Health Policy Report (1/23)January 23, 2023
Both chambers of Congress will return for legislative business this week, starting with the Senate later today, followed by the House on Tuesday. On the floor, House Republican leadership has queued up a dozen suspension bills for consideration, including legislation that would nix the Security and Exchange Commission’s (SEC) leasing authority. Lawmakers will take up a pair of measures related to disaster relief that would: (1) establish an online repository of certain reporting requirements for recipients of federal disaster assistance (H.R. 259); and (2) conduct a study that focuses on streamlining and consolidating information collection and preliminary damage assessment (H.R. 255). In the upper chamber, Senators will hold a final up-or-down vote on Brendan Owens’ nomination to be an Assistant Secretary of Defense. Meanwhile, the current expectation on Capitol Hill is that all committee assignments in both chambers will be completed this week as lawmakers look to begin committee work for the 118th Congress in earnest.
Energy and Commerce Democrats Put Pressure on NIH, FDA to Report on Clinical Trials
House Energy and Commerce Ranking Member Frank Pallone (D-NJ) sent aletter last week to the Food and Drug Administration (FDA) and National Institutes of Health (NIH) inquiring about the agencies’ requirement to publicly report clinical trial results. Pallone harped on the NIH’s failure to report trial results on ClinicalTrials.gov, referencing a recent report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG). He also pointed towards The FDA’s lack of adequate enforcement, as the agency is supposed to warn companies and trial investigators when results are not reported (which it has not done). Pallone’s frustrations echo a similar letter that Republican lawmakers sent to the NIH last fall, which cites the same OIG study. After that letter, the NIH and FDA sent some warning letters — which seemed to be effective — but there appeared to be no sustained effort to improve the lack of publicly available trial results.
Bipartisan Lawmakers Coalesce Around Medicare Payment Policy
After the December 2022 omnibus bill mitigated several physician payment cuts facing Medicare providers, lawmakers want to search for a more permanent fix for this recurring crisis while the iron is still hot. This effort represents a bipartisan issue for lawmakers with a medical background who want to see physicians get a pay raise in the next few years. Statutory cuts to Medicare physician payments are intended to go into effect each year, though Congress generally reduces or eliminates the cuts to some extent, providing what doctors generally perceive as a last-minute move to soften the blow of lower payments.
In the context of the U.S. provider shortage, many stakeholders view payment cuts as having a particularly adverse impact on low-income and rural patients. Bipartisan lawmakers interested in identifying policy solutions include Reps. Larry Bucshon (R-IN), Michael Burgess (R-TX), Raul Ruiz (D-CA), and Kim Schrier (D-WA), among other members of key committees overseeing the Medicare program. However, differing political pressures on both sides of the aisle may prove to be a hurdle for bipartisan agreement, as some Republicans are looking to decrease Medicare spending in the midst of these funding shortfalls.
Senator Warner to Examine Health Care Cybersecurity
Sen. Mark Warner (D-VA) announced he intends to introduce legislation during the first half of 2023 to protect patients’ health care data. Back in November of last year, he issued areport that asserted that adopting minimum standards for data could mitigate many of the privacy dangers facing patients. Warner’s report suggested that imposing new cybersecurity regulations could be accomplished by linking Medicare and Medicaid payments to data requirements, though the Senator has also suggested circumventing the Department of Health and Human Services (HHS) and instilling a health care cybersecurity point person directly within the White House. Warner is not alone in working to fulfill these aspirations to secure patients’ health care data. He has hinted that he’s been trading ideas with Sens. Bill Cassidy (R-LA) and Jacky Rosen (D-NV), both of whom sit on the Senate Health, Education, Labor, and Pensions (HELP) Committee.
988 Hotline Sees Boost in Utilization
The 988 Hotline — a newly minted program serving as an alternative to 911 for Americans experiencing mental health crises — is experiencing positive results. Since its inception in July of 2022, wait times are going down as demand for the service rises. The Substance Abuse and Mental Health Administration (SAMHSA), the agency within the Department of Health and Human Services (HHS) handling the hotline, reported that it is seeing a large uptick in texts and chats, especially among younger people.
As of September, SAMHSA has been partnering with the Trevor Project to train 988 counselors in sensitivity training for the LQBTQIA+ community. The agency is using new funding from the December 2022 omnibus spending bill to further expand its cultural competency training for Native communities as well as build a foundation for a video chat option to accommodate those with hearing disabilities. The congressional funding influx will be directed towards network capacity as well, such as hiring counselors and enhancing the Spanish-speaking network. Still, however, much of the 988 hotline Is enabled through state-based funding, which is leading to patchy success rates. Only 16 states have passed legislation to permanently fund the crisis hotline, and the U.S.’s shortage of mental health professionals is pervasive.