The Week Ahead

Week Ahead: The Fireworks Aren’t Done Yet

The fireworks are just starting in Washington, DC even if Independence Day celebration is over. Democratic offices on the Hill are still working out the best way to handle President Biden’s debate performance, his subsequent interview with ABC, and questions about his fitness for office. Additionally, there is a new framework on how to implement federal regulations with the repeal of the Chevron Deference doctrine. So don’t put away those lawn chairs and blankets just yet. Welcome to the Week Ahead!

The Administration

We are eagerly waiting for the release of the CY 2025 proposed rules for the Physician Fee Schedule and the Outpatient Prospective Payment System. While we expected them last week, don’t worry the rules aren’t late – they dropped mid-July last year.

The Centers for Medicare and Medicaid Services (CMS) did drop the CY 2025 Home Health Proposed Rule and the CY 2025 End Stage Renal Disease (ESRD) Proposed Rule on June 26 and June 27, respectively. The proposed home health rule included an overall rate reduction of -1.7%. The proposed ESRD rule increases the base rate to $273.20.

Don’t forget – the FY 2025 final rules for inpatient hospitals, skilled nursing facilities, and inpatient rehabilitation facilities are coming out soon.  They are under review at OMB right now.

But what about Chevron? The repeal of the Chevron Deference Doctrine by the Supreme Court on June 28 ends the long-held practice of giving deference to federal agencies when the laws they are tasked with implementing are not clear. This decision could complicate finalizing all sorts of rules, including health care provider payment rules. The Administration condemned the decision as one that will “block common-sense rules that keep us safe, protect our health and environment, safeguard our financial system, and support American consumers and workers.” Leading Democratic members of Congress, including Senate Majority Leader Schumer and House Judiciary Committee Ranking Member Nadler, have also criticized the decision.

The Senate

Nursing Home Staffing Rule Rebuke Possible

Speaking of rules, we are hearing rumors from within the Senate Democratic caucus that a Congressional Review Act vote may occur on the Biden Administration’s rule that would create a nursing home staffing mandate. This rule has come under fire from nursing homes and hospitals, and drawn bipartisan criticism on the Hill, especially in rural districts.

Although many Democratic senators are expected to vote against repealing the mandate, Democratic leadership may be looking to give a pass to vulnerable senators who face tough re-election campaigns in November. We expect the measure to pass in the Senate to pass this measure and to eventually make its way to President Biden’s desk where we expect he will veto the bill. We don’t see a scenario in which there is enough Democratic support to overturn the veto.

Health Care Hearings to Watch

  • July 9: Senate Health, Education, Labor, and Pensions Subcommittee on Children and Families hearing on the impact of high costs (not explicitly health care, but health care costs are certainly a concern members like to talk about)
  • July 11: Senate HELP Committee hearing on medical debt
  • July 11: Senate Special Committee on Aging hearing on health care transparency
  • July 11: Senate Appropriations Markup of Milcon-VA, Ag-FDA, and Legislative Branch Appropriations Acts and FY25 Subcommittee Allocations
  • July 11: Senate Homeland Security and Governmental Affairs Committee hearing on Oversight of Taxpayer-Funded High-Risk Virus Research

The House

Biden’s House Woes

More Democratic Representatives are calling for President Biden to step aside and let someone else face former President Trump in the 2024 election as the House returns from recess. So far, that list includes Reps. Craig, Quigley, Kuster (Nem Democat Coalition Chair), Moulton, Doggett, and Grijalva. The New York Times is also reporting that Reps. Nadler, Adam Smith, Takano, and Morelle have urged House Minority Leader Jeffries to get President Biden to end his reelection bid. These House Democrats join the Democratic Governor of Massachusetts in calling for Biden to let someone else run. Additionally, Sen. Warner of Virginia is reportedly working on building support among Senate Democrats to urge Biden to get out of the race.

Labor-HHS and FDA Appropriations Bills Set to be Marked Up

The House Appropriations Committee is scheduled to markup the Labor, Health and Human Services (HHS), Education, and Related Agencies Appropriations Bill for FY 2025 on July 10. It is also scheduled to markup other appropriation legislation, including its version of the Agriculture, Rural Development, Food and Drug Administration (FDA) Appropriations Bill for FY 2025. We will be watching for details on these bills as we move closer to the markup date, and to see if the bills that emerge include any controversial provisions on hot button issues like abortion.

Ways and Means Goes West

Much like the prospectors who went west during the California gold rush, the House Ways and Means Committee will be heading west for a field hearing in Utah on July 12. But unlike those prospectors looking for gold and silver, the Committee is looking for a different type of treasure. That is how to support medical innovation.

In theory, this is an area that could be a gold mine for bipartisan action. However, it remains to be seen if the committee can strike it rich or if things will be held up by partisan disagreements over how to best get the gold. We expect Republican members to criticize government interference in private-sector innovation, while Democratic members will likely highlight the importance of investing in research to make such innovations possible and the need to ensure those innovations are affordable.

