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On the Hill: Mental Health, Appropriations, Medicare Part B

This week, Congress is expected to focus on mental health legislation. Today, the House Committee on Energy and Commerce is scheduled to mark up the Helping Families in Mental Health Crisis Act of 2015 (H.R. 2646). Meanwhile, in the Senate, Sen. Chris Murphy (D-CT) has expressed concern that time is running out to get the Mental Health Reform Act of 2016 (S. 2680) to the Senate floor by year’s end. Murphy is a lead sponsor of the bill, which passed the Committee on Health, Education, Labor, and Pensions in March. He has said he might work to include provisions of the legislation in a conference-negotiated opioids bill.

Last week, the Senate Committee on Appropriations successfully passed its labor, health and human services, and education spending bill. The bill would boost funding for the National Institutes of Health and to combat the opioid epidemic. It also includes $1.1 billion to fight the Zika virus, which falls short of the Obama administration’s $1.9 billion request.

The measure also includes a 0.1 percent user fee for the 340B Drug Pricing Program that covered entities would pay toward program management and oversight by the Health Resources and Services Administration (HRSA).

Related report language for the legislation also instructs HRSA to consider stakeholder feedback when finalizing its proposed 340B omnibus guidance. The controversial proposal, known as the 340B mega-guidance, would significantly narrow the definition of eligible patients and facilities and jeopardize access to the program. The final guidance was expected this summer, but HRSA recently pushed back that date to December, at the earliest.

America’s Essential Hospitals has strongly advocated for HRSA to withdraw the omnibus guidance and consult all stakeholders, including essential hospitals, for any new proposal. The association urged House and Senate appropriators to intervene, and the Senate appropriations language reflects that effort.

Also under fire is the Centers for Medicare & Medicaid Services (CMS) Medicare Part B demonstration project to lower drug spending by curbing prescriptions for high-cost medications when less expensive alternatives are available. The proposal has been controversial, with lawmakers on both sides of the aisle voicing strong opposition. At the same time, a number of progressive Democrats strongly support the proposal.

It’s unclear if the House will vote to stop CMS from moving forward with the Part B demonstration or work to find alternatives. In the Senate, the Committee on Finance is expected to hold a hearing on the project June 28; it has yet to be officially announced. America’s Essential Hospitals sent a May 9 letter to CMS expressing its concerns with the proposal.

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About the Author

Jocelyn Wiles is the manager of legislative affairs at America's Essential Hospitals.