On the Hill:
Senate Minority Leader Chuck Schumer (D-NY) called on Congress to pass a healthcare package that includes healthcare extenders, addresses the opioid crisis and includes both the Alexander-Murray legislation to stabilize the Affordable Care Act (ACA) individual markets and the Collins-Nelson legislation to provide federal reinsurance funding. The so-called extenders refer to programs whose funding has expired, including those affecting Medicare, rural hospitals and community health centers. Funding for such programs was not tied with the six years of Children’s Health Insurance Program (CHIP) funding included in the Jan. 22 continuing resolution (CR). Schumer also wants to extend CHIP funding from six to ten years.
Senator Orrin Hatch (R-UT) said he would be open to adding four more years to the six years of funding for CHIP that passed with the January CR. In early January, the Congressional Budget Office (CBO) announced an analysis showing that a ten-year CHIP extension would save the federal government about $6 billion.
In a Jan. 29 letter, House Oversight Committee Chair Trey Gowdy (R-SC) criticized the Department of Health and Human Services (HHS) for failing to respond to requests for information, including a list of guidance documents, information on cost-sharing reduction payments, documents related to Medicare Part D and the opioid crisis and work related to the 2017 hurricanes and federal disaster preparedness. Beginning in October, following the resignation of former HHS Secretary Tom Price, HHS began missing deadlines or providing incomplete information to the Committee.
At the agencies:
New HHS Secretary Alex Azar has selected former hospital executive Peter Urbanowicz to serve as his chief of staff. Urbanowicz worked under Azar as deputy general counsel at HHS from 2001 to 2003, where he helped to draft the Medicare Prescription Drug, Improvement and Modernization Act of 2003. While working in the private sector at Tenet Healthcare and, most recently, Alvarez & Marsal, he helped for-profit health systems navigate federal criminal investigations and helped turn around large healthcare organizations. Urbanowicz has expressed concerns over rising federal spending under the ACA, while also noting the implications of rolling back the healthcare law in terms of people losing health coverage.
Many physician groups have grown concerned about how Medicare will pay doctors under Alex Azar’s tenure as HHS secretary. During his confirmation hearing, Azar said he wanted to shift Medicare away from a fee-for-service system, which pays based on the number of procedures and services, to a more quality- and outcome-based system. It remains unclear how Azar will address the Medicare Access and CHIP Reauthorization Act (MACRA), which worries some physicians who will need time to adjust to changes.
A senior official at the Centers for Medicare and Medicaid Services (CMS) overseeing Medicaid, Brian Neale, will soon leave the agency. Neale joined the agency under CMS Administrator Seema Verma to lead the Center for Medicaid and CHIP services, which approved the recent Medicaid work requirement and tried to expand opioid addiction treatment available to enrollees. Neale worked with Verma for then-Governor of Indiana Mike Pence to expand Medicaid in the state under the ACA. Neale’s departure follows a string of senior Trump health officials leaving the agency.
Just two days after Alex Azar was sworn in as HHS secretary, Centers for Disease Control and Prevention (CDC) Director Brenda Fitzgerald handed in her resignation over conflicts of interest. While director, Fitzgerald had traded in tobacco, drug and food stocks and failed to divest her other holdings. Fitzgerald had also recused herself from work on cancer detection and aspects of the opioid crisis. It is unclear whether Azar demanded the resignation. Lawmakers had also expressed frustration over Fitzgerald’s inability to testify before Congress or respond to inquiries.
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