There You Have It

Can you believe it’s already July? As if that was not hard enough to believe, the Republican National Convention begins July 15! Before you know it, summer will end, and the final push to the election will be upon us. So, soak up the sun and the speeches while you can. Make it a great week!

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Week Ahead: Ready or Not Here It Comes – For Testing

The first presidential debate for the 2024 electionis upon us, with President Biden and former President Trump set to take the stage in Atlanta on June 27. As the candidates and the country prepare, we at Chamber Hill Strategies are also watching for the release of two proposed Medicare rules, a possible Ways and Means markup, and more. So, let’s get into it, welcome to the Week Ahead!

The Administration

Summers in Washington bring blazing heat and crowds of tourists. Summer is also when we start seeingthe arrival of more Medicare payment proposed rules. So as the temperature climbs,we are hearing these 2 rules could be released as early as June 28:

  • Proposed CY 2025 Physician Fee Schedule Rule: The PFS is how the Centers for Medicare and Medicaid Services (CMS) pays for physician services, incidental services, non-clinical laboratory diagnostic tests, and radiology services.
  • Proposed CY 2025 Outpatient Prospective Payment System. The OPPS is how CMS generally pays for hospital outpatient department services.

We are eagerly anticipating the rules governing the Home Health Prospective Payment System and the End-Stage Renal Disease Prospective Payment System, but those are still under review at the Office of Management and Budget.

These proposed rules are vitally important to health care providers and the Medicare beneficiaries they serve. They also provide an opportunity for the Administration to advance health care priorities with a Republican-controlled House and a Senate that lacks a filibuster-proof majority for Democrats. For example, we could see the Administration try to advance payment policies in the PFS that require inclusion of data on social determinants of health. We might also see the Administration include provisions in the OPPS rule designed to encourage hospitals to adopt stronger cybersecurity protections. We will be watching closely for the release of these rules and diving into the details as soon as they come out.

The Senate

The Senate is out of session until after the 4th of July Holiday. We will provide updates when they return the week of July 8.

The House

Ways and Means Looks at Innovative Products

Rumor is that that the House Ways and Means Committee could meet this week to mark up legislation that would extend Medicare coverage for new and innovative technologies and products.  While the markup has yet to be noticed, the Committee’s interest in advancing coverage for newly developed treatments and devices is not a secret in health policy circles. One possible candidate for consideration is H.R. 1691, the Ensuring Patients Access to Critical Breakthrough Products Act, which was introduced last year by Ways and Means member Rep. Brad Wenstrup (R-OH) and fellow committee members, Reps. Suzan DelBene (D-WA), Blake Moore (R-UT), and Rep. Terrie Sewell (D-AL); the bill would extend temporary Medicare coverage to devices approved under the Food and Drug Administration’s Breakthrough Devices Program.  Also, rumored for possible consideration is H.R.5389, National Coverage Determination Transparency Act, which counts committee member Rep. Mike Kelly (R-KY) among its lead cosponsors. The legislation which was introduced by Energy and Commerce Health Subcommittee Chair Rep. Brett Guthrie (R-KY) was approved by the Energy and Commerce Committee in December.

These bills both become prime contenders for a House vote during a possible “health care week” in July.

Other Health Care Hearings on the Radar

  • June 26: House Ways and Means Health Subcommittee hearing on Value-Based Care
  • June 26: House Veterans Affairs’ Oversight Subcommittee hearing on the VA’s Healthcare Network
  • June 27: House Education and the Workforce Health, Employment, Labor, and Pensions Subcommittee hearing on the Employee Benefits Security Administration
  • June 27: House Appropriations Labor, Health and Human Services, Education Subcommittee Markup

There You Have It

Did you know that the first televised debate about a presidential election featured two women? That’s right,in 1956, former First Lady Eleanor Roosevelt, acting as a surrogate for Democratic candidate Adlai Stevenson, debated Sen. Margret Chase Smith, acting as a surrogate for Republican President Dwight Eisenhower. Do you know any other fun facts about presidential debate history? If so, let us know! Make it a great week!

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Week Ahead: Ready or Not Here It Comes

The first presidential debate for the 2024 electionis upon us, with President Biden and former President Trump set to take the stage in Atlanta on June 27. As the candidates and the country prepare, we at Chamber Hill Strategies are also watching for the release of two proposed Medicare rules, a possible Ways and Means markup, and more. So, let’s get into it, welcome to the Week Ahead!

The Administration

Summers in Washington bring blazing heat and crowds of tourists. Summer is also when we start seeingthe arrival of more Medicare payment proposed rules. So as the temperature climbs,we are hearing these 2 rules could be released as early as June 28:

  • Proposed CY 2025 Physician Fee Schedule Rule: The PFS is how the Centers for Medicare and Medicaid Services (CMS) pays for physician services, incidental services, non-clinical laboratory diagnostic tests, and radiology services.
  • Proposed CY 2025 Outpatient Prospective Payment System. The OPPS is how CMS generally pays for hospital outpatient department services.

