Like an ATM
You can’t expect to get out
What you don’t put in
Publication Note: Congress is departing for a two-week spring recess, and so is our newsletter! We will return to our regular publication schedule the week of April 17th. For breaking news in the meantime, please follow us on Twitter @DukeGovRel or join the Duke Health Advocacy Teams channel (more information below).
The Rundown
- Congress votes to end COVID-19 national emergency
- Hearings feature conversations on healthcare price transparency and competition, PBMs, and Veterans’ healthcare
- ICYMI: Guidance issued on MATE Act requirements
- Virtual Office Hours – starting April 21
- The latest from our desks
- Join the Duke Health Advocacy Network!
Federal Updates
Congress votes to end the COVID-19 National Emergency
Both the House and Senate have now held bipartisan votes to pass a resolution to end the COVID-19 national emergency order first declared by then-President Trump in March 2020 and extended by the Biden administration. Congress has the legal authority to review and vote to terminate certain executive actions under the Congressional Review Act.
Despite issuing a statement of administrative policy that opposed legislative efforts to end both the national emergency order and the public health emergency before their planned May 11 expirations dates, President Biden has indicated he will not veto the national emergency resolution. The administration has pledged to provide as much notice and assistance as possible as part of any wind down efforts related to expiring COVID-19 orders.
The national emergency order is separate from and not as expansive as the public health emergency declaration, but its termination will have implications for some waivers related to Medicare, Medicaid, the Children’s Health Insurance Program, and COBRA coverage. Additional guidance from the administration and Department of Health and Human Services is expected once the resolution is signed.
Our team continues to engage with policymakers on the broader wind down of COVID-related flexibilities and will provide updates and resources as they become available.
Heard on the Hill: Congress takes a deeper dive into key healthcare issues
Congress is on the precipice of beginning a two-week spring recess period – and you know what that means: let’s talk about everything before we head back home to our states and districts. To say it’s been a busy week for committee activity and hearings would be putting it mildly, and within the policy scrum, there were a number of conversations with direct relevance to healthcare, hospitals, and public health operations. Here’s a quick snapshot of a few that our team has been following:
House Energy and Commerce Subcommittee on Health
This week, the House Energy and Commerce Subcommittee on Health held a hearing entitled, “Lowering Unaffordable Costs: Examining Transparency and Competition in Healthcare.” Witnesses included representatives of the healthcare advocacy and policy development communities, a regional hospital, the business community, and a healthcare economist.
Hospital price transparency requirements and enforcement were among the most widely discussed issues of the hearing, receiving opening statement acknowledgement from both Subcommittee Chair Brett Guthrie (R-KY) and full Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA). While it was noted that hospital compliance with price transparency rules has increased, concerns remain that patients are not yet benefiting from their intent. Subcommittee members and witnesses discussed the need for enforceable federal standards, which could include requiring all listed prices to be displayed in precise dollars and cents; requiring standardized descriptions of medical services across platforms; and formatting pricing data to be more easily read by patients and aggregated by third-party comparison tools.
Other notable issues discussed include the impact of the 340B drug program, horizontal and vertical integration, including a growing number of larger health system and hospital consolidations that affecting regional hospitals and markets, and the practices of Pharmacy Benefit Managers (PBMs) and efforts to further lower the cost of and increase access to prescription medications.
Our team will continue outreach and engagement with Energy and Commerce Committee staff and members as they further examine healthcare costs and the roles of healthcare providers and hospitals.
Senate Finance Committee
The Senate Finance Committee held a hearing on “Pharmacy Benefit Managers and the Prescription Drug Supply Chain: Impact on Patients and Taxpayers.” Witnesses included legal experts, economists, and a representative from the PBM industry. The conversation focused largely on what Finance Committee Chair Ron Wyden (D-OR) framed as “new strategies” employed by PBMs, including the addition of administrative fees tied to the price of prescription drugs, that have negatively impacted prices and access for patients. Committee members noted the important roles that PBMs can play in negotiating lower prices for seniors and other vulnerable populations while also cautioning that they need to be better stewards of opportunities to maximize federal investments in healthcare for the benefit of consumers.
House Veterans’ Affairs Subcommittee on Health
The House Veterans’ Affairs (VA) Subcommittee on Health held a legislative hearing this week examining nine recently introduced bills. The pieces of legislation focus on increasing access for Veterans' care at VA facilities, as well as making technical changes to the operations of VA Medical Centers across the country – and many are holdovers of bills that did not receive final votes in the 117th Congress. Full House VA Committee Chair Mike Bost (R-IL) has made greater oversight of VA medical center operations among his priorities for the 118th Congress.
ICYMI: Guidance Issued on MATE Act
This week, guidance was issued from Substance Abuse and Mental Health Services Administration (SAMHSA) regarding a new provision authorized as part of the Medication Access and Training Expansion (MATE) Act, which requires a one-time, eight-hour training requirement for all Drug Enforcement Administration (DEA)-registered practitioners on the treatment and management of patients with opioid or other substance use disorders. This requirement replaces this DATA Waiver (X-Waiver) requirement for prescribing buprenorphine. Read the DEA letter on the new requirements.
Virtual Office Hours – April 21
Our office, Duke Health (federal) Government Relations, is partnering with our Duke State Relations colleagues to hold open, virtual "office hours" starting next month. Open to members of the Duke Health Advocacy Network, these “office hours” will not be formal presentations. Instead, we're looking forward to a real conversation about some of the things we're working on and to learning which issues are at the forefront for you and your work.
Date: Friday, April 21, 2023
Time: 10:30 a.m.
A link to access the event will be published in the Duke Health Advocacy Network Teams Channel
Not yet a member of the Duke Health Advocacy Network? No problem! This community is open to all members of the Duke Health community who are interested in learning more about advocacy on the federal and state level. Click to Join Now!
From our desk(s): Duke Health GR this week
This week, our office joined Duke University School of Nursing Dean Vincent Guilamo-Ramos as part of the Deans’ Nursing Policy Coalition meeting in D.C. Our office also attended the AACN Student Policy Summit reception to meet with DUSON students that had been on Capitol Hill meeting with NC delegation members as part of their program.
We participated in the American Hospital Association’s Government Relations Officers Network (GRON) meeting, where we heard from AHA leadership, key Hill staff, and others on policy issues impacting hospitals. Following the GRON meeting, our office joined the North Carolina Healthcare Assocation in a roundtable meeting with NC congressional staff to talk about priorities impacting NC hospitals.
Our team coordinated a meeting for Dr. Michael Pencina, Director of Duke AI Health, to meet with staff of Rep. Valerie Foushee (D-NC-04) to discuss Duke’s leadership in healthcare AI issues, including the development of policies for ethical practices in AI. Rep. Foushee is a member of the House Science, Space, and Technology Committee, which is expected to examine and develop legislation related to AI issues in the 118th Congress.
Members of our team participated in national coalition and strategy conversations on surprise medical billing, telehealth, data privacy and cybersecurity, and federal support for trauma centers.
Finally, in coordination with Duke Health leadership and experts, our team submitted a health system response to a request for input from the Senate HELP Committee regarding reauthorization of the Pandemic All-Hazards and Preparedness Act (PAHPA).
Join the Duke Health Advocacy Network!
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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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