HealthCare Roundtable e-News – March 18, 2024

 

 

Top News

Bipartisan Group of Representatives Introduce Legislation to Expand Telehealth Services for Seniors

Representative Buddy Carter (R-GA) along with fellow Reps. Lisa Blunt Rochester (D-DE), Greg Steube (R-FL), Terri Sewell (D-AL), Mariannette Miller-Meeks (R-IA), Jefferson Van Drew (R-NJ), and Joe Morelle (D-NY) introduced the bipartisan Telehealth Modernization Act of 2024. This act improves telehealth flexibilities for Medicare beneficiaries by creating permanent access to services and extends these flexibilities to federally qualified health centers and rural health clinics. Through enhancing telehealth access and ensuring service continuity, a broader range of patients including seniors and individuals in rural communities can utilize this type of care. As telehealth service usage has increased since the COVID-19 pandemic, this bill aims to protect and expand the availability of these high-quality and affordable virtual care services. Telehealth can increase continuity of care, mitigate impacts of physician shortages, and enhance healthcare accessibility outside standard clinic operating hours. This bill is crucial in leveraging the capabilities of telehealth to improve outcomes, particularly for rural and underserved populations through ensuring the permanence of telehealth flexibilities for Medicare beneficiaries.

 

Senators Wyden and Sanders Author Letter Urging Federal Agencies to Protect Patients Against Surprise Medical Bills

Senate Finance Committee Chair Ron Wyden (D-OR) and Senate Health, Employment, Labor and Pension (HELP) Committee Chair Bernard Sanders (I-VT) sent a letter to the Secretaries of Health and Human Services (HHS), Treasury, and Labor Departments (The Departments) requesting they issue guidance to insurers to eliminate cost-sharing practices that leave patients with unexpected medical bills. In their letter, the Senators refer to the Patient Protection and Affordable Care Act of 2010 (ACA) which required that most private individual and group health plans cover certain evidence-based preventive services without cost-sharing. The Chairs of the Finance and HELP committees authored this letter following recent news coverage that revealed that dishonest provider billing practices are not being caught by insurers, leading to individuals being charged hundreds of dollars in unexpected bills for preventive services that should be covered without cost sharing. The letter specifically asks The Departments to issue clarifying guidance to protect patients from being charged cost-sharing when they receive recommended preventive services and address inappropriate charges for services that are integral to recommended preventive services. Additionally, Senators Wyden and Sanders encouraged The Departments to conduct investigations and audit health insurers participating in the Federally Facilitated Marketplace and employer-sponsored plans to ensure they are in compliance with the ACA.

 

White House Hosts Briefing as President Biden Releases FY 2025 Budget

President Biden released his budget for fiscal year (FY) 2025. In a briefing hosted by the White House, the Office of Public Engagement Director Steve Benjamin and Office of Management and Budget Director Shalanda Young provided insights into the administration’s priorities, which center on key areas of focus in the budget. Director Young outlined the President’s vision, emphasizing efforts to lower costs for families, grow the economy, reduce the deficit, and protect Social Security and Medicare. Healthsperien covered the briefing, and a summary of the discussion can be found here. The President’s 2025 budget prioritizes significant investments related to healthcare, aiming to expand access to high-quality and affordable services while lowering costs. Key provisions include permanent premium tax credits and Medicaid coverage, drug price negotiation to reduce prescription costs, and initiatives targeting mental health services and substance abuse treatment. The budget also addresses health equity, veterans’ healthcare needs, and bolstering public health infrastructure. Furthermore, it emphasizes innovation through agencies like ARPA-H, signaling a commitment to advancing healthcare reform and addressing pressing health challenges facing Americans.

 

Senate HELP Committee Holds Hearing on the Older Americans Act

The U.S. Senate Health, Education, Labor and Pension (HELP) Committee held a hearing on the Older Americans Act (OAA). It began with Chairman Sanders (D-VT) highlighting the financial struggles faced by many seniors and emphasizing the importance of the OAA in improving their lives. He stressed the effectiveness of the OAA in funding essential services such as home care, caregiver support, and transportation, with a significant portion allocated to meal programs like Meals on Wheels. Ranking Member Cassidy (R-LA) echoed the importance of the OAA in supporting seniors to age in place and advocated for efficient use of taxpayer dollars through private-public partnerships. Testimony from experts such as Ramsey Alwin from the National Council on Aging (NCOA) and Ellie Hollander from Meals on Wheels emphasized the critical need for increased funding to address growing demand and provide essential services, especially in combating social isolation and hunger among seniors. Discussions among senators and panelists highlighted the need for long-term planning, collaboration, and innovative approaches to meet the evolving needs of older adults. Alison Barkoff from the Administration for Community Living (ACL) stressed the effectiveness of OAA programs in preventing hospitalizations and emphasized the need for increased resources to support seniors’ overall well-being. Additionally, there was significant bipartisan support for increasing seniors’ access to meals and combatting social isolation within the older adult population. Healthsperien covered the hearing and detailed notes are available here.

