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Federal Health Policy Updates for the Week of May 6, 2024

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Congress peeks behind 
In the middle of the sprint 
Fall is gaining fast


The Rundown

  • Congress is finding rhythm in the spring session
  • Committee updates – telehealth, GME, and reducing administrative burden
  • Biomedical research updates
  • What’s up NC delegation  
  • The latest from our desks  
  •  Join the Duke Health Advocacy Network

Federal Updates

Keep on keeping on 
As we reported last week, Members of Congress are facing an unusual situation for themselves: what do you do when you don’t have multiple impending legislative crises on the calendar? It’s not a pop quiz in the same vein of Dennis Hopper in Speed, but it is a test of, dare we say it? Normalcy. Doing business. 

In the absence of looming deadlines and forcing events, Congress is doing what Congress does best, holding hearings and briefings on a variety of topics (more on some of the healthcare items below), and exploring legislative solutions for various issues that may be less time sensitive as what we have seen over the last few months. It’s critical fact finding – plus some theater.  

This week included another threatened change to leadership in the House of Representatives. But this was no repeat of last fall, as the saber rattling of a few was parried away in the span of one afternoon. A motion from Rep. Marjorie Taylor Greene (R-GA) to vacate the chair, due to disagreements over a foreign aid package passed a couple of weeks ago, was defeated in an overwhelming 359-43 bipartisan vote. Speaker Mike Johnson (R-LA) is safe... for now. 

The House adjourned for the week after completing work on legislation to reauthorize the Federal Aviation Administration, leaving the Senate to grapple with its approval of reauthorization. Both chambers are back in full force next week. 

Heard on the Hill: Committee updates 
House Ways and Means Committee 
This week, the House Ways and Means Committee held a markup of several legislative priorities, including bills related to telehealth expansion, critical access hospitals, and rural access to care. 

The Committee unanimously approved “The Preserving Telehealth, Hospital and Ambulance Access Act” (H.R. 8261), which would extend for two additional years (through 2026) current telehealth flexibilities under Medicare and for five additional years (through 2029) the Medicare Acute Care Hospital at Home program. The bill would also establish new requirements for certifying claims of certain durable medical equipment (DME) purchases beginning after 2026, mandate a federal report on wearable medical devices, and extend the increased inpatient payment adjustment for certain low-volume hospitals, the Medicare dependent hospital program, and add-on payments for ambulance services through 2025.  

This bill is the first significant telehealth extension legislation to receive full committee attention this Congress and a good signal that at least another short-term extension of current policies is the most likely path forward.  

The Committee also approved the “Rural Physician Workforce Preservation Act” (H.R. 8235), which was introduced by Rep. Greg Murphy, MD (R-NC-03) last week. The bill would modify how new Medicare graduate medical education slots authorized in 2021 and 2023 are distributed to rural hospitals to exclude “those treated as rural” but that might lie outside of a statistically rural area. 

Senate Budget Committee  
The Senate Budget Committee also held a hearing on relieving administrative burdens in healthcare. Witnesses and committee members discussed a variety of issues, including Medicare Advantage reform, including gold card legislation to streamline prior authorizations, prompt claims reimbursement, and standardization practices. 

Biomedical Research Updates  
White House releases Policy for Oversight of Dual Use Research of Concern and Pathogens with Enhanced Pandemic Potential  
The White House Office of Science and Technology Policy (OSTP) issued a Policy for Oversight of Dual Use Research of Concern and Pathogens with Enhanced Pandemic Potential. OSTP also released Implementation Guidance to “aid and assist with consistent implementation of this Policy.” The intent of the new policy, which is set to take effect one year after the release date, is to strengthen oversight of life sciences research with biological agents and toxins throughout the research lifecycle by: 

  • Defining an expanded scope of biological agent and toxin research subject to additional oversight by the U.S. government; 
  • Providing a unified framework to support the consistent identification and oversight of research proposals subject to this Policy that accounts for safety, security, and ethical considerations; and 
  • Delineating the roles and responsibilities of principal investigators, research institutions, and federal departments and agencies that conduct, fund, or oversee research within the scope of this Policy, with an emphasis on institutional oversight and management of this research. 

Following the release of the new policy, National Institutes of Health (NIH) Director Monica Bertagnolli issued a statement noting that “this new U.S. government-wide policy, which combines the current dual use research of concern and enhanced potential pandemic pathogen oversight frameworks, expands the scope of research requiring additional scrutiny and strengthens our partnership with institutions to ensure robust review and oversight…NIH intends to work closely with the biomedical research community as we move towards the policy’s year effective date and encourages the biomedical research community to review the helpful and extensive guidance developed to assist with implementation.”  

Senator Cassidy Releases White Paper to Modernize NIH 
Senator Bill Cassidy, MD (R-LA), who serves as Ranking Member on the Senate Health, Education, Labor and Pensions (HELP) Committee, released a white paper focusing on modernizing NIH. Our office coordinated the Duke Health response to Senator Cassidy’s request for information earlier this year and held subsequent meetings with his HELP Committee staff on the issue. We are reviewing the recent release and will continue to engage with Senator Cassidy and his staff. 


What’s up, NC Delegation 
Rep. Don Davis (D-NC-01) joined Rep. August Pfluger (R-TX-11) in introducing the “Old Drugs, New Cures Act,” which would carve out an exemption for “priority research” drugs in existing law, allowing for a smoother path from drug development to patient access. To ensure equal access to lifesaving cures, a drug designated as a “priority research drug” would be excluded from the definition of a “line extension,” therefore making it more accessible to all patients and encouraging innovation at the same time. 

Rep. Alma Adams (D-NC-12) joined Senators Elizabeth Warren (D-MA), Cory Booker (D-NJ), Bob Casey (D-PA), and Congresswomen Gwen Moore (D-WI-04), Ayanna Pressley (D-MA-07), Lauren Underwood (D-IL-02), and Debbie Dingell (D-MI-06) in reintroducing the “Mamas First Act” to require state Medicaid programs to cover services provided by doulas and midwives. Rep Adams, co-founder and co-chair of the Black Maternal Health Caucus, said, “as we’re seeing today at the state level in North Carolina, Medicaid expansion continues to improve outcomes for mothers, babies, and all Americans…That’s why I’m proud to support the reintroduction of Congresswoman Moore’s Mamas First Act. Maternal mortality remains significantly higher in the United States than in other comparable countries, especially for Black mothers. This legislation addresses the maternal mortality crisis by expanding Medicaid to include doula and midwifery care, because having trusted partners in the birthing process saves lives. Mothers are less than half of the population, but we give birth to 100% of it - Congress needs to put Mamas First because our Mamas can’t wait.”  The bill awaits committee consideration. 

From our desk(s): Duke Health GR this week 
This week our office coordinated and participated in a meeting with health policy staff for Rep. David Rouzer (R-NC-07) and leadership from Duke University School of Medicine Department of Family Medicine and Community Health to discuss rural health, workforce, and primary care policy.  

Our team met with the leadership of the Duke-UCLA National Center for Child Traumatic Stress (NCCTS) to discuss federal strategy, legislative priorities, and the National Child Traumatic Stress Network’s upcoming annual meeting. 

Members of our team also joined stakeholder and coalition strategy meetings and calls on issues related to clinical trials, laboratory developed tests (LDTs), the 340B drug program, telehealth, and surprise medical billing. 

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