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Federal Health Policy Updates for the Week of April 8, 2024

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We just funded it 
But, that’s so last fiscal year 
Let’s do it again


The Rundown

  • Congress returns with a full slate and FY 2025 in sight 
  • Regulatory update – drug shortages and inpatient payment proposed rule 
  • Committee updates – substance abuse care, telehealth, and FDA oversight 
  • What’s up, NC delegation  
  • The latest from our desks  
  • Join the Duke Health Advocacy Network! 

Federal Updates

They’re back; we never left 
Put the word out. They’re back up. 

Fresh off from passing the remaining six appropriations bills for FY 2024 two weeks ago, Congress returned to DC this week ready to work on the other items on its to-do list. Dominating the headlines this week were funding for Ukraine and Israel, the impeachment trial for Homeland Security Secretary Alejandro Mayorkas, and reauthorization of a controversial surveillance law, known as FISA. 

While these topics are getting the most attention, work is more quietly continuing on the FY 2025 appropriations process. Cabinet secretaries have started testifying about the President’s FY 2025 Budget Request to the relevant subcommittees – and as we reported just before recess, Health and Human Services Secretary Xavier Becerra testified before the House Ways and Means Committee on March 20.  

Closer to home, our office is submitting appropriations requests for Duke Health priorities to congressional offices across the state. Over the next few months, we'll continue engaging with NC congressional offices to promote Duke Health policy and funding priorities for the next fiscal year.   

It rules: Regulatory updates  
Last week, the Department of Health and Human Services released a white paper entitled, “Policy Considerations to Prevent Drug Shortages and Mitigate Supply Chain Vulnerabilities in the United States.” The white paper provides an overview of the drug shortage problem, including causes and actions taken by the Administration, and offers policy recommendations to address shortages, including a Manufacturer Resiliency Assessment Program (MRAP) and a Hospital Resilient Supply Program (HRSP).   

On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2025 Inpatient Prospective Payment System (IPPS) proposed rule, which would increase Medicare payment rates to general acute hospitals paid under the IPPS by a net 2.6%. Among other provisions, it would also continue the low wage index hospital policy for FY 2025; establish a separate IPPS payment for establishing and maintaining access to essential medicines; establish a new mandatory CMS Innovation Center model that would provide bundled payment for certain surgical procedures; distribute new graduate medical education (GME) slots under section 4122 of the Consolidated Appropriations Act of 2023; seek public comments on the use of Medicare IPPS payments for maternity care by other payers; and add seven new measures to the inpatient quality reporting program that are largely focused on hospital patient safety-related practices and outcomes. 

Public comments are due on June 10, 2024, and our team will work with Duke Health experts and leadership to coordinate any system-wide response. 


Heard on the Hill: Committee updates 

New Leadership Tapped for House Appropriations Committee 
This week, Rep. Tom Cole (R-OK) was approved by the GOP Steering Committee and then by the full GOP conference to become the next Chairman of the House Appropriations Committee. He was not challenged for the position. Rep. Cole has been an important champion for biomedical research and NIH, recently receiving the Association of American Medical Colleges 2024 Champion of Academic Medicine Award. He will replace Rep. Kay Granger (R-TX), who stepped down from her leadership role following her announcement that she would not seek reelection.  

Senate Finance Committee 
On Tuesday, the Senate Finance Subcommittee on Health held a roundtable discussion entitled, “Closing Gaps in the Care Continuum: Opportunities to Improve Substance Use Disorder Care in the Federal Health Programs.” Subcommittee Chairman Ben Cardin (D-MD) discussed federal resources for addressing substance use disorder, including the SUPPORT for Patients and Communities Act, coverage under CHIP, and annual appropriations from Congress. He outlined questions he hoped witnesses for the roundtable might address, including whether federal tools are adequate, Medicare and Medicaid are doing enough, insurance coverage is adequate, and telehealth can be utilized more for this purpose. 

The Senate Finance Committee also held a hearing on Thursday entitled, “Bolstering Chronic Care through Medicare Physician Payment, one of several efforts to examine a more sustainable Medicare physician payment system.   

House Energy and Commerce Subcommittee on Health 
On Wednesday, the House Energy and Commerce Subcommittee on Health held a legislative hearing examining over a dozen bills that would seek to make some or all of the current public health emergency (PHE)-era telehealth flexibilities permanent. Among the legislation discussed was the Duke Health-endorsed CONNECT for Health Act (H.R. 4189), which would permanently eliminate site and geographic restrictions and provide CMS with the broad authority to continue supporting the current list of reimbursable telehealth services, as well as consider further expansion in the future.  

Witnesses included representatives from academic policy centers and representatives. There was broad agreement about the benefits of expanded telehealth, but questions persist about long-term costs and utilization. Policymakers expressed some concern about the potential for telehealth to crowd out in-person care, although data suggests that usage has fallen and somewhat plateaued following the end of the PHE. 

Our team connected with committee staff and committee member staff ahead of the hearing, including the office of Rep. Richard Hudson (R-NC-09), to share Duke Health data and support for permanently expanded telehealth. 

House Committee on Oversight and Reform 
On Thursday, the House Committee on Oversight and Reform held a hearing on “Oversight of the Food and Drug Administration (FDA).” FDA Commissioner Robert Califf, MD, was the lone witness invited to testify, and his testimony covered a broad range of FDA priorities, including lessons from the public health emergency, future readiness, food safety and nutrition, combating the “overdose crisis,” regulating tobacco products, new approvals and pathways, and emerging technologies, such as artificial intelligence and machine learning systems. 

What’s up, NC Delegation 
Senator Thom Tillis (R-NC) joined colleagues in introducing the “Creating Access and Resources in Education (CARE) for Student Mental Health Act.” According to his office, “this legislation builds on the historic Bipartisan Safer Communities Act by further expanding access to school-based mental health care that is critically important as students navigate the challenges of today. Crucially, this legislation helps provide mental health professionals to the communities that need them the most.” 

Rep. Deborah Ross (D-NC-02) joined other members of the House in introducing the “Reproductive Data Privacy and Protection Act” to prevent law enforcement’s use of surveillance technologies with respect to reproductive or sexual health information.  

Rep. Alma Adams (D-NC-12) held her 1st Quarter Adams Hunger Initiative Webinar, which our office joined. This quarter’s webinar featured Elizabeth Lower-Basch, Deputy Executive Director for Policy at the Center for Law and Social Policy and member of the USDA Equity Commission. Among other topics, she provided an overview of the U.S. Department of Agriculture Equity Commission’s 2024 report

From our desk(s): Duke Health GR this week 
Members of our office attended the Deans Nursing Policy Coalition meeting with School of Nursing Interim Dean Michael Relf. This is a coalition comprised of research-intensive schools of nursing that generate evidence for effective health care practice and translate that knowledge to the education and policy environments. 

Duke Health hosted health staff from Senator Ted Budd’s office to see firsthand the work of our team members and learn more about policy priorities.  

Our team met with government relations colleagues at the American Psychological Association and the American Nurses Association to learn more about their policy priorities, which impact Duke Health and its team members.  

Thank you to everyone who joined us on March 26 for our office hours. We appreciated the great conversation. We’ll post a date and time for April soon! 

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