Policy Updates: Hill Happenings and Administration Activities

By Mike Weir April 2, 2018

Hill Happenings

Medicaid

Senate Finance Committee ranking member Ron Wyden (D-OR) and House Energy and Commerce ranking member Frank Pallone (D-NJ-6th) are asking the U.S. Government Accountability Office (GAO) to review the costs associated with implementing and administering new Medicaid 1115 waivers — specifically work requirements — approved by the Trump administration. In a letter to U.S. Comptroller General Gene Dodaro, the lawmakers say they are concerned these waivers pose "substantial and unknown administrative costs" to Medicaid. They request a GAO review of administrative costs associated with setting up the programs and whether states are using contractors to implement and administer them.

Administration Activities  

FY2019

The Congressional Justification (CJ) for the Substance Abuse and Mental Health Services Administration (SAMHSA) was recently released. The CJ proposes to eliminate all SAMHSA Minority AIDS Initiative (MAI) programs. In place of MAI programing, the Administration is proposing a $150 million “Reducing Injection Drug Use, HIV/AIDS and Hepatitis” program. NASTAD will continue to provide updates as Congress examines the Administration’s budget requests.

Health and Human Services Priorities

On Thursday, Health and Human Services (HHS) Secretary Alex Azar announced the appointments of Daniel Best and Brett Giroir to lead initiatives in areas identified as priorities for the Department. Secretary Azar has previously identified four initiatives for his transformation agenda: combating the opioid crisis; bringing down the high cost of prescription drugs; addressing the cost and availability of health insurance; and transforming our healthcare system to a value-based system.

News Bulletin

Grindr App to Offer H.I.V. Test Reminders

“In an effort to shrink the global AIDS epidemic, the world’s largest gay dating app is changing its software this week to urge millions of users to get frequent H.I.V. tests. Grindr, which claims to have 3.3 million daily users from every country in the world, will send men who opt into the service a reminder every three to six months, and simultaneously point them to the nearest testing site. It will also let clinics, gay community centers and other testing sites advertise for free.”

Testing for hepatitis C lags with baby boomers despite high infection rate

“Testing for hepatitis C, a major cause of liver cancer, is lagging behind among the group of Americans with the highest rate of infection: baby boomers. A study published Tuesday showed that only about 13 percent of baby boomers were tested in 2015, up just slightly from 12 percent in 2013. U.S. public health authorities recommend all people in that demographic — those born between 1945 and 1965 — be screened for hepatitis C.”

This study changed how a Harvard professor thinks about health care

“What does, of course, set the American health care system apart from its peers — what makes the US exceptional and not average — are the prices patients face when they do seek treatment. That is why the United States doesn’t look average on this other chart, which looks at our health care spending overall.”

Utah seeks to partially expand Medicaid

“It's the latest state to ask the Trump administration for millions of dollars in Medicaid funds without fully expanding its program under Obamacare – putting additional pressure on Trump health officials to let states expand coverage despite their criticisms of the 2010 health law, POLITICO's Rachana Pradhan reports. Utah is one of 19 states that has not expanded Medicaid up to 138 percent of the federal poverty line under the ACA. Instead, it wants to let people earning up to the poverty line qualify.”

Meet the man leading the charge against the global HIV/AIDS epidemic

“Dr. Tedd Ellerbrock, chief of the HIV Care and Treatment Branch at the Centers for Disease Control and Prevention, has played a vital role in building, expanding and improving the U.S.-led program that provides medicine and assistance to more than 13 million people worldwide living with HIV/AIDS.”

Treat the opioid crisis like the HIV/AIDS epidemic: Elizabeth Warren & Elijah Cummings

“In 2017, the Centers for Disease Control and Prevention (CDC) warned that life expectancy in the United States dropped for the second year in a row — and drug overdoses are the single biggest reason why.  As states and communities on the front lines struggle to respond to the opioid crisis, Washington has only nibbled around the edges. Politicians and policymakers make vague promises, treating the crisis as if it is a novel, intractable problem. It is neither. America has addressed this kind of public health emergency before, and we call on Congress to do so now.”

