Washington Health Policy Update July 15, 2022

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This week’s dose

This week marked the start of a three-week working stint in Congress (four weeks for the Senate) with 12 voting days before the August recess and only 120 days until the election. On Thursday, Sen. Joe Manchin threw a major wrench into ongoing negotiations with Majority Leader Chuck Schumer (D-NY) on reconciliation, noting that he could not support any tax increases or climate provisions, but remaining open to a health-only package including Medicare prescribing, drug negotiation and an extension of the Affordable Care Act tax credits. In addition, both houses of Congress held hearings on the impact of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, the House voted on additional protections for abortion services, and the administration continued to issue policies aimed at protecting reproductive health services. Stakeholder physicians also delved into the details of the proposed physician fee schedule rule, which features many new payment and benefit policies.

Congress

House and Senate committees hold hearings on reproductive health. This week there were four hearings on the impact of Dobbs:

  • The Senate Committee on Health, Education, Labor and Pensions held a hearing titled “Reproductive Care in a Post-Roe America: Obstacles, Challenges, and Threats to Women’s Health,” which considered the decision of the Supreme Court on Dobbs and its impact on access to reproductive services, maternal mortality, and health care in the United States.

  • The Senate Judiciary Committee held a hearing entitled “A Post-Roe America: The Legal Consequences of the Dobbs Decision”, which reviewed the legal implications of Dobbs.

  • The House Oversight Committee held a hearing titled “The Impact of the Supreme Court’s Dobbs Decision on Abortion Rights,” which focused on state restrictions on reproductive health services.

  • The House Judiciary Committee held a hearing titled “What Next: The Threat to Individual Liberties in a Post-Roe World,” which examined the decision’s broader impact on individual liberties and personal rights.

Each of the hearings focused on the impact of Dobbs decision on women’s health care, but did not describe specific legislation or policy proposals. Hearings followed a similar cadence, with Republicans focusing on the benefits of life-affirming care clinics, exemptions from current anti-abortion legislation for the life of the mother, the constitutionality of Dobbs, and issues of state rights. Democrats have focused heavily on provider accountability, the possible lack of access to health care other than abortion, maternal mortality disparities, health equity issues, and how women who seek an abortion will no longer be able to access it safely.

The House Energy and Commerce Committee also has a hearing scheduled for next Tuesday, July 19, titled “Roe Reversal: The Impacts of Take Away the Constitutional Right to an Abortion.”

House votes on reproductive health bills. The House passed two abortion-related bills on Friday, July 15. The first, the Women’s Health Protection Act (HR 8296), would codify federal abortion protections for health care providers. He passed a nearly party-line vote of 219 to 210, with a Democrat joining Republicans in opposition (Rep. Cuellar (D-TX)). The second, the Ensuring Abortion Protections Act (HR 8297), would ensure that states could not pass laws restricting interstate travel to obtain an abortion. He passed a largely partisan vote of 223 to 205, with three Republicans joining all Democrats in support (Reps. Fitzpatrick (R-PA), Kinzinger (R-IL) and Upton (R-MI)). Neither bill is expected to gain enough support in the Senate to move forward. On July 14, Senator Catherine Cortez Masto (D-NV) sought unanimous consent to introduce a similar bill protecting travel across state lines, the Freedom to Travel for Health Care Act. , but was blocked by Senate Republicans led by Senator James. Lankford (R-OK).

