House and Senate Set to Move Health Legislation

The House returns Monday to take up the following bills under Suspension of the Rules: H.R. 4771, the Designer Anabolic Steroid Control Act of 2014 and S. 2154, the Emergency Medical Services for Children Reauthorization Act of 2014, which was passed in the Senate last week. On Tuesday the suspension calendar includes the following health-related bills: H.R. 4276, the Veterans Traumatic Brain Injury Care Improvement Act of 2014 and H.R. 4994, the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. It is also possible that House Republicans will again attempt to repeal the Patient Protection and Affordable Care Act’s (PPACA) medical device tax, this time by including the provision in another tax bill that could be brought up this week. Also of note, the Chairman of the House Energy and Commerce Committee, Fred Upton (R-MI), announced at a committee hearing that he plans to release in January a discussion draft of legislation which is an outgrowth of the committee’s “21st Century Cures” hearings and roundtables. The legislation is expected to target the acceleration of medical breakthroughs by, among other things, modernizing clinical trials and creating incentives for the development of new drugs and devices and increasing the number of young scientists.

House and Senate Pass Additional Health-Related Bills

Despite Democrat opposition and a veto threat, last week House Republicans were successful in their efforts to pass H.R. 3552, the Employee Health Care Protection Act, which would allow health insurers to continue to offer group health insurance coverage in 2014 outside of PPACA exchanges to the extent that such policies were offered on any date in 2013 (even though they do not meet PPACA minimum essential coverage provisions). Without opposition, the House also sent to the Senate the following measures: H.R. 4067, to delay enforcement for the remainder of 2014 of a Medicare supervision requirement for outpatient therapeutic services in critical access and small, rural hospitals; H.R. 669, the Sudden Unexpected Death Data Enhancement and Awareness Act; H.R. 4290, to reauthorize the Emergency Medical Services for Children Program, the Wakefield Act of 2014; and H.R. 4701, the Vector-Borne Disease Research Accountability and Transparency Act of 2014. In addition, the House Judiciary Committee voice voted H.R. 4299, the Improving Regulatory Transparency for New Medical Therapies Act, which would require the Drug Enforcement Agency (DEA) to issue an interim final rule on the scheduling of a new drug no later than 60 days after it receives the FDA’s scheduling recommendation as well as change the process the DEA uses in approving controlled substances for clinical trials. In addition, the President signed into law the following legislation: H.R. 3230, to improve the access of veterans to medical services from the Department of Veterans Affairs (Public Law 113-146) and H.R. 4631, to reauthorize certain provisions of the Public Health Service Act relating to autism (Public Law 113-157).

House Republicans Focus on PPACA Implementation

In a House Ways and Means Health Subcommittee hearing, the Internal Revenue Service (IRS) Commissioner testified that the IRS needs additional funding if the agency is to administer the PPACA properly. He said, of the 150 million individual income tax returns to be filed for 2014, about 120-125 million persons will only have to check a box that they have obtained PPACA mandated coverage. Others who obtain premium tax subsidies will have to make calculations so as to determine whether they are due refunds or owe additional tax because their actual income differs from the initial estimate used for the subsidy payments. The newly appointed Deputy Administrator of the Centers for Medicare and Medicaid Services (CMS) also testified that the upcoming open enrollment will go more smoothly after fixes were made this summer to HealthCare.gov, but that the auto-enrollment feature has yet to be fully tested. He said that the number of discrepancies that were found regarding citizenship and U.S. residency eligibility has been reduced from 310,000 to less than 10,000. Despite U.S. Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell’s statement that she wants her agency and Congress to establish a better working relationship with regard to the reform law, House Energy and Commerce Committee Republicans sent her a letter demanding that the agency stop “stonewalling” their request for information on state-run exchanges and the billion dollars HHS provided to states that failed to adequately implement their websites. To help individuals enroll this fall in health insurance exchanges, HHS announced that about $60 million has been awarded to navigator organizations in 34 states.

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