This Week’s Dose: The focus was back on surprise billing this week with the third hearing of the year. We also saw hearings on Medicare for All and vertical consolidation in the health care industry, and the House advanced an appropriations package.
Another Busy Week for Hearings.
House Voted on Appropriations Minibus. The House initiated floor action on H.R. 2740, a $1 trillion appropriations bill that would provide funding for the Departments of Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development appropriations for fiscal year 2020. Lawmakers introduced 221 amendments to the bill, and votes will be taken on each one. Votes began on Wednesday and will likely continue into next week.
Health Reimbursement Arrangements Final Rule Published. The Departments of the Treasury, Health and Human Services (HHS), and Labor published the final rule Health Reimbursement Arrangements and Other Account-Based Group Health Plans. This rule expands health reimbursement arrangements (HRAs). Under the rule, employers can provide employees with tax-preferred funds to purchase coverage on the individual market through individual coverage HRAs. Additionally, the final rule creates excepted benefit HRAs, which can be used to pay for vision and dental coverage, as well as premiums for short-term limited duration insurance plans. The excepted benefit HRAs are capped at $1,800 per year. Provisions of the final rule are set to be implemented January 1, 2020.
FDA Issued New Guidance for E-Cigarette Submissions. The Food and Drug Administration (FDA) finalized guidance for manufacturers to submit e-cigarettes and other electronic vaping devices for regulatory review. The guidance requires that manufacturers demonstrate appropriate marketing that aligns with the FDA’s recent push to limit e-cigarette use among children. The FDA originally required manufacturers to submit vaping devices for review beginning in 2018 before former Commissioner Scott Gottlieb pushed implementation back to August 2021.
CMS Issued RFI on Patients over Paperwork Initiative. The Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) seeking new ideas from the public on maintaining the progress of the Patients over Paperwork initiative, which is focused on reducing the burden of the healthcare system through streamlined regulations and the reform of other administrative policies. Comments are due August 12, 2019.
South Carolina Submitted a Waiver Application for Medicaid Work Requirements. South Carolina submitted a new 1115 waiver application to CMS. The waiver includes work requirements, expands coverage for children, pregnant women and parents, and expands coverage for some individuals with substance use disorders, who are chronically homeless, or involved in the justice system. CMS is accepting comments on the application through July 10, 2019. Read our full summary of the waiver application here.
New Hampshire Defends Medicaid Work Requirements. New Hampshire, along with CMS, has filed a brief in the US District Court for the District of Columbia defending its decision to implement new Medicaid eligibility requirements that mandate most adults in the state’s Medicaid expansion population work 100 hours a month or participate in qualifying activities. CMS approved the requirement as part of a Section 1115 waiver, and it will take effect June 1, 2019. The state can begin un-enrolling people who fail to comply starting on August 1, 2019. In defending the work requirements, New Hampshire and CMS are relying primarily on the argument that the Secretary of HHS has broad discretion to allow states to test different Medicaid policies if the Secretary believes the policy will help sustain Medicaid. This is the same position taken in previous court cases that challenged work requirements in Kentucky and Arkansas. In both states, the waivers were overturned.
Next Week’s Diagnosis: The Health, Education, Labor and Pensions (HELP) Committee’s cost containment discussion draft, the Lower Health Care Costs Act of 2019, will be in the spotlight during a HELP Committee hearing on Tuesday, June 18. We will also be watching an E&C Health Subcommittee hearing on strengthening health care in the US territories on Thursday, June 20, and we may see a prescription drug package emerge from the Senate Finance Committee as well.
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