HealthCare Roundtable e-News – July 25, 2022

 

Top News

Bipartisan Group of Lawmakers Sides With Hospitals in 340B Dispute

A bipartisan group of 181 House members sent a letter to HHS, urging the agency to stop drug manufacturers from restricting discounts to hospitals in the 340B program. The lawmakers asked HHS to take all available enforcement actions, including the implementation of severe civil monetary penalties. There have been 14 lawsuits against the government this month, as drug companies work to avoid potential monetary penalties from the Health Resources & Services Administration (HRSA) for imposing such restrictions. To date, HRSA has sent out violation letters to nine drug manufacturers and referred seven companies to either the OIG or the Department of Justice.

 

House Passes FY 2023 Minibus, Increases FDA Funding by $341 Million

The House passed a six-bill funding package in a 220–207 party-line vote. The package contains six funding bills that will be added to the final 12-bill appropriations package. It includes the Agriculture, Rural Development, Food and Drug Administration (FDA), and Related Agencies bill (HR 8239), which gives the FDA $3.6 billion in discretionary funding for FY 2023, marking a $341 million increase over FY 2022. The legislation increases funding for drug and device activities by $64 million and includes an increase of $77 million for food inspections and food outbreaks. Senate appropriators have not yet introduced FY 2023 funding legislation for the FDA and HHS.

 

Administrative Action

  • The Substance Abuse and Mental Health Services Administration (SAMHSA) released a 988 Partner Toolkit with the goal of facilitating collaborative efforts among stakeholders and aligned 988 communication planning. The toolkit includes key takeaways, relevant statistics, and fact sheets along with presentation decks and other resources.

  • The Department of Health and Human Services Office of the Inspector General (HHS OIG) published their audit of nursing home safety and emergency preparedness. The audit found that residents, visitors, and staff were at increased risk of injury or death during a fire or other emergency due to several factors, including inadequate managerial oversight, staff turnover, inadequate oversight by State survey agencies, and a lack of mandatory standardized life safety training programs. Opportunities for CMS to expand on its life safety requirements in nursing homes include proposed regulations to install carbon monoxide detectors, improving support to State survey agencies, standardizing nursing home training, and more frequently surveying high-risk facilities.

Litigation

A judge in Tennessee temporarily prohibited two federal agencies from enforcing directives issued by the Biden Administration that extend protections for LGBTQ people in schools and workplaces. U.S. District Judge Charles Atchley Jr. ruled in an order for the 20 state attorneys general who sued last August, claiming the Biden administration directives infringed on states’ rights. The directives followed a 2020 U.S. Supreme Court case that, under a provision called Title VII, protects gay, lesbian, and transgender people from discrimination in the workplace.

Marketplace

Amazon and One Medical have entered into a definitive merger agreement for Amazon to acquire One Medical for $3.9 billion. One Medical has over 100 locations nationwide and prides itself on convenience, offering in-house lab tests, and same or next-day appointments. In addition to accepting insurance, it also has a membership program, which starts at $199 per year. The deal still requires approval from One Medical’s shareholders and regulators. Several months ago, Amazon announced plans to grow its network of brick-and-mortar clinics following the expansion of its virtual care services through Amazon Care.

Medicaid

  • The Center for Medicaid and CHIP Services (CMCS) Director Daniel Tsai made a statement during a Georgetown Center for Children and Families conference keynote saying that beneficiary advocates’ concerns about expiring Medicaid coverage are not unique to the end of the Public Health Emergency (PHE), and instead are a signal that the overarching Medicaid system needs improvement. Tsai highlighted the benefits of adopting continuous Medicaid eligibility for at least 12 months and conducting ex parte renewals and suggested several reforms.
  • First Focus on Children, FamiliesUSA, and UnidosUS collaboratively published a report on the looming equity crisis facing children’s Medicaid coverage at the expiration of the COVID-19 PHE. The report found that the country will see its largest-ever drop in children’s Medicaid coverage if states do not expand eligibility, and Black and Latino children will experience coverage losses at twice the rate of White children. The authors strongly urge policy action to prevent coverage losses that would disproportionately affect families of color and exacerbate inequities within the health system.
  • CMS released a letter outlining a new set of measures to assess the quality of Medicaid-funded Home and Community Based Services (HCBS). CMS cross-references the measures to the 1915(c) waiver service plan and health and welfare sub assurances and the policy areas of access, rebalancing, and community integration. CMS strongly encourages but does not require states to incorporate the measures into their quality reporting requirements for their HCBS programs. However, CMS notes that they will be incorporating the measure set into the reporting requirements for specific authorities and programs in the future.
  • The Centers for Medicare & Medicaid Services (CMS) awarded a total of $49 million to 36 grantees in 20 states to connect more children, parents, and families to health care coverage. These awards support President Biden’s Executive Order on Strengthening Medicaid and the Affordable Care Act and reflect Secretary Becerra’s priority to expand access to affordable, quality healthcare. The program will offer enrollment and renewal assistance to expectant parents, as well as children and their families. Grantees will receive up to $1.5 million over the course over three years to advance Medicaid and Children’s Health Insurance Program (CHIP) enrollment.

Medicare

Better Medicare Alliance released their 2022 report on the state of the Medicare Advantage (MA) program. This annual document compiles and summarizes the latest research and data on the MA program and gives a comprehensive picture of MA experience, including supplemental benefit options, consumer savings, beneficiary demographics, enrollment trends, and health outcomes. The report found that 45% of the Medicare population choose MA, and enrollment has doubled over the past decade. Only seven percent of MA beneficiaries identify as racial or ethnic minorities as opposed to 16 percent in FFS, but the number of diverse beneficiaries has grown 111 percent since 2013, along with 125 percent growth in dually eligible beneficiaries.

Research

The Urban Institute, in partnership with the American Benefits Council and Deloitte, released a research report focused on disparate health outcomes as a result of inconsistent and incomplete race and ethnicity (R/E) data. Health plans could use data to improve health equity by modifying payment arrangements with providers to include health equity incentives and analyzing algorithms and other similar technologies for implicit biases. Health plans can address the barriers to R/E data collection by enhancing community engagement, reducing legal uncertainty, updating, and standardizing self-reported R/E data collection practices, and prioritizing organizational resources. The full text of the report can be found here.

Event Coverage

The Hill hosted a comprehensive discussion on advancing access, the pursuit of health equity, and resetting the care paradigm across the United States. The summit also covered technology and care development, and the United States’ preparedness for the next health emergency. Speakers from the event included Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), Chiquita Brooks-LaSure, Administrator of the Centers for Medicare and Medicaid Services (CMS), and Dr. Ashish Jha, White House Coronavirus Response Coordinator. Click here to watch the discussions and here to view Healthsperien’s detailed analysis of the event.

Roundtable Reminders

SAVE THE DATE – November 9-11, 2022
Annual Conference Returns to Alexandria, VA

After two years of virtual meetings, the Roundtable is planning an in-person Annual Conference for this November. We will return to The Alexandrian Hotel in Old Town Alexandria, Virginia for our annual policy conference from Wednesday, November 9 to Friday, November 11, 2022.

Details will be released later this year. For now, save the dates!