DCMedical News: Tuesday, November 27, 2018
DCMedical News-DCMN
Washington, D.C.
Tuesday, November 27, 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
Gender and Equity Issues: The Hill reports on the “Five controversial health actions on Trump’s agenda.” The five include rolling back transgender protections, narrowing the definition of gender under federal civil rights law to either male or female, an HHS initiative which would nullify anti-discrimination provisions in the Patient Protection and Affordable Care Act. Second, proposed regulations to prevent Planned Parenthood and other abortion providers receiving family planning (Title X) money. Third, state Medicaid work requirements, having led to the removal of 12,000 Medicaid beneficiaries from the rolls in Arkansas, have now been re-approved for Kentucky, with only “technical changes” from the initial effort which was blocked by a federal district court. Fourth, indefinite detention of migrant families, also pending final regulations, to replace the “Flores” agreement, governing the detention of migrant children for the past two decades. The Flores agreement was the result of settlement of a federal class action suit; attempting to replace it with new regulations is novel. Finally, nursing home emergency preparedness rules would be loosened, notwithstanding their adoption last year, a decade after originally recommended by the HHS Office of Inspector General in the wake of Hurricanes Katrina and Rita.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Physician Misery Index Climbing: Geneia, a “healthcare analytic solutions and services company,” has published a survey report (here) indicating that the nationwide “Physician Misery Index” increased last year from 3.78 to 3.94, out of a possible (very miserable) rating of five. Among the findings in the Geneia report: Physicians generally are experiencing higher rates of cynicism, diminished empathy toward patients, and departure from clinical practice. “Physicians working in corporate or hospital-owned organizations feel the impacts of burnout more keenly than peers working independently or within physician-owned practices.”
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Moving Wisely: A study in JAMA Internal Medicine (here) contends that “Recognition of low mobility scores at admission or declining mobility status during hospitalization should prompt early engagement of physical therapists, case managers, and social workers to address issues of patient mobility and facility placement,” and also that “[R]ecognition of high mobility scores may allow physicians to choose wisely and decrease low-value physical therapy consults to reallocate this scarce resource to patients who may achieve greater benefit.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Big Change for Drugs Under Medicare Part D and Medicare Advantage Programs: CMS has proposed (Federal Register insert for November 30 here, “Fact Sheet” here) that the Part D and MA programs can limit drugs in the “protected” classes, under certain circumstances.
Association Health Plans (AHP), CQ Health Report: CQ Health reports that in Minnesota and Nebraska the member-owned cooperative Land O’ Lakes is launching AHP plans for farmers and ranchers. The AHP Final Rule, published in June (here), expanded access to the plans but prohibited them from charging higher premiums or denying enrollees based on preexisting conditions. However, AHPs are not required to cover the ten “Essential Health Benefits” delineated in the Patient Protection and Affordable Care Act, nor are they prohibited from charging higher premiums based on age or gender. Individual states are adopting regulations which may promote or limit the AHPs. In Nebraska, a half-dozen plans offered by the Farm Bureau Federation are approximately 25% less expensive than plans available on the exchanges. Age rating for older consumers is four times that of younger adults in the Land O’ Lakes plans, and five times the cost in plans offered by the Small Business Association of Michigan.
DRUGS AND DEVICES
510(k) Process May be Limited by FDA: Responding in part to a series of stories developed by the International Consortium of Investigative Journalists (at https://www.icij.org/investigations/implant-files) the FDA announced that it is seeking Congressional input to modify the device approval process known as “510(k)” which relies on prior approvals of similar technology to “clear” new devices for sale.
EVENTS & MEETINGS (Events Newly Added to This List Noted in Bold)
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.
12:00 to 1:30 p.m., Understanding the Role of Rebates in Prescription Drug Pricing, Alliance for Health Policy, (Stars: Gerard Anderson, Hopkins; Jack Hoadley, Georgetown), Dirksen Room G-50, 50 Constitution Ave NE, Washington. Open to public, lunch served at 11:30 a.m. www.allhealthpolicy.org.
1:00 to 2:00: CMS briefing on proposed rulemaking for Medicaid and CHIP managed care regulation Comments, due January 14, 2019, register here: https://meetings.cms.gov/orion/joinmeeting.do?MTID=a5c77db9a01b8e77f7d5d03ab672ef0e
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.
Dec. 18
First meeting, the HHS Deputy Secretary’s Innovation and Investment Summit. Program announced, here; participants selected, list here; FAQs 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: 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