Congress Extends Government Funding-Congress averted the threat of a partial government shutdown and passed the fourth interim spending measure of fiscal year 2024 on Thursday. The latest stopgap spending bill (H.R. 7463) maintains a laddered approach to government funding-extending appropriations for some departments through March 8 and others through March 22. The bill passed the House of Representatives in a 320-99 vote on Thursday and was approved by the Senate hours later in a 77-13 vote. President Biden signed the legislation into law on Friday.
Congress Reaches Deal on Six Appropriations Bills and Health Provisions-Lawmakers have reached agreement on the Consolidated Appropriations Act, 2024, which includes funding for several appropriations measures (Agriculture-Food and Drug Administration; Transportation-Housing and Urban Development; Veterans Affairs; Energy; Commerce-Justice; Interior) through September 30, the end of the fiscal year. Leadership hopes to finalize and pass the deal, which accounts for approximately 27% of federal agency spending, first in the House and then in the Senate this week-ahead of the March 8 deadline. In the coming days, an agreement is expected to be released for the remaining six appropriations bills, including the U.S. Department of Health and Human Services. Congress has until March 22 to fund those remaining portions of the federal government.
The Consolidated Appropriations Act, 2024 to be considered by Congress this week includes provisions related to Public Health, Medicaid, and Medicare (Division G, Title I). Notably, the agreement includes a provision related to Medicare physician payment. However, the agreement leaves in place the full Medicare physician cut of 3.37% (relative to 2023 payments) from January 1 to March 8, and then, from March 9 through December 31, 2024, subjects them to a cut of 1.69% (relative to 2023 payments).
The package does not include reauthorizations of the Pandemic and All-Hazards Preparedness Act (PAHPA) or the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. Other health programs and policies not addressed in the package include the President’s Emergency Plan for AIDS Relief (PEPFAR), pharmacy benefit manager (PBM) reforms advanced by the Senate Finance Committee earlier this Congress, and extension of telehealth flexibilities which expire on December 31, 2024.
The full list of health provisions included in the agreement follows:
Subtitle A-Public Health Extenders
- 101-Extension for Community Health Centers, National Health Service Corps, and Teaching Health Centers that Operate GME Programs (p. 899)
- 102-Extension of Special Diabetes Programs (p. 902)
- 103-National Health Security Extensions (p. 903)
Subtitle B-Medicaid
- 201-Requirement for State Medicaid Plans to Provide Coverage for Medication-Assisted Treatment (p. 904)
- 202-Collection and Reporting of Comprehensive Data for Specified Populations Enrolled in Medicaid and CHIP (p. 905)
- 203-Monitoring Prescribing of Antipsychotic Medications (p. 916)
- 204-Extension of State Option to Provide Medical Assistance for Certain Individuals in Institutions for Mental Diseases (p. 917)
- 205-Prohibition on Termination of Enrollment Due to Incarceration (p. 922)
- 206-Addressing Operational Barriers to Promote Continuity of Care for Medicaid and CHIP Beneficiaries Following Incarceration (p. 925)
- 207-Guidance Relating to Improving the Behavioral Health Workforce and Integration of Care Under Medicaid and CHIP (p. 936)
- 208-Funding for Implementation and Operations (p. 941)
- 209-Certified Community Behavioral Health Clinic Services Under Medicaid (p. 942)
- 210-Eliminating Certain Disproportionate Share Hospital Payment Cuts (p. 945)
- 211-Promoting Value in Medicaid Managed Care (p. 946)
- 212-Medicaid Improvement Fund (p. 946)
Subtitle C-Medicare
- 301-Extension of Funding for Quality Measure Endorsement, Input, and Selection (p. 946)
- 302-Extension of Funding Outreach and Assistance for Low-Income Programs (p. 947)
- 303-Extension of the Work Geographic Index Floor Under the Medicare Program (p. 950)
- 304-Extending Incentive Payments for Participation in Eligible Alternative Payment Models (p. 950)
- 305-Temporary Payment Increase Under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment (p. 951)
- 306-Extension of Increased Inpatient Hospital Payment Adjustment for Certain Low-Volume Hospitals (p. 952)
- 307-Extension of the Medicare-Dependent Hospital (MDH) Program (p. 954)
- 308-Extension of Adjustment to Calculation of Hospice Cap Amount Under Medicare (p. 955)
- 309-Medicare Improvement Fund (p. 955)
House to Vote on Health Bills This Week-The House of Representatives plans to consider several health care related bills on the floor this week under suspension of the rules. The chamber is scheduled to vote on:
- S. 206-END FENTANYL Act;
- R. 3838-Preventing Maternal Deaths Reauthorization Act;
- R. 3821-Firefighter Cancer Registry Reauthorization Act;
- R. 3836-Medicaid Primary Care Improvement Act, as amended;
- R. 3843-Action for Dental Health Act;
- R. 3391-Gabriella Miller Kids First Research Act; and
- R. 498 – 9-8-8 Lifeline Cybersecurity Responsibility Act of 2023, as amended.