We are eagerly anticipating the rules governing the Home Health Prospective Payment System and the End-Stage Renal Disease Prospective Payment System, but those are still under review at the Office of Management and Budget.

These proposed rules are vitally important to health care providers and the Medicare beneficiaries they serve. They also provide an opportunity for the Administration to advance health care priorities with a Republican-controlled House and a Senate that lacks a filibuster-proof majority for Democrats. For example, we could see the Administration try to advance payment policies in the PFS that require inclusion of data on social determinants of health. We might also see the Administration include provisions in the OPPS rule designed to encourage hospitals to adopt stronger cybersecurity protections. We will be watching closely for the release of these rules and diving into the details as soon as they come out.

The Senate

The Senate is out of session until after the 4th of July Holiday. We will provide updates when they return the week of July 8.

The House

Ways and Means Looks at Innovative Products

Rumor is that that the House Ways and Means Committee could meet this week to mark up legislation that would extend Medicare coverage for new and innovative technologies and products.  While the markup has yet to be noticed, the Committee’s interest in advancing coverage for newly developed treatments and devices is not a secret in health policy circles. One possible candidate for consideration is H.R. 1691, the Ensuring Patients Access to Critical Breakthrough Products Act, which was introduced last year by Ways and Means member Rep. Brad Wenstrup (R-OH) and fellow committee members, Reps. Suzan DelBene (D-WA), Blake Moore (R-UT), and Rep. Terrie Sewell (D-AL); the bill would extend temporary Medicare coverage to devices approved under the Food and Drug Administration’s Breakthrough Devices Program.  Also, rumored for possible consideration is H.R.5389, National Coverage Determination Transparency Act, which counts committee member Rep. Mike Kelly (R-KY) among its lead cosponsors. The legislation which was introduced by Energy and Commerce Health Subcommittee Chair Rep. Brett Guthrie (R-KY) was approved by the Energy and Commerce Committee in December.

These bills both become prime contenders for a House vote during a possible “health care week” in July.

Other Health Care Hearings on the Radar

  • June 26: House Ways and Means Health Subcommittee hearing on Value-Based Care
  • June 26: House Veterans Affairs’ Oversight Subcommittee hearing on the VA’s Healthcare Network
  • June 27: House Education and the Workforce Health, Employment, Labor, and Pensions Subcommittee hearing on the Employee Benefits Security Administration
  • June 27: House Appropriations Labor, Health and Human Services, Education Subcommittee Markup

There You Have It

Did you know that the first televised debate about a presidential election featured two women? That’s right,in 1956, former First Lady Eleanor Roosevelt, acting as a surrogate for Democratic candidate Adlai Stevenson, debated Sen. Margret Chase Smith, acting as a surrogate for Republican President Dwight Eisenhower. Do you know any other fun facts about presidential debate history? If so, let us know! Make it a great week!

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Week Ahead: It’s Quiet…Too Quiet

After two tumultuous weeks dominated by historic trials, reactions to an Israeli hostage recuse mission, and a visit to Capitol Hill by former President Trump, this week looks to be a lot quieter. But looks can be deceiving, and things are always going on behind the scenes in this town if you know where to look. So, let’s get to it. Welcome to the Week Ahead!

The Administration

OMB on the Clock to Review DEA Rule on Prescribing Controlled Substances Via Telehealth

The Office of Management and Budget (OMB) has received a proposed rule from the Drug Enforcement Agency (DEA) that would allow individuals to be prescribed certain controlled substances from a practitioner utilizing telehealth even if they had not had an in-person evaluation from the practitioner. The proposed rule would only apply to non-narcotic schedule III-V controlled medications when certain circumstances are met.

The DEA currently has temporary telehealth flexibilities in place through the end of the year. If the agency does not finalize its proposed rule before then, patient advocates argue that those who have been utilizing the flexibilities will face barriers to prescriptions for conditions such as ADHD.

The Senate

Senate Finance Chair Readies Rural Maternal Health Bill

Senate Finance Committee Chair Ron Wyden (D-OR) announced on June 14 that he will be holding a press call on June 17 to preview legislation he plans to introduce to address concerns about the availability of maternal health services in rural areas. The press call is scheduled for 2 PM EST.

Both rural and maternal health care are areas with huge potential for bipartisanship. But the devil is in the details…

While the House is Away the Senate will Play…Detective

What do you do if you’re in the Senate, but the House is out of session? Of course, you can vote on nominations. But It’s a lot more fun to hold investigations on hot button issues that are sure to make headlines. We are tracking a couple of such investigations in 2 committees this week.

