HealthCare Roundtable e-News – December 2, 2020


SAVE THE DATE – Tuesday, December 8 at 3:00 PM (EST)

The Roundtable will present its next post-conference webinar – Innovation in Home-based Care Delivery. A Zoom link and speaker information will be announced on Friday.

Annual Conference Follow-Up

Conference presentations, together with speaker profiles and an attendance list, are available on the Roundtable website at https://www.healthcareroundtable.org/events/.


Bipartisan, Bicameral Group Offers Compromise for COVID-19 Relief Bill

A bipartisan, bicameral group of lawmakers unveiled a $908 billion COVID-19 relief package on Tuesday which Senate Majority Leader Mitch McConnell (R-KY) alleged was a waste of time as he pushed his own bill — while House Speaker Nancy Pelosi (D-CA) said that she and Senate Minority Leader Chuck Schumer (D-NY) sent a different proposal to House and Senate Republicans and are negotiating with Treasury Secretary Steve Mnuchin. (InsideHealthPolicy)

“Secretary Mnuchin said he would be reviewing the proposal Leader Schumer and I made to Leader McConnell and Leader McCarthy last night and the bipartisan Senate proposal unveiled today. Additional COVID relief is long overdue and must be passed in this lame duck session,” Pelosi said in a statement.

The separate bipartisan package is backed by Sens. Joe Manchin (D-WV), Susan Collins (R-ME), Mark Warner (D-VA), Bill Cassidy (R-LA), Jeanne Shaheen (D-NH), Lisa Murkowski (R-AK), Angus King (I-ME), Mitt Romney (R-UT), and Maggie Hassan (D-NH), as well as Reps. Josh Gottheimer (D-NJ), Tom Reed (R-NY), Anthony Gonzalez (R-OH), Dusty Johnson (R-SD), Dean Phillips (D-MN), Abigail Spanberger (D-VA), and Fred Upton (R-MI).

Romney points out in a statement that the bill includes $560 billion in “repurposed funds from the first CARES Act, so the amount of new money is actually $348 billion.” He also touts a liability provision that would provide a temporary suspension of COVID-19 liability-related lawsuits at the state or federal level, which he says is aimed at giving states enough time to put in place their own protections.

The bipartisan bill includes $35 billion for provider relief — far less than sought by providers. It also contains $5 billion for opioid treatment and $160 billion for state, tribal and local governments. The bill would also provide $16 billion for vaccine testing and distribution, as well as COVID-19 testing and contact tracing.

The bill, and Pelosi’s call for COVID-19 legislation, came a day after McConnell on the Senate floor called for COVID-19 relief, though he said that Democrats were blocking such a bill. 

McConnell released his own revised version of COVID-19 relief legislation that includes liability protections and $16 billion for testing, contact tracing and COVID-19 surveillance in states, according to a summary. It would also extend the deadline to spend COVID-19 relief funds to the end of fiscal 2021, but it doesn’t provide any additional funds or flexibility.

McConnell’s bill would provide $31 billion for vaccine, therapeutic and diagnostic development, vaccine distribution, the Strategic National Stockpile and grants for the establishment of state stockpiles.

When asked about the bipartisan bill on Tuesday, McConnell said, “We just don’t have time to waste time.” He indicated that his bill had administration support so it would be a better bet.

Biden-Harris Transition Team Commences Talks with HHS

The Department of Health and Human Services officially began discussions with President-elect Joe Biden’s transition team after a weeks-long delay following the 2020 Presidential Election. The General Services Administration confirmed last Monday (Nov. 23) that President-elect Joe Biden was the “apparent winner” of the election, which enabled Biden’s team to coordinate with federal agencies on plans for taking over on Jan. 20.

Azar stated the agency began working with the president-elect’s transition team after the GSA formerly acknowledged Biden’s win, saying he wanted to ensure Biden’s transition would be “in the spirit of looking out for the health and well-being of the American people and, in particular, saving lives through this COVID-19 pandemic.”

“We are immediately getting them all of the pre-prepared briefing transition materials. We will ensure coordinated briefing materials with them to ensure they’re getting whatever information they feel they need that’s consistent with statute and past practice,” Azar said. (InsideHealthPolicy)

President Trump had declined to provide the Biden transition team with post-election resources while lawsuits regarding recounts and election fraud were ongoing in battleground states. Despite repeated calls on both sides for the president to concede since the race was called by The Associated Press on Nov. 7th, Trump’s legal team had said they are “pushing on to fight the election results tooth-and-nail.”