Mitch McConnell to Step Down from Senate Leadership-Senate Minority Leader Mitch McConnell (R-Ky.) has announced his intention to step down as Republican leader at the end of his two-year term, which concludes at the start of the next Congress in January. He does not plan to retire from the Senate entirely, and is not up for reelection until 2026. With a 17-year tenure as Republican leader, McConnell, 82, is the chamber’s longest serving party leader in history. Minority Whip John Thune (R-S.D.), John Cornyn (R-Texas), and GOP Conference Chair John Barrasso (R-Wyo.) are widely viewed as McConnell’s most likely potential successors. An election for McConnell’s replacement will take place in November.
Lawmakers Respond to Alabama Embryo Ruling-Sen. Cindy Hyde Smith (R-Miss.) blocked consideration of legislation on the Senate floor last week that would have provided federal protections for in vitro fertilization. Sen. Tammy Duckworth (D-Ill.) sought unanimous consent to pass her Access to Family Building Act (S. 3612), which would establish a statutory right to access IVF and other fertility treatments for all Americans. Hyde-Smith argued that the bill’s definition of assisted reproductive technology was too expansive and could legalize cloning and the creation of human-animal chimeras; other Republicans have argued that state legislatures should lead in protecting access to fertility treatments. Duckworth stated that she plans to request a roll call vote on the bill to force members to take a stand on the issue. In the wake of its Supreme Court ruling on frozen embryos, the Alabama state legislature passed measures last week to protect in vitro fertilization patients and providers from criminal or civil liability if embryos they create are subsequently damaged or destroyed. The bills must be reconciled between the state House and Senate before being sent to Gov. Kay Ivey (R), who is expected to sign the bill into law. In related news, Sen. Hyde-Smith, alongside Rep. August Pfluger (R-Texas), led an amicus brief signed by nearly 150 other Republican members of Congress and submitted last week urging the Supreme Court to maintain a lower court’s restrictions around the medication abortion drug mifepristone. Democrats submitted their own amicus brief in January, arguing that the court should not curtail access to the medication.
Grassley Releases Updates on FTC’s PBM Investigation-The Federal Trade Commission (FTC) has informed lawmakers on Capitol Hill that none of the six pharmacy benefit managers (PBMs) contacted as part of the agency’s investigation into PBMs have fully responded to the agency’s orders. “We expect to have all the materials very soon. If, however, some of the companies fail to fully comply with the orders or engage in any actionable delaying tactics, the FTC can take them to court to compel compliance,” FTC Chair Lina Khan stated. The agency’s letter was released by Sen. Chuck Grassley (R-Iowa), who was part of the bipartisan group of senators that initially called for the administration to investigate PBM industry practices. The FTC launched its investigation in June 2022, and expanded it in May and June 2023. Grassley expressed concerns with the FTC’s latest response, highlighting that PBMs had been provided with 90 days to submit requested materials. He called for a “concrete status update” from the FTC and noted his intention to continue to push for “swift and thorough results.”
AI Work Group Considers Role of Medicare/Medicaid Investments-The Senate’s bipartisan Artificial Intelligence Working Group is recommending that the Senate Finance Committee consider how the Medicare and Medicaid programs can be used to fund AI innovations in health care, according to Sen. Mike Rounds (R-S.D.). Rounds, along with Senate Majority Leader Chuck Schumer, Sen. Todd Young (R-Ind.), and Sen. Martin Heinrich (D-N.M.), form the chamber’s bipartisan Artificial Intelligence Working Group, which organized a series of “AI Insight Forums” last year. According to Rounds, the working group plans to issue a report by the end of this month containing ideas and guidelines to inform AI legislation.
