They’ll sprint for three weeks
To set up the next three months
The countdown is on
The Rundown
- Congress returns from recess for a busy September agenda
- Committees hold hearings on FDA, organ transplants, non-competes, and telehealth
- DC comes to Duke Health in August
- Departments issue key final rules on mental health parity coverage
- What’s up, NC delegation?
- The latest from our desks
- Join the Duke Health Advocacy Network!
Federal Updates
They’re back – but for how long?
Members of Congress returned to DC this week with one big item on their agenda: figure out a way to get consensus on a continuing resolution (CR) to fund the federal government before current funding runs out on September 30. The most likely outcome, after House Speaker Mike Johnson (R-LA) pulled his six-month CR, is a clean three-month CR that would move the deadline into December, after the November elections tell us what the incoming Congress and administration will look like in January. But what happens between now and September 30, and what other proposals are voted on first, remains to be seen. Rumors are swirling about a possible House Energy and Commerce (E&C) Committee markup of key legislation next week, including an extension of current enhanced waivers for telehealth and Hospital at Home under Medicare. Congress is also finalizing a deal to help the Department of Veterans’ Affairs bridge a $3 billion budget gap.
Congress is only scheduled to be in session through September 27, before Senators and Members of Congress return to their states and home districts to work and campaign, so some fireworks are anticipated between now and then.
Back to work for congressional committees
With the congressional clock ticking down as members prepare to head back to the districts before the November election, congressional committees held a number of hearings and markups this week to try to advance issues.
On Tuesday, the Energy and Commerce (E&C) Health Subcommittee held a hearing entitled, “Evaluating FDA Human Foods and Tobacco Programs.” The hearing featured James Jones, Deputy Commissioner for Human Foods at the U.S. Food and Drug Administration (FDA); and Dr. Brian King, Director, Center for Tobacco Products at the FDA.
Leading up to the hearing, Full Committee Chair Cathy McMorris Rodgers (R-WA) and Subcommittee Chair Brett Guthrie (R-KY) noted that teenagers and children are at risk of consuming dangerous products, “especially without safer alternatives and clear rules in place.” Legislation considered to inform the hearing included H.R. 9443, Federal and State Food Safety Information Sharing Act of 2024, introduced at the end of August by Rep. Deborah Ross (D-NC-02). According to Rep. Ross, the bill would give FDA the statutory authority to share important information with state and local regulatory agencies, which conduct most food safety inspections.
On Wednesday, the E&C Subcommittee Oversight and Investigations held a hearing entitled, “A Year Removed: Oversight of Securing the U.S. Organ Procurement and Transplantation Network Act Implementation.” The Securing the U.S. Organ Procurement and Transplantation Network Act was signed into law in September 2023, and the hearing examined HRSA’s implementation of the law, including ongoing patient safety concerns and efforts to strengthen oversight and accountability within the Organ Procurement and Transplantation Network (OPTN).
Also, this week, the House Education and the Workforce Committee, which is chaired by Rep. Virginia Foxx (R-NC-05), advanced several bills including H.R. 3120, the Healthy Competition for Better Care Act to “ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care.” The American Hospital Association submitted a statement to the Committee opposing the bill, which it stated would lead to fewer choices for patients and further limit access to care, particularly for patients in urban, rural, and other vulnerable communities. Among AHA’s concerns, it said the bill includes harmful contracting provisions that would prevent doctors and hospitals from negotiating reasonable agreements with commercial health insurance plans and allow insurers to make it more difficult for patients to choose their own doctors and hospitals by steering them to the providers the insurers own or favor.
The Committee also advanced H.R. 9457, Transparent Telehealth Bills Act of 2024, which would “prohibit increased payments under a group health plan or group health insurance coverage for telehealth services furnished by a provider located at a facility.” AHA also opposes this bill, which it said would cut hospital reimbursements since payment (including facility fees and any additional services) would be capped for facility-based providers at non-facility rates.
Bringing DC to Duke Health
Our office used the August congressional recess to provide Duke Health team members opportunities to engage with Members of Congress and their staff while they were back in the state. Visits to Duke Health by Congressional members and their staff provide a unique chance to hear from team members on a variety of topics and get a firsthand look into different aspects of patient care and innovative work happening across Duke Health to help inform policy.
On August 21, our office organized a Congressional staff day hosted by DUHS, which was attended by several staff from the North Carolina congressional delegation. Staff spent time interacting with team members at Duke Regional Hospital, learning more about the patient and team member experience and how policies play out at the bedside. Staff also had the opportunity to tour Duke Behavioral Health before meeting with leadership from DUHS, DUSOM, and DUSON, and learning more about work in AI and gene and cell therapy.
The week before, Congresswoman Valerie Foushee (D-NC-04) visited Duke Health to meet with Mary Klotman, MD, executive vice president of health affairs at Duke University and dean of the School of Medicine, as well as leadership and a patient of the Duke Center for Brain and Spine Metastasis (DCBSM). Rep. Foushee presented a copy of the resolution she introduced in Congress to establish June as Brain and Spine Metastasis Awareness Month, an effort that was started by the Center for Brian and Spine Metastasis and coordinated by our office. Learn more here.
