Policy Updates: Hill Happenings and Administration Activities

By Mike Weir July 16, 2018

Hill Happenings

340B Hearing
The House Energy and Commerce Health Subcommittee held a hearing on the 340B program on July 11. The hearing was entitled, “Opportunities to Improve the 340B Drug Pricing Program.” The subcommittee reviewed a recent report by the Government Accountability Office (GAO) on the 340B program. 

FY2019 Appropriations
The House Appropriations Committee passed its FY2019 Labor, Health and Human Services, Educations and Related Agencies Appropriations (LHHS) funding bill on July 11 by a vote of 30-22. The House and Senate intend to bring their bills to a vote on the floor. NASTAD has provided this analysis and released this statement, in partnership with AIDS United, the National Coalition of STD Directors (NCSD), NMAC, and The AIDS Institute, on the FY2019 appropriations bills. 

Administration Activities 

ACA Navigator Grants
The Centers for Medicare & Medicaid Services (CMS) announced it has reduced the budget for navigators who help people sign up for coverage through the Affordable Care Act (ACA). A minimum of $100,000 will be awarded in each of the 34 states that use HealthCare.gov to enroll people into coverage. Grantees will also now be expected to promote not just qualified health plans but association and short-term plans as well. 

ACA Risk Adjustment Payments
CMS recently announced that they would suspend the ACA’s risk adjustment payments to health insurers. The risk adjustment program is a federal program that provides payments to issuers to offset the cost of covering sicker individuals with chronic and complex conditions. The risk adjustment program has been the subject of litigation, and CMS announced that it was suspending payments pending final resolution of the court case. The impact of the decision is unclear. Issuer financial reports released over the past several months had indicated that the 2019 plan year was showing signs of stabilizing, with new issuers preparing to enter the Marketplace in some states. Some experts have cautioned that the suspension of risk adjustment payments pending the court decision may not actually have a significant impact on 2019 premiums. Issuers will continue to finalize their 2019 rates over the summer. Kaiser Family Foundation has developed a premium tracker for the 2019 enrollment period.

Ryan White HIV/AIDS Program Funding Reallocation
A recent article in Slate detailed the Trump Administration’s plan to pay for child separation activities using, at least in part, Ryan White HIV/AIDS Program funds. NASTAD has no reason to believe the referenced reallocations will impact current Ryan White HIV/AIDS Program funding in any way. We are working to obtain detailed information from the Health Resources and Services Administration (HRSA) about the reported reallocation.

340B Coalition Summer Conference
During the recent 340B Coalition Summer Conference, Health and Human Services Secretary Alex Azar emphasized the "need to disrupt the entire system of rebates" as well as the Administration's intentions to reduce the gap between drug discounts and reimbursements.

Office of the Assistant Secretary for Health
Richard Wolitski, PhD, has been placed on detail to develop a new strategic plan for the Office of the Assistant Secretary for Health (OASH). Kaye Hayes, MPA, will be acting Director for the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP).   

2018 National STD Prevention Conference
The 2018 STD Prevention Conference will be held August 27-30, 2018 in Washington, DC. Registration for the conference is now open. 

2018 National Ryan White Conference on HIV Care & Treatment
The 2018 Ryan White Conference on HIV Care & Treatment will be held December 11-14, 2018 in Washington, DC. Registration for the conference is now open. 

2019 National HIV Prevention Conference
The 2019 National HIV Prevention Conference (NHPC) will be held March 18-21, 2019 in Atlanta, Georgia. Check out the updated website for more information about tracks, session and abstract formats, and to view the tentative conference schedule. Abstract submissions are due by midnight EDT on July 20, 2018.

Resources
Surveillance for Certain Health Behaviors and Conditions Among States and Selected Local Areas — Behavioral Risk Factor Surveillance System, United States, 2015

Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop

Expired and Expiring Authorizations of Appropriations Fiscal Year 2018, Revised 

Webinar: Planning ahead for Open Enrollment: What's new for 2019

Webinar: More than Tested, Empowered – Addressing Barriers to HCV Care Among People Who Use Drugs

Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected — 10 States, July 2016–June 2017

Viral suppression for HIV treatment success and prevention of sexual transmission of HIV

News Bulletin

State Prisons Fail To Offer Cure To 144,000 Inmates With Deadly Hepatitis C
“State prisons across the U.S. are failing to treat at least 144,000 inmates who have hepatitis C, a curable but potentially fatal liver disease, according to a recent survey and subsequent interviews of state corrections departments. Many of the 49 states that responded to questions about inmates with hepatitis C cited high drug prices as the reason for denying treatment. The drugs can cost up to $90,000 for a course of treatment.”

Declaring War on Poverty ‘Largely Over,’ White House Urges Work Requirements for Aid
“President Trump’s Council of Economic Advisers declared on Thursday that America’s long-running war on poverty “is largely over and a success,” as it made the case for imposing new work requirements on Americans who benefit from federal safety net programs. The report contends that millions of Americans have become overly reliant on government help — and less self-sufficient — and provided data intended to support the administration’s goal of tying public benefit programs more closely to work.”

NJ Gives Medicaid Patients with Hepatitis C Earlier Access to Life-Saving Drugs
“Tens of thousands of New Jersey Medicaid patients diagnosed with hepatitis C will no longer have to wait until they have liver damage for their insurance to cover potentially life-saving medical treatments, thanks to a new state program and public funding that could also reduce the spread of the infectious disease.”

“The End of Safe Gay Sex?”: A Joint Response from NCSD and NASTAD
“We agree with Patrick William Kelly that much more must be done to tackle skyrocketing rates of STDs in our country and to end the HIV epidemic, but his solution to these problems is all wrong.”

Job Opportunities 

HIV/AIDS Program Manager 
The Minnesota Department of Human Services is hiring for a HIV/AIDS Program Manager position to oversee the Department’s Ryan White Part B Program.