Administrative Action

The Biden-⁠Harris Administration announced the White House Challenge to Save Lives from Overdose as a nationwide initiative to engage stakeholders from various sectors to expand training on and increase access to lifesaving opioid overdose reversal medications. As part of President Biden’s Unity Agenda efforts to beat the overdose crisis, the challenge is a call-to-action for organizations and businesses across the country to empower communities with life-saving tools to reduce opioid deaths. The Biden-Harris Administration is promoting actions such as training employees on opioid overdose reversal medications, maintaining medications in first aid kits, and providing medications to employees and customers. Groups can make a commitment to protecting communities from overdose and share stories about lives saved through this White House initiative. Numerous air travel, entertainment, and hospitality companies as well as labor worksites, schools, and transit systems have already taken action and committed to saving lives from overdose. This initiative furthers the National Drug Control Strategy, and over the course of the last three years, the Biden-Harris Administration has made naloxone available over-the-counter, supported the State Opioid Response (SOR) grant program, boosted awareness and education of opioid overdose reversal medications, and invested in harm reduction services. The White House Challenge to Save Lives from Overdose aims to create a whole-of-society response to reduce opioid deaths.

Congressional Action

  • The U.S. House Ways and Means Committee held a hearing on “Enhancing Access to Care at Home in Rural and Underserved Communities.” During the hearing, committee members heard from patients of home-based care services, including Hospital-at-Home, a physician leader, a health care executive, and a health policy expert. Chairman Jason Smith (R-MO) explained the importance of maintaining crucial home-based care options for patients, especially in rural counties that do not have timely access to the same levels of care as other parts of the country. Chairman Smith also discussed the high levels of patient satisfaction and lower costs associated with home-based care. Finally, he stated one of the committee’s priorities is ensuring that patients maintain access to the crucial services, which are set to expire at the end of the year.

 

  • The U.S. Senate Finance Committee held a hearing to discuss the President’s Fiscal Year 2025 Health and Human Services (HHS) Budget, which was released earlier this week on March 11 as part of the President’s larger budget for the U.S. Government. HHS Secretary Xavier Beccera was the sole witness and answered questions from the committee on various policy areas including drug pricing, pharmacy benefit manager (PBM) reform, mental and behavioral health, nursing homes, telehealth, the Inflation Reduction Act (IRA), and more. In his opening remarks, Secretary Beccera underscored the significance of the budget, emphasizing key priorities such as extending Medicaid-like coverage to low-income individuals in states that have not expanded Medicaid, alongside focusing on the largest investment in behavioral health in a generation. The budget also addresses pressing issues like the maternal health crisis, aiming to make childcare more affordable and accessible, and strengthening cybersecurity initiatives. Notably, efforts to lower prescription drug costs, particularly for insulin, have been highlighted as successful as ongoing drug price negotiation programs continue. Additionally, the budget reflects commitments to strengthen Medicare for future generations, and a focus on enhancing preparedness capabilities in the face of health crises.

Research

Fierce Healthcare recently published an article that highlights the growing use of hospital-at-home (HaH) services as an alternative to a traditional hospital setting. The article sheds light on a hospital-at-home provider, DispatchHealth, as an example of the potential of these services that were instrumental in providing care during the COVID-19 public health emergency (PHE). During the PHE, the Centers for Medicare and Medicaid Services (CMS) implemented the Acute Hospital Care at Home Waiver, which is set to expire at the end of this year without legislative action to extend it. In response to the looming expiration of the program, more than 50 organizations signed a letter to Congressional leaders calling for at least a five-year extension to the CMS waiver. The letter cites the relief that the HaH services provide to hospitals by freeing up beds for the sickest patients and the growing demographic trends that will drive demand for these services as a part of their rationale for an extension of the program. Additionally, the article references a DispatchHealth case study that found that 95 percent of caregivers preferred in-home care to the traditional hospital setting, and a study conducted at Mass General Brigham that found low rates of mortality and less use of skilled nursing facilities for patients receiving their care at home.


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