Summary
Welcome back Congress! The House and Senate both come back into session this week after a 5+ week summer recess. Both sides of the Capitol are scheduled to be in session for only 3 weeks before they recess again to focus on the upcoming elections. The primary goal in this work period will be to pass a Continuing Resolution (CR) to keep the government in operation past September 30, the end of the fiscal year. Nothing has been easy to pass during the 118th Congress, and this will be no different.
Senate Majority Leader Chuck Schumer (D-NY) put out a “dear colleague” letter last night calling on his fellow Senators to work together to pass a clean CR and potentially work on passing bipartisan bills like the annual defense policy bill, “rail safety, lowering the cost of insulin and prescription drugs, and artificial intelligence, among others” prior to the election. On Wednesday, House Republicans will take up a 6-month CR, which will carry into March 2025. The 6-month CR under consideration does not include any extensions for the many health care provisions that are set to expire at the end of the calendar year, including telehealth flexibilities or scheduled DSH cuts. Though there are some House Republicans in leadership and on the Appropriations Committee that prefer to finish the budget and start fresh in the new Congress, the CR is expected to pass on a party line basis. Senate Democrats will respond with a much shorter CR that goes through early-mid December.
The timeframe of the CR is not the only disagreement between the two parties. Even with the election in less than 2 months, House Freedom Caucus members and Republican Presidential nominee Donald Trump are insisting that a CR must also include the SAVE Act, legislation that would require proof of citizenship to vote to target non-citizen voting. This is a non-starter for Democrats, who argue this is a political bill and completely unnecessary since it is already illegal for non-citizens to vote. Former President Trump has gone so far as to say that if it were up to him he would shut down the government if the SAVE bill is not attached to the CR, a statement that has made some vulnerable swing district Republicans very nervous. Other, more realistic, riders to the CR include the Administration’s request for additional funding to support current needs such as the CDC’s respiratory virus preparedness and response, and disaster aid to rebuild the Francis Scott Key Bridge in Baltimore.
In Presidential election news, Vice President Kamala Harris and former President Donald Trump are scheduled to hold what may be their only debate tomorrow evening in Philadelphia.
Hearings
There are several hearings scheduled for this week, including:
- House Energy & Commerce Committee: On Tuesday the House Energy & Commerce Subcommittee on Health will hold a hearing “Evaluating FDA Human Foods and Tobacco Programs.” On Wednesday the House Energy & Commerce Subcommittee on Oversight will hold a hearing on HRSA’s Organ Procurement and Transplantation Network OPTN Modernization Effort.
- House Education and the Workforce Committee: On Tuesday the House Committee on Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions will hold a hearing to examine the value of employer-sponsored health benefits in honor of ERISA’s 50th
- Senate HELP Committee: On Tuesday the Senate HELP will hold a Hearing: Examining the Bankruptcy of Steward Health Care: How Management Decisions Have Impacted Patient Care. This is despite last the Steward CEO sending a letter to the Committee defying the Committee’s subpoena to testify.
Regulatory Update
The Office of Management and Budget (OMB) completed reviewing the following rules:
- Mental Health Parity – The final rule would clarify plans’ and issuers’ obligations under the Mental Health Parity and Addiction Equity Act (MHPAEA) and implement new requirements (July 2024).
- Organ Procurement – The proposed rule would make clarifications and technical modifications to the standards used to evaluate and recertify organ procurement organizations (OPOs) and to the competition and decertification process for organ procurement organizations (March 2025).
OMB is also reviewing the following rules:
Medicare
- Fraud – The final rule would modify the Medicare Shared Savings Program (Shared Savings Program) regulations to address the impact of significant anomalous billing patterns on performance year (PY) 2023 Accountable Care Organization (ACO) financial reconciliation (no date).
Medicaid
- Drug Rebate Program – The final rule would establishes requirements related to manufacturers’ misclassification of covered outpatient drug products under the Medicaid Drug Rebate Program (MDRP). In addition, it finalizes beneficiary protections, as well as MDRP program integrity and administration changes (June 2024).
Private Insurance
- ACA Marketplace – The proposed rule would set payment parameters and provisions related to the risk adjustment programs; cost-sharing parameters; and user fees for issuers offering plans on Federally-facilitated Exchanges and State-based Exchanges using the Federal platform. It would also provide additional standards for several other ACA programs (September 2024).
Other Topics
- Healthcare System Resiliency and Modernization – The proposed rule would revise and update national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers (was set for December 2023).
- Retail Pharmacy Standards – The final rule would require pharmacies and vendors to modify the currently adopted National Council for Prescription Drug Programs (NCPDP) standards to the Telecommunications Standard Implementation Guide Version F6 (F6); Batch Standard Implementation Guide version 15; and Batch Standard Subrogation Implementation Guide version 10 (was set for February 2024).