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Health Policy Updates for the Week of April 1, 2019

The Headlines

  1. Dr. Sharon Fekrat testified in the Senate Special Committee on Aging hearing about research on Alzheimer's disease.
  2. Congress passed a Medicaid package, which includes the ACE Kids Act.
  3. The House advanced bills that bolster the Affordable Care Act (ACA) and address rising prescription drug costs.
  4. Bills were introduced to overhaul 42 CFR Part 2, a statute that protects substance use treatment records.
  5. The Centers for Medicare and Medicaid Services (CMS) finalized its 2020 payment updates for Medicare Advantage and Part D plans.

The Details

1. Dr. Sharon Fekrat at Senate Special Committee on Aging
On Tuesday, Dr. Sharon Fekrat testified in the Senate Special Committee on Aging about research on using retinal blood vessel density to detect Alzheimer’s disease. Coauthors of the research presented are: Stephen P. Yoon, BS, Dilraj S. Grewal, MD, Atalie C. Thompson, MD, MPH, Bryce W. Polascik, Cynthia Dunn, PA, and James R. Burke, MD, PhD. During their time on Capitol Hill, Dr. Fekrat and her coauthors, including Stephen Yoon and Dr. Grewal, also met with Senator Richard Burr (R-NC), Congressman David Price (D-NC-04), and health staff from Senator Thom Tillis’ office (R-NC) to speak about their research.
 
2. Medicaid Package with ACE Kids Act Passess
Congress passed H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019 on Tuesday. The package included extensions for several Medicaid programs, including the ACE Kids Act, which ensures coordinated care for children with medically complex conditions through state Medicaid programs. The bill would also prevent misclassification of drugs under the Medicaid Drug Rebate Program by issuing penalties to manufacturers. The bill is awaiting the President’s signature.  
 
3. Committee Hearings
On Tuesday, the House Education and Labor Subcommittee on Health, Employment, Labor and Pensions held a hearing on protecting patients from surprise billing. While hospitals did not testify at the hearing, the American Hospital Association (AHA) noted this issue is a top priority and that most hospitals have protocols to notify patients of the potential for out-of-network care. AHA also mentioned that ensuring adequate networks and educating patients about their health insurance are "critical to addressing surprise medical bills," and that bundling emergency services would be administratively complex "and, alone, do nothing to protect patients from surprise bills."
 
On Wednesday, the House Committee on Energy and Commerce advanced a dozen bills that bolster the ACA marketplaces, lower the cost of coverage for consumers and address the rising prescription drug costs. The bills await action by the House and are expected to pass. The Senate is not expected to take up similar legislation.
 
4. Substance Abuse Record Sharing Bills
The Overdose Prevention and Patient Safety Act (H.R. 2062) was reintroduced on Wednesday in the House. The bill would overhaul 42 CFR Part 2, a statute that protects substance use treatment records, and align it with the Health Insurance Portability and Accountability Act (HIPAA) regulations to help provide clinicians more complete treatment history. A similar bill has been introduced in the Senate as well, the Protecting Jessica Grubb’s Legacy Act (S.1012). While both bills are bipartisan, they still face an uphill battle given tensions between whole patient care and patient privacy concerns.
 
5. CMS Finalizes Medicare Advantage and Part D Payment Changes for 2020
CMS finalized its 2020 payment updates for Medicare Advantage and Part D plans. The finalized updates specifically address the risk adjustment model for aged and disabled Medicare Advantage Part C plans, and the cost-sharing reductions and targeted benefits for those undergoing addiction treatment or suffering with chronic pain.