SPRING DEADLINE DRIVES 2020 HEALTH POLICY AGENDA

Few policy issues consumed more political oxygen on Capitol Hill last year than prescription drug prices and surprise medical bills – but without significant legislative achievement on either.

But Congress is going to try again, setting up a spring deadline to force action on key healthcare provisions. Despite the new inflection point, lawmakers remain far apart on drug prices, though they are much closer to agreeing on legislation that would end surprise medical bills.

The budget legislation that Congress approved last month created a May 22 deadline when several popular health programs will expire. Congressional leaders intentionally set this date in the hopes that it would drive action on drug prices and surprise billing, and that legislation to extend the expiring programs will act as a vehicle for major health policy.

Yet despite lawmakers’ professed hopes to ultimately solve both issues this year, there is no evident path to do so amid sharp divisions on policy details.

The House last month passed Democrats’ broad drug pricing bill, but that is as far as their approach will advance. In the Senate, a more moderate proposal from Finance Committee leaders Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., remains stalled amid opposition from several Republicans, including Majority Leader Mitch McConnell, R-Ky. Grassley has been increasingly vocal about his frustration over the lack of progress, but his comments to the press haven’t changed McConnell’s reticence to advance legislation that would divide Republicans.

Meanwhile, a turf battle among committees also stalled progress on addressing unexpected bills for out-of-network medical care. Leaders of the Senate HELP Committee and House Energy and Commerce Committee believed they had a legislative solution that could have become law late last year. But a rival proposal from the House Ways and Means Committee favored by doctors and hospitals sunk efforts at a year-end deal. Frustration flared last month as the competition between the two proposals ultimately prevented a solution.

COMMITTEE LEADERS PRESS FORWARD WITH SURPRISE BILLING PROBE

As part of their effort to keep surprise billing at the top of the congressional to-do list this year, the bipartisan leadership of the Senate HELP Committee and the House Energy and Commerce Committee expanded an investigation into the billing practices of insurers and physician staffing firms.

Late last month Reps. Frank Pallone, D-N.J., and Greg Walden, R-Ore., and Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., sent letters to several large insurers and staffing companies seeking information about their rate negotiations and billing practices. They also asked about the role that private equity firms play as owners of the physician staffing firms – building on an earlier investigation that Pallone and Walden launched.

In their letters, the committees noted that they had “heard countless heart-wrenching stories from individuals who have received thousands of dollars in medical bills after inadvertently receiving care from out-of-network providers. These surprise medical bills have led to patient confusion and financial hardship, and have inspired the [committees] to act through bipartisan legislation.”

Despite their legislative solution stalling at the end of last year, the committee leaders hope that their investigation will help inspire Congress to push that bipartisan legislation over the finish line.

MORE DEMOCRATS CALL FOR VERMA’S OUSTER

Joining a growing chorus of criticism from congressional Democrats, last month the chairman of the House Energy and Commerce Committee called for the resignation of Centers for Medicare and Medicaid Services chief Seema Verma.

Rep. Frank Pallone, D-N.J., became the highest-ranking Democrat to say Verma should resign over questions about her agency’s spending, including millions of dollars in contracts for public relations efforts.

Verma had already been in Democrats’ crosshairs over questions about how she was implementing the Affordable Care Act. She’s been at the center of public feuding with Alex Azar, the secretary of the Department of Health and Human Services, over policy disagreements inside the Trump administration. Verma has also faced media scrutiny for asking that the federal government reimburse her for $47,000 for personal property that she says was stolen while she was on a work trip.

Rep. Joe Kennedy, D-Mass., also called on Verma to resign. He had clashed with Verma at a hearing of Pallone’s committee over the administration’s policy of imposing work requirements on Medicaid recipients.

HOUSE PANEL OPENS 2020 WITH BIPARTISANSHIP

The House Energy and Commerce Committee leadership promised a busy start to the year on health policy with the panel’s health subcommittee holding a hearing on seven bipartisan bills.

Full committee Chairman Frank Pallone, D-N.J., and Health Subcommittee Chairwoman Anna Eshoo, D-Calif., said the emphasis of the hearing is legislation “to improve health outcomes for kids and strengthen benefits and coverage for Medicare and Medicaid beneficiaries.”

The agenda includes proposals aiming to fight infant mortality; help students manage asthma and allergies; ensure proper insurance coverage for children with birth defects; protect Medicaid benefits for non-emergency transportation; and extend the length of Medicare coverage for immunosuppressive drugs for kidney transplant patients.

Each of the seven bills enjoys bipartisan support.

SENATORS SEEK REVIEW OF ORGAN TRANSPLANTATION

Senate Finance Committee Chairman Chuck Grassley, R-Iowa, and committee member Todd Young, R-Ind., are seeking a comprehensive review of the organ procurement and transplantation system in the United States.

In a letter last month to Health and Human Services Acting Inspector General Joanne Chiedi, the senators asked questions about HHS oversight of federal contractors called organ procurement organizations (OPOs), which connect available organs with patients who need them. Grassley and Young highlighted research indicating that “thousands of eligible organs are not being transplanted due to a serious lack of accountability, transparency and objective donor standards.”

The Centers for Medicare and Medicaid Services on Dec. 17 proposed changes aimed at reforming and enhancing oversight of OPOs, as part of President Donald Trump’s 2019 Executive Order on Advancing American Kidney Health. Grassley and Young in their letter praised the administration’s actions but sought more immediate action as the rulemaking process progresses.