02 Mar March 2, 2020
Congress Prepares Its Coronavirus Response
Lawmakers have been quick to push for emergency funding. The Trump administration proposed $2.5 billion, with $1.25 billion in new funding and the remaining amount coming from existing programs. Senate Democratic Leader Chuck Schumer (D-NY) proposed $8.5 billion for emergency funding to fight the outbreak. House Speaker Nancy Pelosi (D-CS) and Senator Schumer released a joint statement to Congress urging the Administration’s response to be comprised of entirely new funding. There are more hearings planned to finalize the emergency response budget in the coming weeks. Click here for Senator Schumer’s budget request. Click here for President Trump’s announcement. Click here for Speaker Pelosi and Senator Schumer’s statement.
- CDC announced that every state and local health department could have coronavirus test by the end of this week, click here.
- The CDC and FDA have developed a protocol that will allow for at least 40 laboratories to test for the virus, click here.
- The FDA Commissioner confirmed the first drug shortage related to a manufacturing site affected by the virus, click here.
- The assistant director-general of the World Health Organization said the new experimental antiviral treatment drug, Remdesivir, is currently the only drug that may be effective for the outbreak; while drugmaker, Gilead Sciences Inc, tests its new treatment in Wuhan, China and will test another trial at the University of Nebraska Medical Center and the National Institute of Allergy and Infectious Disease, click here.
- U.S. biotech company, Moderna, began Phase I of its clinical trial, in partnership with the National Institute of Allergy and Infectious Disease and the Coalition for Epidemic Preparedness Innovations, click here.
- After a trip to China, a man with a short-term health insurance plan in Miami went to the hospital to test for the coronavirus. He tested negative and got a $3,270 medical bill, click here.
New Coalition Supports Provider-Friendly Surprise Billing Legislation
Action for Health, a new coalition launched by eight groups including Practicing Physicians of America, the Center for Medicine in the Public Interest and the Hispanic Leadership Fund are tackling “new legislative proposals in Congress to solve surprise medical bills that are attempting to fix the price for a doctor’s treatment.” One of the first actions of the group will be to initiate a five-figure digital ad campaign in Washington, DC and three states in March to push for legislation modeled after the New York state style plan that would “that treats doctors and insurance companies equally.” Click here for the group’s website.
Insurers Challenging Hospitals with Their Own Clinics and Physicians
Insurers are sending more of their members to clinics that they own, leading to increased competition for hospitals and other providers, according to a Wall Street Journal report. Hospitals’ biggest concern may be the power that primary-care doctors have over where their patients go for care such as imaging scans and specialist procedures. Hospitals rely on doctors to direct patients to them for such services – one reason they have bought up physician practices. Insurer-owned clinics might refer patients away from certain hospital systems, cutting off important revenue. Click here for details.
- Although anti-addiction medications are the most effective treatment for opioid abuse, only 15 percent of patients in residential drug treatment centers received medication-assisted treatment in 2015 according to a new JAMA report, click here.
- Mallinckrodt Pharmaceuticals reaches a proposed $1.6 billion settlement to settle opioid lawsuits with 47 states and thousands of U.S. municipalities. Plaintiffs will receive payments over eight years to pay for treatments and efforts against the epidemic, click here.
Thousands of Health Care Professionals Voice Opposition to CMS Medicaid Reform Regulation
More than 4,200 organizations and individuals have publicly commented on CMS’ proposed Medicaid rule: MFAR, Medicaid Fiscal Accountability Regulation. One analysis by the AHA estimated the rule could reduce Medicaid spending by $37 billion to $49 billion a year. The analysis also estimated the rule could reduce federal Medicaid payments for hospitals by $23 billion to $31 billion a year. Opposition to the rule is bipartisan and the majority of public comments against the rule have come from health professionals. To read more on this, click here.
Nearly A Quarter of Americans Fear They Can’t Afford Health Care
Twenty-three percent of Americans polled stated that they are worried about their ability to afford their health care in the next 12 months. When asked about specific health care costs such as health insurance premiums and deductibles, out-of-pocket costs for prescription drugs and long-term care, they expressed more concern. Nearly half (46 percent) of those polled with medical bill problems have used their savings to pay their medical bills and about 80 percent believe that reducing health care costs should be a high priority for the next president. Click here for the full poll results.
House Passes Anti-Vaping Legislation
After scrabbling to gain support for the Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339), the House narrowly passed the bill 213 – 195 with 17 Democrats voting against the measure. Members raised concerns after groups, such as the ACLU, National Association of Social Workers, and National Action Network voiced concerns that the “blanket prohibition on menthol and other flavored tobacco products, which will apply to adults, will (1) disproportionately impact people and communities of color; (2) trigger criminal penalties, prioritizing criminalization over public health and harm reduction; and (3) instigate unconstitutional policing and other negative interactions with local law enforcement.” The bill would impose a tax on e-cigarettes similar to the current tax on traditional cigarettes, ban flavored tobacco including menthol, and increase the minimum age to purchase tobacco products to 21. The bill heads to the Senate where the outcome is uncertain. To read the letter from the groups, click here, and for the legislation, click here.
