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Weekly Health Care Update:COVID-19 and Beyondjune 22-26, 2020

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Weekly Health Care Update:COVID-19 and Beyondjune 22-26, 2020 Weekly Health Care Checkup: COVID-19 and Beyond September 14-18, 2020 IN BRIEF What Happened This Week: In an effort to break the stalemate between Congressional negotiators and the White House on the next COVID stimulus measure, a bipartisan group of House lawmakers unveiled a new $1.5 trillion “March to Common Ground” COVID Response Framework this week. President Trump seemingly signaled his support for the package; however, a deal appears unlikely given Speaker Pelosi’s (D-CA) most recent comments and the fact that at least 15-20 GOP Senators will likely not support any additional COVID funding legislation. On the House floor, lawmakers voted on a slew of bills this week ranging from diversity in education (H.R. 2639), racial discrimination (H.R. 2574), and rights for pregnant workers (H.R. 2694). Members also agreed (243-164) to a resolution to condemn all forms of anti-Asian sentiment related to COVID-19 (H. Res. 908). On Wednesday, the House Financial Services Committee held hearing to review the Federal Housing Finance Agency's Response to the pandemic. Later that day, the House Veterans’ Affairs Oversight and Investigations Subcommittee held a hearing to examine the progress the VA has made thus far to modernize its medical supply chain and discuss lessons learned from the pandemic. On the other side of the Capitol this week, the Senate continued to vote on Trump Administration judicial nominees. On Wednesday, the Senate Appropriations Labor-HHS-Education Subcommittee heard from three Trump Administration officials – including CDC Director Redfield – during a hearing to review the Administration’s response to the pandemic. In his testimony, Director Redfield suggested that while a COVID vaccine would most likely be ready for first responders and vulnerable populations in November / December of 2020, it most likely will not be available to the rest of the US population until the third quarter of 2021 (a prediction that was later refuted by President Trump, and then adjusted again during a press conference earlier today). Meanwhile, over at the White House, the CDC outlined its COVID-19 vaccine distribution plan in a report to Congress and separate playbook for states (though the CDC Director has said that an additional $6 billion would be needed to adequately distribute the vaccine). In other non-COVID health news, CMS announced two new models today – the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model (which was a product of the Administration’s Advancing American Kidney Health Initiative), and a new Radiation Oncology (RO) Model. 1341 G Street NW Washington, DC 20005 www.mehlmancastagnetti.com 202-585-0258 The Agency also released Part I of the Contract Year (CY) 2022 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies earlier this week. CMS said the Advance Notice is being published in two parts this year due to requirements in the 21st Century Cures Act that mandate certain changes to Part C risk adjustment and a 60-day comment period for these changes (the other payment methodology changes that are typically included in the Advance Notice only require a 30-day comment period and, as a result, will be released at a later date in accordance with that requirement). What to Expect Next Week: The House is expected to be in session Tuesday, September 22 – Friday, September 25. At some point during the week, lawmakers will consider several bills under suspension of the rules (list of bills still TBA), the House Democrats’ clean energy package (H.R. 4447, the Clean Economy Jobs and Innovation Act), and a continuing resolution (text has not been released) to fund the government beyond the end of the current fiscal year (September 30). The Senate will be in session Monday, September 21 – Friday, September 25. Expect Majority Leader Mitch McConnell (R-KY) to continue plowing through a number of Trump Administration nominees. And if all goes according to plan (meaning the House approves a stopgap funding bill early next week), the Senate could move to take up the House- passed measure before the end of next week. Looking even further ahead, both chambers will be out Monday, September 28 and Tuesday, September 29 in observance of Yom Kippur. If the Senate votes on the House-approved government funding bill at the end of the month, it’s possible that the chamber will head home early for the October recess to campaign. Over the in the House, Speaker Pelosi did recently tell lawmakers to be on “standby” for votes in the event that a deal is reached on the next COVID stimulus package; however, given that a deal on any additional funding measures is unlikely, a more likely scenario is that House members will head home to their districts to campaign beginning October 2 and not return to Washington until after the November elections (though hearings are expected to continue remotely during this time). Noteworthy Upcoming Events: Nemours Children’s