Capitol Insights Newsletter
Authors: Luke Schwartz, Caroline Oliver, and Matt Reiter
What happened in Congress this week?
On Tuesday, March 12th, the House Energy & Commerce Health Subcommittee forwarded 19 pieces of legislation geared towards improving health for patients to the full Energy and Commerce Committee. Many of the bills reauthorize health programs that would otherwise expire later this year.
Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) are aiming to revive Pharmacy Benefit Manager (PBM) legislation in the senate following bipartisan disappointment after it was not included in the federal spending package passed last week. Their bill, the Modernizing and Ensuring PBM Accountability Act, would prevent PBMs from billing based on the discounts they receive from employers and restrict PBMs’ income to exclusively service fees.
Healthcare Boasts Stronger than Expected Jobs Report, However Staffing Problems Persist
At the end of last week, the Bureau of Labor Statistics released its February job report, which came in much stronger than many expected. The economy added 275,000 jobs during the month of February.
Out of the 275,000 new jobs, approximately 67,000 were in the healthcare sector, constituting roughly a quarter of the total new jobs. These were broken down into three main categories:
- Ambulatory Healthcare Services: 28,000
- Hospitals: 28,000
- Nursing and Residential Care Facilities: 11,000
More specifically, ambulatory healthcare services notably include subcategories like physicians, where 8,700 jobs were added. However, not every subcategory gained jobs—outpatient care centers lost 3,500 jobs in February.
While the Hospitals category is not further broken down by the job report, among the 11,000 jobs added in Nursing and Residential Care Facilities, 6,400 were added in skilled nursing care facilities. Another noteworthy statistic is that only 300 jobs were added in assisted living facilities for the elderly.
As the US population continues to age, the demand for jobs in the health sector is going to continue to rise. Despite efforts to increase employment opportunities in this field, residential care facilities, particularly nursing homes, are facing difficulties in filling vacancies. According to a February report from the Office of the Inspector General (OIG), nursing homes continue to face significant staff shortages even in the post-pandemic period.
This is why the Biden administration has been pushing to increase staffing requirements in long term care facilities. However, last week the Republican controlled House Ways and Means Committee blocked HHS from finalizing a rule that would impose minimum staffing requirements for nursing facilities. The logic from the Republicans (and a few Democrats) as that this rule would lead to the closure of numerous facilities, especially in rural and impoverished communities. If true, this could exacerbate health disparities and worsen the already challenging problem of accessing nursing homes in America.
Despite 67,000 new jobs being added to the health sector last month, there are still specific areas suffering from significant staffing shortages. Innovative approaches are essential to increase staffing in healthcare facilities without forcing some facilities to close their doors, especially as closures would disproportionately impact rural and low-income communities.
Change Healthcare Update
UnitedHealth Group (UHG)/Optum plan to start bringing Change Healthcare back online today. UHG/Optum has said it will reconnect Change Healthcare in a gradual/phased approach beginning with payments for claims that were already submitted before the cyberattack. Over the course of the week of the 18th, UHG/Optum will begin to reconnect all other aspects of Change Healthcare. They will provide verification from third-party cybersecurity contractors that have assisted the company’s response to the cyberattack. UHG/Optum continues to make financial assistance available. More information about this assistance is available on the UHG cyberattack website.
CMS began offering advanced/accelerated payments to Medicare providers to help provide cashflow relief until Change Healthcare is reconnected. CMS also published a new FAQ to provide more information about this assistance program.
Meanwhile, HHS OCR announced it is investigating data breaches that may have resulted from the Change Healthcare cyberattack.
Top Stories in Healthcare Policy
The Biden administration released its proposed budget for fiscal year 2025 on Monday, March 11th. Provisions for healthcare address cybersecurity, extend ACA tax credits, and expand Medicare drug price negotiations.
Last Friday, March 8th, the FDA approved Novo Nordisk’s weight-loss drug Wegovy for reducing cardiovascular events, such as strokes and heart attacks, for adults with cardiovascular disease. This approval is the first of its kind for a weight-loss drug.
Eli Lilly’s Alzheimer’s drug Donanemab will be reviewed by an external advisory committee, delaying the expected approval of the drug by the FDA. The date to convene the advisory committee has not been set.
A letter sent from HHS Secretary Xavier Becerra and Department of Labor Acting Secretary Julie Su to UnitedHealth Group urged insurers to take action to assist providers by making interim payments, easing administrative burden, and forgoing prior authorization.
The Office of the National Coordinator for Health Information Technology (ONC) is working on its second rule for Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability. HTI-2 will focus on standards that will further interoperability, promote public health data modernization, and certify application programming interfaces.
A study published in Health Affairs this month found that Medicare Part D plans excluded brand-name compounds from formularies at a higher rate than Medicare Advantage-Part D plans. Standalone part D plans subjected 14% of compounds to prior authorization or step therapy in 2020, compared to 11.5% in 2011.
The Department of Health and Human Services (HHS) task force on artificial intelligence consists of senior officials from the agencies that comprise HHS and working groups on various AI issues. The AI task force is responsible for developing monitoring and assessment for AI performance and quality.