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Federal Health Policy Updates for the Week of May 18, 2020

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The Headlines

  1. Congress, the Administration, and stakeholders continue to respond to the COVID-19 public health emergency.
  2. The FY2021 appropriations process takes steps forward, and Duke Health submits Senate testimony in support of funding priorities.
  3. Duke Health supports autism research amid COVID-19 challenges.

The Details

1. Federal health updates from Capitol Hill and the Administration
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.
 
The Senate entered its third full week back in session, although a number of Senators are continuing to join virtual hearings outside of Washington, D.C. The Senate will be out next week for its previously scheduled recess, while the House may return on a limited schedule.
 
The House has approved a resolution to permit remote proxy voting, and Members will have the option to vote by proxy as soon as next week. Members who represent their colleagues are limited to casting ten proxy votes. The resolution also authorizes virtual committee hearings for the first time. The new rules expire at the end of the 116th Congress and will have to be reauthorized next year.
 
Last week, the House passed its version of “Phase IV” COVID-19 recovery and stimulus legislation along party lines, but Senate Majority Leader Mitch McConnell (R-KY) maintains that he is in no rush to pick up negotiations. However, warnings from Federal Reserve Chairman Jerome Powell this week that the economic impact of the pandemic could last for years has prompted a growing group of Senate Republicans to push for Senate efforts to begin in early June.
 
Duke Health continues to support $26 billion in dedicated funding for research to be included in final “Phase IV” legislation and will work with our partners to ensure that critical research funding is prioritized and protected.
 
The Association of American Medical Colleges (AAMC) sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma offering recommendations for a number of telehealth related policies and waivers to be made permanent after the end of the public health emergency, including payment parity, site origination requirements, and the types of telehealth services covered. The letter also requests that all of the telehealth policy enhancements and waivers made by CMS be extended for at least a year after the emergency’s end to give Congress and CMS time to evaluate and make any necessary legislative or rulemaking adjustments to ensure permanence.
 
On Tuesday, the President signed an executive order asking federal agencies to compile a list of COVID-19 regulatory waivers and flexibilities that would help the economy if made permanent, indicating that some regulatory waivers could be extended beyond the COVID-19 crisis. Anticipating that Congress could consider similar policy measures, Duke Health Government Relations has been updating leadership on the Congressional Telehealth Caucus on the impact of waivers.
 
Reps. G.K. Butterfield (D-NC-01) and Pete Olson (R-TX) sent a bipartisan letter to Department of Health and Human Services (HHS) Secretary Alex Azar, urging HHS to allocate a significant portion of the remaining Provider Relief Fund to hospitals and providers that serve a disproportionate number of Medicaid and low-income patients. The letter, signed by over 90 Members of the House, offers praise for how quickly HHS has distributed the first $72 billion of the $100 billion fund originally created by the CARES Act – but also notes the critical need of health systems that have been supporting low-income communities during the COVID-19 health emergency.
 
2. FY 2021 appropriations work moves forward; Duke Health submits testimony
Senate Appropriations Chairman Richard Shelby (R-AL) met with the president this week to discuss the Senate’s FY 2021 appropriations process. By the time the Senate returns from the Memorial Day recess, Senator Shelby is expected to instruct the subcommittee chairs to begin work on their individual appropriations measures with markups of the subcommittee spending bills targeted for the third week of June.

In anticipation of the Senate’s upcoming appropriations work, this week Duke Health Government Relations submitted written testimony to the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education outlining its biomedical and healthcare priorities. Duke Health Government Relations has also been in contact this week with the Subcommittee about its priorities, including support for NIH and the biomedical research and workforce impacted by COVID-19.

The House Appropriations Committee has already set topline spending numbers for subcommittees to begin drafting legislation with markups to begin when the House has a more regular D.C. schedule, possibly in early June. However, the possibility remains that work on "Phase IV" recovery and stimulus legislation may push appropriations work into later in the summer.

The Bipartisan Budget Act of 2019 set spending limits of $671.5 billion for defense and $626.5 billion for non-defense discretionary spending for FY 2021. While this represents only a modest increase from FY 2020, leaders in the House and Senate are discussing ways to provide additional funding not subject to the spending caps for agencies and programs offering COVID-19 services and relief.

3. Duke Health advocates for autism research amid COVID-19 concerns
The Duke Center for Autism and Brain Development sent a letter this week to Reps. Mike Doyle (D-PA) and Chris Smith (R-NJ), co-chairs of the bipartisan Autism Caucus in Congress. The letter discusses the work at the Center and the impact of COVID-19 on its research and important activities such as early intervention and diagnoses, as well as the impact on individuals with autism spectrum disorder (ASD) and their families. Duke Health Government Relations is working with the Center to identify ways to elevate this important issue in Congress.