Warner, Rubio Push Commerce Department to Better Protect Biotech Sector-Senate Intelligence Committee Chairman Mark Warner (R-Va.) and Ranking Member Marco Rubio (R-Fla.) have sent a letter to the Department of Commerce urging Secretary Gina Raimondo to more sufficiently use its existing authorities to prevent adversary access to U.S. technology, capital, data, and talent in critical technology sectors, including the biotechnology sector. Warner and Rubio argue that China has continuously attempted to “leverage the lack of U.S. controls surrounding access to American innovation, data, and talent to undermine U.S. superiority in critical sectors and related supply chains.” The lawmakers specifically suggest that the Department of Commerce implement an export-control regime targeting the biotechnology sector-as undertaken with the semiconductor industry-and impose controls on the sharing of American data.
Health Sector Coordinating Council Releases Cybersecurity Strategic Plan Amid Fallout From Cyberattack on Major Clearinghouse-The Health Sector Coordinating Council Cybersecurity Working Group published its Five-Year Health Industry Cybersecurity Strategic Plan last week. The document aims to guide C-suite executives, information technology and security leaders, and other relevant stakeholders toward investment and implementation of strategic cybersecurity principles that will measurably reduce risks to patient safety, data privacy, and care operations. The plan was released in the midst of fallout from a cyberattack on UnitedHealth’s Change Healthcare, which has resulted in widespread disruptions for both patients and health care providers. UnitedHealth Group is directing providers facing a liquidity crisis due to the outage to a Temporary Funding Assistance Program administered by its subsidiary Optum Financial Services, though some providers have taken to social media to highlight that the amounts made available fall short of what’s needed to maintain their operations. The White House National Security Council reportedly is considering administrative options to provide short-term financial relief from federal health programs for hospitals impacted by the cyberattack.
CDC Releases New Respiratory Virus Guidance-The Centers for Disease Control and Prevention released new guidelines related to respiratory viruses last week. The agency’s recommendations aim to provide a unified approach to a range of common respiratory viral illnesses, including COVID-19, flu, and RSV. Under the latest guidance, individuals whose COVID-19 symptoms are improving and who have been fever-free for 24 hours without medication no longer need to isolate for a prolonged period. If individuals do choose to return to public places, however, they should take steps such as masking and keeping their distance from others for five days. The CDC’s guidance includes additional recommendations for people who are pregnant, immunocompromised, have disabilities, or are over the age of 65.
Congressional Retirements and Resignations-Rep. Mark Green (R-Tenn.), chairman of the Homeland Security Committee, has reversed his decision to retire from Congress this year. Green will run for reelection to represent the Tennessee’s 7th congressional district in November. “While my strong desire was to leave Congress at the end of this year, since my announcement, I have received countless calls from constituents, colleagues, and President Trump urging me to reconsider,” he said in a statement.
A running list of members of Congress who are retiring or seeking other office can be found below.
