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Federal Updates
And how was your recess?
Congress is back (at least the Senate this week), and so is our weekly newsletter. We’ll get back to our usual format next week when Capitol Hill is once again “fully operational” – so, for now we’re going to take a moment to catch up and look ahead.
Traditionally, August has been a time to step back, assess, and plan strategically for the final months of the year. The “to-do” list isn’t necessarily any shorter than other points in the year, but rarely does anything feel as if it’s on fire or in need of constant surveillance so that smoldering embers don’t suddenly reignite. This past August was… not that. We’ll share a few more details about what we’ve been up to the past few weeks in just a moment, but for now let’s take a look at the remaining month ahead.
September
There has been a fair amount of coverage over the past week noting that Congress isn’t returning from summer recess with a lengthy agenda for the month of September. It’s true, but there are some unspoken caveats. It may not be the size of the list that matters this time around, but the scope has far-reaching implications. Congress has two “must address” issues before the end of the month and then likely adjourning for the midterm elections:
- FY 2023 appropriations – The current fiscal year (in which final spending levels weren’t settled until February of this year) ends on September 30th. While the House has passed roughly half of its appropriations bills and Senate Democrats released details of theirs just before recess, there are still no bipartisan agreements on top-line spending or individual bills. Congress will almost certainly need to pass a continuing resolution (CR) to keep the government funded beyond September 30th – and this reality is relatively non-controversial among a vast majority of congressional leaders. It gets more complicated with another reality that the CR may one of the only moving legislative vehicles before December. The White House has already requested over $22 billion in supplemental funding for COVID response needs, as well as additional funding for Ukraine. The administration also recently signaled it’s open to addressing scheduled Medicare cuts and other payment policies in the CR. So far, anything but a “clean” CR seems to be a non-starter for Republican leaders, and avoiding even a temporary government shut down seems a priority for both sides of the aisle. We will be watching this debate and advocating strongly for Duke Health priorities over the next few weeks.
- FDA user fees – The current Food and Drug Administration (FDA) user fee agreement also expires on September 30th. Negotiations bogged down over the summer after Senate Health, Education, Labor and Pensions (HELP) Committee ranking member Richard Burr (R-NC) withdrew from talks over concerns about "anti-competitiveness" provisions being added in the committee process and introduced a “clean” user fee bill, the Food and Drug Administration Simple Reauthorization Act. Senator Burr’s bill differs from both a House-passed measure and one approved earlier this summer by the HELP Committee. The good news is that talks have reportedly resumed behind the scenes, but there isn’t much time to reach a final deal. The FDA is already preparing for potential furloughs and other temporary workforce reductions if negotiations push past the deadline.
From our desk(s): Catching up with Duke Health GR
As noted above, we spent our August recess advocating and planning ahead, while also navigating new challenges.
Our team met with the offices of Rep. Alma Adams (D-NC-12) and Rep. Ted Budd (R-NC-13) to connect on Duke Health priorities and mutual areas of interest for the fall session. We also connected with NC congressional delegation staff on telehealth expansion and federal research priorities and coordinated a meeting for Duke University School of Nursing Dean Vincent Guilamo-Ramos to meet with Rep. Kathy Manning (D-NC-06) to discuss access to healthcare and nursing workforce and education.
We coordinated and ramped up Duke Health's federal outreach efforts to support the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 7961), working with DUHS leadership, including Executive Vice President and Chief Operating Officer Dr. Craig Albanese, on community outreach, as well as federal partners and the NC congressional delegation. The bipartisan bill would give healthcare workers the same legal protections against assault and intimidation that flight crews and airport workers currently have under federal law.
Our team coordinated outreach on behalf of Duke Connected Care to support the Value in Health Care Act, which among other provisions would extend the 5 percent Advanced Alternative Payment Model incentive payment, and connected with national stakeholders, congressional staff, and fellow health system colleagues to highlight the current challenges facing hospitals and healthcare providers.
August also proved to be quite active on the regulatory front. We coordinated the Duke Health-wide response to the proposed Centers for Medicare and Medicaid Services (CMS) 2023 Physician Fee Schedule (PFS) rule, apprised health system leadership on an updated final rule for the federal ban on surprise billing and a final rule from the Department of Homeland Security for the Deferred Action for Childhood Arrivals (DACA) policy, connected with Duke Health experts on provisions in the Outpatient Prospective Payment System (OPPS) proposed rule, and monitored responses to the Department of Health and Human Services’ (HHS) proposed update to the nondiscrimination protections in Section 1557 of the Affordable Care Act.
Our team was pleased to join a meeting with the Duke University School of Medicine and guests from the Infectious Diseases Society of America and representatives from the federal government to discuss the building blocks of infectious disease preparedness: addressing antimicrobial resistance; building a strong pipeline of physician/scientists who are experts in infectious disease; and creating new and different pathways for acquiring research funding.
Finally, we were honored, along with our colleagues in Duke State Relations, to participate in a health system-wide lunch and learn event to discuss policy efforts and priorities to advance health equity. We appreciate these opportunities to connect directly with our Duke Health colleagues, share more about our work, and learn about the priorities and issues of importance for various departments and their team members. We’d love to engage more with you, too. If you are interested in having our team join yours for a brief conversation about our work, please contact us at govrelations@dm.duke.edu.
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