Lawmakers Hit a Wall with Funding Negotiations – Shutdown Continues

The three-week partial government shutdown continues without any progress towards an agreement to fund the federal government. Tomorrow, January 12, will mark the longest government shutdown on record as it exceeds the 21-day shutdown in 1996.

Congress was in action this week. On Thursday, the House passed a fiscal year 2019 Agriculture-FDA spending bill and an Interior-Environment spending bill. However, this legislation is a non-starter in the Senate, as the upper chamber has indicated they will not move legislation funding parts of the government without stand-alone funding for border security.

House Clears Pandemic Preparation and Over-the-Counter Drug Reform Bill

The House passed legislation (H.R. 269), introduced by Reps. Susan Brooks (R-IN) and Anna Eshoo (D-CA), authorizing power for HHS to respond to pandemic and biological threats and fund health preparedness programs. The measure also overhauls the way FDA regulates over-the-counter drugs. It would expand the FDA’s authority and create a five-year, $134 million over-the-counter user fee program.

These measures were originally introduced and passed separately in the House, but they were combined in December for a last-minute push to get both passed last Congress. The legislation will go to the Senate for a third time since last summer, where it is expected to pass.

House Committee Leaders Question Medicare Innovation Lab

Top lawmakers from the House Ways and Means Committee, Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX), sent a letter demanding greater transparency from the Center for Medicare & Medicaid Innovation (“CMMI”). The lawmakers want more information as CMMI develops new delivery and payment models and are also pushing CMS leaders to obtain more input from industry stakeholders.

Chairman Neal and Rep. Brady urged CMS Administrator Seema Verma to inform Congress of what models are being considered by CMMI. Additionally, they asked the agency to provide an estimated timeline for any model under development at CMMI, any rulemaking or other public comment period that will be provided before finalization of the model parameters and the Innovation Center Investment Proposals for these models. The lawmakers requested a response to the questions by January 23, 2019.

CMS Advocates for Hospital Price Transparency

On Thursday, CMS Administrator Seema Verma pushed hospitals to get ahead of potential price transparency regulations by going beyond the bare minimum to provide pricing to health care consumers. Administrator Verma told reporters that current regulations do not prevent hospitals from providing more price transparency and the department is considering including penalties for facilities that do not comply. As of this year, hospitals must post standard charges online in a machine-readable format and there are currently no penalties if a hospital fails to do so.

Many critics claim the pricing information is useless for many consumers because hospitals do not have to adjust the information to take a patient’s insurance, copayment or deductible into account. Administrator Verma acknowledges this issue and called the rule a “first step” in price transparency for patients, such as allowing tech companies to develop apps and other tools for patients using this information.

Health-Related Bills Introduced This Week

Rep. David Joyce (R-OH) introduced H.R. 383 to amend the Patient Protection and Affordable Care Act to ensure that preexisting condition exclusions with respect to enrollment in health insurance coverage and group health plans continue to be prohibited.

Rep. Julia Brownley (D-CA) introduced H.R. 373 to amend Title XVIII of the Social Security Act to provide for certain administrative or judicial review respecting the identification of primary care practitioners under part B of the Medicare program.

Sen. Doug Jones (D-AL) introduced S. 68 to require the Medicaid and CHIP Payment and Access Commission to publish an annual report on the estimated impact in each state of the Medicaid expansion added by the Patient Protection and Affordable Care Act, including the estimated impact that adopting such expansion would have in states that have not expanded their Medicaid coverage.

Rep. Earl Blumenauer (D-OR) introduced H.R. 420 to provide for the regulation of marijuana products.

Sen. Amy Klobuchar (D-MN) introduced S.62 to amend Title XVIII of the Social Security Act to allow the Secretary of Health and Human Services to negotiate fair prescription drug prices under part D of the Medicare program.

Next Week in Washington

Negotiations will continue to end the partial government shutdown. As the House and Senate continue to finalize their committee assignments for the 116th Congress, no health-related hearings have been scheduled yet for next week.

This Week in Washington in History

1867, 151 years ago this week: Congress expands suffrage in the nation’s capital after overriding President Andrew Johnson’s veto of a bill granting all adult male citizens of the District of Columbia the right to vote, and the bill becomes law. It was the first law in American history that granted African-American men the right to vote.

1962, 56 years ago this week: Leonardo da Vinci’s masterpiece, the Mona Lisa, is exhibited for the first time in America at the National Gallery of Art in Washington, D.C. President John F. Kennedy and his wife, along with over 2,000 other dignitaries, came to view the painting that evening. The French wouldn’t let the painting travel by plane so it sailed across the ocean aboard the SS France in a custom protective case designed to float.