Zika Update

The House and the Senate approved two very different funding packages last week to combat the Zika virus. The Senate attached an amendment from Sens. Roy Blunt (R-Mo.) and Patty Murray (D-Wash.) for $1.1 billion in Zika funding through September 2017 to the merged Transportation-Housing and Urban Development, Military Construction and Veterans Affairs appropriations legislation. The amendment would require a spending plan update to be submitted to the Senate Appropriations Committee every 90 days through the end of September 2017, and every 180 days thereafter until all of the funding appropriated has been spent. Although the Zika funding measure was criticized by some conservatives for not being offset, and by Democrats for being inadequate, the bill was passed by a vote of 89-8. While the $1.1 billion in Zika funding passed by the Senate is less than the President’s request of $1.9 billion, it is significantly more than the $622 million approved to fight the virus through the end of the current fiscal year (FY) in the House. The fully offset supplemental spending bill (H.R. 5234) was offered by Appropriations Chairman Harold Rogers (R-Ky.). It includes $103 million for the Biomedical Advance Research and Development Authority (BARDA), $119.1 million for State Department and U.S. Agency for International Development (USAID) programs, $170 million for the Centers for Disease Control and Prevention (CDC), $230 million for the National Institutes of Health (NIH) and $2 million for oversight of how the funding is spent. The House package is paid for through $252.1 million in money originally set aside to address the Ebola virus, and $270 million in unused administrative funding at the U.S. Department of Health and Human Services (HHS). The House funding level has been denounced by both Democratic lawmakers and the administration, and the bill has received a veto threat from the White House. A potentially complicated conference will now be necessary to reconcile the considerable differences between the two chamber’s spending provisions. The CDC also released updated figures on U.S. Zika infection rates last week, announcing that at least 279 pregnant women in the United States and territories are infected with the virus.

New Draft of Mental Health Bill Circulating the House

Chairman of the House Energy and Commerce Committee Fred Upton (R-Mich.) is circulating a revised draft of Rep. Tim Murphy’s (R-Pa.) mental health legislation, which has seen no movement in recent months due to concerns about the bill from members on both sides of the aisle. In order to accommodate conservative members, Upton is working to reduce the cost of H.R. 2646, the Helping Families in Mental Health Crisis Act of 2016, through scaling back a provision that would allow Medicare to cover more care at mental health facilities. One of the many provisions committee Democrats have voiced objection to is a change to the Health Insurance Portability and Accountability Act (HIPAA) in order for family members to have more information about mentally ill patients. The revised draft would drop this language and instead encourage the U.S. Department of Health and Human Services (HHS) to review HIPAA privacy regulations. Chairman of the Health Subcommittee Joe Pitts (R-Pa.) has said that he expects the bill to be marked up by the full Committee before the congressional recess in July.

Ways and Means Releases Hospital Bill

The House Ways and Means Committee has unveiled legislation that would revise a measure impacting hospitals included in last year’s budget deal. H.R. 5273, the Helping Hospitals Improve Patient Care Act of 2016, would allow hospitals that were already in the process of constructing off-campus outpatient centers last year to be grandfathered into outpatient payment rates. The budget agreement largely restricted the application of such rates to these centers. The Ways and Means bill would also exclude certain cancer centers from the payment changes included in the budget deal, which attempted to address concerns about Medicare paying more for the same services provided in hospital outpatient departments than in the physician’s office. Additionally, H.R. 5273 would temporarily exclude doctors providing the majority of their Medicare services at ambulatory surgical centers (ASC) from electronic health record (EHR) requirements under both meaningful use (MU) and the merit-based incentive payment system (MIPS). The legislation also includes a delay on the authority of Medicare to terminate a Medicare Advantage (MA) plan based solely on the failure to achieve a minimum quality rating. The bill is fully offset. The Ways and Means Committee meets to markup H.R. 5273 on Tuesday.

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