Washington Watch for February 2022

Carter L. Alleman, J.D.

HHS Announces Additional Distribution of Phase 4 Provider Relief Funds
On January 25, the U.S. Department of Health and Human Services (HHS) announced the distribution of an additional $2 billion from the Provider Relief Fund (PRF) Phase 4 General Distribution. This is in addition to the $9 billion distribution announced in December 2021, but it does not complete the full distribution of $17 billion initially allocated to Phase 4. According to HHS, Phase 4 payments have an increased focus on equity, including reimbursing a higher percentage of losses for smaller providers and incorporating “bonus” payments for providers who serve Medicaid, Children’s Health Insurance Program (CHIP), and Medicare beneficiaries. Approximately 82% of all Phase 4 applications have now been processed. For additional information, visit www.hrsa.gov/provider-relief.

Supreme Court Justice Breyer to Retire
Supreme Court Justice Stephen Breyer has announced plans to retire at the end of the Supreme Court’s current term, which is expected to end in late June or early July. At age 83, Breyer is the court’s oldest justice. He is known as a pragmatist who typically sides with the liberal wing of the court in divisive cases. It has been his position that “it is wrong to think of the court as another political institution.” Breyer has served in the Supreme Court since 1994 when he was nominated by President Bill Clinton. President Joe Biden has nominated Ketanji Brown Jackson to the Supreme Court.

HELP Leadership Release Pandemic Preparedness Discussion Draft
Bipartisan leadership of the Senate Health, Education, Labor, and Pensions (HELP) Committee have released a discussion draft of their major pandemic preparedness legislation to overhaul the nation’s public health programs. The bill from Chair Patty Murray (D-Wash.) and Ranking Member Richard Burr (R-N.C.) would change how the U.S. monitors disease outbreaks, stockpiles supplies, and responds to public health threats. The legislation, the PREVENT Pandemics Act, has been in the works since last year

Lawmakers Request Investigation Into Nurse Staffing Industry
A group of nearly 200 members of the House of Representatives is urging the administration to investigate the nurse- staffing industry amidst reports that some companies are using the Omicron surge to charge rates that are two or three times more than the rates charged before the pandemic. The letter, which was led by Representatives Peter Welch (D-Vt.) and Morgan Griffith (R Va.), was sent to White House COVID-19 response coordinator Jeff Zients. It asks him to “enlist one or more of the federal agencies with competition and consumer protection authority to investigate this conduct to determine if it is the product of anticompetitive activity and/or violates consumer protection laws.”

CMS Under Pressure to Lower Medicare Premiums
House Energy and Commerce Health Subcommittee Chair Anna Eshoo (D-Calif.) has sent a letter to the Centers for Medicare and Medicaid Services (CMS) asking the agency to reduce Medicare Part B monthly premiums for beneficiaries this year. CMS has planned a 14.5% increase in premiums – the largest annual increase in the program’s history – which is in part attributed to the price of the new Alzheimer’s treatment Aduhelm.

More Lawmakers Request Medicare Coverage of At-Home COVID Tests
A group of 18 senators led by Sen. Debbie Stabenow (D-Mich.) has sent a letter to the administration asking the Centers for Medicare and Medicaid Services (CMS) to broadly cover at-home coronavirus tests for Medicare beneficiaries. The lawmakers argue that Medicare enrollees – older adults and individuals with disabilities – are at the highest risk of severe illness and death from COVID-19.

HHS Provides Details on COVID Spending
In response to a request from Senators Roy Blunt (R-Mo.) and Richard Burr (R-N.C.), the U.S. Department of Health and Human Services (HHS) has detailed the $18 billion in unobligated funds for coronavirus testing, mitigation, and contact tracing. Only $4.6 billion have not been allocated for a specific purpose; the remaining $16.6 billion were appropriated in the American Rescue Plan Act. Unused funds will likely be taken into consideration during congressional negotiations on the need for additional coronavirus relief.

GOP Healthy Future Task Forces Request Comments on Health Care Affordability and Patient Access
The Republican Healthy Future Task Force Subcommittee on Affordability has issued a request for information (RFI) to health care stakeholders on legislation that could increase hospital price transparency, lower barriers to competition, and empower consumers to have more choice in their health care providers. The RFI is also interested in information on 340B program eligibility and how Congress can transfer more power back to state governments to manage health insurance coverage for its residents.

Build Back Better to Be Scaled Back, Broken Down
President Joe Biden conceded last week that his $2 trillion economic agenda will need to be significantly scaled back and broken down to win enough support for passage amidst continued opposition from Senators Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.). The President specifically highlighted those provisions in the Build Back Better reconciliation package to lower prescription drug prices and expand support for childcare and the elderly would make the economy more productive and lower costs for Americans. The Senate and the House of Representatives are scheduled to be in recess until January 31.

President Pushes for Rules Change, Voting Rights Bill Fails in Senate
President Joe Biden’s push to pass voting rights legislation failed last week amid a party split and GOP opposition. Senate Democrats forced a vote on a one-time change to the chamber’s filibuster rules to create a pathway specifically for passage of voting rights legislation. Democrats had sought to pass a bill combining the Freedom to Vote Act, to revise elections and campaign finance laws, and the John Lewis Voting Rights Advancement Act, which would strengthen the 1965 Voting Rights Act. The rules change, which would have required a simple majority vote, was rejected 52-48, with Senator Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.) voting to uphold the 60-vote threshold.

Appropriators Work to Meet Feb. 18 Government Funding Deadline
Appropriators are still working to negotiate a spending framework to allow a roughly $1.5 trillion omnibus appropriations package to fund the government for the remainder of fiscal year (FY) 2022 to move forward by February 18, the expiration of the current continuing resolution (CR).

Lawmakers Ask CMS to Reevaluate Premium Increase
A group of House Democrats led by Representative Angie Craig (D-Minn.) have sent a letter to the Centers for Medicare and Medicaid Services (CMS) asking the agency to reduce is planned increase of 14.5% to Medicare Part B premiums following the agency’s proposal to limit coverage of the Alzheimer’s treatment Aduhelm.

Murray Requests Permanent OSHA Standard for Health Care Workers
Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Patty Murray (D-Wash.) has sent a letter to Secretary of Labor Marty Walsh and the Occupational Safety and Health Administration (OSHA) urging the administration to issue a permanent standard to protect health care workers, and to take immediate action to secure strong workplace protections for all workers.

CBO Examines Hospital, Physician Pricing Practices
The Congressional Budget Office (CBO) has released a new report examining the potential reasons the prices paid by commercial health insurers for hospital and physician services are higher, rise more quickly, and vary more by area than the prices paid by the Medicare fee-for-service (FFS) program. The agency concludes that greater market power among providers consistently leads to higher prices for commercial insurers. CBO also asserts that providers do not raise the prices they negotiate with commercial insurers to offset the lower prices paid by government programs – also known as cost shifting – as the share of patients covered by Medicare and Medicaid is not related to the higher prices in the commercial market.

GAO Reports on Operation Warp Speed Management
A new report from the Government Accountability Office (GAO) asserts that the U.S. Department of Health and Human Services (HHS) assumed control of the effort formerly known as Operation Warp Speed (OWS) without the personnel needed to oversee it properly. GAO makes five recommendations related to workforce needs, scheduling best practices for vaccine-related activities, and lessons learned from key stakeholders. HHS did not concur with GAO’s recommendation on workforce needs.