This week’s intake
Senate Finance Committee holds hearing on disability benefits. The hearing discussed ways to increase work incentives for people receiving Social Security disability benefits. Senate Finance Committee Chairman introduces Anti-Obstetric Desert Act. The Obstetric Maintenance Local Act aims to prevent the closure of birthing units in rural and underserved areas. House Energy and Commerce Committee Chairman introduces NIH Reform Framework. Chairman Rogers (R-WA) introduced the framework detailing the challenges currently facing the National Institutes of Health (NIH). CMS announces termination of AAP program for healthcare cyberattacks. Centers for Medicare & Medicaid Services (CMS) announces that payments under the Accelerated Advance Payment (AAP) program for healthcare transformation/Optum payment interruptions will end on July 12, 2024. Administration releases findings of study on nonfatal overdoses. Federal study focuses on opioid epidemic, identifying critical gaps in effective interventions and care.
meeting
The Senate Finance Committee held a hearing on disability benefits. The hearing discussed ways to increase incentives for Social Security disability recipients to start working. Senators and witnesses noted that there are currently disincentives for Social Security disability recipients to start working, such as fear of losing benefits and the complexity of work incentive rules. They expressed concern that the Social Security Administration continues to use outdated occupational data, even though it has invested in developing alternative data to this data. They also expressed concern about the number of large overpayments of Social Security disability benefits and the negative economic impact it has on recipients.
Senate Finance Committee Chairs Release Draft Prevent Obstetric Deserts Bill. Chairman Wyden (D-Oregon) and 15 Democratic Senators released a draft bill to address the growing problem of obstetric deserts. The bill notes that between 2012 and 2022, roughly a quarter of rural hospitals stopped offering obstetric services. The draft bill is divided into four titles and focuses on:
It will provide increased financial support to rural and safety-net hospitals that provide obstetric services, expand maternal and child health coverage, make new workforce investments, and create new public communications requirements related to closures.
The specific provisions are as follows:
Increases Medicaid base payment rates for maternity services to 150% of the Medicare rate for rural hospitals and hospitals where at least 60% of births are paid for by Medicaid, Indian Health Service, or self-pay Increases the percentage of federal medical assistance for maternity services in covered hospitals Provides additional payments to certain hospitals with low birth volumes.
The bill extends enhanced payment rates and federal financial participation for labor, delivery, and birth services to the Children’s Health Insurance Program (CHIP). The bill requires 12 months of continued full benefits coverage for pregnant and postpartum individuals under Medicaid and CHIP and creates a Medicaid option for health homes for pregnant and postpartum women. Finally, the bill streamlines screening and enrollment in state Medicaid programs for out-of-state obstetric care providers.
A section-by-section summary of the bill can be found here. A press release with a full list of co-sponsors and a list of stakeholder support can be found here. The bill currently has no support from Senate Republicans. Many of the policies laid out in the draft bill will likely cost money, but the Congressional Budget Office (CBO) has not yet released estimates. The bill was released in draft form; proponents are still seeking comments and may revise the 150% payment threshold and other provisions. Proponents plan to formally introduce the bill in the fall.
The Chairman of the House Energy and Commerce Committee releases a framework for NIH reform. The discussion framework includes several recommendations for reforming NIH, including structural reform, mission and leadership reform, funding reform, and grant reform. A one-page document on the framework can be found here. Interested parties can submit written feedback and comments by August 16, 2024, to [email protected].
Chairman Rogers also co-authored a position paper on the issue with the House Appropriations Committee’s Subcommittee on Labor and Health and Human Services (HHS) and Education Chairman Rep. Aderholt (R-Ala.) detailing why NIH reform is necessary. While highlighting support for the NIH and its role in advancing scientific discovery, the paper also notes the need to address concerns that have arisen during and after the COVID-19 pandemic.
In related news, the House Energy and Commerce Committee released an interim staff report on the Committee’s ongoing investigation into the proposed MPXV project at NIH. The investigation revealed a lack of oversight and transparency from HHS, NIH, and the National Institute of Allergy and Infectious Diseases. The report includes a set of biosecurity recommendations to ensure future transparency and accountability regarding similar research.
management
CMS Announces Termination of AAP Program for Change Healthcare Cyberattack. In a press release, CMS emphasized that the AAP program payments were designed to mitigate the cash flow disruptions experienced by some Medicare providers and suppliers as a result of the cyberattack that took Change Healthcare offline in February 2024. CMS stated that accelerated payments have been made to more than 4,200 Part A providers (e.g., hospitals) totaling more than $2.55 billion. CMS also stated that it has paid 4,722 advance payments totaling more than $717.18 million to Part B suppliers, including physicians, non-physician practices, and durable medical equipment suppliers. After July 12, 2024, CMS will no longer accept new applications for accelerated or advance payments for the Change Healthcare/Optum payment interruption. CMS states that any providers or suppliers having issues billing or receiving claims payment at this time should contact Change Healthcare and/or their Medicare administrative contractor.
Administration releases findings from study examining nonfatal overdoses. Researchers from the Substance Abuse and Mental Health Services Administration, NIH National Institute on Drug Abuse, Centers for Disease Control and Prevention, and CMS conducted a study evaluating 137,000 Medicare beneficiaries who experienced a nonfatal overdose in 2020. Of this cohort, approximately 24,000 (17.4%) experienced another nonfatal overdose, and approximately 1,300 (1%) died from an overdose in the following year. The study found that beneficiaries who received methadone (58% lower odds), buprenorphine (52% lower odds), or behavioral health evaluation or crisis services (75% lower odds) had reduced odds of dying from a subsequent fatal overdose. Those who received a naloxone prescription had a 30% reduced risk of dying from an overdose.
The study also noted significant gaps in care. For example, only 4.1% of beneficiaries received medications for opioid use disorder and only 6.2% filled a prescription for naloxone. Beneficiaries who received medications for opioid use disorder waited an average of 72 days after their overdose to receive their medication. Researchers concluded that quality care interventions are needed to address the drug overdose crisis. The CMS press release can be found here.
Quick Hit
CBO releases projections for health insurance coverage in the United States. CBO noted that 7.7% of the U.S. population will be uninsured in 2024. CBO projected that the percentage of the uninsured population will increase to 8.9% by 2034 due to the COVID-19 pandemic-related termination of Medicaid policies, the expiration of enhanced subsidies available through the Affordable Care Act’s health insurance marketplaces, and the immigration surge that began in 2022. The number of people enrolled in Medicare is expected to increase from 60 million in 2023 to 74 million in 2034. CMS Announces NOFO for IBH Model. The Innovations in Behavioral Health (IBH) Model allows specialized behavioral health clinics to integrate behavioral health with physical health care and health-related social needs. CMS will select up to eight state Medicaid agencies to participate in the model. Interested applicants can access the Notice of Funding Opportunity (NOFO) application here. CMS also announced that it will host a webinar on NOFO on July 11, 2024.
Next week’s diagnosis
With the House in session and the Senate in recess next week, health care-related activity is taking place at the committee level, including a House Ways and Means Health Subcommittee hearing on value-based care and a possible markup of privacy legislation in the House Energy and Commerce Committee.
[View source.]