Health Policy Report (5/10)

May 10, 2021

Capitol Hill Update 

Both chambers of Congress will resume votes this week, starting with the Senate later this afternoon. Senators are expected to focus on clearing presidential nominations to kick off May votes, beginning with the nomination of Andrea Palm to be Deputy Secretary of Health and Human Services (HHS). It is also possible that Senate Majority Leader Chuck Schumer (D-NY) will move to discharge Chiquita Brooks-LaSure to be Administrator of the Centers for Medicare and Medicaid Services (CMS) from the Finance Committee, followed by consideration of her nomination on the floor sometime later in the week. Brooks-LaSure’s nomination failed to advance (14-14) at the Committee’s executive session last month due to GOP opposition. In the House, Majority Leader Steny Hoyer (D-MD) announced that lawmakers will take up a series of bipartisan suspension bills that seek to address several mental health needs related to: (1) suicide prevention efforts; (2) grants for school-based mental health services; and (3) disparities in care among underserved and high-poverty communities. Also on the floor next week, Members will take up a package of debt collection reform bills out of the House Financial Services Committee. 

White House Announces New Goal to Inoculate 70 Percent of Adult Americans By July 4 

The Biden administration announced a new goal on Tuesday of administering at least one COVID-19 vaccine jab to 70 percent of the U.S. adult population by July 4, 2021, and fully vaccinate at least 160 million Americans. The White House noted that the next phase of the vaccination campaign will focus on increasing access to vaccination, growing vaccine confidence, and ensuring all Americans are reached by these efforts. Specific steps the White House is taking to accomplish this includes: (1) increasing availability of walk-in vaccinations at local pharmacies; (2) establishing community-based and mobile vaccination clinics; (3) supporting community vaccine education and local outreach efforts; (4) increase funding for rural health clinics and hospitals; and (5) shipping new allocations of the vaccine to rural health clinics. The president is also expected to announce efforts to get adolescents vaccinated as soon as emergency use authorization is granted to available vaccines by the Food and Drug Administration (FDA) and recommended for use by the Centers for Disease Control and Prevention (CDC). According to federal data, the U.S. is currently on track to reach these goals, with 56 percent of adults 18 and over having already received at least one vaccine dose. White House officials explained that 100 million more doses would need to be administered within the next two months to reach the president’s goal, which falls within the current pace of vaccinations. 

Biden Administration Announces Support for TRIPS Waiver

 U.S. Trade Representative Katherine Tai last Wednesday announced that the U.S. would back a proposed waiver of international intellectual property rights, known as TRIPS, for the COVID-19 vaccine at the World Trade Organization (WTO). Under WTO procedure, the waiver “will have to be approved by consensus,” and Trade Representative Tai noted the U.S. would “actively participate in text-based negotiations.” German Chancellor Angela Merkel weighed in against the proposal to waive patent protections for Covid-19 vaccines, however, casting doubt on whether the idea has enough international support to become a reality. The plan would create “severe complications” for the production of vaccines, a German government spokesperson said Thursday in an e-mail.  

In announcing the Biden administration’s decision, Tai explained that “the administration believes strongly in intellectual property protections, but in service of ending this pandemic, supports the waiver of those protections for COVID-19 vaccines.” Trade Representative Tai clarified that the WTO talks “will take time,” and the next formal TRIPS Council meeting will not occur until June 8 and June 9. 

Almost 940,000 Sign up for Health Coverage Under Special Enrollment Period 

Last Thursday, the Department of Health and Human Services (HHS) announced thar nearly 940,000 Americans had signed up for health coverage through during the special enrollment period (SEP) opened as a result of the COVID-19 public health emergency. HHS Secretary Xavier Becerra noted that abut 469,000 Americans gained health insurance through the Marketplace in April. Under the American Rescue Plan’s expanded advance payments of premium tax credits implemented on April 1, HHS announced nearly two million current enrollees have returned to the Marketplace and monthly premiums have been reduced by an average of 40 percent after premium tax credits. The administration noted that the American Rescue Plan has also lowered costs for new consumers enrolling in plans during the SEP, as increased tax credits lowered the average monthly premium by over 25 percent and the median deductible fell by almost 90 percent. The increased subsidies are set to expire at the end of 2022, but the President’s American Families Plan calls on Congress to allocate $200 billion to make them permanent. 