| SENATE | |
| Stabenow (D), MI | Braun (R), IN |
| Cardin (D), MD | Romney (R), UT |
| Carper (D), DE | |
| Butler (D), CA | |
| Manchin (D), WV | |
| HOUSE OF REPRESENTATIVES | |
| Porter (D), CA | Mooney (R), WV |
| Lee (D), CA | Banks (R), IN |
| Gallego (D), AZ | Bishop (R), NC |
| Schiff (D), CA | Lesko (R), AZ |
| Slotkin (D), MI | Granger (R), TX |
| Allred (D), TX | Buck (R), CO |
| Trone (D), MD | Burgess, MD (R), TX |
| Blunt Rochester (D), DE | Wenstrup, DPM (R), OH |
| Napolitano (D), CA | McHenry (R), NC |
| Wexton (D), VA | McCarthy (R), CA (effective Dec. 31, 2023) |
| Kim, Andy (D), NJ | Johnson (R), OH (effective Jan. 21, 2024) |
| Jackson, Jeff (D), NC | Ferguson, IV, DMD, PC (R), GA |
| Sarbanes (D), MD | Curtis (R), UT |
| Blumenauer (D), OR | Luetkemeyer (R), MO |
| Kilmer (D), WA | Lamborn (R), CO |
| Spanberger (D), VA | Bucshon, MD (R), IN |
| Kildee (D), MI | Pence (R), IN |
| Phillips (D), MN | Duncan (R), SC |
| Cardenas (D), CA | Armstrong (R), ND |
| Eshoo (D), CA | McMorris Rodgers (R), WA |
| Manning (D), NC | Gallagher (R), WI |
| Higgins (D), NY (effective Feb. 2, 2024) | |
| Nickel (D), NC | |
| Ruppersberger (D), MD | |
| Sablan (D), MP | |
Upcoming Congressional Hearings and Markups
Senate Homeland Security and Governmental Affairs Committee continuation of January 31 markup of legislation, including, S. 3558, a bill to prohibit contracting with certain biotechnology providers; 9:30 a.m.; March 6
Senate Budget Committee hearing to examine how primary care improves health care efficiency; 10:00 a.m.; March 6
House Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic hearing “Examining the White House’s Role in Pandemic Preparedness and Response;” 10:00 a.m.; March 6
House Select Committee on the Chinese Communist Party hearing “Growing Stakes: The Bioeconomy and American National Security;” 9:00 a.m.; March 7
Senate Health, Education, Labor, and Pensions Committee hearing “The Older Americans Act: Supporting Efforts to Meet the Needs of Seniors;” 11:00 a.m.; March 7
Recently Introduced Health Legislation
H.R.7442-To direct the Comptroller General of the United States to conduct a study to assess the feasibility and financial effects of expanding coverage under the Medicare program to items and services furnished in the Philippines. Sponsor: Moylan, James C. [Del.-R-GU-At Large]; Committees: House – Ways and Means; Energy and Commerce
H.R.7436-To direct the Comptroller General of the United States to prepare a report on Federal efforts to address antimicrobial resistance. Sponsor: Griffith, H. Morgan [Rep.-R-VA-9]; Committees: House – Energy and Commerce
H.R.7434-To ensure that only licensed health care professionals furnish disability examinations under a certain Department of Veterans Affairs pilot program for use of contract physicians for disability examinations, and for other purposes. Sponsor: Finstad, Brad [Rep.-R-MN-1]; Committees: House – Veterans’ Affairs
H.R.7432-To amend title XIX of the Social Security Act to enable State Medicaid programs to provide comprehensive, coordinated care through a health home to individuals with sickle cell disease. Sponsor: Burgess, Michael C. [Rep.-R-TX-26]; Committees: House – Energy and Commerce
H.Res.1029-Amending the Rules of the House of Representatives to establish a Permanent Select Committee on Aging. Sponsor: Magaziner, Seth [Rep.-D-RI-2]; Committees: House-Rules
S.Res.566-A resolution designating September 2024 as “National Cholesterol Education Month” and September 30, 2024, as “LDL-C Awareness Day”; Sponsor: Hyde-Smith, Cindy [Sen.-R-MS]; Committees: Senate-Judiciary
S.3803-A bill to make price gouging unlawful, to expand the ability of the Federal Trade Commission to seek permanent injunctions and equitable relief, and for other purposes. Sponsor: Warren, Elizabeth [Sen.-D-MA]; Committees: Senate – Commerce, Science, and Transportation
S.3805-A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate – Finance
S.Res.567-A resolution recognizing the seriousness of widespread health care worker burnout in the United States and the need to strengthen health workforce well-being, and expressing support for the designation of March 18, 2024, as the inaugural “Health Workforce Well-Being Day of Awareness”; Sponsor: Kaine, Tim [Sen.-D-VA]; Committees: Senate – Health, Education, Labor, and Pensions
S.3821-A bill to amend title XVIII of the Social Security Act to improve the payment method for oxygen and oxygen related equipment, supplies, and services, to increase beneficiary access to oxygen and oxygen related equipment, supplies, and services, and for other purposes; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate-Finance
