On The Hill

Labor-HHS-Education/Defense Package

On Tuesday, the Senate passed the dual Labor-HHS-Education/Defense spending bill, paving the way for final passage in the House next week.  Senate Appropriations Chairman Richard Shelby (R-AL) called the bill “the most significant step we have taken yet,” noting the large pay increase provided for service members and increased resources to combat the opioid epidemic.[i]  The bill was passed with overwhelming bipartisan support, with only 7 senators voting no.  The House is expected to take up the legislation next week, at which point the bill will be sent to the president’s desk for signature.  Notably, the passage and eventual signature of this bill will avoid a fall government shutdown, as the package contains a continuing resolution through December 7^th to account for any appropriations bills not enacted before the end of this month.

Opioid Crisis

President Trump declared this week “Prescription Opioid and Heroin Epidemic Awareness Week.”  In conjunction with related events of the week, HHS Secretary Alex Azar published a piece in USA Today to discuss administration efforts to address the opioid crisis and taut some recent successes.  One encouraging sign that Secretary Azar pointed to was the release of last week’s HHS annual survey of American drug use and mental health.  “For the second year in a row, the number of Americans misusing legal or illegal opioids dropped.”[ii]  Sec. Azar’s full piece can be read here.

The opioid epidemic received an enormous boost in the recent conference agreement for the Labor-HHS-Education/Defense spending package.  Included in the bicameral report language is $120 million for the Rural Communities Opioids Response Program, $1.5 billion for State Opioid Response Grants, $475,579,000 for opioid prescription drug overdose prevention activity at the Centers for Disease Control, and $500 million in dedicated funding for research related to opioid addition and the development of opioid alternatives.

Meanwhile on Monday, the Senate passed Sen. Lamar Alexander’s (R-TN) opioid package on an overwhelming 99-1 vote.  The HELP Committee chairman said he is “already working to combine the Senate and House-passed bills (the House passed its opioid package over the summer) into an even stronger law…there is a bipartisan sense of urgency to send the bill to the President quickly.”[iii]  Provisions in the Senate-passed Opioid Crisis Response Act of 2018 include the STOP ACT (legislation intended to intercept illegal drugs at the border), language to develop non-addictive painkillers, improvements to state prescription drug monitoring programs, and support for opioid recovery centers.  A full analysis of the legislation can be viewed here.

Last Friday, the Employment and Training Administration (ETA) issued a guidance letter to state workforce agencies regarding the National Dislocated Worker Grants (DWGs).  The purpose of the letter was to explain how the ETA interprets requirements of the grant as it may apply to the opioid crisis.  Grants can be used to provide training for employment reintegration for individuals affected by an opioid abuse disorder, and the ETA outlines how states can apply for disaster recovery DWGs to respond to the ongoing crisis.[iv]  The full guidance letter can be viewed here.

340B News

The American Hospital Association (AHA) announced new 340B “Good Stewardship Principles” this week, teaming up with 340B hospitals around the country to announce a new initiative to increase transparency and communicate the benefits of the prescriptions drug pricing program.  “The 340B stewardship principles will help hospitals better tell their story of how this crucial program is delivering a variety of important benefits to patients and communities,” said AHA President and CEO Rick Pollack.  The good stewardship principles and related resources from AHA can be found here.

Veterans Affairs Confirmation

This week, the Senate VA Committee advanced the nomination of James Gfrerer to become the next Chief Information Officer at the Department of Veterans Affairs.  His nomination now goes before the full Senate.  Chairman Johnny Isakson (R-GA) urged swift confirmation in the Senate, citing the IT needs at the department.  He said, “The chief information officer oversees a number of critical projects at the VA, including the massive electronic health records merger, a new system to support the expanded VA caregiver benefits, processing of G.I. Bill payments, and many other priorities.”[v]

Past Hearings

The Senate HELP Committee met this week to discuss how transparency can play a role in lowering spending on health care.  Both Democrats and Republicans on the committee stressed the burden that high medical costs continue to have on consumers, with lack of transparency in readily available information for seeking the most affordable care playing a significant role.  All four witnesses on the panel agreed that there is a greater need for access to data and transparency from CMS and the federal government to ensure that patients can choose the most affordable care.  The witnesses also stressed the importance of consumers doing their research on surgery and procedure costs—and that it is critical to not sacrifice quality of care for lower cost.  Ultimately, the committee and witnesses agreed that all stakeholders are responsible in providing transparency and that when patients maximize their own research before seeking care, costs are almost always lowered.

Upcoming Hearings

Next week, the House Committee on Energy and Commerce will hold a hearing entitled “Better Data and Better Outcomes: Reducing Maternal Mortality in the US.”  The hearing will take place at 10:00 am on Thursday, September 27^th.  A live stream of the hearing can be accessed on the day of by clicking here.

Also on Thursday, the House Ways and Means Social Security Subcommittee will hold a hearing entitled “The State of Social Security’s Information Technology.”  Discussion will examine Social Security’s information technology, modernization, management, and acquisitions.  This hearing will take place at 11:00 am, and can be found by clicking here.

[i] https://www.appropriations.senate.gov/news/majority/senate-passes-final-defense-labor-hhs-education-appropriations-minibus-conference-report

[ii] https://www.usatoday.com/story/opinion/2018/09/19/donald-trump-opioid-crisis-epidemic-addiction-nalaxone-heroine-column/1347574002/

[iii] https://www.help.senate.gov/chair/newsroom/press/senate-majority-leader-mitch-mcconnell-says-opioid-crisis-response-act-of-2018-is-landmark-legislation

[iv] https://wdr.doleta.gov/directives/attach/TEGL/TEGL_4-18.pdf

[v] https://www.meritalk.com/articles/senate-panel-okays-va-cio-nomination/