Policy Updates: Hill Happenings and Administration Activities

By Garrett Eberhardt February 18, 2020

Hill Happenings

Surprise Billing Legislation Passes House Committee

Last week, the House Committee on Ways and Means passed a bill to fix “surprise” billing, an effort to protect patients from receiving unexpected healthcare bills from outside of their insurance network. H.R. 5826, which has been backed by hospitals and providers, is estimated to save $24 billion over ten years by the Congressional Budget Office. It would use a federal benchmark based on pre-negotiated payments to constrain out-of-network rates for physicians, hospitals, and air ambulances. Providers and insurers could go to outside arbiters on disputed bills higher than $750. The White House had previously requested that any final legislation include air ambulances, but also expressed concern that a push to overuse arbitration will raise healthcare costs.

Senate Majority Leader McConnell Expresses Intent for Appropriations to Adhere to Budget Caps

Following last week’s release of President Donald Trump's fiscal year 2021 budget request that reneged upon previously agreed upon budget caps in the Bipartisan Budget Act of 2019, Senate Majority Leader Mitch McConnell expressed his chamber’s intention to adhere to the agreement. The Senator stated that the legislative body would be aiming for a "relatively regular appropriations process” which would include following the budget caps deal agreed to last year.

Administration Activities

FDA to Create New Controlled Substances Program

Last week, the FDA’s Center for Drug Evaluation and Research announced that it would be creating a program that will coordinate its work on controlled substances, starting with opioids and stimulants. The program will encompass FDA's controlled substances staff, and will launch an opioid data warehouse integrating internal and external data sources next month that will help the agency  to better assess vulnerability points in the population, inform on trends, anticipate new developments in the crisis, and support regulatory changes. It will also work to address rising rates of stimulant drug overdose deaths and may develop guidance on developing medications to treat cocaine and methamphetamine use disorder. On March 10, it  will hold a Patient-Focused Drug Development (PFDD) meeting to obtain patient perspectives on the impact of stimulant use disorder, including cocaine, crystal meth and misuse of prescription stimulants such as Adderall or Ritalin, as well as views on treatment approaches.

Federal Court Rules Against Medicaid Work Requirements in Arkansas

On Friday, a federal appeals court unanimously ruled against the Trump administration’s plan for work requirements under the Medicaid program in Arkansas. In a 3-0 vote, the U.S. Court of Appeals for the District of Columbia Circuit ruled that the Department of Health and Human Services (HHS) does not have the authority to require some Medicaid enrollees to work in order to receive coverage. Their decision upholds an earlier ruling in a lower court blocking the administration from allowing states to require some enrollees to work or participate in a similar activity, such as job training, volunteering, or enrolling in school. Work requirements have been approved in ten states with nine others seeking similar rules. HHS’ Centers for Medicare and Medicaid Services says that it is reviewing and evaluating the opinion and determining next steps.

Ending the Epidemic

PS20-2010 NOFO Materials Available Online

The Centers for Disease Control and Prevention’s Division of HIV/AIDS Prevention recently announced the publication of Notice of Funding Opportunity (NOFO) PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States with an application deadline of March 25, 2020 11:59 p.m. Eastern Standard Time. Webinar recordings for Components A and B have been made available, as has a fillable version of the optional EPMP and Work Plan template and an FAQ. For any questions, please contact Angela Johnson or Emily McCloskey.

Upcoming Conferences

Hep B United’s 2020 Summit will be held on July 16-17, 2020 in Atlanta, GA at the CDC Global Communications Center. Information regarding how to register for the conference will be forthcoming over the next few months.

Job Opportunities

Associate, Hepatitis – Washington, DC

NASTAD is currently seeking a Hepatitis Associate who will support NASTAD’s viral hepatitis program in providing technical assistance and capacity building to health departments throughout the nation to advance efforts related to integrated viral hepatitis prevention and surveillance activities. The position will support key activities under Centers for Disease Control and Prevention (CDC) Technical Assistance for Viral Hepatitis Prevention and Surveillance cooperative agreement, support the Senior Manager of Hepatitis in the tracking and reporting of viral hepatitis technical assistance, and contribute to Monitoring, Evaluation, and Learning activities within the viral hepatitis program and overall NASTAD prevention portfolio.