Health System and the Duke-Margolis Center for Health Policy are co-hosting an upcoming webinar on Tuesday, September 29 from 2:30 - 4:00 PM ET titled: Caring for Kids in the COVID- 19 Era: Promoting Health Equity and Value. The event is expected to highlight the roles health systems, payers, and all levels of government can play to address the pandemic’s negative impacts, reduce disparities, and promote health equity for children and their families. In addition, speakers will identify action steps the federal government can take to improve the COVID-19 response for children. Click here for more information and to register for the event. DEEP DIVE Path to Passage for New $1.5 Trillion COVID Response Proposal Unlikely, Despite Support from President Trump: On Tuesday, a bipartisan group of House lawmakers unveiled a new $1.5 trillion COVID response framework with the hopes of breaking the stalemate between negotiators and the White House on the next stimulus measure. The Problem Solvers Caucus proposal – dubbed the “March to Common Ground” COVID Response Framework – calls for both new stimulus money and the reallocation of previously appropriated CARES Act funding, and allocates resources to the following categories: testing & healthcare ($100b); direct assistance to individuals & families ($316b); unemployment assistance ($120b); small business & non-profit support ($290b); school & child care ($145b); state & local aid ($500.3b); election support ($400b); broadband, agriculture, USPS, & Census ($52b); worker & liability protections; and automatic boosters & reducers. Additionally, the proposal includes a series of what the group calls automatic “boosters” and “reducers” designed to incrementally increase or decrease the amount of relief to individuals and families depending on the severity of the pandemic and whether or not a successful vaccination program is adopted by March 2021. 1341 G Street NW Washington, DC 20005 www.mehlmancastagnetti.com 202-585-0258 On Wednesday, President Trump somewhat unexpectedly called Republican Lawmakers to “go for the much higher numbers” on a COVID package; however it remains to be seen whether House Speaker Nancy Pelosi (D-CA) – who has repeatedly said the House will not take up any COVID funding bill less than $2.2 trillion – and Senate Majority Leader Mitch McConnell (R-KY) – who continues to face opposition from members of his own party for any additional COVID response measures – will be able to shore up enough support for the bill in the near future. Further complicating matters – negotiators in both the House and Senate are now almost entirely focused on drawing up and passing a temporary stopgap funding bill to fund the government beyond the September 30 deadline. Most recent reports indicate that House leaders are eyeing a vote on a temporary stopgap funding bill as early as the week of September 21. Should this scenario play out, this timeline would give the Senate enough time to vote before the end of the month. It is very likely that an extension of several Medicare, Medicaid, and public health programs will also be attached to the legislation, which is expected to fund the government through mid-December. Trump Administration Outlines COVID Vaccine Distribution Plan: On Wednesday, the CDC outlined its COVID-19 vaccine distribution plan in a report to Congress and separate playbook for states. The Agency’s distribution plan gives states 30 days (until October 16) to draft their own individual vaccine distribution plans. CDC says each state will have an assigned technical assistance officer to assist the state with creating their plan. The Agency also encouraged states to establish their own public/private “Vaccine Program Implementation Committee” and identified 21 different kinds of groups for representation (ranging from businesses, health insurance issuers, churches/religious leaders, and pharmacies to immunization coalitions, education agencies, and health systems and hospitals). CDC Director Robert Redfield spoke about the timeline for vaccine distribution during a House Oversight Select Subcommittee on the Coronavirus Crisis hearing on Wednesday, telling members that the vaccine would most likely be ready for first responders and vulnerable populations in November / December, though he added that it most likely would not be available to the rest of the US population until the third quarter of 2021 (though this projected timeline was later refuted by President Trump, during a press conference on Wednesday evening and then adjusted again during a press conference earlier today). CDC Backtracks on Testing Guidance for Asymptomatic Individuals: Earlier today (Friday), Politico reported that the CDC is walking back on its earlier COVID testing guidance, which previously suggested that asymptomatic individuals who have been in close contact (aka within 6 feet) with a person with COVID-19 but are asymptomatic “do not necessarily need a test” unless they are considered vulnerable or if their health care provider or state or local public health officials recommend that they take a test.
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