Verma to Begin Confirmation Process

The Senate Finance Committee will hold a hearing on the nomination of Seema Verma to be administrator of the Centers for Medicare and Medicaid Services (CMS) on Thursday. The Office of Government Ethics posted an agreement on potential conflicts of interest with the nominee last week, which will allow her confirmation process to move forward. This agreement is a routine step for vetting presidential nominees. Verma has worked with a number of states as a Medicaid consultant, and listed Arkansas, South Carolina, Virginia, Maine, Nebraska, Iowa, Idaho, Ohio and Kentucky as her clients. Ms. Verma will likely be questioned by Democrats about her role in reshaping the Medicaid program, particularly in the state of Indiana. The Healthy Indiana program uses accounts similar to health savings accounts (HSAs) to help Medicaid beneficiaries manage their own care. Verma is known for favoring increased flexibility for states to administer their Medicaid program.

Grassley to Examine Orphan Drug Program

Sen. Chuck Grassley (R-Iowa) announced plans to examine whether the orphan drug program is being inappropriately used by pharmaceutical manufacturers to increase the price of drugs. His decision was announced a day after the Food and Drug Administration (FDA) approved Emflaza, a treatment for Duchenne muscular dystrophy, for which insurers could pay as much as $89,000 for a year of treatment. Because Emflaza is used to treat a rare condition with few other treatment options, it was awarded an orphan drug designation by the FDA. This designation permits a longer period of exclusivity before a generic can enter the market. Sen. Grassley said he is interested in learning about the unanticipated effects of the designation, whether it contributes to unnecessarily high drug prices, and what the extent of the problem is.

Lawmakers Continue Work on Medicaid Reform

Last week, a group of Republican senators met to discuss the future of the Medicaid program amidst work being done to repeal and replace the Affordable Care Act (ACA). All of the Senators came from states that expanded their programs as a result of the 2010 health care law. Medicaid expansion provided coverage for an additional 11 million people across the 31 states that decided to expand program eligibility. While Republicans are collectively supportive of repealing and replacing the law, some governors and members of congress are concerned about constituents who could lose coverage as a result. While no decisions were made at the meeting, Sen. Rob Portman (R-Ohio) said that there was agreement about the need for more state flexibility. Senators also agreed that savings from repeal should be put toward maintaining health insurance coverage during the transition away from the ACA. Additionally, the House Energy and Commerce Health Subcommittee advanced two Medicaid bills last week. Both target beneficiaries who lawmakers believe may earn too much to qualify for the program. H.R. 829 would alter Medicaid eligibility for recipients of large lump-sum payments, such as lottery winners. It was advanced by a vote of 20-11, with Rep. Kurt Schrader (D-Ore.) being the only Democratic member to vote for the legislation. H.R. 181 would count income from annuities in determining Medicaid eligibility for those in long-term care. The bill was advanced by a party-line vote of 19-13. While Republicans support the bills as commonsense approaches to ensure Medicaid expenditures are available to those who most need assistance, Democrats argued that the legislation would only serve to curb benefits, and pointed to the lack of evidence that these policies will save money for the program. The Government Accountability Office (GAO) also released a new report that underscores the need for improved oversight of the Medicaid program. GAO finds that Medicaid made an estimated $36 billion in payment errors last year. The agency reports that program administrators rely on state submitted data to inform their oversight activities, but there are continuing concerns about the completeness, accuracy and timeliness of this data. GAO recommends expedited efforts to assess and ensure the quality of new Medicaid data.

Upcoming Congressional Hearings and Meetings

House Science, Space, and Technology Research and Technology Subcommittee will hold a hearing titled “Strengthening U.S. Cybersecurity Capabilities;” 10:00 a.m., 2318 Rayburn Bldg.; February 14

The Senate Appropriations Labor/HHS Subcommittee will hold a hearing on “Mental Health Care: Examining Treatments and Services;” 10:30 a.m., 138 Dirksen Bldg.; February 15

Senate Finance Committee hearing on the nomination of Seema Verma to be the administrator of the Centers for Medicare and Medicaid Services; 10:00 a.m., 215 Dirksen Bldg.; February 16

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