  • Senate Health, Education, Labor, and Pensions (HELP) Committee
    • o   Chair Bernie Sanders (I-VT)was ready to hold a vote to subpoena Novo Nordisk’s President of North American Operations to testify about the company’s pricing of Ozempic and Wegovy in the United States.
    • However, Chair Sanders dropped his threat after the company’s global CEO Lars Fruergaard Jørgensen said he will testify at a hearing scheduled for September, according to Inside Health Policy.
    • This sets the stage for a potentially dramatic hearing 2 months before the 2024 elections.
    • But Novo Nordisk is not out of the woods yet, because the HELP Committee is still scheduled to vote to authorize an investigation into the company at a hearing scheduled for June 18.
  • Senate Homeland Security and Governmental Affairs Committee (HSGAC)
    • HSGAC is scheduled to hold a hearing on the origins of the COVID-19.
    • We’ve seen a lot of action on this issue in the House Oversight Committee, with Republicans and Democrats often disagreeing about what the focus of those efforts should be (even issuing conflicting reports).
    • But this is the Senate.  And the Senate is controlled by Democrats. Will we see bipartisan agreement about needed actions to understand the origins of COVID-19, unlike the partisan outcomes of the House hearings?

The House

The Ways to End a Month and What it Means

The House is in recess, so we are looking ahead to when they return. As we wait, we are tracking rumors that the Ways and Means Committee may be planning a markup related to innovation and medical coverage issues.

So What?

After July ends, we go to August recess and the unofficial final push to the November elections. As that date gets closer, many members of Congress will start having more things to do outside of Washington (and we are not talking about field hearings). These rumored hearings might be some of the last ones we see from the committee until after the elections or even until after the end of the year.

There You Have It

One of the reasons this week is so quiet is because Wednesday, June 19 is Juneteenth, the federal holiday that marks the date when the news of emancipation reached slaves in Texas in 1865. As we take time to celebrate this important date, we look back on progress so far and recognize the work that still needs to be done to form a more perfect union with liberty and justice for all.  Make it a great week!

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Week Ahead: Trying Times in Washington

Not two weeks have passed since the historic felony conviction of former President Trump, and now we could be heading towards another historic felony conviction, this time for Hunter Biden, the son of the current president. If these last few weeks have shown us anything, they show us that history stops for no one. So, let’s get to it. Welcome to the Week Ahead!

The Administration

JUUL Catches a Break from FDA

The Food and Drug Administration (FDA) announced the agency is rescinding its marketing denial orders (MDOs) against JUUL Labs, Inc. tobacco products, including e-cigarettes on June 6. These MDOs, issued on June 23, 2022, called for JUUL tobacco products to be removed from the market. Weeks later, FDA issued an administrative stay on the MDOs on July 5, 2022, because “certain scientific issues warranted additional review.” In its June 6 update, FDA cited this review and recent court decisions as the basis for the recession. The agency was clear in its announcement that the decision is not an authorization or denial of JUUL’s marketing applications and that the applications are once again under review.

JUUL wasted no time in celebrating the announcement and noted that JUUL products would be on the market during the review process.

Now What? 

  • Health advocacy groups, such as the American Lung Association and the Campaign for Tobacco-Free Kids, expressed disappointment regarding the decision.  What next steps will they take to pressure the FDA to pull JUUL products from the market?
  • What will congressional opponents of e-cigarettes do in response to this decision?  Appropriations season is underway, and opponents could use funding legislation to direct or block agency action.

Save the Date: June 20 is when the Supreme Court is scheduled to hear a request from the FDA to overrule a previous court ruling that found FDA had to consider applications for e-cigarettes one at a time, and could not just reject all of them, according to Inside Health Policy.

The Senate

Stillbirth Prevention Act up for UC?

We are hearing that the Senate could move by unanimous consent to pass H.R.4581, Maternal and Child Health Stillbirth Prevention Act of 2024. This bill would allow Maternal and Child Health Services Block Grant funds to be used for stillbirth research and prevention activities. Since this bill has already passed the House, the bill would go to the President’s desk if passed.

But this bill isn’t out of the woods yet. The UC process is dicey because a single senator can stop the process at any point. Senators have been known to block bills even if they agree with the underlying premise but have another issue (i.e. procedural concerns, concerns about related bills not getting a vote).

Health Care Hearings in the Senate

  • June 12: Senate Finance Committee hearing on youth residential treatment facilities
  • June 12: Senate Judiciary Committee hearing on youth vaping

The House

E&C Mark-Up Watch

What we are hearing: The House Energy and Commerce is expected to put out a notice of a mark-up on June 12 of several health care bills. These bills could be on a range of different topics, but we expect them to be non-controversial.

Just because these bills are non-controversial does not mean they are insignificant. Even bills that may not produce rage-inducing headlines can still involve significant appropriations in public health programs and major changes to the health care system. Plus, those non-controversial bills have the best shot of becoming law. Speaking of which…

Health Care Week? 

Just when we thought bipartisanship was dead, rumors of a bipartisan “health care week in the House” keep hopes alive. This rumored health care week would most likely occur in the second week of July and would be marked by votes on health care legislation. What bills would be included? Although we don’t know for sure, we bet that any bills coming out of that expected E&C markup would be prime contenders.

