This Week in Washington: CMS releases SNF minimum staffing standards final rule; Senate HELP Committee chairman requests information on Ozempic and Wegovy pricing; HHS OCR releases final rule concerning HIPAA reproductive healthcare privacy.

House

House Budget Committee Chairman Requests GAO Investigation of CMMI

On April 25, House Budget Committee Chairman Jodey Arrington (R-TX) and House Budget Committee Healthcare Task Force Chairman Michael Burgess (R-TX) sent a letter to Government Accountability Office (GAO) Comptroller General Gene L. Dodaro, requesting the GAO investigate whether Center for Medicare and Medicaid Innovation (CMMI) payment models will decrease net federal spending for Medicare.

The chairmen are concerned that the models will increase federal spending despite initial estimates that they would decrease spending. A September 2023 Congressional Budget Office report revealed that CMMI activities increased spending by $5.4 billion between 2011 and 2020 despite projections that they would save $2.8 billion.

For more information, click here.

House Members Urge HHS to Ensure Coverage of CDC-Recommended Vaccines Without Cost-Sharing

On April 19, Reps. Eshoo (D-CA), Bucshon (R-IN), Trone (D-MD) and Garamendi (D-CA) sent a letter to Department of Health and Human Services (HHS) Secretary Xavier Becerra, concerning commercial coverage of vaccines recommended by the Centers for Disease Control and Prevention (CDC).

The members state that final regulations issued by HHS and the Departments of Labor and Treasury that limit health insurance coverage of vaccines to those that are considered “routine,” defy congressional intent and the Public Health Services Act requirement that all CDC-recommended vaccines be covered without cost-sharing. The members are urging HHS to align the final regulations with the statutory requirement.

For more information, click here.

House Energy and Commerce Committee Oversight and Investigations Subcommittee to Hold Hearing on Change Healthcare Cyberattack

On May 1, the House Energy and Commerce Committee Oversight and Investigations Subcommittee will hold a hearing to examine the Change Healthcare cyberattack. The UnitedHealth Group Chief Executive Officer will testify.

For more information, click here.

Senate

Senate HELP Committee Chairman Requests Information on Ozempic and Wegovy Pricing

On April 24, Senate Health, Education, Labor and Pensions Committee Chairman Bernie Sanders (I-VT) sent a letter to Novo Nordisk Chief Executive Officer Lars Fruergaard Jørgensen, concerning the list and net prices of Ozempic and Wegovy.

The chairman is requesting information on the:

  • Costs and volumes of the drugs sold;
  • Prices paid by government payers;
  • Revenue Novo Nordisk has made from selling the drugs;
  • Manner in which prices are determined; and
  • Research and development expenditures linked to the drugs.

For more information, click here.

Sanders Long COVID Proposal Receives Mixed Comments

On April 9, Senate Health, Education, Labor and Pensions Committee Chairman Bernie Sanders (I-VT) released a draft proposal concerning Long COVID and requested stakeholder feedback. The proposal has received mixed comments from stakeholders who are divided over the proposal’s funding levels and on whether other chronic conditions should be addressed in the bill.

The Long COVID Moonshot Advocacy Group has requested that the proposal’s funding be used to study infection-associated chronic conditions and illnesses but the Long COVID Foundation has expressed concern that the funding is inadequate. The Long COVID Action Project and the Long COVID Foundation have requested that these conditions be addressed by separate legislation.

Senate Finance Committee to Hold Hearing on Change Healthcare Cyberattack

On May 1, the Senate Finance Committee will hold a hearing to examine the Change Healthcare cyberattack. The UnitedHealth Group Chief Executive Officer will testify.

For more information, click here.

Read more on healthcare policy in McGuireWoods Consulting’s Washington Healthcare Update.