WASHINGTON — Alex Azar, JD, Secretary of the Department of Health and Human Services, garnered a warm reception from community health centers who he called “pioneers” in the transformation to value-based care. But the mood at a House subcommittee hearing was less convivial.
Azar Champions Community Health Centers
Alex Azar, JD, the new head of the Department of Health and Human Services, gushed over community health centers’ achievements during a speech to the National Association of Community Health Centers (NACHC) at its Policy and Issues Forum on Friday.
“Wouldn’t it be nice if we had a set of thousands of partners with a long record of providing quality care in both urban and rural communities? Wouldn’t it be great to have a set of partners who are leading on efforts to integrate physical and behavioral healthcare?” Azar asked.
The tenor of that meeting contrasted sharply with a fiery House subcomittee hearing he participated in a day earlier.
Rep. Rosa DeLauro (D-Conn.), Ranking Member on the Labor, Health and Human Services, and Education Appropriations Subcommittee, said the proposal had “bright spots” but questioned some of the suggested cuts.
“On the one hand, the department requests funding for opioids, which is great. On the other hand, the department slashes access to substance abuse treatment and cuts million from the Substance Abuse and Mental Health Services Administration. Again, I don’t understand the logic.”
Keep Fee Schedule Update, Get Rid of MIPS, Says MedPAC
Congress should stick to the scheduled Medicare physician fee schedule payment update of 0.5% for physicians in 2019, according to a report released Thursday by the Medicare Payment Advisory Commission (MedPAC).
“The landscape for the fee-for-service sector this year is very consistent with overall trends observed in the last several years,” with beneficiaries generally having adequate access to doctors, and that’s why no additional increase or decrease is required, MedPAC executive director Jim Mathews said on a phone call with reporters. The report also recommended that the fee schedule for hospital inpatient and outpatient services continue as specified by current law, he added.
But the commission was a little harsher when it came to ambulatory surgery centers (ASCs), recommending that Congress eliminate the 2019 scheduled update to ASC payment rates; the group recommended that Health and Human Services secretary Alex Azar require ASCs to submit their cost data to the Centers for Medicare & Medicaid Services (CMS).
In terms of physician payments specifically, the commission voted in January to eliminate Medicare’s Merit-Based Incentive Payment System (MIPS) and replace it with a voluntary program “under which physicians could elect to be measured on a small number of population-based outcomes measures,” Mathews said.
GOP Senator: Solve Opioid Crisis Through Community, Not Policy
Trying to understand who gets addicted to opioids, and what drives them to drugs in the first place, can help shape a response to the issue, according to a Republican lawmaker.
At an American Enterprise Institute (AEI) briefing on Tuesday, Sen. Mike Lee (R-Utah) tied the roots of the opioid abuse epidemic in the U.S. back to the Civil War, and the “social turmoil” that followed. The war “robbed Americans of a sense of purpose” that left people vulnerable to addiction, just as opioids were entering the country, he stated.
A Republican lawmaker and policy experts explored the role of social and cultural factors in the opioid epidemic and ways to address the crisis during an AEI panel discussion on Tuesday.
Lee added that he sees parallels with that crisis and the current epidemic. “The people most vulnerable to opioid addiction are often lonely and cut off from sources of personal fulfillment. “And by that I mean family, meaningful work, and engagement with friends and with neighbors.”
FDA Sets Path to Lower Nicotine in Cigarettes
The FDA has issued an advance notice of proposed rulemaking (ANPRM) to explore lowering nicotine levels in combustible cigarettes to non-addictive levels, FDA Commissioner Scott Gottlieb, MD, announced Thursday.
“This new regulatory step advances a comprehensive policy framework that we believe could help avoid millions of tobacco-related deaths across the country,” Gottlieb explained in a written press statement.
The proposal to reduce nicotine levels in cigarettes is the centerpiece of a comprehensive tobacco regulatory strategy announced by FDA officials last July.
The FDA will conduct a comprehensive review of the scientific evidence involving nicotine’s role in cigarette addiction and seek input from the public. At this time, however, no specific nicotine limit has been set.
Senate Panel Addresses Native Americans’ Opioid Troubles
Native American tribes need federal funding to help tackle the opioid epidemic and new legislation can help, witnesses told the Senate Committee on Indian Affairs on Wednesday.
Testimony also addressed workforce shortages and the importance of culturally appropriate care. Some witnesses urged that more support be given to traditional healing practices that can be incorporated into mainstream substance use disorder treatment programs.
An administration official — Christopher Jones, PharmD, policy laboratory director in the Substance Abuse and Mental Health Services Administration — appeared hesitant to directly press for more funding. Nevertheless, Sen. Jon Tester (D-Mont.) said Native Americans would be getting some.
Currently about $10 billion has been earmarked for the Department of Health and Human Services to deal with opioids, he said.
“I will try … to peel some of this money off and dedicate it to Indian Country and I would hope you wouldn’t oppose that when it comes through,” he said.
On Monday, Health IT Now and the Bipartisan Policy Center will convene a panel to examine the what role the government should play in health IT.
On Wednesday, the House Commitee on Energy and Commerce will discuss public health efforts to prevent the opioid crisis from worsening.
And a House Committee on Government Reform will discuss improper payments in Medicaid.
Also on Wednesday, The Atlantic hosts a briefing on “The State of Care: Patient Access and Affordability.”
And POLITICO and CALL9 host “Avoiding 9-1-1” a discussion about improving healthcare in nursing homes and reining in costs.
On Wednesday and Thursday, the FDA hosts a joint meeting of its Blood Products Advisory Committee and the Microbiology Devices Panel of the Medical Devices Advisory Committee to provide recommendations to the agency regarding the classification of devices and regarding research programs in the Office of Blood Research and Review.
On Thursday, the FDA’s Pediatric Advisory Committee and the Endocrinologic and Metabolic Drugs Advisory Committee will explore “major objectives of a phase 3 drug development program indicated for the treatment of children with achondroplasia.”