Now that we’ve talked about what might happen, here’s a look at the health care hearings in the House this week:

  • The show-stopper will be CMMI Director Liz Fowler on the hot seat at the June 13 House Energy and Commerce Health Subcommittee hearing on the CMS Innovation Center.  Director Fowler, a Hill alum, will try to defend the results-to-date of the evergreen funding the learning lab received from the ACA.
  • June 13: House VA Committee hearing on spinal cord injuries and disorders in the veteran community
  • June 13: House Budget Committee hearing on Medicare and Social Security

There You Have It

Flag Day is June 14! Check out these interesting facts about Flag Day. Let us know if you know any other fun facts about the Stars and Stripes. Make it a great week!

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Week Ahead: Of Convictions and Congress

Donald Trump made history on May 30 as the first former President to be convicted of a felony. Congress now returns for the first time since that conviction, and many lawmakers will be focusing their attention on the fallout from the verdict. We won’t add to the pile of punditry that has already been printed but will instead focus on the latest health care policy news.  Welcome to the Week Ahead!

The Administration

ACLA Tests the Legal Waters with LDT Lawsuit

As the former president prepares his appeal, the Food and Drug Administration (FDA) is preparing for a legal fight of its own. On May 29, the American Clinical Laboratory Association (ACLA) announced it was filing a lawsuit against the FDA to stop the agency’s Final Rule to regulate laboratory-developed tests (LDTs) as medical devices. The ACLA argues that Congress never gave the FDA the authority to regulate these tests.

So what?  The lawsuit is just the latest effort by the ACLA to stop this rule from going into effect. We expect the lab industry to follow the lawsuit with increased lobbying. Some Republicans on the House Energy and Commerce Committee have expressed concerns about potential unintended consequences from the rule, but what will become of efforts to pull back the rule?

Senate

Multiplan Madness

Senate Finance Committee Chair Wyden (D-OR) and Senate HELP Committee Chair Sanders (I-VT) are looking to get answers from Mutliplan regarding concerns about certain practices the company uses when negotiating out-of-network payment rates for insurers. Specifically, the Senators are concerned these practices increase costs for patients and may be allowing insurers to skimp on fulfilling their obligations to patients. They requested a response by June 5. Here are some things to watch for:

  • Will the two Democratic chairs get any help from their GOP Ranking Members?
  • Will we see any corresponding action in the House?

Senate Health Care Hearings 

  • June 4: Senate HELP Committee hearing on the Impact of Abortion Bans on Women’s Health
  • June 5: Senate Special Committee on Aging and Senate VA Committee hearing on Services for Veterans and Their Caregivers

The House

Checking in with Ways and Means

Work continues behind the scenes at the House Ways and Means Committee on provisions that could find their way in a late year, post-election health care package:

  • Telehealth: It sounds like a 2-year extension of telehealth flexibilities is picking up steam and is likely before year’s end. While advocates would love action before the November elections, it’s unclear at best if Congress can agree on addressing the issue sooner than December.
  • Rural health: In addition to the bills passed out of the Committee at its May 8 markup, the Committee is hoping to move additional rural bills before summer’s end. Any measures cleared by the Committee will be in play to move in a larger health package during the lame duck session.
  • Medicare physician payment: With Congress waiting for the release of the Medicare physician fee schedule in late June, it’s hard to see any significant movement on Medicare payment legislation before the election. In addition, word is that there is growing interest among policymakers in H.R. 6371, the Provider Reimbursement Stability Act, which would address Medicare’s budget neutrality requirement.

House Health Care Hearings

  • June 3: House Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic hearing with Dr. Fauci
  • June 4: House Energy and Commerce Oversight and Investigations Subcommittee hearing on 340B Drug Pricing Program
  • June 4: House Natural Resources legislative hearing, including H.R. 6395, Recognizing the Importance of Critical Minerals in Healthcare Act of 2023

There You Have It

Summer is officially here! Have any big summer travel plans? Favorite summer- time activities? Let us know! Make it a great week!

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Week Ahead: Congress Loves Rural

After a frenzied finish to last week that included a last-minute vote on legislation to reauthorize the Federal Aviation Administration in the Senate, and the bipartisan tabling of the motion to vacate House Speaker Mike Johnson in the House, the Congress reconvenes this week with only 2 work weeks before the Memorial Day break.  So, let’s get into it. Welcome to the Week Ahead!

The Administration

Cybersecurity Standards for Hospitals on the Horizon 

Deputy National Security Advisor for Cyber and Emerging Technology Anne Neuberger said that the Biden Administration plans to release a rule requiring hospitals to meet minimum cybersecurity standards in response to the Change Healthcare cyberattack in February, according to a Bloomberg News article republished on govtech.com.  She also said the administration plans to provide free training to small, rural hospitals who may have trouble meeting the standards.

