Be bold. Be clear. Be.
Because if you never ask
The answer is no.
The Rundown
- Ten days until the end of the federal fiscal year
- House committee action on public health, telehealth, and chronic disease
- What’s up, NC delegation?
- The latest from our desks
- Join the Duke Health Advocacy Network!
Federal Updates
Can we just keep the lights on?
If you have been reading our newsletter over the last few years, or just the last few months, you know what we are about to say, same story-same deadline. October 1 starts a new fiscal year, and Congress has yet to pass any of its 12 annual appropriations bills to keep the government funded. As a result, Congress will need to pass a continuing resolution (CR) to keep the government funded or face a shutdown. The smart money is on a last-minute CR, as Senate Minority Leader Mitch McConnell (R-KY) summed up the situation when he was quoted this week saying that it is “politically beyond stupid” for Congress to shut down the government before an election.
Earlier this week, House Speaker Mike Johnson (R-LA) moved forward with a vote on a six-month continuing resolution coupled with the Safeguard American Voter Eligibility Act (SAVE Act), which would require proof of citizenship when registering to vote. Speaker Johnson did not have the support of the entire Republican Conference for this approach, and the vote on the floor failed to pass. House Republicans have now gone back to the drawing board to see what they may be able to pass next week. While the House is going through the motions, the Senate has taken a wait-and-see approach, with Senate Majority Leader Chuck Schumer (D-NY) starting the process for a CR in the Senate next week if needed. We expect Congress to pass a short-term CR that would extend funding at current levels through mid-December before the October 1 deadline.
This week, the House approved 14 health-related bills, including the Accelerating Kids Access to Care Act, which has been a priority for our office. This bill 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.
Among the other bills passed this week was the Autism CARES Act, which is the primary source of federal funding for autism research, services, training, and monitoring. The Duke Center for Autism and Brain Development, which has been an NIH Autism Center of Excellence since 2017, has received funding from previous iterations of this legislation. The House also passed the BOLD Infrastructure for Alzheimer’s Reauthorization Act to reauthorize the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act.
Heard on the Hill
Congress is only in town for a short amount of time this month – and what better place to spend it than a committee room?
Energy and Commerce Committee
The House Energy and Commerce Committee held a markup of 16 bills, including legislation to extend current telehealth flexibilities under Medicare. The Telehealth Modernization Act (TMA), much like legislation passed by the House Ways and Means Committee in the spring, would extend for two years current Medicare telehealth flexibilities set to expire at the end of this year and for five years the Medicare Acute Care Hospital at Home program. Unlike the Ways and Means bill, the TMA also includes provisions to extend in-home cardio-pulmonary flexibilities, as well as a program for virtual diabetes program suppliers.
Most of the bill would be paid for with reforms to pharmacy benefit managers, but there is also a provision that would require a unique provider identifier and attestation for every off-campus outpatient department of the primary provider. This controversial provision was originally included in price transparency legislation considered by the committee earlier this year and was likely added in part as a placeholder for members seeking to add stronger waste, fraud, and abuse guardrails for telehealth. The Ways and Means bill does not include the provider identifier.
The House could take up some form of telehealth extension legislation before the expected recess period before the elections, but it is more likely that the issue will have to wait until the lame duck session in November and December.
Ways and Means Health Subcommittee
On Wednesday, the House Ways and Means Health Subcommittee held a hearing entitled, “Investing in a Healthier America: Chronic Disease Prevention and Treatment.” In his opening statement, Chair of the Subcommittee Rep. Vern Buchanan (R-FL) discussed the increasing prevalence of disease like cancer, Alzheimer’s, and heart disease, noting the nation is about to hit a bleak milestone as new cases of cancer cross the 2 million mark. He said this tells him that investments in new technologies are needed to catch these chronic diseases early and often. He also mentioned the growing challenges with obesity and a larger share of the GDP going to healthcare expenditures. Rep. Buchanan recently launched the Preventive Health and Wellness Caucus with Rep. Gwen Moore (D-WI) to focus on Medical Research and Innovation (MRI), Food as Medicine (FAM), exercise, health disparities, coverage, stigma, obesity’s effect on military readiness and physical fitness.
Witnesses for the hearing included representatives from the Bipartisan Policy Center; Food Fix Campaign; Senior Care Action Network (SCAN) Health Plan; and Keck School of Medicine of USC.
What’s Up NC Delegation
Rep. Greg Murphy (R-NC-03) introduced the bipartisan No Surprises Act Enforcement Act to reinforce the No Surprises Act, which was signed into law in 2020 and seeks to address surprise medical bills. This new legislation reinforces the No Surprises Act by closing enforcement gaps through increased penalties for non-compliance of statutory payment deadlines, providing parity between penalties imposed against parties non-compliant with statutory patient protection provisions, and increasing transparency in reporting requirements. A press release about the bill is available here.
On Wednesday, Reps. Alma Adams (D-NC-12) and Ashley Hinson (R-IA) teamed up with Senators Jeff Merkley (D-OR), Cory Booker (D-NJ), and Chuck Grassley (R-IA) to introduce a bipartisan, bicameral resolution recognizing September 19 as National Stillbirth Prevention Day. Earlier this year, the bipartisan Maternal and Child Health Stillbirth Prevention Act was signed into law by President Biden. With at least 25 percent of stillbirths being potentially preventable, the resolution stresses the need for continued stillbirth prevention activities in the United States. A press release about the resolution is available here.
From our desk(s): Duke Health GR this week
This week, our office advocated for support for a Dear Colleague letter being led co-led by Rep. Greg Murphy (R-NC-03) and seven other Members of the House urging Congressional leadership to provide an update to the Physician Fee Schedule (PFS) prior to January 1, 2025 to mitigate the pending 2.8% cut proposed by the Centers for Medicare and Medicaid Services. Our office stressed that continued cuts are unsustainable and urged support. To date, Reps. Valerie Foushee (D-NC-04) and Deborah Ross (D-NC-02) have supported the letter at our request, and we are hopeful for additional support before the deadline.
Earlier this week, members of our team joined Duke State Relations and several Duke Health and Duke University Affinity Groups for a conversation about the upcoming elections and what to expect for the remainder of the year and into early next year. Our team also met with the inaugural cohort of the new Duke Pediatrics Health Equity and Advocacy Leadership (HEAL) track to discuss the importance of advocacy. The HEAL track is designed to equip residents to become leaders in advocacy and health equity to reduce health disparities.
Members of our team travelled to DC this week to participate in a summit for congressional and federal agency staff hosted by the Health AI Partnership (HAIP), of which Duke Health is a founding member. Entitled “AI Product Lifecycle Management in Healthcare,” the summit examined the challenges and opportunities associated with the safe, effective, and equitable integration of AI solutions in healthcare delivery.
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