On Monday, House Leaders decided not to proceed with their initial plans to move the Lower Costs, More Transparency Act under suspension of the rules this week. The legislation was released by the House Energy and Commerce, Ways and Means, and Education and the Workforce committees, and would reauthorize the Community Health Center Fund, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education program, all set to expire on September 30. Among other provisions, it would also delay around $16 billion in cuts to hospitals serving a disproportionate number of low-income patients through 2025.

On Thursday, House Republicans delayed plans to take up a stopgap funding measure this week after members of the GOP conference warned there would not be enough votes to pass a continuing resolution to avert a government shutdown at the end of the month. The immediate plan is to prepare more of the chamber's 11 remaining full-year appropriations bills for votes, focusing on passing those to establish a negotiating position for talks with the Senate. The pivot effectively puts the first move on a Continuing Resolution (CR) to the Senate or a bipartisan group of House lawmakers via a discharge petition. The pivot comes as several House Appropriations subcommittee cardinals spoke with McCarthy and other GOP leaders on Thursday afternoon. Following the meeting, attendees confirmed plans to begin bringing up individual FY24 appropriations measures on the House floor. Leadership is moving forward on a plan to reduce the overall cost of the fiscal 2024 spending bills by $60 billion, with exceptions for Defense, Homeland Security (H.R. 4367) and the Military Construction-VA measure (H.R. 4366), which the chamber has already passed. That would bring the full set of bills into compliance with the new $1.526 trillion topline for fiscal 2024 that the GOP conference largely accepted in a meeting Wednesday night.

In the Senate, the focus has shifted from trying to pass a minibus, which stalled over objections from Senator Johnson to Senate Leaders laying the groundwork to take up a stopgap funding measure next week. Senate Majority Leader Charles Schumer (D-NY) filed cloture on a motion to proceed to the House-passed Federal Aviation Administration reauthorization bill (H.R. 3935), which could become the vehicle for the Senate to pass its own CR.

·        $2.3 billion in savings from requiring “honest billing” from hospitals;

Read the Mehlman markup summary here.

House Vote on The Lower Costs, More Transparency Act, Healthcare Package Delayed

On Monday, House Leaders decided not to proceed with their initial plans to move the Lower Costs, More Transparency Act under suspension of the rules this week. Chair Cathy McMorris Rodgers (R-WA) stated she was “100% committed to getting this bill up for consideration on the floor, passed out of the House, and ultimately onto the president’s desk” but declined to explain further why it was pulled. Among the reasons that the bill is not likely to advance in the near term are the broader challenges the House is encountering to pass spending legislation and keep the government operational past the end of the current fiscal year; the legislation, which has bipartisan support and was approved unanimously by the Energy and Commerce Committee, faced opposition from Ways and Means Ranking Democratic Member Richard Neal (D-MA) and Education and the Workforce Ranking Member Robert Scott (D-VA). The Congressional Budget Office estimates the bill would decrease deficits by $833 million over 10 years. The Legislation includes the following key provisions:

Read the bill here.

On Tuesday, the House Oversight and Accountability Committee held a hearing to examine pharmacy benefit managers (PBMs), with witnesses from industry groups, including JC Scott, the CEO of the PBM trade group, and industry opponents, including PhRMA, which represents brand drugmakers, the National Community Pharmacists Association and the Biosimilars Council. Congress has been increasingly critical of PBMs and is looking to pass bipartisan legislation imposing new transparency requirements or restrictions on PBMs. Read more on the hearing and witness testimonies here.

Read the bills included here, and the Mehlman hearing summary here.