Will the industry go along? We will be watching how stakeholders in the health care industry react to the news. An article published in the Record notes that Ms. Neuberger has argued that the industry has been asked to address cybersecurity concerns for more than a decade. But these arguments might be a moot point if the industry can find enough sympathy from members of Congress who have not been shy when it comes to pushing back on the administration’s rulemaking authority.

New DOJ Health Care Task Force Joins the Anti-Trust Parade

The Department of Justice (DOJ) Antitrust Division announced a new task force dedicated to addressing concerns about anti-competitive behavior in health care markets.  DOJ is also working with the Federal Trade Commission (FTC) and the Department of Health and Human Services (HHS) to extend the comment period for an investigation into how corporate ownership affects health care.

One big question: Will this task force impact voters’ perceptions of Biden’s handling of the economy? As this task force gets going, we know President Biden must be aware of polls such as this one from Gallup that shows him fairing the worst of any president on the question of economic management since 2001. We expect the President to continue to tout his efforts to increase competition and break up trusts – including in health care. But will it be enough to capture the support of November voters?

Bird Flu on the Brain

HHS announced several actions it is taking actions to respond to a recent outbreak of the avian flu (H591) along with the U.S. Department of Agriculture (USDA). The actions announced by HHS to address the avian flu threat do not come cheap. According to the agency, the CDC and FDA investments announced on May 10  will cost more than $100 million.

What we will be watching for: Politico reported on discussions between FDA Commissioner Califf and Ranking Member Hoeven (R-ND) regarding a potential avian flu supplemental funding request.  If such a request comes, how will the President handle negotiations with a Republican House that has been skeptical of spending requests and public health proposals from this administration?

The Senate

Schumer Provides Update on AI Legislation 

When asked about the specific timelines for AI legislation, Senate Majority Leader Chuck Schumer (D-NY) shared at a recent event that the committees are all over the map:
•    Homeland Security, Commerce, and Rules committees are “pretty well along on this.”
•    The Senate committees with jurisdiction over health care and education as being “a little further back.”
He said the hope is to have legislation start to come out “within a few weeks throughout the summer and fall.”

Senate Health Hearings

The big hearing this week on health is at Senate Finance Committee entitled “Rural Health Care: Supporting Lives and Improving Communities on May 16.  Both the House and Senate committees have been working behind the scenes and with the administration on rural health policy, and this hearing will set the stage for further legislating this summer. Other hearings include:
•    May 15: Senate Appropriations Subcommittee on Interior, Environment, and Related Agencies hearing entitled “A Review of the President’s Fiscal Year 2025 Budget Request for Indian Country.
•    May 15: Senate Veterans Affairs’ Committee hearing entitled “Frontier Health Care: Ensuring Veterans’ Access No Matter Where They Live.”
•    May 15: Senate Homeland Security and Government Affairs hearing to markup legislation, including S.4035, the FEHB Protection Act, which would direct the Director of the Office of Personnel Management to take certain steps to address concerns about improper enrollment in the health insurance program for federal employees.
•    May 16: Senate HELP Committee hearing entitled “Examining the Dental Care Crisis in America: How Can We Make Dental Care More Affordable and More Available?”

The House

Ways and Means Continues to Work on Rural  

House Ways and Means Committee took the first bite on a rural health package with the markup of telehealth and rural health legislation.  Telehealth was the only bill with a bipartisan vote, even though both Democrats and Republicans support improvements to rural health care.  Not to be outdone, House Energy and Commerce may be marking up telehealth legislation this week. Both the House and Senate would like to advance rural health legislation ahead of the August district work periods where they can tout legislative accomplishments to their constituents.
 
Becerra in the Hot Seat….Again 

HHS Secretary Xavier Becerra is once again returning to his old stomping grounds in the House when he testifies at a May 15 hearing at the House Education and Workforce Committee.   Other House health-related hearings include:
•    May 13: House Veterans’ Affairs Health Subcommittee field hearing entitled “Iowa: A Leader in Veteran Healthcare Innovation.”
•    May 16: House Oversight & Accountability Select Subcommittee on the Coronavirus Pandemic hearing entitled “Overseeing the Overseers: A Hearing with NIH Deputy Director Lawrence Tabak.” 

There You Have It

It’s going to be a busy one!  We want to join with those who have come to D.C. to honor our law enforcement officers for National Police Week and Peace Officers Memorial Day on May 15. Be sure to thank a police officer this week for what they do to keep our families and communities safe.

Here’s to a great week ahead – let us know your questions and feedback!

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Week Ahead: Congress Comes Back to Approps Season

Unseasonably cool weather in Washington last week left us feeling less than springy. However, we did see a thawing of relations between Republicans and Democrats on a foreign aid package. Additionally, the endorsement of Speaker Mike Johnson (R-LA) by former President Trump likely brings some feelings of rejuvenation to the embattled Speaker. The forecast this week calls for a return of Congress, a response to the Biden administration’s nursing home staffing mandate, and a possible rule on lab-developed tests (LDTs). Welcome to the Week Ahead!

