DCMedical News: Friday, Sept. 14, 2018
DCMedical News
Washington, D.C.
Friday, Sept. 14, 2018
DCMedical News is published every day either the House or the Senate is in regularly scheduled session.
THE BIG STORY TODAY IN HEALTH CARE:
Hurricane Florence Hurries Appropriations: The FY2019 spending package for the departments of Education and Health and Human Services (together with Defense and Labor) totals more than $850 billion. Approval of the appropriations by House and Senate conferees means that final action will likely be completed prior to the expiration of FY2018, on September 30th. CQ noted that “If Congress can adopt the conference report before federal funding runs out on Sept. 30, it would be the first time since fiscal 2009 that the Pentagon was funded on time. For the Labor-HHS-Education bill, it's been 22 years since lawmakers beat the new fiscal year deadline.”
Already completed and waiting for the President’s signature are appropriations bills for military construction, veterans’ affairs, the legislative branch and energy. Other appropriations, not so far along, will have a “stopgap” funding measure through December 7, avoiding a “shutdown” of those departments. To maximize the prospect for Labor-HHS passage, conferees left out these provisions: attempts to block funding for Planned Parenthood and to introduce new “conscience” protections, and a Senate-passed initiative to compel pharmaceutical companies to show prices in their advertising.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS:
PTAC Proposals Move Forward: The Physician-Focused Payment Model Technical Advisory Committee (PTAC) recommended three new alternative payment models in its meeting 9/6-7 (MedPage Today report here). Included were the American College of Emergency Physicians “Acute Unscheduled Care Model,” (here); the “Innovative Model for Primary Care Office Payment,” (here); and the “Comprehensive Care Physician Payment” model from the University of Chicago (here), the latter two to receive limited-scale testing. But Committee members have expressed frustration (here) with the lack of response by HHS and CMMI to its recommendations.
Who You Calling ‘Elderly’?: A study in JAMA Oncology (here) recommends against screening and aggressive treatment of men over 70 years of age for prostate cancer. “Prostate cancer is the most commonly diagnosed solid tumor in men, and the majority of cases are detected through screening. Given the long natural history of this disease, many patients die with, rather than from prostate cancer. Whether routine prostate cancer screening in the general population is beneficial is a subject of debate; however, there is wide consensus that screening should not occur among elderly men and those with limited life expectancy because screening does not provide a significant survival benefit within 10 years.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Do Conflict-of-Interest and Kickback Prohibitions Inhibit “Value-Based” and “Innovative” Medical Care? The House Energy & Commerce Subcommittee on Health Thursday began its examination of “Barriers to expanding innovative value-based care in Medicare.” The barriers appear to be the anti-kickback statute and the Stark fraud and abuse limitations on self-dealing and conflict of interest. A Committee staff-authored background paper is here.
Testimony came from Nishant Anand, MD, population health/transformation/ACO-CMO for the Adventist Health System (here); Mary Grealy, President of the Health Care Leadership Council (here); Timothy C. Peck, MD, Co-Founder and CEO, Call9 (here); Morgan Reed, executive director of the Connected Health Initiative (here); Michael Robertson, MD, CMO of Covenant Health Partners, on behalf of the National Association of ACOs (here); and Michael Weinstein, MD, president of Digestive Health Physicians Association (here). The group testified that prohibitions on self-dealing were obstacles to innovation, but not all Subcommittee members agreed.
PHARMA
At Morgan Stanley’s Global Healthcare Conference: Larry Merlo, CEO, CVS Health Corporation (transcript here), “[W]e see the front-of-our store evolving from not just selling thousands of products but certainly they'll be a product component but they'll also be a service component. And the products will have a focus on health, beauty, personal care, and elements of convenience and the service component will be an element that's hard to replicate online. And we've got some pilots and experiments in market that we’re learning from and you’ll hear more about that in the coming months.”
At the Financial Times Pharma Pricing and Value Summit: HHS Secretary Azar, promoting generics, biosimilars, step therapy, Part D plan negotiation flexibility, remarks here.
READING
Nicholas Bagley on formulary limitations facing the states under §1115 waivers, NEJM, here.
Michael Porter and Thomas Lee on “What 21st Century Health Care Should Learn from 20th Century Business,” NEJM Catalyst, here.
Medicare Program; “Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program,” Federal Register July 27, 2018, here, comment period on proposed rule closed 9-10.
EVENTS & MEETINGS
Sept. 14
[Postponed due to hurricane Florence] 9:15 a.m. House Energy and Commerce Committee’s Health Subcommittee holds a hearing (in 2322 Rayburn HOB) on “Better Data and Better Outcomes: Reducing Maternal Mortality in the U.S.,” with focus on H.R. 1318 which would create grants to improve reporting of maternal health outcomes.
Sept. 18
Noon, Families USA, “What’s at Stake for Medicaid in 2018 Elections,” conference call with focus on Nebraska, Utah, Idaho, information at press@families.usa.org
Sept. 26
9:00 a.m. to 4:00 p.m., continuing September 27, meeting of the National Advisory Council on Nurse Education and Practice. Details here.
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
September publication dates: 17, 18, 20, 21, 24, 25, 26, 27, 28.
October publications dates: 1, 2, 3, 4, 5, 9, 10, 11, 12, 15, 16, 17, 18, 19, 22, 23, 24, 25, 26
November publication dates: 13, 14, 15, 16, 26, 27, 28, 29, 30
December publication dates: 3, 4, 5, 6, 7, 10, 11, 12, 13, 14
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com