POLICY BRIEFINGS


OMB Will Not be Invited to Testify on President’s Budget Proposal


Senate Budget Committee Chairman Mike Enzi (R-Wyo.) and House Budget Committee Chairman Tom Price (R-Ga.) announced last week that they would not hold hearings with White House Budget Director Shaun Donovan to review the president’s fiscal year (FY) 2017 budget, as is customary practice. The budget chairmen blame the administration’s focus on new spending instead of reducing the nation’s debt as reason for their decision. The announcement was strongly criticized by both the administration and congressional Democrats. The President’s budget will officially be released tomorrow, and congressional Republicans are expected to release their own budget proposal in the coming weeks.


Feedback Sought on Site Neutral Payments


Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and Health Subcommittee Chairman (R-Pa.) are soliciting input on policy changes regarding site neutral payments, specifically policies that would potentially amend or expand the site-neutral provision included in the Bipartisan Budget Act of 2015. The Committee requests written feedback be provided no later than February 19.


FDA Announces Plans to Change Opioid Approvals


The Food and Drug Administration (FDA) has announced a new set of actions to address the opioid abuse epidemic. The announcement was made in response to holds placed on the nomination of Robert Califf to lead the FDA over senators’ concerns about agency opioid approval policies. The FDA will convene independent advisory committees for new opioid drugs that do not have abuse-deterrent proprieties. The agency will strengthen post-market reporting requirements for manufacturers of opioids, and make changes to opioid labeling requirements. It will also update its opioid risk evaluation and mitigation strategy program, and issue guidance on approval standards for the development of drugs with abuse-deterrent formulations. The FDA will work on increasing access to drugs like naloxone, and evaluate how it considers risk when reviewing opioid drug applications. Sen. Edward Markey (D-Mass.) and Sen. Joe Manchin III (D-W.V.) praised some of the agency’s actions but reaffirmed their position that the FDA does not go far enough to strengthen the oversight of opioid medications.


MACPAC Releases Report on Medicaid DSH Payments


The Medicaid and CHIP Payment Advisory Committee (MACPAC) has released a report to Congress examining how Medicaid disproportionate share hospital (DSH) payments relate to changes in the number of uninsured individuals, amounts and sources of hospitals’ uncompensated care costs and the number of hospitals with high levels of uncompensated care that also provide access to essential community services for low-income, uninsured and vulnerable populations. The analysis does not find a meaningful relationship between state DSH allotments and any of these factors. The Commission recommends that DSH payments be better targeted towards states and hospitals that serve a disproportionate share of Medicaid and low-income patients and that have higher levels of uncompensated care. MACPAC notes the need for greater transparency on how hospitals are being paid and more data on hospital uncompensated care.



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