H.R.7464-To amend title 38, United States Code, to provide for access standards with respect to the provision by the Department of Veterans Affairs of hospital care, medical services, or extended care services that are applicable to certain veterans with mental disorders; Sponsor: Yakym, Rudy [Rep.-R-IN-2]; Committees: House – Veterans’ Affairs
S.3832-A bill to amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program; Sponsor: Tillis, Thomas [Sen.-R-NC]; Committees: Senate-Finance
S.3834-A bill to direct the Secretary of Veterans Affairs to ensure veterans may obtain a physical copy of a form for reimbursement of certain travel expenses by mail or at medical facilities of the Department of Veterans Affairs, and for other purposes; Sponsor: Rubio, Marco [Sen.-R-FL]; Committees: Senate – Veterans’ Affairs
S.3841-A bill to require the Secretary of Veterans Affairs to submit a report on the impact of a proposed rule submitted by the Centers for Medicare & Medicaid Services on access of veterans to long-term care facilities; Sponsor: King, Angus S., Jr. [Sen.-I-ME]; Committees: Senate – Veterans’ Affairs
S.3847-A bill to authorize the Director of the Centers for Disease Control and Prevention to carry out a Social Determinants of Health Program, and for other purposes; Sponsor: Smith, Tina [Sen.-D-MN]; Committees: Senate – Health, Education, Labor, and Pensions
S.3849-A bill to promote United States leadership in technical standards by directing the National Institute of Standards and Technology and the Department of State to take certain actions to encourage and enable United States participation in developing standards and specifications for artificial intelligence and other critical and emerging technologies, and for other purposes; Sponsor: Warner, Mark R. [Sen.-D-VA]; Committees: Senate – Commerce, Science, and Transportation
S.3850-A bill to provide for research and improvement of cardiovascular health among the South Asian population of the United States, and for other purposes; Sponsor: Booker, Cory A. [Sen.-D-NJ]; Committees: Senate – Health, Education, Labor, and Pensions
H.Res.1036-Expressing support for the designation of February 29, 2024, as “Rare Disease Day”; Sponsor: Carson, Andre [Rep.-D-IN-7]; Committees: House – Energy and Commerce
H.Res.1037-Providing the sense of the House of Representatives that In Vitro Fertilization (IVF) is necessary for women who cannot conceive naturally, and for other purposes; Sponsor: Chavez-DeRemer, Lori [Rep.-R-OR-5]; Committees: House – Energy and Commerce
H.Res.1039-Recognizing the significance of Charcot-Marie-Tooth disease and the need for robust funding of the National Institute of Neurological Disorders and Stroke at the National Institutes of Health; Sponsor: Gottheimer, Josh [Rep.-D-NJ-5]; Committees: House – Energy and Commerce
H.Res.1042-Recognizing the historical contributions and value of the Freedom House Ambulance Service; Sponsor: Lee, Summer L. [Rep.-D-PA-12]; Committees: House – Energy and Commerce
H.Res.1043-Expressing support for continued access to fertility care and assisted reproductive technology, such as in vitro fertilization, in light of the Supreme Court of Alabama’s ruling that has jeopardized access to in vitro fertilization and other assisted reproductive technology; Sponsor: Mace, Nancy [Rep.-R-SC-1]; Committees: House – Energy and Commerce
H.Res.1045-Expressing support for the designation of March 3, 2024, as “National Triple-Negative Breast Cancer Day”; Sponsor: Morelle, Joseph D. [Rep.-D-NY-25]; Committees: House – Oversight and Accountability
H.R.7481-To authorize the Director of the Centers for Disease Control and Prevention to carry out a Social Determinants of Health Program, and for other purposes; Sponsor: Barragan, Nanette Diaz [Rep.-D-CA-44]; Committees: House – Energy and Commerce
H.R.7482-To amend the Public Health Service Act to reauthorize the WISEWOMAN program; Sponsor: Beatty, Joyce [Rep.-D-OH-3]; Committees: House – Energy and Commerce
H.R.7489-To increase the recruitment and retention of school-based mental health services providers by low-income local educational agencies; Sponsor: Chu, Judy [Rep.-D-CA-28]; Committees: House – Education and the Workforce
H.R.7503-To amend the Public Health Service Act to provide health equity for people with disabilities; Sponsor: Payne, Donald M. [Rep.-D-NJ-10]; Committees: House – Energy and Commerce