A deal in two parts
No, not that one - a new one
To keep the lights on
The Rundown
- Congress passes another continuing resolution to fund the government into March
- House introduces legislation addressing drug shortages
- Senate HELP Committee holds Long COVID hearing
- Regulatory policy update
- The latest from our desks
- Virtual office hours - come see us on January 23rd!
- Join the Duke Health Advocacy Network!
Federal Updates
Timeline extended: Government funding deadline moves to March
As we reported last week, House Speaker Mike Johnson (R-LA) and Senate Majority Leader Chuck Schumer (D-NY) came to an agreement on topline numbers for FY 2024 spending. The deal makes minor adjustments to last year’s Fiscal Responsibility Act, with an acceleration of $10 billion more in Internal Revenue Service (IRS) funding to be cut this year, as well as $6.1 billion in cuts to remaining Covid-relief funds. But with little time remaining before a partial government shutdown today, January 19, it became clear that more time was needed to put this into effect.
On Sunday evening, House and Senate leaders released a new continuing resolution (CR) that would extend the government’s spending authority until March 1 and March 8. The CR extends the shutdown deadline until March 1 for the Agriculture, Energy and Water, Military Construction-Veterans Affairs, and Transportation-Housing and Urban Development spending bills, while funding for the remaining federal agencies – including Health and Human Services (HHS) – would expire on March 8. Following some logistical wrangling, the Senate passed the CR yesterday, which was quickly followed by House passage later that same evening.
The CR is designed to give appropriators more time to write the 12 spending bills to adhere to the topline deal described above. Now, we wait to see if lawmakers will use these 40-ish additional days to get the spending bills in order. Otherwise, Congress will need to approve yet another CR to avoid a partial government shutdown – and during the time in which it would normally be starting budget and appropriations process for the next fiscal year.
House introduces legislation addressing drug shortages
This month, two bills have been introduced in the House focused on addressing drug shortages, an issue that has the attention of both Congress and the Biden administration. Reps. Anna Eshoo (D-CA), who serves as Ranking Member of the Energy and Commerce Health Subcommittee, Diana DeGette (D-CO), and Kim Schrier (D-WA) introduced the Pediatric Cancer Drug Supply Act, which would direct HHS to establish a program to create a reserve supply of essential pediatric cancer drugs. Through this program, HHS would contract with eligible drug manufacturers to produce a stockpile of the most essential pediatric cancer drugs. As part of the contract, drug manufacturers would receive payments from HHS based on the quantity and cost of pediatric cancer drugs held in reserve. HHS would have authority to order manufacturers to distribute drugs from the buffer stocks into the commercial market to alleviate or prevent drug shortages. Friends of Cancer Research, the American Society of Health-System Pharmacists, and the American Society for Clinical Oncology issued statements in support of the bill.
Separately, Reps. Doris Matsui (D-CA) and Larry Bucshon (R-IN) introduced the Mapping America’s Pharmaceutical Supply (MAPS) Act, which would require HHS to update its Essential Medicines List and create a database mapping the pharmaceutical supply chain. The database would include the country of origin, quantity manufactured and other key information about critical drug products to identify supply chain weaknesses that could lead to shortages or other challenges in a future public health emergency. HHS could then use this information to predict future supply interruptions, helping to combat drug shortages and increase resiliency and readiness. The American Hospital Association issued a statement supporting the bill.
Senate HELP Committee holds Long COVID hearing
On Thursday, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing entitled, “Addressing Long COVID: Advancing Research and Improving Patient Care.” The first panel included patient witnesses, while the second panel was comprised of experts from academia, several of whom are working with the NIH-funded RECOVER Initiative.
In his statement, HELP Chairman Bernie Sanders (I-VT) said that not enough attention has been paid to this issue, and that something is going on in the U.S. and Congress has not done enough. He discussed the debilitating impact Long COVID can have on individuals, noting it is not just a health issue but an economic issue, too. He discussed the importance of making sure medical professionals are educated on diagnosing Long COVID, the risks associated with it, and identifying potential therapeutic options.
