Legislative Call Agenda, Today, Thursday June 18th 3:00 PM EST

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Legislative Committee Conference Call

3:00 pm EST, Thursday, June 18th
Call in number is 712-432-3900
Passcode is 471334
Moderator code is 406354.
Please press *6 on your phone to mute and *7 to unmute.
(Moderators/Speakers use #0 to mute all participant lines and #1 to unmute.)
To get previous issues of our Legislative agenda, please follow this link to our website. 
I. Discussion of Medical Homes Act of 2007 and Legislative Schedule for Health Care Reform with Staff for Senators Durbin and Burr (Congressional Schedule Permitting)
II. Overview of Recent Legislative Activity
  • Senate HELP puts out draft legislation, holds roundtable, and starts a markup. See below.
  • The HELP draft has specific grant programs in section 212 Grants to Establish Community Health Team to Support a Medical Home Model and section 213 Grants to Implement Medication Management Services in Treatment of Chronic Diseases.
  • The HELP draft would require group health plans and insurers to have incentives for “implementation of case management, care coordination, chronic disease management, and medication and care compliance activities that include the use of the medical home model….”
  • Congressional Budget Office issues preliminary letter indicating over $1 trillion in costs. See below.
  • President Obama continues to campaign for health care reform
  • Senate Finance Committee appears to be scheduling a “conceptual mark-up” without text. Amendments are due on Monday June 22 and markup is scheduled to begin on Tuesday June 23. 
  • House appears likely to come in July rather than June.  No text has been released.
     
III. Upcoming Hearings
  • Senate Finance Committee

'Health Care Overhaul'
Tuesday, June 23rd, Time - TBA
Tentative
The Senate Finance Committee wil mark up draft legislation that would overhaul the nation's health care system.

IV. Possible Procedural Path for Health Care Reform Legislation
• Introduction
Technically, the Majority in both the House and Senate have still have not introduced a comprehensive health care reform bill. However, Senate HELP has released some text of the Affordable Health Choices Act which is scheduled for mark-up. See below.
• Senate Finance Committee
• Senate Health Education Labor and Pensions
On June 9th Released draft text of parts of the Affordable Health Choices Act. Click here.  
On June 11th the Committee held a hearing on Health Care Reform which included some comments on the bill. Click here.  
On June 17th the Committee began mark-up of the Affordable Health Choices Act

• House Energy and Commerce Committee
• House Ways and Means Committee
• House Education and Labor Committee
• Hearings
• Markups
• CBO Scoring
The Congressional Budget Office provided a letter to Senator Enzi regarding potential scoring of the Affordable Health Choices Act. Click here.  
• Rules
• Floor
• Conference
V.  General News
  • June 16th New York Times: Cost Concerns as Obama Pushes Health  Click here.  
  • June 11th House Health-Care Proposal Adds $600 Billion in Taxes Click here.  
  • June 9th Baucus and Conrad introduce bill to invest in research on best practices. Click here.  
VI. White House
  • June 11th Obama on the Road for Health Reform. Click here.  
  • Many White House and Administration activities can be found here  
     
VII. Recent Hearings
A.  Senate Finance Committee
  • June 9th Baucus and Conrad introduce bill to invest in research on best practices. To view, please click here.
  • On May 18th the Committee released Baucus, Grassley Policy Options for Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options. To view, please click here.
  • On May 12th the Committee held a Roundtable Discussion on "Financing Comprehensive Health Care Reform". To view, please click here.
  • On May 11 the Committee released the Baucus-Grassley paper styled Description of Policy Options: Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans Baucus, Grassley Policy Options for Expanding Health Care Coverage:   Proposals to Provide Affordable Coverage to All Americans. To view, please click here.
  • On May 5 the Committee held a Roundtable Discussion on "Expanding Health Care Coverage". To view, please click here.
  • On April 28th the Committee released: Baucus, Grassley Policy Options for Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs. To view, please click here.
  • On April 21st the Committee held a Roundtable to Discuss Reforming America’s Health Care Delivery System. To view, please click here.
B.  Senate Health, Education, Labor, & Pensions Committee
  • On June 17th the Committee began mark-up of the Affordable Health Choices Act
  • On June 11th the Committee held a hearing on Health Care Reform which included some comments on the bill. Click here.   
  • On June 9th Released draft text of parts of the Affordable Health Choices Act. Click here.  
     