CMS Selects Applicants for Emergency Triage, Treat, and Transport (ET3) Model
Just over 200 participants, including Medicare-enrolled ambulance service suppliers and ambulance providers, have been selected to test CMMI’s Emergency Triage, Treat, and Transport (ET3) Model. The participating providers span 36 states and the District of Columbia. The ET3 initiative is part of the current push by HHS and CMMI toward payment for outcomes, as outlined in the President’s FY 2021 HHS Budget. The primary component of the new payment model allows ambulances to transport Medicare beneficiaries to places other than emergency departments, such as a doctor’s office or urgent-care clinics. A beneficiary can still choose to be brought to an ED they prefer. The model also involves state and local governments implementation of medical triage lines integrated with the Public Safety Answering Points that receive 911 calls in eligible regions. The Model will test whether these two components will work together to improve quality and lower costs by reducing avoidable transports to the ED and unnecessary hospitalizations. To view the CMS press release, click here. For the list of selected participants, click here.
States Move to Lower Insulin Prices; Senators Send Optum a Warning Letter
Senate Finance Committee Chairman Chuck Grassley (R-IA) and ranking member Ron Wyden (D-OR) wrote to the pharmacy benefit manager, Optum, warning the company to comply with the Committee’s investigation into rapidly increasing insulin prices. In related news, the Minnesota House passed an insulin affordability bill last week. The bill, HF 3100, establishes a state-wide insulin assistance program to lower the costs of emergency and long-term insulin. For the letter to Optum, click here, and here for Minnesota’s bill.
FTC Challenges Proposed Merger of Two Leading Philadelphia Hospitals
The Federal Trade Commission issued a complaint against the merger of two leading Philadelphia-area hospital systems, Jefferson Health and Albert Einstein Healthcare Network. Jefferson and Einstein have a history of competing against each other, which has led to improvements in medical facilities, investment in new technologies, and lower rates. The complaint alleges the merger would reduce the competition and eliminate the benefits for patients. The FTC has authorized staff to seek temporary restraining order and preliminary injunction to stop the merger. For the FTC complaint, click here.
Bi-Partisan Group of Senators Introduce Legislation to Improve Hemophilia Care
Senators Bob Menendez (D-N.J) and Mike Enzi (R-WY) lead a group of bi-partisan Senators to introduce a bill to enhance access to “critical” health care services provided by Skilled Nursing Facilities for people with hemophilia. Under current statute, Medicare patients with the bleeding disorder are frequently denied access to clotting factor therapies that can exceed $10,000 a day because of certain restrictions on the program’s per-diem reimbursement rates. The Hemophilia SNF Access Act would add treatments for hemophilia to the list of services paid for by Medicare. To read the bill, click here.
National Social Determinants Group Releases 2020 Health Equity Report
The Root Cause Coalition, representing 77 organizations from the health care, social services, education and business sectors that are committed to achieving health equity for all Americans, has released its 2020 Status of Health Equity Report, which highlights eight actionable steps that should be implemented by 2025 in order to improve the nation’s health equity. Click here for details.
New Report Urges Health System to Address Seniors’ Social Isolation
Social isolation among seniors is associated with significantly increased risk of early death from all causes, according to a report by the National Academies of Sciences, Engineering, and Medicine. On average, Americans aged 60 and older spend more than half of their waking hours alone. The report urges HHS to fund more research for health care providers to directly address loneliness in seniors, and Medicaid programs and private insurers to include social isolation in their social determinants programs. For the full report, click here.
AMA Releases Medical Record Sharing Guidelines
The AMA released new guidelines for helping health care providers share medical records with patients – in advance of upcoming HHS rules freeing up the data. The Patient Records Electronic Access Playbook outlines best practices for giving patients access while also protecting their privacy, including forms and formats for sharing records, patient requests and involvement of third parties, timing for record request fulfillment, denial of record request access and confidentiality of substance use disorder records. The AMA has urged ONC and CMS to incorporate more privacy protections for patients in forthcoming rules ordering providers and insurers to use common data sharing standards, enabling patients to download it or share it with apps. Click here for the AMA press release.
As Suicide Rates Rise, Arizona May Lead the Nation in Improved Crisis Care
The “Arizona Model” for crisis care has formed a comprehensive system of services that works with local first responders to address the first 24 hours of an individual’s psychiatric emergency. Their suicide hotlines, mobile crisis units, and crisis facilities are electronically linked and the crisis centers are open 24 hours, accepting anyone with or without insurance. Georgia and Colorado are also developing crisis services similar to Arizona’s and 14 more states are gaining inspiration from this model. For more on the crisis care, click here.
FDA Advisory Committee Approves Eli Lilly Drug for Lung Cancer
The FDA Oncologic Drug Advisory Committee narrowly supported use of a new combination therapy for lung cancer, while rejecting a therapy to treat low-grade prostate cancer. The committee voted 6-5 to approve Eli Lilly’s ramucirumab (Cyramza) in combination with erlotinib (Tarceva) for some forms of lung cancer. Data showed that the combination increased progression-free survival by an average of seven months when compared to erlotinib alone. The committee voted 13-2 against recommending Steba Biotech’s alternative drug treatment for early prostate cancer: Tookad. The committee consensus was the treatment did not represent an advance over watchful waiting for low-grade prostate cancers, which have a near 100 percent five-year survival rate. To view the FDA advisory committee meeting information, click here.