Ranking Member Bill Cassidy, MD (R-LA), also expressed empathy for those suffering from Long COVID, discussing his experience as a doctor working with patients who had chronic fatigue syndrome or other conditions that were difficult to diagnose and the frustration with having symptoms and no real tests to help diagnose.
Our team has discussed this issue with the Committee.
It rules: Regulatory roundup
Here are a couple of policy proposals, changes, and updates we’re following from the executive branch.
Medicare Advantage and Medicaid Managed Care
This week, the Centers for Medicare and Medicaid Services (CMS) issued a long-awaited final rule designed to reform the way insurers handle prior authorizations for Medicare Advantage, Medicaid managed care, and children’s health insurance plans. Under the new rule, beginning in 2026, Medicare Advantage and Medicaid plans will have 72-hours to answer urgent requests and 7 days for a standard request. A Medicare Advantage or Medicaid plan will also be required to give a provider a specific reason for denying a claim. The final rule does not include other sought-after reforms currently part of bipartisan legislation pending in Congress, including a requirement Medicare Advantage plans adopt a real-time process for answering routinely approved items and a 24-hour response for any care determined to be urgent. Our team has worked closely with Duke Health leadership and the NC congressional delegation on the prior authorization issue and will continue to advocate in support of further legislative reforms.
Agency action on the White House executive order on AI
Over the next several weeks and months, executive agencies, including HHS, tasked by the Biden administration to develop safety programs and more comprehensive standards for the use of artificial intelligence (AI) under programs that they administer and oversee, will begin rolling out new directives. HHS is also establishing a larger AI Task Force that will include partnerships with the Departments of Defense and Veterans’ Affairs. We anticipate that some of these developments will provide opportunities for public comment and feedback and will monitor closely to best engage Duke Health experts as the process moves forward.
From our desk(s): Duke Health GR this week
This week our office participated in a Research!America discussion with staff from the office of House Energy and Commerce Health Subcommittee Chair Brett Guthrie (R-KY). Our office also participated in the quarterly meeting of the American Association of Colleges of Nursing’s University Government Relations Collaborative.
Our office met with staff for Senator Ted Budd (R-NC) and continue to meet internally with Duke Health experts on a range of issues. Please reach out to our office if you would like to engage on issues of interest to you.
We worked with a clinician and member of the Duke School of Medicine faculty to guide the development of non-rulemaking comments to an advisory committee for the Food and Drug Administration (FDA) on the potential for false readings and bias in pulse oximeters when factoring in skin pigmentation, race, and ethnicity.
See You Soon – Virtual “Office Hours” on January 23rd
Duke Health (federal) Government Relations is once again partnering with our Duke State Relations colleagues to hold virtual "office hours.” Open to members of the Duke Health Advocacy Network, these “office hours” are not formal presentations but instead an opportunity to talk about health-related issues before Congress and for us to learn more about the issues that are at the forefront for you and your work.
Date: Tuesday, January 23, 2024
Time: 12:00pm
A meeting invite was distributed earlier this week. If you would like to be added to the meeting invite, click here.
Not yet a member of the Duke Health Advocacy Network? No problem! Learn more about how to join below.
Join the Duke Health Advocacy Network!
Looking for more opportunities to connect with fellow advocates and professionals interested in public policy across the health system? Join the Duke Health Advocacy Teams Channel!
Managed and moderated by Duke Health Government Relations and Duke State Relations, the purpose of the platform is for you to connect with your colleagues throughout the health system who are engaged and/or interested in public policy advocacy. We hope the channel will be used as a space for sharing ideas, collaboration, and engaging with the government relations teams on the issues most important to your work.
We encourage you to explore the channel, as we will post relevant news items, policy updates, questions, advocacy resources, and opportunities for engagement. As importantly, this is your space to do the same and to help grow the community.
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(Note: This is only open to Duke Health employees. By joining this teams channel, you acknowledge that the platform and your participation are intended for information sharing and connections/relationship building and is not an inducement by Duke Health Government Relations and Duke State Relations, or the channel’s participants, to act as an unauthorized advocacy and/or lobbying representative of Duke Health or Duke University).