Health Resource Analyst II – Nevada

The state of Nevada is looking for a Health Resource Analyst to assist in the development, maintenance, implementation, and revision of State health care policies and programs. The position will be located in Las Vegas with the Division of Public and Behavioral Health, Community Health Services, Office of HIV. It serves as the lead for HIV epidemiology and data analyses, mapping and visualization, investigation of anomalies, coordination with other disease surveillance systems, data quality review and assurance, and alerting and dissemination of health information.

Epidemiology Unit Manager – Michigan

The state of Michigan is seeking an HIV/STD Epidemiologist Manager to direct to a team of epidemiologists in its Lansing and Detroit offices regarding HIV/STD reports and activities. The position would also be responsible for conducting analysis and interpretation of surveillance data, working with other unit managers to set and complete objectives, performing data analyses, helping to resolve database issues and presenting data to groups as requested. This position also provides support and consultation to other units within the HIV and STD Division.

Program Director – New York

Whitney M. Young Jr Health Center, located in NY’s Capital District, is a regionally-focused FQHC that provides outreach, screening and treatment to patients with, and at-risk for, HIV/AIDS, STIs and Hepatitis C. The health center is looking to hire a Program Director of Community Prevention & Treatment Services who would oversee multiple federal and State-funded initiatives. The position offers not only the chance to lead program services, but also influence policy through advocacy and interaction with the NYS Department of Health, AIDS Institute.

Program Specialists IV – Texas

The Texas Department of State Health Services (DSHS) is seeing applicants for two Program Specialist IV positions. The positions will be responsible for ensuring that organizations who enter into written agreements with DSHS to provide HIV, STD, and hepatitis C (HCV) programs deliver services that are consistent with the needs of the population to be served and are in accordance with State and Federal mandates and program requirements. The positions will also administer and oversee HIV/STD/HCV prevention activities (which may include focused or routine testing, linkage to HIV-related medical care, structural interventions, nPEP/PrEP, and varied evidence based interventions) and plans and direct the development, implementation, and evaluation of HIV/STD/HCV programs.

Policy Fellowship – Online

Positive Women’s Network USA is seeking applicants for a year-long fellowship on effective engagement in federal, state and local policy and advocacy. The Fellowship period is April 2020 – March 2021 and fellows will participate in a series of interactive web-based and a possible in-person skills-building session delivered by PWN staff and other policy experts. Fellows will also expand their understanding of the structure of government and how federal policy is developed, implemented and funded, learn key frameworks for advocacy interventions, and learn to analyze policy.

Manager, Prevention – Washington, DC

NASTAD is seeking a Prevention Manager as part of its prevention team to support health departments and community-based organizations implementation of high-impact HIV prevention programs. The position is responsible for providing technical assistance and training related to HIV cluster response, biomedical interventions, and Pre-Exposure Prophylaxis (PrEP). The Manager, Prevention will coordinate training strategies related to HIV policy and health systems; and implement Jurisdictional TA Plans for health departments.

Associate, Prevention – Washington, DC

NASTAD is seeking a Prevention Associate to support NASTAD’s Capacity Building Assistance (CBA) program in providing technical assistance to health departments in the southern U.S. to advance efforts related to integrated HIV prevention activities and structural interventions. This position will report to the Senior Manager, Prevention and will be expected to work with other NASTAD teams, including Drug User Health, Hepatitis, Health Care Access, Health Systems Integration, and Health Equity to support cross-program collaborative activities.

News Bulletin

5 Years After Indiana's Historic HIV Outbreak, Many Rural Places Remain At Risk

“Ethan Howard cradled his prized Martin-brand guitar, strumming gently as he sang of happiness he thought he'd never find. With support from his family and community, the 26-year-old is making his way as a musician after emerging from the hell of addiction, disease and stigma. The former intravenous drug user was among the first of 235 people in the southern Indiana community of Austin, Ind., to be diagnosed in the worst drug-fueled HIV outbreak ever to hit rural America.

Now, five years after the outbreak, Howard counts himself among the three-quarters of patients here whose HIV is so well controlled it's undetectable, meaning they can't spread it through sex. He's sober in a place that has new addiction treatment centers, a syringe exchange and five times more addiction support groups than before the outbreak.

But as this city of 4,100 recovers, much of the rest of the country fails to apply its lessons. The Centers for Disease Control and Prevention deemed 220 U.S. counties vulnerable to similar outbreaks because of overdose death rates, the volume of prescription opioid sales and other statistics tied to injecting drugs.”