Congress returned to session this week, and while healthcare issues were not the focus of House and Senate floor activity, there was plenty of activity off the floor, including important updates on the FY 2024 appropriations process. The House Select Subcommittee on the Coronavirus Pandemic held a roundtable examining policy decisions, and the House Energy and Commerce Committee held a hearing on data privacy. Across the Capitol, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on community health centers. The Medicare Payment Advisory Commission (MedPAC), the Medicaid and CHIP Payment and Access Commission (MACPAC), and the Physician-Focused Payment Model Technical Advisory Committee (PTAC) all held public meetings.
Senate and House Announce FY 2024 Appropriations Guidance, with House Prohibiting Earmarks in Labor-HHS Appropriations Bill.
Under Senate rules, senators requesting congressionally directed spending projects must comply with specific accountability and transparency procedures. Requests must be in writing and must verify that members (and their immediate family) have no financial interest in the project, among other rules.
Each Senate appropriations subcommittee has a specific deadline by which senators must submit their requests. Of note for health-related projects, the Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) Subcommittee has a deadline of April 13, and the Agriculture, Rural Development, Food and Drug Administration and Related Agencies Subcommittee has a deadline of March 31. A full list of deadlines can be found in the guidance document.
The Labor-HHS Subcommittee is still accepting requests for report language (directing or encouraging specific actions by federal agencies) and programmatic requests (requests for specific funding levels for agencies and programs funded through the annual appropriations bills). Additional guidance from the Labor-HHS Subcommittee on those requests, along with a Dear Colleague, can be found here and here.
The Labor-HHS Subcommittee deadline for Members to submit programmatic and report language requests is March 24, and the full list of subcommittee deadlines can be found in the guidance materials.
Lawmakers Issue RFI on PAHPA. On February 27, Reps. Richard Hudson (R-NC) and Anna Eshoo (D-CA) issued a request for information regarding the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA), which is up for reauthorization this year. The deadline to submit feedback (through the above link) is March 13.
PAHPA authorizes many of the federal government’s biodefense and pandemic preparedness programs, including the Administration for Strategic Preparedness and Response, the National Health Security Strategy, and the Biomedical Advanced Research and Development Authority. PAHPA reauthorizations have also established and enhanced other federal emergency response programs, including the Strategic National Stockpile, the Project BioShield Special Reserve Fund, Public Health Emergency Preparedness cooperative agreements and the Hospital Preparedness Program.
CMS Releases New Memo on PHE Transition. On February 27, the Centers for Medicare & Medicaid Services (CMS) released a new fact sheet on the transition from the COVID-19 public health emergency (PHE), which is scheduled to end on May 11. CMS also continues to update its issue-specific fact sheets, which are found on its landing page on waivers and flexibilities.
DEA Releases Proposed Telehealth Rules. On February 24, the US Drug Enforcement Administration (DEA) released proposed rules related to the prescribing of controlled substances via telehealth. The proposed rules—found here and here—would set forth policies to replace the flexibilities that have existed under the COVID-19 PHE.
Prior to the PHE, telehealth prescribing of controlled substances was permitted following one in-person visit. That in-person requirement was lifted during the PHE, allowing for the prescribing of medically necessary controlled substances through telehealth.
The proposed rules would allow medical practitioners to provide an initial prescription for the following substances via telehealth without an in-person evaluation or referral from a medical practitioner that has conducted an in-person evaluation, as long as the prescription is otherwise consistent with any applicable federal and state laws:
For refills of those substances beyond 30 days, or for the prescription of Schedule II or narcotic controlled medication, an in-person visit must occur. A summary chart from DEA can be found here, a highlights document for medical practitioners can be found here, and explanatory flow charts can be found here and here.
While stakeholders had hoped to maintain the pandemic-era flexibilities, the DEA’s proposed rules more strictly limit prescribing via telehealth compared to the flexibilities that have existed under the PHE. Under such limitations, patients who face significant barriers to accessing care without telehealth may have difficulty receiving the controlled medications they need.
The proposed rules also would ease the transition by maintaining current PHE-related flexibilities for an additional 180 days beyond the PHE’s expiration, which is scheduled for May 11. Comments on the proposed rules are due by March 31.
The House and Senate are both in session next week. Congress is expected to receive the president’s FY 2024 budget request on March 9, laying out the Biden Administration’s funding and policy goals for the coming year.
For more information, contact Debra Curtis, Kristen O’Brien or Erica Stocker.
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