Our office also coordinated a meeting for staff from Senator Thom Tillis’s (R-NC) office to meet with Duke Health leaders on graduate medical education (GME). The meeting was informed by a response our office coordinated on behalf of Duke Health to a bipartisan group of members of the Senate Finance Committee interested in advancing GME proposals. Senator Tillis is a member of that group.
Tri-departments issue final rules on mental health coverage parity
This week, the Departments of Health and Human Services, Treasury, and Labor jointly issued key final rules to clarify and strengthen protections to expand to those with private insurance equitable access to mental health and substance abuse disorder benefits as compared to medical and surgical benefits and reduce barriers to accessing these services.
The rules are intended to support the Mental Health Parity and Addiction Equity Act of 2008, which requires group health plans and individual insurance plans that offer mental health and substance abuse disorder coverage to do so at parity with medical and surgical benefits. The Departments noted that despite enforcement efforts over the past 15 years, barriers to access remain for private insurance holders.
The final rule may be found here and a White House fact sheet here.
What’s Up NC Delegation
Senator Thom Tillis recently joined 10 other Senate Republicans in introducing the Ensuring Continuity in Veteran’s Health Act, legislation that would require the Department of Veterans Affairs (VA) to consider continuity of healthcare when deciding whether seeing a provider in the community is in a Veteran’s best medical interest. A press release about the bill is available here.
Sen. Tillis also recently introduced the bipartisan Physician Fee Stabilization Act, legislation that would protect access to Medicare services by reforming the program’s physician fee schedule. This legislation would increase the budget neutrality threshold to $53 million with an increase every five years to keep pace with the Medicare Economic Index. The budget neutrality threshold was last updated in 1992. A press release about the bill is available here.
Rep. Don Davis (D-NC-01) recently introduced the bipartisan Pharmacy and Medically Underserved Areas Enhancement Act, legislation to reimburse state-licensed pharmacists through Medicare for essential healthcare services like diabetes management and health screenings. A bipartisan senate companion bill, co-sponsored by Senator Ted Budd (R-NC), was introduced in May 2023. A press release about the bill is available here.
Rep. Valerie Foushee (D-NC-04) introduced the bipartisan Expanding AI Voices Act of 2024, legislation to facilitate capacity building, promote increased access, and broaden participation in artificial intelligence research, education, and workforce development. Duke University has endorsed this bill. A press release about the bill is available here.
Rep. Foushee also joined 29 other House Democrats in introducing the National Gun Violence Research Act, legislation that would establish a coordinated national gun violence research program and fund projects through federal agencies that will examine the nature, root causes, consequences, and prevention of gun violence. Reps. Deborah Ross (D-NC-02), Alma Adams, (D-NC-12), and Jeff Jackson (D-NC-14) have signed on as co-sponsors of the bill. A press release about the bill is available here.
Last month, Rep. Alma Adams (D-NC-12) and Rep. Bonnie Watson Coleman (D-NJ-12) reintroduced the Black Breastfeeding Week resolution, aiming to garner national attention to the role that breastfeeding plays in improving Black maternal and infant health outcomes in the United States. Black Breastfeeding Week began in 2013 to highlight disparities in the rates of Black mothers who breastfeed their children compared to white women. A press release about the resolution is available here.
From our desk(s): Duke Health GR this week
This week, we coordinated submission of health system comments for the Calendar Year (CY) 2025 Medicare Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) proposed rules. We worked closely with Duke Health experts and leadership to highlight specific priorities of interest for health system operations, provider reimbursement, and patient care.
Our team recently joined the health system's nursing clinical operations director and international nursing recruitment coordinator in DC to update congressional offices on the health system's international recruiting work and challenges. Following that conversation, Rep. Valerie Foushee's Office (D-NC-04) wrote a letter to the Department of Homeland Security asking the agency to explore ways to include nursing in STEM optional practical training (OPT). Duke Health provided information and data included in the letter and will continue exploring other options to support our nursing workforce.
Our office organized Duke Health’s support of a community letter led by the Infectious Disease Society of America asking for support for the Public Health Workforce Loan Repayment Program and the Bio – Preparedness Workforce Pilot Program in the 2026 President’s Budget Request. Our office also conducted outreach to our delegation to alert them that the Duke Human Vaccine Institute received funding from the National Institute of Allergy and Infectious Diseases (NIAID) to manufacture H5N1 avian flu vaccines for use in clinical trials and to continue to serve as a resource on this issue.
Our office continues to coordinate opportunities for Duke Health to inform policy discussions. Our office worked with Duke University Office of Government Relations and leadership to respond to the request from the House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) on her framework for NIH reform. Our office also coordinated a response to a request from Reps. Diana DeGette (D-CO) and Larry Bucshon, M.D. (R-IN) requesting information on the next-generation CURES bill.
We also participated in stakeholder and coalition strategic advocacy calls on key issues in support of Duke Health’s missions, including telehealth, cancer centers, hospital and health system operations, 340B, trauma centers, and artificial intelligence.
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