Funding Bills Still in Limbo as Deadline Approaches

Congress is rapidly approaching another deadline to fund the government. The government is slated to shut down in 27 days on November 21 when the latest stopgap funding measure expires. There are just 12 legislative days for Congress to be in session between now and then, so this is becoming an urgent issue for lawmakers to address. The House has already passed its funding provisions. However, the Senate has made progress only on measures to fund the departments of Agriculture, Transportation, Commerce, Housing and Urban Development, Interior and Justice, plus the FDA, EPA and National Science Foundation. The Labor-HHS funding package, which funds health care programs, has a long way to go before both chambers can agree on funding provisions.

Senate Appropriations Chairman Richard Shelby (R-AL) predicted that Congress is moving toward another continuing resolution that would extend current funding levels at least through early next year. Sen. Shelby and his counterpart in the lower chamber, House Appropriations Chairwoman Nita Lowey (D-NY), say it’s still too early to determine how long the next patch could span. However, neither one is ruling out the option of a stopgap next month that would extend funding for the entire federal government beyond the December holidays and into 2020.

Another House Committee Advances Pelosi Drug Plan

The House Ways and Means Committee advanced an updated version of Speaker Nancy Pelosi’s sweeping drug pricing package, which included three provisions that would add dental, vision and hearing coverage for Medicare beneficiaries. The Speaker’s plan, which passed the three other House committees along partisan lines, has a high chance of approval by the full House. While some were optimistic this package would hit the House floor next week as previously planned, House leadership now indicates the vote will not happen until after November 12.

Clearly, this is a tense time for Speaker Pelosi and President Trump, given the ongoing impeachment inquiry. However, the parties seem to still be trying to figure out a way to push through a deal to lower prescription drug prices. Both the White House and Speaker Pelosi’s office confirmed that the Speaker’s top health aide, Wendell Primus, spoke on the phone last week with Joe Grogan, Director of President Trump’s Domestic Policy Council. Even if Pelosi and the Trump administration come to an agreement, the bill has a very difficult path before becoming law. Not a single Republican is expected to support the drug bill when it goes to the House floor, and Senate Majority Leader Mitch McConnell has vowed not to bring it up for a Senate vote.

MACPAC Releases Report on Medication-Assisted Treatment in Medicaid

The Medicaid and CHIP Payment and Access Commission (“MACPAC”) released a report examining access to medication-assisted treatment (“MAT”), which combines medication with counseling or behavioral therapies to treat individuals with opioid and alcohol use disorders. The report focuses on policies such as prescription limits, step therapy, prior authorization, quantity or dose limits, and lifetime limits in eight states: Arkansas, Illinois, Maine, Missouri, Tennessee, Utah, Washington and West Virginia. MACPAC members stated they were unclear as to what extent these policies posed barriers for access to treatment. Through passage of the SUPPORT Act, Congress directed MACPAC to study MAT policies that may affect access to clinically appropriate treatment.

Health-Related Bills Introduced This Week

Rep. James McGovern (D-MA) introduced H.R. 4838 to amend Title XVIII of the Social Security Act to allow payments under the Medicare program for certain items and services furnished by off-campus outpatient departments of a provider to be determined under the prospective payment system for hospital outpatient department services.

Rep. Josh Gottheimer (D-NJ) introduced H.R. 4834 to amend Title XVIII of the Social Security Act to provide for an exception to the definition of an off-campus outpatient department of a provider under the Medicare program for certain departments of a provider if such provider was forced to relocate its campus.

Rep. Mark DeSaulnier (D-CA) introduced H.R. 4830 to provide payment for patient navigator services under Title XIX of the Social Security Act.

Rep. Tim Ryan (D-OH) introduced H.R. 4801 to amend the Public Health Service Act to reauthorize the Healthy Start program.

Sen. Cory Booker (D-NJ) introduced S. 2675 to authorize the Secretary of Health and Human Services to carry out activities relating to neglected diseases of poverty.

Next Week in Washington

Next week, Congress is back to work with impeachment and funding the government taking over much of the focus. On Thursday, the Senate Health, Education, Labor, and Pensions Committee will mark up over-the-counter drug reform legislation, along with seven other public health bills. The House Energy and Commerce Health Subcommittee holds a hearing on “Safeguarding Pharmaceutical Supply Chains in a Global Economy.” Also on Wednesday, the Senate Finance Health Care Subcommittee holds a hearing on “Medicaid: Compliance with Eligibility Requirements.”