Haikus - syllables
Arranged for meaning; like bills
It’s good to be clear
Publication Notice: Congress will take a brief recess to head home next week – and our newsletter will also take a one-week hiatus. We’ll resume our regular publication schedule the week of June 24th.
The Rundown
- Congress continues its summer work
- Energy and Commerce Committee stays busy with health bills and oversight
- Supreme Court rejects challenges to mifepristone access
- What’s up NC delegation
- The latest from our desks
- Virtual “Office Hours” on June 24th
- Join the Duke Health Advocacy Network!
Federal Updates
Back to the future from the present and the past
It is hard to get a lot done when you are out for a week, back for two, and then out again for another week. And that’s where Congress finds itself today, about to head out for another week-long congressional recess. But even while many legislative items remain unfinished, the work still goes on and will continue into the summer and fall. The House is currently considering the nation’s annual defense policy bill – the National Defense Authorization Act (NDAA) – and the more than 350 amendments proposed to the bill. Our office is monitoring the bill’s progress and weighing in on amendments that could impact Duke Health.
Heard on the Hill
Energy & Commerce Committee
This week, the House Energy and Commerce Committee held a full Committee markup of 13 health related bills. Advancing out of Committee was the Accelerating Kids’ Access to Care Act, which has been a legislative priority for our office. This bill would streamline regulatory barriers for eligible out of state providers and help children who have complex medical conditions get the care they need that might be out of state. For kids seeking care for treatments only offered at Duke, this bill could be a tremendous improvement. In her remarks, full Committee Chair Cathy McMorris Rodgers (R-WA) said that this bill is “even more important now with exciting innovation in cell and gene therapies that could cure children with sickle cell and other rare diseases, but potentially require children to travel across the country.” Full Committee Ranking Member Frank Pallone (D-NJ) said, “I hope that it will bring some peace of mind to the families of children who face unnecessary and devastating delays in getting the care they need.”
Energy & Commerce Subcommittee on Health
On Thursday, the House Energy and Commerce Subcommittee on Health held a hearing entitled, “Checking-In on CMMI: Assessing the Transition to Value-Based Care.” The hearing’s sole witness was Dr. Elizabeth Fowler, Deputy Administrator and Director for the Center for Medicare and Medicaid Innovation (CMMI).
Both full committee Chair Rep. Cathy McMorris Rodgers (R-WA) and Subcommittee Chair Brett Guthrie (R-KY), as well as other Republicans on the Committee, shared concerns about the limited savings CMMI models have shown. However, Chair McMorris Rodgers stated that while she has concerns on the overall direction and lack of results with CMMI, there have been a few positive outcomes that deserve to be recognized, specifically noting CMMI’s work on ACOs and on improved care for Alzheimer’s and dementia patients. The Subcommittee Chair also noted his concern on CMMI’s Cell and Gene Therapy Access Model, which he said may inhibit states’ ability to use value-based agreements to pay for curative cell-and-gene therapies approved by FDA.
Dr. Fowler used her time to comment in support of CMMI, discussing how models have changed how care is delivered and financed. She said that every model tested has yielded important learnings and ultimately informed an approach to caring for patients that is more team-based, integrated, and person-centered. She stressed that, through these models, CMMI knows the basic building blocks that help clinicians move toward value, such as upfront investments for infrastructure and data that gives providers the ability to identify the sickest patients that are most likely to be hospitalized or reemitted. She also discussed new models that have been announced, including the Guiding an Improved Dementia Experience (GUIDE) Model, Transforming Maternal Health (TMaH), and the Innovation in Behavioral Health (IBH) Model.
Both sides of the aisle asked questions about why CMMI and models are not generating more savings, including Subcommittee Ranking Member Anna Eshoo (D-CA) who also asked about what metrics CMMI uses to decide if a model is successful outside the savings it generates. Dr. Fowler stressed that CMMI has learned something from every model tested, and discussed some of the challenges that may limit savings such as the impact of having voluntary models where providers can come in when the terms look favorable and leave if they do not perform as well as they thought. Some other questions focused on specific models being implemented by CMMI.
Access maintained: Supreme Court blocks attempt to restrict availability of abortion drug mifepristone
The US Supreme Court on Thursday ruled against challenges to the Food and Drug Administration’s decisions in 2016 and 2021 to make changes that have increased access to the abortion pill mifepristone. The Court held that plaintiffs representing anti-abortion groups and a group of doctors lacked legal standing to have originally brought the suit in federal court.
Deciding the case on standing does not address the merits of the allegations that the FDA overstepped its authority and did not engage in proper procedure before making certain regulatory decisions. Thus, it is possible for those questions to be raised in a separate suit, but any future plaintiff will have to meet the legal standing requirement of suffering actual harm from the alleged conduct of the agency before a case can move forward.
What’s up NC Delegation
Our office continues to advocate for a House resolution introduced by Rep. Valerie Foushee (D-NC-04) designating June as Brain and Spine Metastasis Awareness Month—an idea that initiated from a dedicated group of individuals in Duke Neurosurgery. Rep. Don Davis (D-NC-01) and Rep. Deborah Ross (D-NC-02) have signed on as cosponsors. The resolution also calls on the U.S. Department of Health and Human Services to increase education and awareness about treatment options, support resources to establish and support centers for brain and spine metastasis, provide resources to increase access to dedicated clinical trials for patients, and invest in research specifically into the biology and treatment of brain and spine metastasis. More information is available here.
This week, Rep. Richard Hudson (R-NC-09) introduced the Safe In-Home Drug Disposal Initiative (SIDDI) Act of 2024, which would award grants for safe in-home drug disposal and practical medication safety education – including in-home opioid prescription disposal and safety education to reduce and prevent drug overdoses. According to information provided by Rep. Hudson’s office, in households across the US, 42-71% of opioids go unused and pose a risk to public health with unintended dangers. As a convenient, in-home solution, Iowa and Missouri implemented a program that allows pharmacists to engage with a patient at the pharmacy counter to gauge their understanding of medication disposal and provide safe and immediate disposal tools and methods.
Last month, Rep Alma Adams (D-NC-12) co-led the introduction of the bipartisan Endometriosis CARE Act, which according to the bill’s summary, would provide $50 million to endometriosis research through the National Institutes of Health and commission a nationwide study on disparities in endometriosis prevalence, detection, treatment, and outcomes. Rep. Adams, co-founder and co-chair of the Black Maternal Health Caucus, said, “in honor of Women’s Health Month, let us acknowledge that health issues that only affect women still matter and should be worthy of everyone’s time… Endometriosis affects one in ten reproductive-age women, causing them regular pain and complicating their pregnancies. I’m proud to co-lead the Endometriosis CARE Act with Congresswoman Nikema Williams to fund research, detection, and treatment for the millions of women who have suffered in silence. This issue deserves attention. Women who suffer from endometriosis can't wait." The bill has been referred to the House Energy and Commerce Committee.
From our desk(s): Duke Health GR this week
Our team participated in the Association of American Medical Colleges' (AAMC) Government Relations Representatives (GRR) meeting to discuss legislation affecting teaching hospitals and medical schools and to connect with congressional staff on key policy issues. James Tucker from our team presented on a panel on the role of artificial intelligence (AI) in academic medicine and the ongoing work at Duke Health in this emerging field.
See You Soon – Virtual “Office Hours” on June 24th
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: Monday, June 24, 2024
Time: 12:00pm
A meeting invite will be distributed soon. If you did not receive it and would like to join us, 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!
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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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