Summary
Congressional Update
Both the House and Senate are in session this week before breaking for a two-week July 4 recess. This will be a big week for appropriations, as the House Appropriations Committee continues to move through their 12 Subcommittee bills. Last week, the Committee agreed on funding totals that amount to about $119 billion less than the spending caps the debt deal set and about $130 billion less than current government funding. The DOD, Military Construction-VA and Homeland Security bills were all spared cuts, while the spending level for the Labor-HHS bill received a 30% cut. The Senate will adopt their subcommittee allocations on Thursday and will markup the Military Construction-VA and Agriculture bills. The Senate, however, will be using the spending totals agreed upon in the debt ceiling package setting the stage for a very contentious fall.
Today, the House Rules Committee is teeing up votes (for Wednesday or Thursday) on several bills reported by the House Ways and Means Committee, including CHOICE Arrangement Act (H.R. 3799) – a package of bills focused on health reimbursement arrangements (HRAs) that mostly passed along party lines. Chairman Jason Smith (R-MO) touted the bills would “giv[e] small businesses and their employees more health care options and flexibility while reducing outdated burdens.” Ranking Member Richard Neal (D-MA) criticized Republicans for “us[ing] high deductible health plans and health savings accounts to undermine comprehensive care.” Only the Small Business Flexibility Act (H.R. 3798) – a relatively innocuous bill requiring the HHS Secretary to notify employers about the availability of HRAs – passed W&M with bipartisan support.
Hearings
House Energy & Commerce Committee: On Wednesday, the Energy & Commerce Health Subcommittee will hold legislative hearing titled “Responding to America’s Overdose Crisis: An Examination of Legislation to Build Upon the SUPPORT Act.” The Subcommittee will discuss 28 pieces of legislation related to substance abuse. Authorizations in the SUPPORT Act expire September 30, 2023.
On Thursday, the Energy and Commerce Oversight Subcommittee will hold a hearing titled “MACRA Checkup: Assessing Implementation and Challenges that Remain for Patients and Doctors.” The hearing is expected to focus on what is and is not working with the 2015 Medicare Access and CHIP Reauthorization Act, which updated the formula Medicare uses to pay doctors.
The House Committee on Education and the Workforce: On Wednesday, the House Committee on Education and the Workforce will hold a subcommittee hearing titled “Competition and Transparency: The Pathway Forward for a Stronger Health Care Market.” The subcommittee will hear from stakeholders representing consumers, employers, and pharmacy benefit managers, as well as a policy expert from Georgetown University Center on Health Insurance Reforms.
Regulatory Update
The Biden Administration recently released its Spring 2023 Unified Agenda, which outlines the Administration’s plans to issue regulations in the near and long term. We are waiting for the Office of Management and Budget (OMB) to finish reviewing a slew of rules:
- Medicare
- Calendar year 2024 Medicare payment policies – Proposed updates to the Physician Fee Schedule and payment and policy updates for hospital outpatient departments and ambulatory surgical centers, home health agencies, and end-stage renal disease facilities;
- TCET Pathway – Proposed rule that would establish criteria for an alternative coverage pathways to provide transitional coverage for emerging technologies (TCET) under Medicare; and
- Episode-based Payment Model – Request for information on an episode-based payment model
- Minimum staffing standards for long-term care facilities – Proposed rule would address staffing requirements at long-term care facilities, including nursing homes.
- 340B Drug Pricing Program – Proposed rule regarding potential remedies for safety-net hospitals affecting cost years 2018-2022. In American Hospital Association v. Becerra, the Supreme Court ruled in favor of safety-net hospitals that challenged Medicare reimbursement cuts for prescription drugs provided in outpatient settings.
- Short-Term Plans – Proposed rule that would ensure short-term limited duration insurance includes protections for people with pre-existing conditions and other ACA protections.