HealthCheck, October 2019

Academy Activity

The Academy hosted a Sept. 25 briefing on Capitol Hill that included a presentation, “Telehealth: A Digital Communication Approach to Improving Health.” Presenters—Telehealth Work Group members Mick Diede and Susan Pantely—noted that technology advances now support an unprecedented level of connectivity previously unimagined, making telehealth an increasingly meaningful area of health care delivery. Senior Health Fellow Cori Uccello moderated. The presenters drew from the Academy’s new issue brief, Telehealth—A Digital Communication Approach to Improving Health, and shared insights on the effects that telehealth could have on access to care, outcomes, and costs, as well as barriers to further adoption of telehealth.

The Individual and Small Group Markets Committee sent comments to the Centers for Medicare & Medicaid Services on rules finalized in the 2020 Notice of Benefit and Payment Parameters (NBPP) concerning risk adjustment data validation (RADV)-related transfers.

Legislative/Judicial/Regulatory Updates

The Centers for Medicare & Medicaid Services (CMS) issued a bulletin on Sept. 30, Opportunity for States to Participate in a Wellness Program Demonstration Project to Implement Health-Contingent Wellness Programs in the Individual Market, which would allow up to 10 states to be approved to implement nondiscriminatory health-contingent wellness programs in the individual market.

On Oct. 3, President Trump issued an executive order, Protecting and Improving Medicare for Our Nation’s Seniors, which is aimed at expanding Medicare Advantage plans, the use of telehealth, and directing agencies to expand access to Medicare medical savings accounts.

H.R. 3, The Lower Drug Costs Now Act of 2019, was introduced in the U.S. House on Sept. 19 by Rep. Frank Pallone, chairman of the Energy and Commerce Committee, which subsequently held a hearing on the bill focusing on efforts to lower prescription drug costs through direct negotiation between the secretary of Health and Human Services and pharmaceutical companies.

The Senate Finance Committee released the text of its bipartisan bill to reform drug pricing, S. 543, on Sept. 26 after previously holding a committee hearing in July. This new text focuses on inflation caps and provisions requiring transparency, such as rebate disclosures from pharmacy benefit managers.

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In the News

• In a Politico story, Telehealth Work Group member Susan Pantely discussed telehealth and how it impacts health care costs.

• The Signal (Santa Clarita Valley, Calif.) published an article citing comments from the Academy on the Affordable Care Act’s health insurance risk pools.

• An AIS Health story examining alternative policy approaches to surprise medical billing quoted Senior Health Fellow Cori Uccello and drew heavily from the Academy’s recent issue brief, Surprise Medical Bills: An Overview of the Problem and Approaches to Address It.

• A Washington Times op-ed on proposed legislation to make Health Savings Accounts (HSAs) available to everyone enrolled in Medicare cited an Academy monograph reviewing studies of the savings provided by consumer-driven health plans.