Healthcare Law & Legislative Update July 31 2020

This Week’s Dose

Senate Republicans launched draft textual content of a coronavirus (COVID-19) aid and stimulus bundle, and the White Home took motion geared toward decreasing drug costs. 

Congress

Senate Republicans Launched Proposal for Subsequent COVID-19 Reduction Invoice. The almost $1 trillion Well being; Financial Help; Legal responsibility Safety; and Faculties (HEALS) Act would supply further funding to spice up state COVID-19 testing and prevention efforts, add $25 billion to the Supplier Reduction Fund, regulate the compensation phrases for the Accelerated and Superior Fee Program, and develop small enterprise loans. The proposal, which was launched as a number of payments from varied committees (S.4320, S.4318, S.4321, and S.4322include well being provisions), would additionally create COVID-19 legal responsibility protections for healthcare entities, besides in sure circumstances of gross negligence or willful misconduct. Notably, a couple of healthcare-related provisions weren’t included. For instance, there is no such thing as a further Medicaid funding, comparable to a rise within the Federal Medical Help Proportion, which was included within the Home-passed Well being and Financial Restoration Omnibus Emergency Options (HEROES) Act. The HEALS Act will not be supported by Democrats and has kicked off negotiations between Republicans, Democrats and the White Home as they race to approve a ultimate invoice.

Administration

White Home Issued Govt Orders on Drug Pricing. Late final Friday, President Trump unveiled three govt orders geared toward lowering the price of pharmaceuticals. These orders embody insurance policies that permit drug importation, require federally certified well being facilities to cross on drug reductions for insulin to diabetes sufferers, and get rid of rebates for well being plan sponsors and pharmacy profit managers if it may be achieved in a manner that does improve federal spending. It’s troublesome to see how the Administration may obtain this given the Workplace of the Actuary’s findings that the coverage would considerably improve federal spending. The White Home additionally introduced, however has but to publish, an govt order tying the value of pharmaceuticals to worldwide benchmarks. The Administration indicated this coverage would go into impact on August 25, 2020, until pharmaceutical producers may strike a take care of the White Home. A gathering between business leaders and the Administration initially scheduled for Tuesday of this week was cancelled. As has been the case with quite a few Trump Administration actions, it’s possible that stakeholders will problem efforts to implement these orders. Count on the Administration to make use of these actions as messaging instruments forward of the presidential election. 

HHS Launched Report on Telehealth Utilization. The challenge transient from the Division of Well being and Human Providers (HHS) examined current telehealth utilization developments in fee-for-service (FFS) Medicare. The report analyzes claims information from major care suppliers and specialists from January 2020, by means of early June. It discovered that Medicare FFS in-person visits for major care fell drastically in mid-March and that in April, almost half (43.5%) of Medicare major care visits had been telehealth visits. As well as, greater than 10.1 million Medicare beneficiaries obtained a telehealth service between mid-March and early-July, and one-third of telehealth visits relied on the normal phone. The problem transient doesn’t communicate to which insurance policies to make everlasting or lengthen past the top of the COVID-19 public well being emergency, however does be aware a number of areas the place extra analysis can be useful to additional assess the affect and developments associated to elevated utilization of telehealth. This report could also be utilized by lawmakers as they push for extra everlasting easing of restrictions round telehealth, an effort that has broad bipartisan help. The Facilities for Medicare and Medicaid Providers (CMS) will use the report because the company continues to judge which insurance policies to keep up past the general public well being emergency by means of regulatory motion. Quite a few payments have been launched in current weeks to handle the longevity of telehealth flexibilities, and we anticipate further adjustments within the forthcoming Doctor Payment Schedule proposed rule.

HHS Launched Report on Shock Billing. The HHS Workplace of the Assistant Secretary for Planning and Analysis launched a Report on Addressing Shock Billing, which gives an summary of the problem and its prevalence, key drivers, federal and state oversight, and up to date congressional proposals to handle the issue. It notes that shock billing most frequently includes a facility’s “ancillary” suppliers, comparable to emergency drugs personnel and specialists, and that out of community billing will increase when non-public staffing companies enter the market. The report encourages Congress to enact laws to guard sufferers from shock medical payments however doesn’t specify the strategy Congress ought to take. In response, Senators Michael Bennet (D-CO), Invoice Cassidy (R-LA) and Maggie Hassan (D-NH) launched a assertion saying they’re dedicated to together with a shock billing repair within the subsequent COVID-19 bundle. There was vital controversy over the assorted approaches proposed to settle cost disputes between insurers and suppliers (e.g., supplier funds based mostly on Medicare charges, common community charges, or by means of arbitration), and motion has to this point stalled in Congress regardless of broad bipartisan help for shielding sufferers from shock payments.  

Courts

Federal Decide Quickly Blocked Public Cost Rule. A federal district court docket agreed to quickly halt a Trump Administration coverage, permitting immigration authorities to disclaim visas or inexperienced playing cards based mostly on an individual’s use of Medicaid or different public advantages, during the COVID-19 public well being emergency. The general public cost rule has been hotly contested even earlier than the pandemic started. A number of federal district courts issued nationwide injunctions in opposition to the rule in 2019 earlier than the US Supreme Courtroom dominated in January 2020 to let the coverage take impact whereas litigation continued. Within the ruling this week, the decide agreed with the argument of immigrant rights teams that the coverage deters immigrants from in search of healthcare, regardless of clarification from US Citizenship and Immigration Providers that immigrants who obtain testing or therapy for COVID-19 won’t be penalized. In his opinion, US District Decide George Daniels notes the disproportionate impact of COVID-19 on minority communities and that “any coverage that deters residents from in search of testing and therapy for COVID-19 will increase the chance of an infection for such residents and the general public.” The Administration is anticipated to attraction the choice. 

Fast Hits

The Senate Finance Committee held a two-part listening to on the reliability of the US medical provide chain. The Home Choose Subcommittee on the Coronavirus Disaster held a listening to on the necessity for a nationwide plan to include the pandemic, and the Home Vitality and Commerce Committee held a legislative listening to on payments to reauthorize varied public well being applications.

Senate Well being, Schooling, Labor and Pensions Committee Chairman Lamar Alexander (R-TN) launched the Telehealth Modernization Act to make everlasting a number of of the telehealth companies Congress prolonged throughout the pandemic, together with in-home visits and rural telehealth entry.

A gaggle of greater than 50 congressional Democrats despatched a letter urging HHS to allocate a portion of the Supplier Reduction Fund to neighborhood well being facilities.

Representatives Jim Clyburn (D-SC), Mark Inexperienced (R-TN) and Invoice Foster (D-IL) referred to as on the Authorities Accountability Workplace to audit Operation Warp Pace, the Administration’s COVID-19 improvement effort.

CMS launched up to date information on the affect of COVID-19 on totally different demographic teams. The brand new information affirm that Black Medicare beneficiaries have the best price of hospitalization for COVID-19, adopted by American Indian/Alaskan Native beneficiaries.

HHS introduced a brand new initiative, the Nationwide COVID-19 Implementation Discussion board, to supply a possibility for public/non-public partnerships to speed up innovation in COVID-19 testing and to judge present testing provide chain points.

Hospital teams will search a rehearing earlier than a federal appeals court docket in a case difficult CMS’ resolution to chop reimbursement charges for sure off-campus provider-based hospital departments. The appeals court docket sided with the Administration final week, however the hospitals argue the court docket didn’t correctly apply the statutory restrictions that bind the company.