|The newsletter is taking next week off, but follow us on Twitter @DukeGovRel for real time updates on the latest in federal health policy. We'll be back the week of July 13!
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1. Federal health updates from Capitol Hill and the agencies
While resuming a more regular schedule, new precautions are being put into place to protect Members and staff. The Office of the Attending Physician, which serves Congress and the U.S. Supreme Court, has warned that pre-COVID-19 normal operations will not be back in place for quite some time.
COVID-19 Federal Policy Updates
The House Energy and Commerce Subcommittee on Health held a hearing this week entitled, "High Anxiety and Stress: Legislation to Improve Mental Health During Crisis." As part of the hearing, Members and witnesses discussed 22 pieces of legislation being considered by the Subcommittee relating to mental and behavioral health. Topics for the hearing covered a number of important issues including (but not limited to) telehealth, workforce, and parity – especially as it relates to compliance with the “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act” that passed in 2008.
Witnesses for the hearing included Former Representative Patrick J. Kennedy, Founder of The Kennedy Forum; Arthur C. Evans, Jr. Ph.D., Chief Executive Officer for the American Psychological Association; Jeffrey L. Geller, M.D., M.P.H., President of the American Psychiatric Association, and Professor of Psychiatry and Director of Public Sector Psychiatry at the University of Massachusetts Medical School; and Arriana Gross, National Youth Advisory Board Member for the Sandy Hook Promise Students Against Violence Everywhere (SAVE) Promise Club.
During the hearing, Rep. G.K. Butterfield (D-NC-1) discussed barriers that individuals encounter when seeking mental or behavioral healthcare, and the impact when an individual receives a denial or limited benefits. He asked what could be done to enforce behavioral health standards and regulations to ensure unnecessary roadblocks are not encountered. In response, former Rep. Patrick Kennedy highlighted the parity bills being considered by the Subcommittee to increase transparency for insurance companies. Duke Health Government Relations shared background and comments from Duke Health behavioral experts with Rep. Butterfield’s staff in advance of the hearing to aid in his preparation.
Department of Health and Human Services (HHS) Secretary Alex Azar indicated this week that he intends to extend the current public health emergency for an additional 90 days to prevent its expiration on July 25. The announcement is welcome news for health providers as a number of temporary policies are tied to the emergency declaration, including the Medicare inpatient 20% add-on payment for COVID-19 patients, increased federal Medicaid matching rates, requirements that insurers cover COVID-19 testing without cost-sharing, and waivers of certain telehealth restrictions.
Despite ongoing challenges and growing agreement that additional COVID-19 stimulus and recovery legislation is needed, Senate Majority Leader Mitch McConnell (R-KY) has maintained that the earliest the Senate will consider a “Phase IV” package would be the week of July 20 following a brief recess period for the Senate. House Democrats passed their version of relief legislation, the HEROES Act (H.R. 6800), on May 15, but Senate Republican leaders have indicated that many of its provisions are non-starters.
Securing $26 billion in emergency relief for federal science agencies remains a priority for Duke Health Government Relations. NC Representatives Butterfield (D-NC-01), David Price (D-NC-04), David Rouzer (R-NC-07), George Holding (R-NC-02), and Alma Adams (D-NC-12) previously joined over 180 colleagues in support of $26 billion for research in the next emergency relief package. Rep. Butterfield this week cosponsored related legislation (H.R. 7308) to authorize $26 billion in emergency funding during FY 2020 and FY 2021 to be made available for expenditure for up to two years across 10 departments and agencies.
Duke Health joined over 340 organizations and health systems in signing on to a multi-stakeholder letter to congressional leaders outlining the actions necessary to ensure that the Centers for Medicare and Medicaid Services (CMS) has the authority to make temporary enhanced telehealth services permanently available after the end of the national health emergency. Specifically, the letter urges Congress to:
Duke Health Government Relations is working in partnership with Duke leadership and the Duke Telehealth Office to ensure that beneficial telehealth policies are strengthened and maintained.
- Remove obsolete restrictions on the location of the patient to ensure that all patients can access care at home, and other appropriate locations;
- Maintain and enhance HHS authority to determine appropriate providers and services for telehealth;
- Ensure Federally Qualified Health Centers and Rural Health Clinics can furnish telehealth services after the public health emergency; and
- Make permanent HHS temporary waiver authority for future emergencies.
House Advances Legislation
The House passed along a party-line vote a massive $1.5 trillion infrastructure package that includes targeted investments for the nation’s roads and bridges, transit, rail, schools, housing, broadband, drinking and wastewater systems, postal service, clean energy, and health care. Among other things, the Moving Forward Act (H.R. 2) would provide $10 billion over five years to reestablish the Hill-Burton program for the construction and modernization of hospitals and medical facilities, $10 billion for community health center capital project funding, $4.5 billion to improve laboratory infrastructure, $5 billion for 21st Century Indian Health Program hospitals and outpatient health facilities, and $500 million for a pilot program to improve community-based care.
Senate Majority Leader Mitch McConnell (R-KY) has indicated that the House bill will not receive any consideration in the Senate. The White House has also prioritized infrastructure spending but has yet to release its own comprehensive package.
House Democratic leaders also advanced, along party lines, the Patient Protection and Affordable Care Act (ACA) Enhancement Act (H.R. 1425). The bill aims to make improvements to the current ACA regulatory structure, including lowering health care costs and providing increased protections for those with pre-existing conditions, encouraging Medicaid expansion and strengthening the Medicaid program, and establishing a Fair Price Negotiation Program to negotiate with drug manufacturers in order to obtain a maximum fair price for certain selected drugs.
The bill is unlikely to receive consideration in the Senate but provides insights heading into the fall election season about longer-term Democratic leadership priorities for the future of the ACA.
The House Appropriations subcommittees are expected to begin a three-day marathon of markups on their versions of the twelve annual appropriations bills on July 6. The Labor-Health and Human Services-Education Subcommittee markup, which will set funding levels for critical research agencies and programs including the National Institutes of Health (NIH), is scheduled for July 8. The Senate Appropriations Committee has not yet announced plans to reschedule mark ups of its versions of the appropriations bills, but it may eschew the subcommittee process altogether because of delays.
2. Are you interested in sharing an example of the impact of COVID-19 on your research or patient care?
Duke Health Government Relations is supporting efforts from the Association of American Medical Colleges to collect and share examples about COVID-19’s impact on young/early stage investigators, the research process, and the potential impact on patients over the long term (including the development of new diagnostics, treatments, and cures and the halting of clinical trials). Duke Health Government Relations would also like to share these stories with policymakers to provide real-world examples to illustrate why additional relief is needed during this unprecedented pandemic.
If you would like to share a story, please contact firstname.lastname@example.org. Visit our website to read more.
3. Duke Health Government Relations Congratulates NIH Office of Behavioral and Social Sciences Research on Turning 25!
On July 1, the NIH Office of Behavioral and Social Sciences Research turned 25. We encourage you to read more about this office and the changing landscape of social behavioral and sciences here.