This Week in Washington: House appropriators release FY2025 topline appropriations levels; Senate Finance Committee releases white paper on Medicare physician payment reforms; House Energy and Commerce Committee Subcommittee on Health marks up 21 bills.

House

House Appropriators Release FY2025 Topline Funding Amounts

On May 16, House appropriators released topline funding amounts for the fiscal year (FY) 2025 appropriations bills. The proposed funding levels total roughly $1.6 trillion and would increase defense spending by 1 percent and decrease non-defense spending by 6 percent. The funding levels are lower than the spending caps agreed to in the debt limit deal from last year.

House appropriators are proposing to allocate:

  • $25.9 billion to the Food and Drug Administration and related agencies; and
  • $184. 6 billion to the Department of Health and Human Services and related agencies.

In addition, House appropriators released the markup schedule of bills and announced they are aiming to approve them by mid-July.

For more information, click here.

House Energy and Commerce Committee Subcommittee on Health Marks Up 21 Bills

On May 16, the House Energy and Commerce Committee Subcommittee on Health marked up and reported out of committee 21 bills that extend Medicare telehealth flexibilities, facilitate rare pediatric disease innovation, improve the Medicaid enrollment process for out-of-state providers and strengthen Medicaid fraud prevention.

The bills are:

H.R. 3433, Give Kids a Chance Act: Amends the Federal Food, Drug and Cosmetic Act with respect to molecularly targeted pediatric cancer investigations.

H.R. 7188, Shandra Eisenga Human Cell and Tissue Product Safety Act: Requires the Department of Health and Human Services Secretary (HHS Secretary) to conduct a national, evidence-based education campaign to increase public and healthcare provider awareness regarding the potential risks and benefits of human cell and tissue products transplants.

H.R. 6033, Supporting Patient Education and Knowledge (SPEAK) Act of 2023: Requires the HHS Secretary to establish a task force to improve access to healthcare information technology for non-English speakers.

H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024: Establishes a Medicare incident to modifier for mental health services furnished through telehealth.

H.R. 7623, Telehealth Modernization Act of 2024: Makes certain telehealth flexibilities under the Medicare program permanent.

H.R. 1406, Sustainable Cardiopulmonary Rehabilitation Services in the Home Act: Permanently extends certain in-home cardiopulmonary rehabilitation flexibilities established in response to COVID-19.

H.R. 7856, PREVENT DIABETES Act: Provides for coverage of the Medicare Diabetes Prevention program.

H.R. 5394, Expanding Remote Monitoring Access Act: Ensures appropriate access to remote monitoring services furnished under the Medicare program.

H.R. 1199, Facilitating Innovative Nuclear Diagnostic Act of 2023: Ensures equitable payment and preserves Medicare beneficiary access to diagnostic radiopharmaceuticals under the Medicare hospital outpatient prospective payment system.

H.R. 6020, Honor Our Living Donors Act: Eliminates consideration of the income of organ recipients in providing reimbursement of expenses to donating individuals.

H.R. 455, To amend the Controlled Substances Act to fix a technical error in the definitions: Amends the Controlled Substances Act to fix a technical error in the definitions.

H.R. 7213, Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2024: Enhances activities of the National Institutes of Health with respect to research on autism spectrum disorder and reauthorizes programs relating to autism.

H.R. 670, Think Differently Database Act: Directs the HHS Secretary to establish a clearinghouse on intellectual disabilities.

H.R. 8084, LIVE Beneficiaries Act: Requires States to verify certain eligibility criteria for individuals enrolled for medical assistance quarterly.

H.R. 8089, Medicare and Medicaid Fraud Prevention Act of 2024: Requires certain additional provider screening under the Medicaid program.

H.R. 8111, To amend title XIX of the Social Security Act to ensure the reliability of address information provided under the Medicaid program: Ensures the reliability of address information provided under the Medicaid program.

H.R. 8112, To amend title XIX of the Social Security Act to further require certain additional provider screening under the Medicaid program: Requires certain additional provider screening under the Medicaid program.