State and Local Officials Call on Biden Administration for Stronger State-Federal Partnership to Fight COVID-19

Last week, members of the National Conference of State Legislatures, National League of Cities, National Association of Counties (NACo), and the Government Finance Officers Association called on the Biden administration to help build a stronger partnership with state legislators and local officials. The call to action comes as states continue to struggle with deadlines on CARES Act spending, COVID-19 stimulus, and building trust among constituents about virus vaccination concerns.

At the Council of State Governments webinar, participants heard from organization representatives on the importance of consultation in the development, prioritization, and implementation of federal environmental statutes and strategic planning at the state level, a process that many participants expressed has not been prioritized by the Trump Administration. Susan Parnas Frederick, National Conference of State Legislatures senior federal affairs counsel, commented on the lack of state-federal partnership in the previous administration and was hopeful that the first 100 days of President-elect Biden’s term would show some improvement, noting that Biden’s transition team has already made an effort to schedule time with local government officials. (InsideHealthPolicy)

In a press announcement, NACo Executive Director Matthew Chase congratulated Biden on his campaign win and said, “As we face an unprecedented public health emergency with rising COVID-19 cases and the resulting economic fallout, a strong federal-state-local partnership is more important than ever.”

During a conference last week with HHS Secretary Alex Azar, Blaire Bryant, Associate Legislative Director for Health Policy at the National Association of Counties, reiterated that a national strategy for communicating vaccine information to the public and the funding to make vaccinations equitable are vital. Bryant cited that states do have access to previously approved funding, but local governments that have been particularly cash-strapped are reluctant to designate the remaining funds for vaccines.

CMS Announces Expanded Hospital Without Walls Program to Combat COVID-19 Patient Capacity Limits

Last Wednesday, CMS announced that the agency would be expanding its Hospitals Without Walls program in order to ease the stress on communities where hospitals are reaching patient capacity as a result of the COVID-19 pandemic. With experts anticipating record high cases and hospitalizations leading into the holiday season, the enhanced program, called Acute Hospital Care at Home, will include new allowances for telehealth and remote monitoring.

“We’re at a new level of crisis response with COVID-19 and CMS is leveraging the latest innovations and technology to help health care systems that are facing significant challenges to increase their capacity to make sure patients get the care they need,” said CMS Administrator Seema Verma in a statement. “With new areas across the country experiencing significant challenges to the capacity of their health care systems, our job is to make sure that CMS regulations are not standing in the way of patient care for COVID-19 and beyond.”

The Hospitals Without Walls program was launched back in March of this year to allow for care outside designated hospitals in an effort to aid the spikes in COVID-19 cases and hospitalizations. CMS sees the new programs as a way to build on the expansion of telehealth it offered earlier during the pandemic and has looked for ways to streamline the waiver request process by creating an online portal. The waivers appear in two categories; hospitals that have previously provided at home acute hospital services to at least 25 patients or those facilities that have not, with hospitals having the previous experience to be shuttled into an expedited waiver process. Those approved will be required to submit monitoring data on monthly basis. (InsideHealthPolicy)

Most-Favored-Nation Model Calls for Mandatory Medicare Pay Cuts to Doctors in New Pilot Program

The Trump administration last month announced a pilot program for the president’s Most-Favored-Nation (MFN) model, a mandate that was signed via Executive Order by the president earlier this year in an effort to curb drug costs. The pilot calls for Medicare pay cuts to doctors nationwide for seven years and includes separate regulations to ban drug rebates. Controversially, HHS did not incorporate the standard rulemaking process before proposing the demo and is expected to face legal challenges from drug manufacturers. (InsideHealthPolicy)

The MFN model will begin on Jan. 1, 2021, with tests paying Part B drugs at comparable amounts to the lowest adjusted price paid by any country in the Organization for Economic Co-operation and Development (OECD). Countries with a GDP per capita that is at least 60 percent of the U.S. GDP per capita will be considered. Throughout the pilot, CMS will evaluate the impact of the model on beneficiary access to drugs, program costs, and the quality of care for beneficiaries. While the demo itself is expected to save more than $85 billion during the period, experts are concerned that fewer drugs will be available to patients as a result.

The demo will apply only to Medicare Part B and excludes the private vendors designated to run the International Pricing Index demo, the previous version of the MFN model with an anticipated pilot program of five years starting in 2020. CMS Administrator Seema Verma said the agency is working on the Part D aspect of the demo but declined to speak on other details of that proposal. (InsideHealthPolicy)