The Administration

While Congress was out of session, the Administration dispatched several highly-anticipated final rules, including the nursing home staffing ratio rule, the Medicaid managed care rule, the Medicaid access rule, and an FTC ban on non-compete agreements, among others.

Banning menthol in cigarettes did not get finalized.  On April 26, Health and Human Services (HHS) Secretary Xavier Becerra acknowledged the need for more time, likely in part due to concerns that the rule would lead to increased law enforcement activity in minority communities.

4-1-1 on LDTs:  Despite all the regulatory activity, we are still waiting on a proposed rule granting the Food and Drug Administration (FDA) explicit authority to regulate LDTs. We expect that rule any day now.

The Senate

UnitedHealth Group CEO Comes to Town

United Healthcare Group CEO Andrew Witty testifies before Congress about the Change Healthcare cyberattack. His first stop will be a Senate Finance Committee hearing.

Some things we will be watching: 
•    Will GOP members use the hearing to criticize the Biden Administration’s response to the cyberattack, or will they focus their attention on UnitedHealth Group’s response?
•    Will any members discuss or propose legislative action to address broader concerns about cybersecurity? In particular, we will be watching to see if Sen. Mark Warner (D-VA) uses the hearing to advocate for legislation he introduced earlier this year that would tie federal payments to health care providers after a cyberattack to the adoption of cybersecurity standards.
•    How will Mr. Witty respond to allegations that United Healthcare has not done enough to help providers in the wake of the attack?

Other Notable Senate Hearings

  • April 30: Senate Armed Services Subcommittee on Personnel hearing on access to pharmaceuticals
  • May 2: Senate HELP Committee hearing on the shortage of minority health care professionals and the maternal health crisis

The House

Movement on Appropriations 

What’s happening: Last week, the House Appropriations Committee released guidance for members on FY 2025 Community Project Funding (earmarks). This comes as the House just finished FY 2024 appropriations only one month ago.

The House Labor, Health and Human Services Appropriations Subcommittee holds its Member Day on April 30.

What it means: The pace is quick: members must submit programmatic and language requests by May 1 and Community Project Funding Requests by May 3. We know how deadlines drive activity in DC!

House Energy and Commerce GOP Looks to Strike Back on Nursing Home Staffing Rule

What’s happening: On April 30, The House Energy and Commerce Health Subcommittee will consider the Protecting America’s Seniors Access to Care Act (H.R. 7513), which would block the implementation of the recently finalized minimum staffing rule during its legislative hearing entitled “Legislative Proposals to Increase Medicaid Access and Improve Program Integrity.”

Some Democrats have crossed the aisle to support this bill. Rep. Jared Golden (D-ME) is one of the bill’s cosponsors, and Rep. Terry Sewell (D-AL) supported the bill’s passage out of Ways and Means. That being said, most Democratic members are supporting the administration’s action. Given the small majority Republicans hold in the House, not to mention the Democratic majority in the Senate and Democratic President, getting this bill across the finish line may be a tall order.

In Other House Committee News 

  • The House Oversight Select Subcommittee on the Coronavirus Pandemic will hold a hearing on May 1 with the president of EcoHealth Alliance. EcoHealth Alliance has been accused by some House GOP members of funding risky gain-of-function research so this hearing will certainly be feisty.
  • After his appearance before the Senate Finance Committee on the morning of May 1, UnitedHealth Group CEO Andrew Witty will be crossing over to the House for an Energy and Commerce Oversight Subcommittee hearing about the Change Healthcare cyberattack.

There You Have It

What are your favorite springtime activities? Did you get to do any spring break traveling this year? Reach out to share and compare. Here’s to a great Week!

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The Week Ahead: March Madness – Washington, DC Version

Let’s start with 3 questions about timing this week.  See if you can guess the answers! 

  • What happened on time?   Selection Sunday for the NCAA Men’s and Women’s Basketball Tourneys – one of our favorite events of the year! 
  • What happened early?  Cherry blossoms.  The National Park Service declared peak blooms hit on March 17 – the second earliest peak on record. 
  • What happened late? Well, sort of, we still don’t have a clear path to fund the government past March 22.  Better late than never?! 

  

The Administration 

Health and Human Services Sec. Xavier Becerra will makes a second set of appearances this week on the President’s Budget.  His testimony before the Senate Finance Committee last week touted the Administration’s efforts to lower prescription drug costs and increase the number of people insured under the Affordable Care Act.  Expect more pointed questions in the House Appropriations Committee about funding priorities and the House Ways and Means Committee about Medicare and health savings accounts on March 20. 

