DCMedical News: Wednesday, November 14, 2018
DCMedical News-DCMN
Washington, D.C.
Wednesday, November 14, 2018
DCMedical News is published every day either the House or the Senate is in session. See scheduled sessions at the bottom of this newsletter. Subscribe to ensure continued receipt of your copy.
THE BIG STORY TODAY IN HEALTH CARE:
Medicaid: In his address to the National Association of Medicaid Directors, HHS Secretary Alex Azar noted a new option for short-term residential treatment for serious mental illness. States can now seek to use Medicaid funds for Institutions of Mental Disease (IMD), together with community-based mental health services. CMS simultaneously issued an announcement (here) enabling states to receive authority to pay for short-term residential treatment in the IMD setting. Medicaid is the largest payer for behavioral health services in the U.S. More than one-quarter of adults with serious mental illness rely on Medicaid.
Federal Spending Package: Congress faces a December 7 deadline for renewal of federal spending authority, including controversy over a southern wall. Among health-related proposals being advanced for the “must pass” federal spending bill are deferring or eliminating taxes associated with the Patient Protection and Affordable Care Act (PPACA), such as the medical device tax, health plan premium taxes and the “Cadillac” tax on higher cost health plans; pushing the donut hole [gap in drug coverage under Medicare] back into a shape where more of the burden of pharmaceutical expense is borne by health plans; reauthorization of HIV/AIDs legislation; and reauthorization of Medicaid’s “Money Follows the Person” program.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Uh-Oh: Treating mild hypertension? In JAMA Internal Medicine this week (here) a study found “No evidence to support guideline recommendations that encourage initiation of treatment in patients with low-risk mild [140/90 to 150/99 mm Hg] hypertension. There was evidence of an increased risk of adverse events, which suggests that physicians should exercise caution when following guidelines that generalize findings from trials conducted in high-risk individuals to those at lower risk.”
340B Eligibility: AMA delegates voted this week to seek 340B eligibility for stand-alone (independent) physician offices. The program currently provides discounted drugs to hospitals which may obtain that benefit for physician practices those hospitals acquire.
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Volume Standards: Minimum volume standards in various countries set for quality, safety or reimbursement purposes are studied in Health Policy, here. The conclusion? “The sets of procedures for which minimum volume standards and corresponding thresholds have been introduced vary across countries, possibly due to different regulatory approaches. In addition, key attributes of the health care system might affect the development and implementation of minimum volume standards. Therefore, it is not feasible to formulate uniform recommendations that are applicable to all countries.”
DRUGS & DEVICES
Drug Spending: Economist and blogger (“The Incidental Economist”) Austin Frakt answers the question “Why Are Drug Costs So High?” He notes that the problem “Traces to the 1990s” (in The New York Times, here) a new study in Health Affairs (here). U.S. spending was roughly the same as OECD countries in the 1980s. Americans don’t use more drugs; in fact, Americans use drugs for fewer days per year than patients in other developed countries. Nor do Americans use more brand-names, as opposed to generics - - 84% of prescriptions in the U.S. are generic. But the prices in the U.S. are much higher for brand-name drugs, primarily because we lack cost-effectiveness or cost-benefit analysis in payment for drugs in the U.S. Stanford legal scholar Michelle Mello notes that “Though we pay high prices for some drugs of high value, we also pay high prices for drug of little value. The U.S. stands virtually alone in this.” In the 1990s “Regulation on drug ads on TV were relaxed, which led to more advertising.” In fact, direct-to-consumer TV advertising was overlooked (here) by a distracted White House in 1997.
READINGS AND REFERENCES
ASPE: The Office of the Assistant Secretary (of HHS) for Planning and Evaluation has published (here) analyses of the impact of PPACA.
EVENTS & MEETINGS
Nov. 14
National Association of Medicaid Directors. Meeting began November 12, continues through November 14, Washington Hilton, Agenda (10 pgs.), here.
8:00 a.m., Roll Call sponsors a discussion on "Election Impact: Improving Patient Care Under a New Congress." Contact: Jonathan Thompson at 202-292-6353 jothompson@newseum.org
9:00 a.m. to Noon, Wall Street Comes to Washington, Health Care Roundtable, investment professionals (Matthew Borsch, BMO Capital Markets; Ana Gupte, Leerink Partners; Paul Heldman, Heldman Simpson Partners) on a panel moderated by Paul Ginsburg, information at www.jktgfoundation.org.
Nov. 15
8:30 a.m., AHRQ Meeting of National Advisory Council for Healthcare Research and Quality, 5600 Fishers
Lane, Rockville, MD, contact: Karen.Migdail@ahrq.hhs.gov
Noon: Rural Health Information Hub and National Organization of State Offices of Rural Health, Access to Healthcare in Rural Communities,” accessed through #RuralHealthChat.
Noon: CMS Webinar on Year 3 Quality Payment Program Final Rule Overview, information and registration here.
Nov. 16
9:30 a.m. to 11:45 a.m., The Century Foundation, Health Affairs, the Commonwealth Fund, present a star panel (e.g. Wagner Dean Sherry Glied on Medicare-Like Plans for the 2020 Health Reform Debate) on “Health Reform: From the Midterms to 2020,” National Press Club, announcement here.
Nov. 27
9:00 a.m., The American Enterprise Institute for Public Policy Research (AEI) holds a discussion on "The new Medicare physician payment regulation: What does it mean for physicians and patients?" Seema Verma, Robert Berenson, AHIP, AMA. Contact: 202-862-5829 mediaservices@aei.org
9:00 a.m., Duke Margolis Center on “Root Causes of Drug Shortages and Finding Enduring Solutions,” Washington Marriott Metro Center, (McClellan, Gottlieb, FDA panel), agenda here.
Nov. 28
10:00 a.m., Senate HELP Committee Hearing: Reducing Health Care Costs: “Improving Affordability Through Innovation,” 430 Dirksen Senate Office Building, announcement here.
Nov. 29
The “Office of the National Coordinator” annual meeting, continuing November 30, two day tentative agenda (Jared Kushner!) here.
8:00 a.m. to 11:00 a.m., STAT Plus correspondents in a discussion of drug pricing, at Hogan Lovells
in Washington, information at https://www.statnews.com/conversation-drug-pricing-2019/?utm_source=STAT+Newsletters&utm_campaign=bb45b691af-STATPlus_1113_event_subs_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-bb45b691af-149691333
Dec. 4
9:00 a.m., CMS sponsors a “Town Hall” meeting “To discuss fiscal year (FY) 2020 applications for add-on payments for new medical services and technologies under the hospital inpatient prospective payment system (IPPS).” Registration required by 11-19-2018, Federal Register notice 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
November publication dates: 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