. The Senate Appropriations Committee is scheduled to mark up their Labor-HHS bill on Thursday. The current agreed upon allocation for Labor-HHS in the Senate is a 6% cut, not as drastic as the 30% cut the House Appropriations Committee passed. However, Senate Appropriations Committee Chair Patty Murray (D-WA) and Vice Chair Susan Collins (R-ME) reached agreement to tack on nearly $14 billion in additional fiscal 2024 spending to Senate appropriations bills. This will be done through emergency spending. Labor-HHS will get an additional $2 billion through this mechanism. The House Labor-HHS bill passed Subcommittee over a week ago but it has yet to be scheduled for full Committee markup.
Regulatory Update
The Office of Management and Budget (OMB) is reviewing a slew of rules, though we are unlikely to see any drop this week. No new rules have cleared OMB review. OMB is reviewing the following:
- Minimum staffing standards for long-term care facilities – Proposed rule would address staffing requirements at long-term care facilities, including nursing homes. Industry pushback has delayed the release of the rule, initially intended for June. Stakeholders are meeting with OMB in early September, meaning we are unlikely to see the proposal until the fall.
- Medicaid and CHIP – Final rules intended to simplify the processes for eligible individuals to enroll and retain eligibility in Medicaid, CHIP and the Basic Health Program. The first final rule expected in September 2023 will remove barriers and facilitate enrollment of new applicants, particularly those dually eligible for Medicare and Medicaid. The second final rule expected in February 2024 will implement changes to align enrollment and renewal requirements for most individuals in Medicaid and promote maintenance of coverage.
- Fiscal year 2024 Medicare payment final rule – Policy and payment updates for acute care hospitals, inpatient psychiatric facilities, skilled nursing facilities, inpatient rehabilitation facilities, and hospice. Final action is not expected until November.