  • The Senate Committee on Health, Education, Labor and Pensions (HELP) has requested ideas to implement and expand the Patient Centered Medical Home (PCMH) in the following areas: (1) Workforce Supply Issue, (2) Consumer Barriers (financial and others), and (3) Data Collection.
  • 'The Kennedy Health Plan, Briefing Paper for Meeting of the Senate Committee on Health, Education, Labor and Pensions'. The Political Bear. 'A New Vision for American Health Care: Strengthening What Works and Fixing What Doesn’t. Overview and Background'. To read the full briefing, please click here.  
  • On May 14th the Committee held a Full Committee Hearing - Delivery Reform: The Roles of Primary and Specialty Care in Innovative New Delivery Models. To view, please click here.
  • On March 24th the Committee held a  Full Committee Roundtable Hearing - Addressing Insurance Market Reform in National Health Reform. To view, please click here.
  • On February 26th the Committee held a Full Committee Hearing - Integrative Care: A Pathway to a Healthier Nation. To view, please click here.
  • On February 5th the Committee held a Full Committee Hearing - Implementing Best Patient Care Practices. To view, please click here.
C.  House Committee on Energy & Commerce
• On March 24th the Subcommittee on Health held a hearing on Making Health Care Work for American Families: Improving Access to Care. To view, please click here.
The hearing examined racial, ethnic, and geographic disparities in access to health care, and the role of the healthcare workforce in addressing these disparities, with particular emphasis on primary care and nursing. The hearing also examined the role of Medicare and Medicaid in addressing disparities and workforce issues. This was the third in a series of five overview hearings on health reform.
• On March 17th the Subcommittee on Health held a hearing on Making Health Care Work for American Families: Ensuring Affordable Coverage. To view, please click here.
 
• On March 10th the Subcommittee on Health held a hearing on 'Making Health Care Work for American Families: Designing a High Performing Healthcare System'. To view, please click here.

The hearing explored options for making the health system work better and for designing a high performing healthcare system.
D.  House Committee on Ways and Means
• On May 6th the Committee held a hearing on Health Reform in the 21st Century: A Conversation with Health and Human Services Secretary Kathleen Sebelius. To view, please click here.
• On April 29th the Committee held a hearing on Health Reform in the 21st Century: Employer Sponsored Insurance. To view, please click here.
J. Randall MacDonald, Senior Vice President for Human Resources at the IBM Corporation spoke to the committee on, among other items, the patient centered medical home and adoption of health information technology as aides to health care reform.  "Payment reform and new models of care delivery with primary care providers, such as occurs within a “patient-centered medical home” model, can encourage providers to keep patients healthy and deliver timely, comprehensive, and appropriate care."
• On April 22st the Committee held a hearing on Health Reform in the 21st Century: Insurance Market Reforms. To view, please click here.
• On April 1st the Committee held a hearing on Health Reform in the 21st Century:  Reforming the Health Care Delivery System. To view, please click here.
• On March 11th, the Committee held a hearing on Health Reform in the 21st Century: Expanding Coverage, Improving Quality and Controlling Costs. To view, please click here.
E.  House Committee on Education and Labor
• On April 23d the Subcommittee on Health, Employment, Labor, and Pensions  had a Hearing on  Ways to Reduce the Cost of Health Insurance for Employers, Employees and their Families. To view, please click here.
• On March 10th the Subcommittee on Health, Employment, Labor, and Pensions  had a Hearing on  Strengthening Employer-Based Health Care. To view, please click here.
VIII. HDHP's and PCPCC Legislative Action
Per the discussion at the last Executive Committee meeting, it was decided that the PCPCC would pursue as part of the legislative platform a revision of the law concerning qualified High Deductible Health Plans. Currently, the law only allows payment for preventive screenings and limited medications that are used to prevent disease prior to satisfaction of the deductible. What this has meant is that patients must pay out-of-pocket for all primary care services and medications related to the care of chronic disease until the high deductible is met. This model does not align incentives for patients to engage in PCMH's. The change in legislation would not mandate that health plans or employers/government add payments related to these primary care services or drugs, but would allow them to do so. As these plans have become much more popular, physicians are realizing the difficulty in getting patients with these plans to actively participate in managing their chronic conditions, when out-of-pocket costs are a factor.
 
