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The Rundown
- Congress stays busy and relatively routine
- Committee updates – House Energy and Commerce and Senate Finance
- New legislation would revamp VA EHR effort and increase Veterans’ healthcare access
- Senate roadmap for AI released
- What’s up NC delegation
- The latest from our desks
- Join the Duke Health Advocacy Network
Federal Updates
And now for a word from...
Happy Friday morning. We can keep it real, right? We’ve been doing this long enough together to play it as straight as we can. It’s busy on Capitol Hill – but in the same way it’s busy at the grocery store on a late weekend morning, or at RDU early in the week with all of the shuttle flights to major East Coast cities, or if you have school-aged children, busy in the manner of all of the sudden year-end activities and social events that come out of nowhere. The point? Everyone is going somewhere and doing something – but at the moment, so much of the work is setting up for bigger moments ahead.
Congress is taking its time to lay down markers and open debate on issues and policies that may not receive much attention until after the November elections – but the work now is imperative to ensuring those critical end steps happen at all. It is... remarkably responsible. And maybe the 118th Congress is learning a lesson that eluded some of its predecessors, even in times that feel as polarized and partisan as we can remember. Some things can wait. Some can’t. It’s all a matter of priorities and deciding what can be done together.
The four-week May session sprint is almost done in a very critical period for Congress to set the board for what happens next. Let’s take a look.
Heard on the Hill: Committee updates
House Energy and Commerce Subcommittee on Health
The House Energy and Commerce (E&C) Subcommittee on Health held a markup of 23 healthcare related bills this week, including legislation that would extend current telehealth flexibilities, expand Medicaid coverage access for critically ill children, and increase access and options for care for seniors and the underserved.
Using the Telehealth Modernization Act (H.R. 7623) as the primary legislative vehicle, the subcommittee unanimously approved a bill substitute amendment that would mandate a two-year extension of Medicare telehealth flexibilities and five-year extension of the hospital at home program – the same policies included in extension legislation passed by the House Ways and Means Committee last week. The Subcommittee also unanimously approved the Accelerating Kids’ Access to Care Act (H.R. 4758), which would require state Medicaid programs to establish a process through which qualifying out-of-state providers may enroll as participating providers for five years without undergoing additional screening requirements to expand access to life-saving care for children with complex medical conditions. Our team has worked to build increased support for this legislation among the NC congressional delegation.
A full committee markup of the legislation considered today is expected in the coming weeks.
Senate Finance Committee Examines Rural Health
This week the Senate Finance Committee held a hearing entitled, “Rural Health Care: Supporting Lives and Improving Communities.” The hearing examined challenges and solutions to improve rural health care.
In his opening statement, Committee Chair Ron Wyden (D-OR) discussed challenges facing rural healthcare, including economic factors. He cited an example of a rural hospital that closed its labor and delivery unit, leaving expecting mothers to travel to the next closest hospital 45 miles away, whose distance can provide additional challenges in winter months. He said that between 2011 and 2021, one out of every four rural hospitals in America stopped providing obstetrics services. That figure accounts for 267 communities across the country where giving birth locally is no longer an option.
Senator Wyden, along with other members of the Committee, also discussed telehealth and the importance of strengthening and extending telehealth flexibilities before the end of the year. Chair Wyden also discussed the rural health workforce. He said that “step one is updating the Graduate Medical Education program in Medicare to make sure rural areas and high-need urban areas are not given short shrift.”
Members asked a range of questions at the hearing aimed at understanding challenges facing rural health, including the reasons rural hospitals are closing or reducing services.
Bicameral legislation takes big swing on VA health policy
This week, leadership of the House and Senate Veterans’ Affairs Committees released details on comprehensive legislation to reform and the improve the delivery of benefits and healthcare to Veterans. Among its provisions, the Senator Elizabeth Dole 21st Century Veterans Healthcare Benefits and Improvement Act (H.R. 8371 / Senate bill number pending) would require the VA to terminate its electronic health records (EHR) contract with Oracle Cerner in two years if certain benchmarks are not met. The VA’s EHR Modernization Project has been plagued by delays and technical issues since Cerner was first identified as the vendor to replace the current VistA system in 2018.
Reps. Greg Murphy, MD (R-NC-03), a member of the House VA Committee, and Chuck Edwards (R-NC-11) are original cosponsors of the House version of the bill.
The bicameral committees are expected to move quickly to take up the legislation in the coming weeks. For more information, a section by section of the legislation is linked here. Full text is available here.
Senate working group releases AI roadmap
Senate Majority Leader Chuck Schumer (D-NY) and a bipartisan working group consisting of Senators Todd Young (R-IN), Martin Heinrich (D-NM), and Mike Rounds (R-SD) have released a roadmap for artificial intelligence (AI) policy in the U.S. Senate.
While the document is not overly prescriptive, it provides a series of recommendations following a series of closed-door Insight Forums that Leader Schumer convened with a variety of stakeholders last fall. Specific regulations and policy development will be left to various committees of jurisdiction. The roadmap also recommends a minimum of $32 billion per year in non-defense AI related investment to spread throughout federal agencies and programs, including HHS and research supported by NIH.
In terms of items specific to healthcare, principles and recommendations include investments in government infrastructure and policies that promote safety and effectiveness. But the broader framework recognizes the need for cross-departmental and sector collaboration on development, governance, and innovation.
The roadmap is ultimately nonbinding but is expected to serve as a bipartisan guidepost as Senate leaders consider AI-related legislation – as well as a signal that the chamber is likely to take a piecemeal approach to AI rather than attempt a singular comprehensive legislative package.
What’s up, NC Delegation
On Tuesday, voters in the new 13th Congressional District went back to the polls for a run-off election to decide the Republican nominee. Brad Knott, a former federal prosecutor, won the runoff election and will now face Democrat Frank Pierce in the November election. The 13th Congressional District includes Caswell, Franklin, Harnett, Johnston, Lee, Person and parts of Granville and Wake counties.
This week, Senator Thom Tillis (R-NC) introduced the “Radiation Oncology Case Rate Value-Based Program Act of 2024,” which was developed with the American Society for Radiation Oncology (ASTRO) and aims to reverse declines in Medicare payments for radiation oncology. The bill is an alternative to a previously mandatory Radiation Oncology (RO) model, which was proposed by the Centers for Medicare and Medicaid Services but was indefinitely delayed. ASTRO said ROCR incorporates the strengths of the RO model, specifically the use of episode-based payments, and addresses its shortcomings, including excessive payment cuts, burdensome administrative requirements, and the absence of a path to reduce disparities.
From our desk(s): Duke Health GR this week
This week our office coordinated meetings with NC congressional offices for Colin Duckett, Vice Dean for Basic Science in the Duke University School of Medicine and Professor of Pathology and Pharmacology & Cancer Biology. Dr. Duckett shared research updates and discussed the importance of federal funding for the National Institutes of Health.
Members of our team also joined stakeholder and coalition strategy meetings and calls on issues related to telehealth, artificial intelligence in healthcare, accountable care organizations, and digital medicine.
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