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On the Hill: Homeland Security, 340B, HIT, ACA, and SGR

This week, Congress convenes to complete last week’s unfinished business. In a partisan stalemate, legislators nearly failed to pass spending legislation to keep the Department of Homeland Security running. While the Senate passed funding through the end of the fiscal year, the House was unable to come to agreement. In a last minute vote, with less than an hour before funding expired, both chambers passed a mere one-week extension. On Tuesday, the House reversed course and passed the original Senate bill, funding the department through the end of the fiscal year. Other legislation under consideration will focus on transportation and the Environmental Protection Agency.

On Thursday, March 5, the House Committee on Energy and Commerce, Subcommittee on Health will hold a hearing to examine the 340 Drug Pricing Program. Witnesses at the hearing will be Diana Espinosa, MPP, deputy administrator of the Health and Human Services Administration (HRSA), accompanied by Krista M. Pedley, PharmD, MS, director of the HRSA Office of Pharmacy Affairs; Debbie Draper, health care director at the Government Accountability Office; and Anne Maxwell, representing the Office of the Inspector General at the Department of Health and Human Services.  The hearing will focus on the functionality of the 340B program and its impact on patients, drug manufacturers, providers, and other stakeholders. America’s Essential Hospitals President and CEO Bruce Siegel, MD, MPH, recently wrote a timely op-ed in Modern Healthcare discussing the critical importance of the 340B program for essential hospitals.  America’s Essential Hospitals also plans to submit a statement for the record for the hearing.

Also on Thursday, the Senate Committee on Health Education and Labor (HELP) will hold a hearing on health information technology and electronic health records. Witnesses will include representatives from the Harvard Global Health Institute at the Harvard School of Public Health, the American Academy of Family Physicians, Epic Systems Corporation, and Louisiana Tech University.

Supreme Court Oral arguments in the King v. Burwell case will begin on Wednesday. The case will review whether or not individuals participating in the federal health insurance marketplace are eligible for subsidies. If the decision, expected in June, finds that premium subsidies are not available under the Affordable Care Act (ACA) in these states, many could lose access to coverage. Republican congressional leaders in the House released an alternate plan to be considered after the decision in June. The plan was released in an op-ed written by Reps. Paul Ryan (R-WI), John Kline (R-MN), and Fred Upton (R-MI) in the Wall Street Journal on Mar. 2 (login required). A Senate alternative plan is expected for release by Republican leadership in the coming weeks.

The House and Senate continue to work on developing a fix for the sustainable growth rate (SGR), the formula for determining Medicare physician payments. The SGR will require cuts to physician payments if no action is taken before the end of the month. Last year, bipartisan negotiators attempted to pass a permanent fix for the SGR, which has required a patch year-after-year, but failed to find consensus on a way to offset the substantial cost of a permanent repeal. A temporary patch is expected to pass later this month. The length of the patch remains unclea, and will likely depend on the offsets to pay for the patch. Extending the ACA-mandated Medicaid disproportionate share hospital (DSH) cuts for an additional year (to 2025) is on the table, as it has been in previous years, along with extending Medicare sequestration, however final decisions have not yet been made. America’s Essential Hospitals is working with key committee members and congressional leadership to protect essential hospitals’ best interests in final SGR negotiations.






About the Author

Jocelyn Wiles was a former manager of legislative affairs at America's Essential Hospitals.

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