  

What hasn’t yet come up in these hearings is the Administration’s response to the cyberattack on Change Healthcare, a unit of UnitedHealth Group that processes 15 billion health care transactions annually and touches 1 in every 3 patient records.  CMS, the HHS Office of Civil Rights, and the Department of Labor have all sent out notices of assistance within their jurisdiction.  The American Hospital Association has indicated the response to date has been woefully inadequate. 

  

The Senate 

The mad dash this week is to make sure the government remains funded past March 22 and before both the Senate and House will go back to their states and districts for a 2-week district work period.  While appropriations leaders have been working through the weekend, there’s no paper yet.  

  

We will be keeping our eyes peeled for any updates on the AI front, as the Gang of Four was predicting releasing their lessons learned from the various AI Insight Forums held over the last few months.  While the leaders will release a set of findings and suggested direction, the work of legislating will be left to the committees. 

  

The House 

If it feels like déjà vu all over again, you’re not alone.  We have 1 week to go to fund 6 major departments including HHS, Education, Labor, Homeland Security, Defense, State, and Treasury.  Funding for Homeland Security is one of the sticking points.  We had been anticipating the possibility of certain health care policy riders being attached, such as pharmacy benefit manager reform, hospital price transparency, and community health center funding, but it looks like these proposals may have to wait until after the election. 

  

  • Don’t forget – Rep. Ken Buck (R-CO-4) is retiring on March 22 – shrinking the GOP majority to a mere 5 votes (218-213). The margin will likely shrink further when New Yorkers go to the polls on April 30 to select a replacement, likely a Democrat, for the recently retired Rep. Brian Higgins (D-NY-26).  

  

Besides Sec. Becerra’s appearance before the House Ways and Means Committee, we will be watching closely as the House Energy and Commerce Health Subcommittee rips into FDA’s controversial proposed rule to regulate lab developed tests on March 21. The full Committee may also be marking up a number of health and non-health bills. 

  

So, here we go – March Madness – DC style.  If you have a free minute, don’t forget that MedPAC and MACPAC sent up their annual March Reports to Congress!  If you remember being able to receive those pubs by mail, let us know….  

 

 

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The Week Ahead: President’s Budget Release and More

The daffodils are in full bloom in Washington and Congress and the administration are trying to make the most of the next 2 weeks before taking a break for the Easter holiday.  There’s a lot going on in DC, so let’s get to it!

The Administration

All eyes on are the President’s annual budget release which will set out the President’s priorities for the government heading into the November elections.

  • Pay attention to what the President is proposing that can be done through Executive Order or regulation vs. what needs Congressional action.  While the “dead on arrival” phrase is often used in Washington, some things will be deader than dead, if that’s a thing, but anything the President can do on his own is fair game.

On March 1, President Biden gave his third State of the Union address, leaning into issues that energize the Democratic base and remind viewers and voters of his accomplishments.  For health care, he:

  • promised to restore Roe v. Wade as the law of the land, noting how red states have restricted access to IVF
  • expressed his desire to extend the Medicare insulin cap at $35/month to those with commercial insurance
  • made the case for expanding the number of prescription drugs subject to Medicare negotiations beyond current law

The Senate

The Senate took a victory lap over the weekend by passing a package of 6 bills to fund the government through September, including the Food and Drug Administration.  Congress now has 2 weeks to figure out how to fund the rest of the government before the March 22 deadline to avoid a partial government shutdown.

  • As an aside, how many times have we typed those words – avoiding a government shutdown – in the last few years?  We’ve lost count….

With immigration remaining at the forefront, the next set of bills, including Defense, Homeland Security, and Health and Human Services, won’t come so easily.

For health care, the Senate Finance Committee will host Sec. Becerra for a discussion of the President’s budget on March 14.  Yes, there will be partisanship but that isn’t what most interests us….

  • Watch for Senators’ priorities as they comment on the budget – this shows what each is championing and what might be able to move forward yet this year.

The House

The House comes back to take up 11 bipartisan bills coming out of the Transportation and Infrastructure Committee under suspension of the rules. But partisan tensions are sure to resume later in the week as the House brings up a resolution denouncing the Biden Administration’s immigration policy.

For health care, the focus is on the committees this week.  On March 12, the House Energy & Commerce Committee will be meeting to markup and move 19 bipartisan health-related bills, covering a wide range of issues, including maternal health, dementia treatment, cancer screening and a host of other initiatives. One bill of note that has garnered considerable attention is the “Dr. Lorna Breen Health Care Provider Protection Reauthorization Act” (H.R. 7153), which seeks to raise awareness and provide resources to address the mental health issues facing the health care workforce.

Also, on March 12, the House Ways & Means Committee will hold a full committee hearing titled, “Enhancing Access to Care at Home in Rural and Underserved Communities,” which will include testimony from both patients and providers about the challenges in improving access to in-home care and to modernizing the delivery of care in rural and other underserved communities.

There You Have It

We at Chamber Hill Strategies, are counting down the days:

  • 10 days left of winter
  • 11 days till the men’s NCAA basketball tourney starts
  • 12 days to avoid a government shutdown
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