DCMedical News: Thursday, March 1, 2018
DCMedical News
Washington, D.C.
Thursday, March 1, 2018
To our new readers: This is an independent newsletter, published every day that one or another House of Congress is in session. Past issues can be accessed by clicking on “View this email in your browser.” Subscription information is found at the bottom of these pages.
THE BIG STORY TODAY IN HEALTH CARE
More opioid action, multiple fronts (see Pharma, below).
MedPAC and MACPAC both in town. The Congressional advisory bodies for, respectively, Medicare and for Medicaid and CHIP, both meet on Thursday (today) and Friday. Can’t make it? DCMedical News is there for you. Agenda for MedPAC here, transcript of last meeting here. Agenda for MACPAC here, transcript of last meeting here.
Countdown: 22 days to the end of the current Continuing Resolution and the expected delivery of appropriations bills for the current (FY 2018) and coming (FY 2019) years.
DOCTORS AND OTHER HEALTH PROFESSIONALS
Apple a day: CNBC reported on “AC Wellness,” (an “independent medical practice dedicated to delivering compassionate effective health care to the Apple employee population”), launching in the spring of this year. Job advertisements on the AC Wellness website indicate that it is a “subsidiary of Apple.” The Financial Times (2-28, found here) tracked previous Apple initiatives in health, including: Apple watch launch 2014; HealthKit and ResearchKit software and data platforms, all for connection of users’ health information; work with Stanford to see if Apple watch sensors can detect cardiac abnormalities. Soon, iPhone owners will be able to download their electronic medical records from participating hospitals.
The American Association of Hip and Knee Surgeons on the messy transition for total knee arthroplasty (CMS has taken it off the “inpatient-only” list, not yet put it on the “ambulatory surgery” list): “The physiology of patients did not change, nor did the standard of care, from December 2017 to January 2018.”
HEALTH INSURANCE, MEDICARE, MEDICAID, COMMERCIAL
Market stabilization legislation moving forward, led by Senators Alexander and Collins, and by some House Energy & Commerce members, supported by the Chamber, Express Scripts and twelve other “bigs,” for (1) reinsurance funding to be used by the states to offset premium increases, for three years with a one year federal fallback for reinsurance; (2) two years of Cost-Sharing Reduction payment reimbursement; and (3) a §1332 waiver process to enable states to use these tools.
The financial attraction for insurers to offer short-term medical coverage: the Accident and Health Policy Experience Exhibit in the NAIC Financial Annual Statement (here) shows (at pg. 17) a loss ratio of 67.34% for short-term medical, or 43.99% for short-term medical with contract reserves, compared to the 85% urban / 80% rural loss ratio required under PPACA.
PHARMA
Medicaid and Opioids: is Medicaid expansion the problem or is it the solution? The Center for Budget and Policy Priorities (report here) reports that the uninsured rate for opioid-related hospitalization fell almost 80% between 2013 and 2015 in Medicaid expansion states, 5% in non-expansion states.
The House Energy and Commerce Subcommittee on Health held the first of three hearings on combatting the opioid crisis. Chairman Burgess, a physician, noted that these hearings were the product of an October meeting in which 50 Members of Congress shared personal stories on how the opioid epidemic had devastated their communities, and offered potential solutions. Testimony from Wednesday is grouped here, here and here, for the ten witnesses before the Subcommittee.
On the Senate side, “CARA 2.0” the Comprehensive Addiction and Recovery Act, would: impose a three-day limit on initial opioid prescription for acute pain; allow states to waive the number of patients a physician could treat with the antagonist Buprenorphine, currently capped at 100; require physicians and pharmacists to use drug monitoring programs; increase penalties for pharmaceutical manufacturers failing to report “suspicious” orders; allow PAs and NPs to prescribe Buprenorphine “under the guidance of a physician”; and authorize $1 billion: one-third of it for Naloxone for first responders and training, one-third of it for medication-assisted treatment (Secretary Azar’s cause), $200 million for treatment facilities, $100 million for treatment of pregnant women; $60 million for addicted babies. This compares to the $6 billion authorized in the budget bill in January for two years for opioid addiction treatment.
OTHER PUBLICATIONS & READINGS
“Medicare Extra for All,” a plan from the Center for American Progress, found here, nice (35 entries) bibliography.
NYT (here) and WSJ (here) both report on divergence in the states, haves and have-nots for health care, as PPACA is dismantled.
FT special report, the future of pharmaceutical therapy for rare diseases (2-28-2018), multiple articles, including analysis of the niche drug market, profile of former Genzyme chief Henri Termeer, a Brazilian clue to congenital Zika, a profile of the fate of Chinese patients with rare diseases, Genomics England’s progress, status of cystic fibrosis therapy, the fight against leprosy.
EVENTS & MEETINGS
Your March Calendar:
March 1
8:30 a.m. MedPAC, advisory body on Medicare, Ronald Reagan Building, Horizon Ballroom, 1300 Pennsylvania Ave, continuing March 2. Subjects on the 1st: Unified payment for post-acute care, hospital ED services, dual-eligibles, readmission reduction. On the 2nd: cost-effectiveness analyses, population-based quality measures.
9:30 a.m., MACPAC, advisory body on Medicaid and the Children’s Health Insurance Program, continuing March 2, at One Constitution Avenue, NE.
March 4
Federation of American Hospitals, annual policy conference, through March 6, agenda here,
HHS Secretary Azar Monday at 11:00 a.m.
March 6
8:30 a.m., Roll Call/CQ News, “Health Care Decoded,” with representatives of CVS, AdvaMed, Kaiser, the
Governors, et al, register at: http://go.cq.com/2018HealthCareDecoded_01.RegistrationPage.html.
9:00 a.m., Health Affairs on advancing health equity, at the National Press Club, 15 or more journal article authors, focus on the March 2018 Health Affairs issue.
9:30 a.m., Brookings, “What’s Ahead for the Individual Health Insurance Market?”--various think tankers.
Information at http://www.brookings.edu.
March 7
8:00 a.m., AHIP National Health Policy Conference, program on opioids featuring FDA Cmsr. Gottlieb, Deputy AG Rosenstein, register at https://www.ahip.org/policy-2018-registration-policies/.
March 13
2:00, CMS webinar (flyer here) on 30 day mortality measures in the Hospital Improvement Innovation Networks, Hospitals Collaboration to Improve Quality of Care.
March 16
11:00 a.m., AHRQ, National Advisory Council for Healthcare Research and Quality, by WebEx,
information at https://www.ahrq.gov/news/events/nac/.
March 26
PTAC, Physician-Focused Payment Model Technical Advisory Committee, continuing March 27, information at www.regonline.com/PTACMeetingsRegistration or livestream at www.hhs.gov/live.
FOR REFERENCE
Members of the Senate (here) and Members of Senate Committees (here), Senate Calendar (here).
Members of the House with their House Committees (here), House Calendar (here).
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
DCMedical News is published every day that either the House of Representatives or the Senate is in session.
March publication dates: 2, 5, 6, 7, 8, 9, 12, 13, 14, 15, 16, 19, 20, 21, 22, 23.
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com