The Headlines
- Congress funded the government for FY 2020!
- Drug pricing and surprise billing may see action in the new year.
- A federal appeals court ruled on the Affordable Care Act.
- The Food and Drug Administration proposed a rule that would allow drug importation.
- A congressional staff visit and cosponsorship of a bill round-out our 2019.
The Details
1. Federal funding and calendar update
After two short-term continuing resolutions to keep the federal government open, Congress finally approved a $1.4 trillion spending deal that funded national security, military, and domestic programs for fiscal year 2020, which started October 1, 2019. It also included a host of tax provisions and extended several health programs through May 22, 2020, including funding for community health centers and delaying scheduled cuts to Medicaid Disproportionate Share Hospital payments. The president is expected to sign the spending packages into law today.
Of note, the massive spending package included a $2.6 billion increase for the National Institutes of Health (NIH) and ten years of funding for the Patient-Centered Outcomes Research Institute (PCORI). The deal also increased funding for health professions programs and nursing workforce development programs in FY 2020. Please be in touch if you would like details on funding for particular federal programs.
The House also voted this week to impeach the president. The two articles of impeachment must now be sent over to the Senate before a trial can begin. One of the House's last votes of the week was to approve a new North American trade deal known as the U.S.-Mexico-Canada Agreement (USMCA) before adjourning for the year. The Senate is expected to take up USMCA in the new year.
2. Surprise billing legislation up next year
Earlier this month, the House Energy and Commerce Committee and Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-TN) released a compromise surprise billing deal that aims to protect patients from surprise billing and establish a federal benchmark payment with an option to go to arbitration for disputes over $750. The House Ways and Means Committee quickly followed with its own new agreement to address surprise bills, although in neither case was legislative text made available for review. No action was taken on either proposal.
The odds of a big bipartisan compromise in an election year are low, but it is possible that one or both issues could be attached to any must-pass health program extensions in May, when funding for several health programs expires. Duke Health Government Relations will continue monitoring and reporting updates in future newsletters.
3. A federal appeals court rules on the ACA
On December 18, a federal appeals court ruled the Affordable Care Act's individual mandate is unconstitutional, but it did not invalidate the entire law. The Fifth Circuit Court of Appeals sent the case back to the district court in Texas to decide if any of the other provisions could exist without the mandate. It is likely the Supreme Court will be asked to immediately review the decision.
4. FDA proposes a rule allowing drug importation
The Food and Drug Administration released a proposed rule that would allow states and other non-federal government entities to establish programs to import certain FDA-approved prescription drug and biological products from Canada. Pharmacists and wholesalers could co-sponsor the programs, which would have to demonstrate that the imported products pose no additional risk to public health and safety and would cost consumers significantly less. The public comment period will be open through mid-February.
5. Congressional updates from Duke Health
Last week, Senator Richard Burr's (R-NC) health policy director met with leadership from the DUHS Clinical Laboratories to tour the Duke Central Automated Lab and discuss laboratory-developed tests (LDTs). The Senator is working with other congressional leaders to draft legislation that aims to develop an LDT framework that promotes innovation and advances patient care.
At the request of Duke Health, Rep. GK Butterfield (D-NC-01) signed on as a cosponsor of H.R. 3414, the Opioid Workforce Act, which would provide federal funding to support 1,000 new training positions supported by Medicare in pain medicine, addiction medicine, addiction psychiatry, or related prerequisite residency programs. It awaits action by the House Energy and Commerce and House Ways and Means Committees.