Resources

Estimated HIV Incidence and Prevalence in the United States 2010–2015

HIV Incidence and Prevalence Report

Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV

NACCHO: Statement of Policy: HIV Prevention, Care, and Treatment

HIV and the Opioid Epidemic: 5 Key Points

Funding Opportunities

FY2018 Ryan White HIV/AIDS Program States/Territories Part B Supplemental Grant Program Notice of Funding Opportunity

“The purpose of this program is to supplement the HIV care and treatment services provided by the States/Territories through the RWHAP Part B and AIDS Drug Assistance Program (ADAP) base funds.  The amount of funding awarded is determined by the ability to demonstrate the need in the State/Territory based on an objective and quantified review process.” Application Due: Monday, May 21, 2018.

Research Grants for the Primary or Secondary Prevention of Opioid Overdose

“The funding will support research that expands and advances understanding about what works to prevent opioid overdose. Specifically, the research will either develop and pilot, or rigorously evaluate, novel primary or secondary preventive interventions that address fatal and nonfatal overdose from prescription opioids, illicit opioids, or both. This research is intended to improve health departments’ ability to implement and improve interventions focused on preventing opioid-related deaths. State, tribal, local, and territorial governments, including health departments, that meet the requirements are eligible.” Letter of Intent Due: Thursday, April 12, 2018. Application Due: Tuesday, May 15, 2018

Other News

Aetna to Provide Pharmacy Rebates at Time of Sale, Encourages Transparency from Drug Manufacturers

“Aetna will automatically apply pharmacy rebates at the time of sale for its Commercial fully insured plan members. While the majority of rebates have always been passed on to plan sponsors and their employees through lower premiums, Aetna believes that greater transparency is needed throughout the pharmaceutical supply chain in response to the nearly 25 percent increase in drug prices between 2012 and 2016.”

Impact of Prescription Drug Benefit Legislation (SB 2532) on Access to HIV and Hepatitis C Medications

“We write to share our strong concerns regarding parts of Senate Bill 2532. Specifically, we oppose the provision in the bill that would allow health plans to prohibit the use of manufacturer drug discount cards and coupons from being applied towards beneficiaries out of pocket maximum. We believe, if passed, it would severely restrict patient access to HIV and hepatitis C (HCV) medications. This would endanger people’s lives and have significant individual and public health consequences. We urge you to reject this provision from the bill.”

Fair Pricing Coalition Welcomes U.S. Launches of Mylan’s Tenofovir and Lamivudine Coformulation (Cimduo) and Efavirenz-based Single Tablet Regimens

“The Fair Pricing Coalition (FPC), an ad hoc coalition of HIV and hepatitis C virus (HCV) activists, welcomes the U.S. Food and Drug Administration approvals and launches for Mylan’s Cimduo and Symfi Lo, with benchmark prices 40 percent lower than those of comparator drugs. Cimduo and two efavirenz-based products join a number of off-patent antiretrovirals (ARVs) – both generic and brands – entering the U.S. market that can potentially increase competition and lead to lower prices for purchasers and payors.”

Cigna's Partnership with Physicians Successfully Reduces Opioid Use By 25 Percent – One Year Ahead of Goal

“Cigna today announced that in partnership with more than 1.1 million prescribing clinicians, the global health service company has achieved a 25 percent reduction in opioid use among its customers, reaching this key metric one year ahead of its ambitious initial goal. The broad based effort meaningfully contributes to curbing the opioid epidemic, which has taken thousands of lives, sidelined millions of workers and diverted billions of dollars in the United States.”

Job Opportunities

Health Planning Administrator

The Ohio Department of Health is seeking a Health Planning Administrator.

Program Specialist

The Texas Department of State Health Services is seeking a Program Specialist.

Director of HIV Prevention

The Tennessee Department of Health is seeking a Director of HIV Prevention.