GAO Announces New MACPAC Appointments 

Last Monday, the Government Accountability Office (GAO) announced the appointment of five new members to the Medicaid and CHIP Payment and Access Commission (MACPAC). Comptroller General Gene Dodaro also reappointed current MACPAC Chairwoman Melanie Bella and named Commissioner Kisha Davis, M.D. of Aledade Health as the new Commission Vice Chair. Commissioner Katherine Weno was also reappointed to another term on the Commission. Departing Commissioners include: Charles Milligan; Leanna George; Sheldon Retchin, M.D., Peter Szilagyi, M.D., and Thomas Barker.

MACPAC will reconvene in September of this year. The Commission will likely focus on the expanded utilization of telehealth during the pandemic and address its future. Commissioners are also predicted to discuss high-cost drugs, continuing Commission work from this cycle. Rebalancing long-term services and supports (LTSS) services away from institutional settings and addressing Dual Eligible Special Needs Plans (D-SNPs) will be additional focuses in the next cycle. 

New Appointments:

  • Heidi L. Allen, Ph.D. — Dr. Allen is an associate professor at Columbia University School of Social Work studying the impact of social policies on health and financial security. She was formerly an emergency department social worker, state health policy specialist, and Fellow in Health and Aging Policy. She is also a member of the National Institute of Health’s (NIH) and Healthcare Disparities study section. Dr. Allen’s term will expire in April of 2024.
  • Robert “Bob” Duncan — Mr. Duncan is the Executive Vice President of Children’s Wisconsin. In this role, he oversees contracting for Children’s systems of care, population health, and value-based contracts. He previously served as the Director of the Tennessee Children’s Health Insurance Program. Mr. Duncan’s term will expire in April of 2024.
  • Dennis Heaphy — Mr. Heaphy is dually eligible for Medicaid and Medicare and the co-founder of Disability Advocates Advancing Our Healthcare Rights (DAAHR), a statewide coalition in Massachusetts. He previously worked on Massachusetts Department of Public Health initiatives. Mr. Heaphy was newly appointed to serve out the remaining term of Thomas Barker, which will expire in April of 2022.
  • Laura Herrera Scott, M.D. — Mr. Scott is Vice President of Clinical Strategy and Product at Anthem. In this position, she focused on payer and data alignment policies to advance population health. She formerly worked in several roles under the Maryland Department of Health and Mental Hygiene and the Veterans Health Administration where she worked on payment reform and delivery system transformation.
  • Verlon Johnson — Ms. Johnson is a Senior Vice President of Corporate Strategy at CNSI, a Virginia-based health IT firm. Before working for CNSI, she worked at IBM Watson Health and held various high-ranking public servant roles, including the Centers for Medicare & Medicaid Services’ (CMS) Associate Consortium Administrator for Medicaid & CHIP. Ms. Johnson’s term will expire in April of 2024.

CMS Increases Medicare Payment for Infusion of COVID-19 Monoclonal Antibodies 

The Centers for Medicare and Medicaid Services announced on Thursday that it would increase the Medicare payment rate for administering monoclonal antibodies to treat COVID-19, regardless of where the treatment is administered. The national average payment rate was increased from $310 to $450 for most care settings, although CMS increased home infusion rates to $750 to support providers’ efforts to prevent the spread of COVID-19. The payment rate for home infusion service will apply to care administered in a beneficiary’s permanent residence or temporary lodging, such as a hotel, cruise ship, hostel, or homeless shelter. The administration explained that the new national payment rate for home infusion of monoclonal antibodies takes into account the increased costs associated with the “one-on-one nature” of home care and was established based on stakeholder feedback on the costs associated with providing home infusion services in a safe and timely manner. CMS also announced it had updated toolkits for providers, states, and insurers to assist the health care system swiftly implement the new Medicare payment rates.