Terry A. McInnis MD, MPH, Medical Director- Health Policy and Advocacy, GlaxoSmithKline has crafted the attached one page "talking points" document, with a final version of the suggested law changes.
IX. VBBD Legislation
News from the Center for Value-Based Insurance Design
 
On May 14, 2009 Senators Debbie Stabenow (D-MI) and Kay Bailey Hutchison (R-TX) introduced Senate Bill 1040, the “Seniors’ Medication Copayment Reduction Act of 2009,” advancing the principles of value-based insurance design in the Medicare population.  This legislation will establish a five-year demonstration program using VBID to assess the impact of a reduction in copayments or coinsurance charged Medicare beneficiaries for certain high value medications on adherence to those medications.  [Details at www.vbidcenter.org]
 
Hutchison says the federal government has lagged behind the private sector in adopting VBID strategies. "Value-based insurance design has the power to truly bend the healthcare cost curve in the right direction.  By taking practical steps to lower healthcare costs and improve health, we can make insurance more affordable for all Americans.  Ultimately, that is the single most important goal of healthcare reform."
Pioneers in the private sector eliminated cost sharing associated with high value medical services and achieved positive cost and quality outcomes.  While many health insurers and employers have increased copays and created high-deductible plans as a way to lower their healthcare costs, VBID supports the use of a "clinically sensitive" cost sharing approach as a more forward-thinking way to tackle spiraling costs.
IX. Discussion on Future Strategy for Legislative and Regulatory Efforts
• Numerous congressional staffers recommended that we discuss the strategy of using health IT money in the stimulus bill for primary care doctors transforming their practice into PCMH with policy officials at HHS.  A strategy is needed for next fiscal year appropriation process, i.e. meetings with appropriations committee staff. 

X.  Legislative Goals to Promote Primary Care
• Broaden the Medicare Medical Home Demo so that it is national in scope.  Subsequently, it should become permanent feature of the Medicare program.
• Increase funding for National Health Service Corps Scholarship and Loan Repayment Programs
• Expand primary care health professions programs in Sec. 747 of Title VII of the Public Health Service Act
• Provide additional pathways for scholarships and loan forgiveness programs to create incentives for new physicians to choose careers in primary care
• Increase Medicare payments for primary care services
• Develop and include some language about engaging consumers/patients as part of the target for stimulus dollars and health reform
XI.   Hill Meetings
Upcoming Meetings
  • Friday, June 19th, 4:00 PM EDT, Jon Sheiner, Office of Congressman Charles Rangel, Committee on Ways and Means, 2354 Rayburn House Office Building
Recent Meetings
  • Tuesday, June 16th, 10:30 AM EDT, Veronica Wong, Legislative Assistant, Congressman Darrell Issa, Ranking Member, Committee on Oversight and Government Reform, 2347 Rayburn Building
  • Thursday, June 4th, 9:00 AM EDT, Kelly Hall, Senior Advisor for Health Care Policy, Congresswoman Allyson Schwartz, 330 Cannon House Office Building
  • Friday, May 29th, 12:30 PM EDT, James Paluskiewicz, Legislative Director, Office of Representative Michael Burgess, 229 Cannon House Office Building
  • Monday, March 16th, 2:30 PM EST, John O'Brien, Congressional Fellow, Senator Robert Casey (Pennsylvania)
  • Wednesday, March 11th, 4:00 PM EST, Stephen Cha, House Energy & Commerce Committee
  • Thursday, March 4th, 10:00 AM EST, Dr. Ken Thorpe, Executive Director, Partnership to Fight Chronic Disease, 712-432-3900, Passcode: 471334#.
  • Thursday, February 26th, 1:00 PM EST, Anne Morris, Committee on Energy and Commerce, 2322 Rayburn Building
  • February 10th, 4:10 PM EST, Mona Shah, Sen. Barbara Mikulski's Staff, 503 Hart Senate Office Building, Washington, D.C. 20510
  • February 6th, 2:00PM EST, Dr. Ken Thorpe, Executive Director, Partnership to Fight Chronic Disease, Dial-In Number: 712-432-3900, Passcode: 471334#.
  • February 5th, 4:45PM EST, Nicole Tapay, Office of Senator Ron Wyden, 223 Dirksen Building
  • February 5th, 4:00PM EST, Patricia DeLoache, Office of Senator Orrin Hatch, 104 Hart Senate Office Building
  • February 5th, 1:00PM EST, Sara Selgrade, Ph.D., ASHG/NHGRI Genetics and Public Policy Fellow, Office of Senator Tom Harkin, 731 Hart Senate Office Building February 3rd, 11:00AM EST, Amy Hall (Rep. Henry Waxman's staff) and Hasan Sarsour (Rep. Frank Pallone's staff), House Energy and Commerce Committee staff, 2125 Rayburn Building
 
Edwina Rogers, Executive Director
Nandan Kenkeremath, Consultant
Relja Ugrinic, Director of Operations and External Affairs
Patient Centered Primary Care Collaborative
The Homer Building
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Edwina Direct:  (202) 417-2081
Edwina Cell: (202) 674-7800
Nandan Direct and Cell: (703) 407-9407
Relja Direct:  (202) 724-3332
Relja Cell: (703) 585-9165
Fax: (202) 393-6148
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