On Tuesday, the House Ways and Means Committee held a hearing to examine the implementation of the No Surprises Act, which was signed into law on December 27, 2020. Republicans and Democrats were united in their criticism of the Biden Administration’s implementation of the law intended to prevent patients from being charged high prices in emergencies and other situations where they cannot control who their medical provider is. Ways and Means Chairman Jason Smith (R-MO) stated the flawed implementation has led to legal challenges, resulting in significant backlogs of disputed cases. Numerous court challenges have been filed by the Texas Medical Association and other provider groups against the administration’s rules governing how payment disputes should be resolved, with major court rulings from the US District Court for the Eastern District of Texas favoring medical providers and finding the rules are contrary to the law. Read the Mehlman hearing summary here.

On Tuesday, the House Oversight and Accountability Committee held a hearing to examine pharmacy benefit managers (PBMs), with witnesses from industry groups, including JC Scott, the CEO of Pharmaceutical Care Management Association (PCMA), and industry opponents, including PhRMA, which represents brand drugmakers, the National Community Pharmacists Association and the Biosimilars Council. Read more on the hearing and witness testimonies here.

On Tuesday, the House Committee on Veterans’ Affairs, health subcommittee held a hearing examining potential new national standards of practice. The VA is weighing allowing providers like optometrists and certified registered nurse anesthetists to provide other care to help facilities with insufficient staff. The American Medical Association (AMA) has been critical of allowing non-physicians to do procedures beyond their current scope, and the American Society of Anesthesiologists said that allowing nurse anesthetists to do work previously reserved for anesthesiologists could lower the quality of care. Both Democratic and Republican lawmakers have stated concern that providers with less rigorous training who take on more types of care could lead to safety issues. Leaders from groups representing optometrists and nurse anesthetists argued that their clinicians can safely perform more advanced care. The VA is holding the last of several listening sessions on Thursday and is expected to release new data from an independent analysis of nurse anesthetists in the coming weeks. Read more on the hearing and witness testimony here.

On Wednesday, the House Energy and Commerce Oversight Subcommittee held a hearing to discuss the Inflation Reduction Act’s impact on drugmakers. Lawmakers had split views over the issue with Republicans questioning the law’s impact on research and development and Democrats defending its Medicare drug price negotiation provisions. Read more on the hearing and the witness testimonies here.

On Tuesday, Rep. Lloyd Doggett (D-TX) and Senators Elizabeth Warren (D-MA) and Angus King, Jr. (D-MA), sent a letter urging Biden’s Health and Commerce secretaries to release a draft framework to keep drug costs down by seizing patents from taxpayer-funded inventions, a procedure called “march-in rights,” to be released immediately for public comment. The Commerce and Health and Human Services Departments are reviewing march-in, an option no federal agency has ever exercised. Read the letter here.

On Monday, Congressman Bob Latta (R-OH) and Congresswoman Debbie Dingell (D-MI), both members of the U.S. House Energy and Commerce Committee, re-introduced the TREAT Act, which would temporarily waive state reciprocity laws to allow mental telehealth services to be provided across state lines during the event of a public health emergency.  Currently, healthcare professionals must maintain licenses in each state in which they render services. The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act would provide temporary licensing reciprocity for providers assisting in telehealth services for those suffering from mental health-related issues. Read the press release here.

On Wednesday, Representatives Glenn "GT" Thompson (R-PA) and Ann Kuster (D-NH), introduced the bipartisan Helping Ensure Access to Local TeleHealth, or the HEALTH Act, as part of National Telehealth Awareness Week. The legislation would secure Medicare reimbursement for telehealth services provided by community health centers and rural health clinics. It would also continue to allow providers to utilize audio-only telehealth visits for patients who do not have access to broadband services. Read the press release here.

On Wednesday, Senators Jacky Rosen (D-NV), Susan Collins (R-ME), and Mike Braun (R-IN) introduced the bipartisan Train More Nurses Act to address the nursing shortage affecting communities across the nation. The legislation would direct the Secretary of Health and Human Services and the Secretary of Labor to conduct a review of all nursing grant programs to find ways to increase faculty at nursing schools, particularly in underserved areas. It will also increase pathways for Licensed Practical Nurses to become Registered Nurses. Read the press release here. 

