Policy Updates: Hill Happenings and Administration Activities

By Mike Weir December 10, 2018

Hill Happenings 

Right Rebate Act of 2018 

Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) introduced the Right Rebate Act of 2018. The bill would allow the Department of Health and Human Services (HHS) to “fine drug companies that knowingly misclassify products in Medicaid and recover rebate payments that are due. It also gives HHS the ability to correct misclassifications.” 

Committee Assignments 

Congressional leaders will spend the coming weeks giving committee assignments to members. With Democrats losing Senate seats in the midterms, Minority Leader Chuck Schumer (D-NY) has to renegotiate committee assignments with Republicans before the 116th Congress begins in January. Since Democrats now control the House, they will have to assign and select leadership for various committees of interest. Many of the committees impacting HIV and hepatitis funding and public health programs will see changes due to retirements and losses. Committee leadership votes will take place on January 3, the first day of the new Congress.  

Anticipated House Committee Assignments

Appropriations Committee: 
Chair:  Nita Lowey (D-NY-17) 
Ranking Member: Kay Granger (R-TX-12) 

Budget Committee: 
Chair: John Yarmuth (D-KY-3) 
Ranking Member: Steve Womack (R-AR-3) 

Energy and Commerce: 
Chair: Frank Pallone (D-NJ-6) 
Ranking Member: Greg Walden (R-OR-2) 

Ways and Means: 
Chair: Richard Neal (D-MA-1) 
Ranking Member: Kevin Brady (R-TX-8) 

Election Results 

As a result of the 2018 elections, Democrats now control the House and Republicans have expanded their Senate majority. Currently in the House, Democrats have 234 seats to Republicans 198; there are still three undecided races. In the Senate, Republicans gained two seats, bringing their majority to have 53 seats to Democrats 47.  

Administration Activities  

Medicare Protected Classes 

Last week the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes amendments to the Medicare Prescription Drug Benefit program (Part D) protected class regulations, commonly known as “the six protected classes.” In close collaboration with its HIV, Medicare, and drug pricing partners, NASTAD continues to assess the impact of three major provisions on Medicare and Part D payer and beneficiary costs; Ryan White HIV/AIDS Programs and ADAPs; and, importantly, patient access to therapeutic options. NASTAD will be preparing comments on the proposed rule and welcomes any feedback from health department programs. 

Personnel Updates 

HHS Secretary Alex Azar announced that John O'Brien will serve as Senior Advisor to the Secretary for Drug Pricing Reform. Previously, O’Brien had served as Advisor to the Secretary for health reform and drug pricing, as well as Deputy Assistant Secretary for Health Policy within the Office of the Assistant Secretary for Planning and Evaluation. 

Presidential Advisory Council on HIV/AIDS 

The first Presidential Advisory Council on HIV/AIDS (PACHA) meeting in over a year has been scheduled for March 14. HHS Secretary Azar is still in the process of finalizing the PACHA members and no invitations have been extended. 

Office of Management and Budget  

NASTAD signed onto a letter urging the Office of Management and Budget (OMB) to include $40 million in funding as authorized for the implementation of the “Eliminating Opioid Related Infectious Diseases Act of 2018” in the Administration’s budget request for FY2020. 

The AIDS Budget and Appropriations Coalition (ABAC), which NASTAD co-chairs, also sent a letter urging OMB to increase crucial funding for domestic HIV and hepatitis programs in the President’s FY2020 budget.  

Wildfire Public Health Emergency  

Secretary Azar declared a public health emergency in Alaska due to the recent earthquake. The declaration gives CMS “beneficiaries, their healthcare providers and suppliers greater flexibility in meeting emergency health needs in the aftermath of the earthquake.” 

USPSTF Recommendation 

The U.S. Preventive Services Task Force (USPSTF) issued a Draft Recommendation Statement for pre-exposure prophylaxis (PrEP), with a proposed ‘A’ grade for “persons at high risk of HIV acquisition.” The opportunity for public comment on USPSTF’s Draft Recommendation Statement expires on December 26, 2018 at 8:00 PM EST.  

USPSTF also released a Draft Research Plan for Screening for Hepatitis B in Nonpregnant Adolescents and Adults. The comment period is open from today, November 29, 2018 through January 2, 2019. 

NASTAD is preparing comments for both drafts and encourages members and partners to submit comments of their own. 

2019 Open Enrollment 

Open enrollment ends on December 15, 2018. Enrollment on the HealthCare.gov platform during the first five weeks of plan selections have lagged roughly 5% behind the rate during the same period last year.  

NASTAD released PrEPcost.org as an online tool to help PrEP navigators and their clients evaluate the cost and coverage for PrEP across on- and off-Marketplace health plans. 

Job Opportunities 

Disease Intervention Specialist – Alaska 
The Alaska Department of Health and Social Services is hiring for a Disease Investigation Specialist I within their Division of Public Health, Section of Epidemiology, HIV/STD Program. 

DExIS Project Coordinator – Philadelphia 
The Philadelphia Department of Public Health is hiring for a DExIS Project Coordinator within their AIDS Activities Coordinating Office. 

Upcoming Conferences 

2019 National HIV Prevention Conference 

The 2019 National HIV Prevention Conference will be held March 18-21, 2019 in Atlanta, Georgia. Check out the updated website for more information about tracks and to view the tentative conference schedule.  

2019 HIV Diagnostics Conference 

The 2019 HIV Diagnostics Conference will be held in Atlanta on March 25-28, 2019. The conference will address advances in diagnostic testing, and strategies for using test technologies in public health programs and clinical practice.  The conference program this year expands beyond HIV testing, and incorporates STI and HCV testing technologies and strategies, with an emphasis on integrating testing programmatically.  As with past conferences, there will be a mix of oral presentations, panel discussions, and poster sessions. We strongly encourage health department HIV, HCV, and STI testing program managers and other staff consider submitting an abstract, attending the conference.   

PrEP Public Health Detailing Institute 

The San Francisco Department of Public Health (SFDPH) is hosting its second annual “Public Health Detailing Institute” for health departments who are interested in building provider capacity to offer PrEP and immediate ART for those diagnosed with HIV. Registration will close on December 17, 2018. The Institute is scheduled in San Francisco from February 20-22 and is free of charge (health departments will need to cover hotel and travel costs). This institute is being co-hosted by the New York City Capacity Building Assistance program and the National Resource Center for Academic Detailing (NaRCAD). 

Resources 

NASTAD released a map detailing jurisdictions who have developed Ending the Epidemic plans. These plans are dynamic and will be updated as progress continues. 

Patient and provider perceptions of a comprehensive care program for HIV-positive adults over 50 years of age: The formation of the Golden Compass HIV and aging care program in San Francisco 

News Bulletin 

The impact PEPFAR had on HIV/AIDS in Africa 
“U.S. Global Aids Coordinator, Ambassador Deborah Birx, discusses the Emergency Plan for AIDS Relief or PEPFAR and its impact on HIV/AIDS in Africa.”