Prime Policy Group’s Healthcare Today – Aug. 9, 2019

The issue of surprise medical bills continues to be a big focus in Washington and around the country. Physicians for Fair Coverage is planning a communications and grassroots blitz in the home states and districts of members of Congress. The organization backs an arbitration model that conflicts with the model of the bill reported from the Senate Committee on Health, Education, Labor, and Pensions (HELP). Meanwhile, members of Congress received a letter in support of the HELP Committee signed by over fifty trade associations, of which the majority are business-related. The House Ways and Means Committee leadership has also weighed in, stating they are planning to write their own bipartisan bill, to be drafted by Chairman Richie Neal (D-MA) and Ranking Member Kevin Brady (R-TX). The two members also wrote to the Secretary of Transportation Elaine Chao urging her to quickly convene the Air Ambulance and Patient Billing (AAPB) Advisory Committee as Congress instructed her to do as part of the Federal Aviation Administration (FAA) reauthorization bill signed into law last year.

The Centers for Medicare and Medicaid Services (CMS) finalized a regulation this week that will allow for coverage of the Chimeric Antigen Receptor T-cell (CAR-T) therapy for the treatment of cancers. CAR-T therapy reinfuses patients with boosted versions of their own immune cells. Coverage of this therapy was previously not covered by Medicare. Under this new policy, coverage will be provided for administration of this treatment in facilities that follow the Food and Drug Administration’s (FDA’s) safety guidelines. This announcement was cheered by the cancer patient advocacy organizations. This treatment is very expensive – CMS has not announced their reimbursement rates at this time.

President Trump plans to make a major healthcare speech in September outlining his plan for overhauling the nation’s healthcare system. The President plans to talk about protections for pre-existing conditions, lower drug prices, and ending surprise medical bills. The President is hoping to contrast his plan with the Democratic presidential candidates plan for Medicare for All. It is not clear at this point whether the White House will send to Capitol Hill legislative language to implement the plan he outlines in his speech.

The University of Washington is conducting a controversial new study to determine the health effects of pregnant women who consume cannabis. Cannabis is known to help with nausea which many pregnant women experience during their early months of their pregnancy. The study will examine the effects of tetrahydrocannabinol (THC) on the infants’ brains. The FDA has approved of the use of a synthetic THC for treating AIDS-related appetite loss but has not approved it for treating morning sickness. The study is being funded by the National Institute on Drug Abuse.

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