On Thursday, HHS announced it helped half a million children and families regain their Medicaid and Children’s Health Insurance (CHIP) coverage. On August 30, the Centers for Medicare & Medicaid Services (CMS) issued a call to action to states about a potential state systems issue where systems were inappropriately disenrolling children and other enrollees. 30 states were required to pause procedural disenrollments for impacted people unless they could ensure all eligible people are not improperly disenrolled due to the issue. CMS offered states strategies to assist in making it easier for people to renew their coverage, and nearly all states have adopted at least some of these strategies. Read the press release here.

Read the press release here.

On Wednesday, the Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized a rule to streamline enrollment in the Medicare Savings Programs (MSPs), making coverage more affordable for an estimated 860,000 people. The MSPs, run by state Medicaid programs, currently cover Medicare premiums and, in most cases, cost-sharing for more than 10 million older adults and people with disabilities who also have limited incomes. One of the key changes is to automatically enroll Medicare-eligible people who get Supplemental Security Income (SSI) from Social Security. The rule also expands eligibility for Medicare Part D’s Low-Income Subsidy that helps lower drug costs. The expansion, which could benefit an estimated 300,000 people, was part of the Inflation Reduction Act. Read the rule here.

On Wednesday, the Department of Health and Human Services (HHS), through the Administration for Strategic Preparedness and Response (ASPR), announced an investment of $600 million across 12 domestic COVID-19 test manufacturers and the reopening of COVIDTests.gov to deliver COVID-19 tests for free to households across the country. These investments in U.S. manufacturing will improve preparedness for COVID-19 and other pandemic threats, strengthen the nation’s capacity to manufacture tests, and secure approximately 200 million new over-the-counter COVID-19 tests for future federal government use. Each household will be able to order four free testing kits via COVIDTests.gov. Read the press release here.

On Wednesday, the Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality (AHRQ), announced nine grant awards of $1 million each for up to 5 years to support existing multidisciplinary Long COVID clinics across the country to expand access to comprehensive, coordinated, and person-centered care for people with Long COVID, particularly underserved, rural, vulnerable, and minority populations that are disproportionately impacted by the effects of Long COVID. The grants are designed to expand access and care, develop, and implement new or improved care delivery models, foster best practices for Long COVID management, and support the primary care community in Long COVID education. Read the press release here.

On Wednesday, a proposed rule from the Departments of Labor, Health and Human Services, and the Internal Revenue Service proposed a new rule that would set fees for filing arbitration cases under the No Surprises Act to be $150 per dispute. The rule is in response to a ruling in August by the US District Court for the Eastern District of Texas. The court found the prior $350 fee violated the Administrative Procedure Act by not providing parties with notice and an opportunity to comment on administrative fees charged for seeking arbitration in medical billing disputes. The arbitration process has been shut down because of the court’s ruling, causing more backlogs in an already jammed system. More than 330,000 cases have been filed, which prevents medical providers from billing patients more than can be charged for in-network care in emergencies, and in situations where people are treated by out-of-network providers at network facilities. Read the proposed rule here. 

Hearing: "Medicare Forever: Protecting Seniors by Making the Wealthy Pay Their Fair Share."

Hearing: “To Consider the Nominations of Marjorie A. Rollinson, of Virginia, to be Chief Counsel for the Internal Revenue Service and an Assistant General Counsel in the Department of the Treasury, Patricia Hart Neuman, of the District of Columbia, to be a Member of the Board of Trustees of the Federal Supplementary Medical Insurance Trust Fund; to be a Member of the Board of Trustees of the Federal Hospital Insurance Trust Fund; to be a Member of the Board of Trustees of the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund, and Demetrios L. Kouzoukas, of Virginia, to be a Member of the Board of Trustees of the Federal Supplementary Medical Insurance Trust Fund; to be a Member of the Board of Trustees of the Federal Hospital Insurance Trust Fund; to be a Member of the Board of Trustees of the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund.”