Administration

CMS Releases Proposed Rule for CY 2023 Medicare Physician Fee Schedule. On July 7, the Centers for Medicare & Medicaid Services (CMS) released calendar year (CY) 2023 payment policy revisions under the Physician Fee Schedule and other changes to the proposed rule of the Payment Policies Part B (CMS-1770-P), which includes proposals related to Medicare payment of physicians and the Quality Payment Program, among others. CMS proposed a conversion factor (CF) of $33.0775, which represents a reduction of approximately 4.42% from the final CY 2022 FC. The proposed FC for anesthesia is $20.7191, which represents a reduction of approximately 3.91% compared to last year. These FC amounts reflect a 0% update required by law, the expiration of a 3% increase in payments for CY 2022, as required by the Protecting Medicare and American Farmers from Sequester Cuts Act, and a budget neutrality adjustment required by law. Beyond the payment updates, the rule includes numerous other policy proposals regarding accountable care organizations, access to behavioral health services and certain dental services, and changes to the incentive-based payment system. Deserves that. CMS released several resources alongside the proposed rule, including a press release, fact sheet, Medicare Shared Savings Program fact sheet, and blog post about the proposed health policy changes. behavioral. Comments on the proposed rule are expected by September 6.

HHS announces new guidelines on reproductive health care. On July 8, President Biden signed an executive order for abortion access. In this order, the U.S. Department of Health and Human Services (HHS) committed to taking steps to ensure that all patients have access to all rights and protections for emergency medical care provided by law. . Currently, medical providers and hospitals are required by the Emergency Medical Treatment and Labor Act to provide stabilizing treatment to patients with emergency medical conditions. On July 11, the Biden administration reiterated, through new HHS guidelines, that medical providers must offer abortion services if a mother’s life is in danger and procedures performed in such circumstances would be protected regardless of state law. The state of Texas has already filed a lawsuit against the Biden administration over this new direction on the grounds that it violates the rights of doctors who oppose abortion and violates a state’s right to sue its own policies.

In addition, the Civil Rights Office has issued guidelines for retail pharmacies on accessing reproductive health services. The guidelines, aimed at the country’s 60,000 retail pharmacies, stated that pharmacists should dispense reproductive health care-related drugs according to instructions and prescriptions from providers. This includes abortion pills, birth control, and other reproductive care treatments. The agency cited reports describing cases in which women were denied certain drugs because the drugs may be abortion-related or the drugs contain ingredients like those used for medical abortion, for example methotrexate, which is sometimes used to treat certain types of cancer, psoriasis and rheumatoid arthritis, but can also be used off-label to terminate ectopic pregnancies.

HHS is hosting an information session on the new 988 Mental Health Helpline. On July 13, the Children’s Health Group and the Child and Adolescent Mental Health Coalition held a special joint meeting with speakers from HHS, to discuss the upcoming launch of 988, the new three-digit hotline that will soon replace the current National Suicide 10 digits. Lifeline Prevention Helpline. The new three-digit number will be a mental health crisis lifeline expanding existing helplines to help callers facing a range of mental health emergencies. It will be accessible for phone calls and text communications from July 16 from any mobile, landline or internet device.

HHS speakers shared hotline features and information about available counselors, and answered questions from briefing attendees, including inquiries about coordinating with the National Maternal Mental Health Hotline , resources to serve the LGBTQI youth population, access to local resources and services, and multiple language accesses.

Quick shots

  • The Senate Appropriations Committee has released a compilation of all community project funding requests for fiscal year 2023 submitted by individual senators. The committee has yet to release the text of the bill, so it is unclear which funding requests will ultimately be included.

  • The House Energy and Commerce Committee held a markup of five bills, including a bipartisan health care bill to ensure Medicare covers medically necessary treatments for lymphedema patients.

  • CMS has approved applications to extend reinsurance programs established under Section 1332 of the Affordable Care Act, for three states – Alaska, Oregon and Minnesota – highlighting how waivers have helped reduce premium costs.

  • On July 15, the proposed hospital outpatient prospective payment system rule was approved by the Office of Management and Budget (OMB). The rule could propose changes to the 340B drug pricing program as well as other important policies for hospital outpatient departments.

  • The COVID-19 Public Health Emergency (PHE) is due to expire on July 15. Although the administration has yet to issue an official extension, the PHE is expected to be renewed for another 90 days.

Diagnosis next week

Both chambers will return next week with a busy agenda that includes continued reconciliation talks, substantial appropriations work and another hearing on the impacts of Dobbs.

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