The Headlines
- Congress begins conducting more regular business, House Democrats introduce their latest recovery and stimulus proposal, and federal officials and stakeholders continue to respond to the COVID-19 health emergency.
- Duke University School of Medicine Dean Mary Klotman and the office of Rep. David Price co-host a congressional staff virtual roundtable on the research enterprise and COVID-19.
- CMS releases the FY 2021 IPPS proposed rule.
The Details
1. Federal COVID-19 virus updates
The Senate entered its second full week back in session, although a number of Senators are continuing to join hearings virtually outside of Washington, D.C. The House returned to session on Friday to vote on House Democrats’ latest recovery and stimulus proposal and will likely not reconvene until sometime after the Memorial Day holiday.
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.
On Wednesday, the House Oversight and Reform Coronavirus Crisis Subcommittee held a briefing on coronavirus testing and tracing. Among a group of experts testifying, former Food and Drug Administration (FDA) Commissioners Scott Gottlieb and Mark McClellan, now Director of the Duke Margolis Center for Health Policy, spoke to the need for comprehensive testing and contact tracing protocols to help states and localities gradually phase in safe economic and social reopening strategies.
The Senate Health Education Labor and Pensions (HELP) Committee held a hearing this week on returning to work and school from a public health perspective. National Institute of Allergy and Infectious Diseases Director Anthony Fauci, MD issued a warning to government officials that skipping over critical steps with respect to ending certain protective measures too soon could prove even more disastrous for the economy and the public health. Dr. Fauci was joined by three other witnesses from the Trump Administration, including Director of the Centers for Disease Control and Prevention Robert Redfield, MD, FDA Commissioner Stephen Hahn, MD, and Admiral Brett Giroir, MD, Assistant Secretary for Health. Sen. Richard Burr (R-NC) asked Dr. Fauci about the timeline for the vaccine development process and concerns about unknowns that may impede progress. Fauci responded that there are no guarantees that any vaccine will be effective but given the way the body responds to a virus of this type, he is "cautiously optimistic" that a viable candidate will emerge from testing.
The House Energy and Commerce Subcommittee on Health held a hearing Thursday on “Protecting Scientific Integrity in the COVID-19 Response.” As the key witness in the opening panel, Dr. Richard Bright, current Senior Advisor at NIH and recently ousted Director of the Biomedical Advanced Research and Development Authority (BARDA), warned the committee that the window is closing to take meaningful steps to mitigate the present impact of COVID-19, as well as that of an expected fall resurgence of the disease. Subcommittee Vice Chair G.K. Butterfield (D-NC-01) pressed Dr. Bright on why the United States is still facing difficulties in obtaining and distributing needed testing supplies. He responded that in his opinion those efforts have been hampered by the lack of a national, coordinated response and leadership to oversee that process.
House Democrats released their $3 trillion “Phase IV” COVID-19 stimulus and recovery package and expect to pass the legislation along party lines later today. The Heroes Act (H.R. 6800), among other provisions, would provide:
- $4.7 billion for NIH (including $3 billion to offset costs related to reductions in lab productivity)
- $100 billion for hospitals and providers
- FMAP increase through June 2021 by a total of 14% points
- DSH payment increase of 2.5%
- Lowered interest rates for the Accelerated and Advance Payment Program
- $75 billion for testing and contact tracing
- $7 billion for the public health infrastructure
- Nearly $1 trillion for state and local government relief
The bill falls short of some research community stakeholder requests, including advocacy efforts by AAMC, of which Duke Health is a member, for $26 billion in dedicated funding for research. We will continue to work with our partners to ensure that critical research funding is prioritized and protected in a final legislative agreement.
Senate Republican leadership quickly rejected the proposal and indicated that it will not be brought up for a vote on the Senate floor. While Senate Majority Leader Mitch McConnell (R-KY) has called for a pause on further negotiations on a Phase IV bill, Republicans are readying policy proposals for what will likely become their version of recovery and stimulus legislation, including additional tax cuts and liability protections for employers during the national health emergency.
2. Dean Klotman, office of Rep. Price co-host virtual roundtable briefing on the research enterprise
This week the office of Rep. David Price (D-NC-04 ) hosted a virtual roundtable with Dr. Mary Klotman, Dean of the Duke University School of Medicine and Vice Chancellor for Health Affairs, for staff from the North Carolina Congressional Delegation. The roundtable, entitled “Research During COVID-19: Ensuring a Strong Biomedical Infrastructure,” helped inform staff about the impact of COVID-19 on the Duke School of Medicine as well as provide perspective on the challenges faced by other academic labs across the country. Dean Klotman made the case for Congress’s continued support of biomedical research through its relief efforts by maintaining the research infrastructure and supporting the research workforce through targeted investment. She further reiterated Duke Health’s support for at least $26 billion to protect research in any final recovery and stimulus legislation that emerges from the next round of negotiations between Democratic and Republican leaders.
This event was the first in a planned series of virtual roundtable initiatives from Duke Health Government Relations focused on linking Duke Health leaders and experts with Congressional staff to provide timely information on policy matters facing Congress.
3. CMS releases FY 2021 Inpatient Prospective Payment System (IPPS) proposed rule
On Monday, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule for inpatient care payment changes to price transparency, CAR-T, residency slots, star ratings, and Meaningful Use, among many other provisions. Our team will be reaching out to Duke’s experts and leaders about various parts of the proposed rule to inform a potential Duke Health comment letter.