H.R. 4758, Accelerating Kids’ Access to Care Act: Streamlines enrollment under the Medicaid program of certain providers across State lines.

H.R. 3227, Ensuring Seniors’ Access to Quality Care Act: Amends titles XVIII and XIX of the Social Security Act with respect to nursing facility requirements.

H.R. 468, Building America’s Health Care Workforce Act: Extends the COVID-19 Emergency Declaration Blanket Waiver relating to training and certification of nurse aides.

H.R. 4534, Women and Lung Cancer Research and Preventive Services Act: Requires the HHS Secretary and Secretaries of Defense and Veterans Affairs, to conduct an interagency review to evaluate the status of and identify opportunities related to research on women and lung cancer.

For more information, click here.

House Committee on Oversight and Accountability Marks Up BIOSECURE Act

On May 15, the House Committee on Oversight and Accountability marked up and reported out of committee nine bills, including H.R. 8333, the BIOSECURE Act. The legislation would prohibit federal agencies from contracting with or procuring equipment or supplies from certain foreign-owned biotechnology providers after 2032.

In March, the Senate Homeland Security and Governmental Affairs Committee reported out of committee a version of the bill with a shorter timeline.

For more information, click here.

Senate

Senate Finance Committee Chairman and Ranking Member Release White Paper on Medicare Doctor Payment Reform

On May 17, Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) released a white paper on Medicare Doctor Payment Reform. The white paper outlines potential policy reforms to streamline clinician payment systems that include:

  • Creating sustainable payment updates to ensure clinicians can own and operate their practices;
  • Incentivizing alternative payment models that reward providing better care at a lower cost;
  • Rethinking how Medicare measures quality care;
  • Improving primary care;
  • Supporting chronic care benefits in Medicare fee-for-service; and
  • Ensuring continued access to telehealth.

For more information, click here.

Senate HELP Committee Majority Staff Release Report Concerning Weight Loss Drug Spending

On May 15, the Senate Health, Education, Labor and Pensions Committee majority staff released a report concerning the impact weight loss drugs could have on prescription drug spending. The majority staff used data on drug net pricing and uptake percentage to assess potential impacts.

The majority staff found that if 50 percent of adults with obesity took weight loss drugs, total spending could equal $411 billion per year and cost the Medicare and Medicaid programs $166 billion per year. The majority staff also found that lower weight loss drug prices could significantly reduce total spending.

For more information, click here.

Senate HELP Committee Schedules Markup of Seven Healthcare Bills

On May 23, the Senate Health, Education, Labor and Pensions Committee will mark up seven healthcare bills that will reauthorize programs relating to Alzheimer’s disease, child emergency medical services, poison control programs and lifespan respite care. The bills are:

S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act: Reauthorizes the Dr. Lorna Breen Health Care Provider Act through fiscal year 2029 to promote the use of mental health and substance use disorder services by healthcare providers.

S. 3765, Emergency Medical Services for Children Reauthorization Act of 2024: Reauthorizes the Emergency Medical Services for Children program through fiscal year 2029.

S. 4351, A bill to amend the Public Health Service Act to reauthorize certain poison control programs: Reauthorizes certain poison control programs through fiscal year 2029.

S. 3775, BOLD Infrastructure for Alzheimer’s Reauthorization Act of 2024: Reauthorizes the Building Our Largest Dementia Infrastructure for Alzheimer’s Act through fiscal year 2029.

S. 4325, A bill to amend the Public Health Service Act to reauthorize the program relating to lifespan respite care, and for other purposes: Reauthorizes the Lifespan Respite Care program through fiscal year 2029.

S. 3757, Congenital Heart Futures Reauthorization Act of 2024: Reauthorizes the Centers for Disease Control and Prevention’s Congenital Heart Disease, Research, Surveillance and Awareness Program through fiscal year 2029.

S. 4045, East Palestine Health Impact Monitoring Act of 2024: Requires the Secretary of Health and Human Services to award a grant, contract or cooperative agreement to an eligible entity to study the public health impacts resulting from the February 2023 train derailment in East Palestine, OH.

For more information, click here.

Senate AI Working Group Releases Roadmap for AI Policy

On May 15, the Senate Bipartisan Artificial Intelligence (AI) Working Group released the Roadmap for Artificial Intelligence Policy. The roadmap outlines considerations for committees of jurisdiction that are developing legislation concerning AI.

The roadmap encourages committees to:

  • Ensure appropriate guardrails and safety measures are implemented to protect patients from fraud and abuse;
  • Support the National Institutes of Health in developing and improving AI technologies;
  • Make healthcare and biomedical data available for machine learning and data science research;
  • Ensure that the Department of Health and Human Services and other healthcare agencies have the tools to weigh the benefits and risks of AI-enabled products; and
  • Promote innovation of AI systems and examine Centers for Medicare and Medicaid Services’ reimbursement mechanisms to strengthen accountability, appropriate use and broad application of AI in all populations.

For more information, click here.

Senate Judiciary Committee Announces Hearing on Prescription Drug Access and Affordability

On May 21, the Senate Judiciary Committee will hold a hearing on prescription drug market competition, accessibility and affordability. Witnesses are:

  • William Feldman, MD, DPhil, MPH, Associate Physician at the Brigham and Women’s Hospital Division of Pulmonary and Critical Care Medicine
  • David Mitchell, President and Founder of Patients for Affordable Drugs
  • Adam Mossoff, Professor of Law at the George Mason University Antonin Scalia Law School
  • Arti Rai, Elvin R. Latty Duke Law Distinguished Professor of Law
  • Jocelyn Ulrich, Vice President of Policy and Research at PhRMA

For more information, click here.

Senate HELP Committee Holds Hearing on Dental Care

On May 16, the Senate Health, Education, Labor and Pensions Committee held a hearing on dental care. Committee members discussed factors that could be exacerbating dental care issues, including the lack of affordable dental insurance, oral health workforce pipelines and incentives for providers to offer rural dental care services. Witnesses were:

  • Lisa Simon, Associate Physician of Brigham and Women’s Hospital and Member of the Harvard Medical School Faculty
  • Myechia Minter-Jordan, MD, MBA, President and CEO of CareQuest Institute for Oral Health
  • Brian Jeffrey Swann, DMD, MPH, Co-Chair of the National Dental Association Global Oral Health Outreach and Member of the Remote Area Medical Board of Directors
  • Gordon Roswell Isbell, III, DMD, MAGD, Past Trustee of the Academy of General Dentistry

For more information, click here.

Senate Finance Committee Holds Hearing on Rural Healthcare

On May 16, the Senate Finance Committee held a hearing to discuss rural healthcare challenges. During the hearing, Chairman Ron Wyden (D-OR) stated that the committee could begin working on permanently extending telehealth flexibilities. Witnesses were:

  • Michael Topchik, Executive Director of the Chartis Center for Rural Health
  • Jeremy P. Davis, MHA, President and Chief Executive Officer of Grande Ronde Hospital
  • Lori Rodefeld, MS, Director of GME Development at the Wisconsin Collaborative for Rural Graduate Medical Education
  • Keith J. Mueller, Ph.D., Gerhard Hartman Professor of Health Management and Policy and Director of the Rural Policy Research Institute

For more information, click here.

Pay PCPs Act Introduced

On May 15, Senate Health, Education, Labor and Pensions Committee Ranking Member Bill Cassidy (R-LA) and Sen. Whitehouse (D-RI) introduced the Pay PCPs Act. This legislation would:

  • Establish a hybrid Medicare payment system that would reward primary care providers based on patient health outcomes;
  • Reduce cost-sharing for patients who participate in certain primary care activities and services; and
  • Create a new technical advisory committee to help the Centers for Medicare and Medicaid Services (CMS) determine Medicare fee schedule rates.

In addition, the senators have issued a request for information on what the structure and makeup of the advisory committee should be and how CMS can strengthen its role in setting fee-for-service payment rates.

For more information, click here.

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