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  • October 4, 2019

Washington Update - October 4, 2019


MONDAY CALL — The next Public Policy Update Call will be held on Monday, Oct. 7, 12:30 p.m. ET. Please register in advance.

CONGRESSIONAL SCHEDULE — Congress is on recess until Oct. 15.


Urge Congress to prevent Medicaid DSH cuts
The current continuing resolution (CR) providing continued funding for government programs delays the onset of the Medicaid disproportionate share hospital (DSH) payment cuts scheduled to begin Oct. 1, but only until Nov. 22. Lawmakers are currently considering legislative proposals to provide additional relief from the DSH cuts. Please continue to ask your hospital leadership to contact members of your Hill delegation—especially members of the Senate Finance Committee and House Energy and Commerce Committee—to urge Congress to protect children’s health by preventing these cuts from taking effect. John Knapp


CMS announces plan to collect 340B drug acquisition price information
On Sept. 30, the Centers for Medicare & Medicaid Services (CMS) published a notice in the Federal Register announcing a proposed hospital survey for specified covered outpatient drugs. In the CY 2018 Hospital Outpatient Prospective Payment System final rule, CMS finalized a policy to reduce payment for outpatient drugs acquired through the 340B Drug Pricing Program from Average Sales Price (ASP) plus 6% to ASP minus 22.5%—the payment cut was challenged by the American Hospital Association and several other plaintiffs. In late 2018, the U.S. District Court for the District of Columbia ruled that the Secretary of the Department of Health & Human Services (HHS) exceeded his statutory authority to adjust payment rates because the Secretary had not collected the necessary data. While the government is appealing the decision, CMS is proposing to start collecting acquisitions costs for drugs acquired through the 340B program. Comments are due to CMS by Nov. 29. Steven Chen 

HHS announces wellness pilots in the individual insurance market
On Sept. 30, CMS announced a new demonstration project that will allow 10 states to implement wellness programs in the individual insurance market that are in conflict with the ACA’s ban on discrimination based on health status. Under the demonstration, insurers would be permitted to offer rewards to health plan enrollees (adults and children) who participate in activity-based (e.g., diet or exercise) or health-contingent (e.g., documented weight loss) wellness programs. Allowable rewards include discounts on premiums, waivers of cost sharing, additional benefits or other incentives. States must demonstrate that the projects will not decrease coverage levels or increase federal costs. However, states can design programs that would increase costs for individuals with pre-existing conditions who may not be able to participate in the wellness initiative. States may design their own programs or allow insurers to do so. CMS is accepting applications immediately and will continue to do so until 10 pilots have been approved. Jan Kaplan 

New GR Subcommittee members announced 
In late September, the CHA Public Policy Committee appointed the members of the Government Relations (GR) Subcommittee for 2020. The new chair is Lindsay Punzenberger, Children’s Hospital of Wisconsin. The three newest members of the subcommittee are:

  • Maggie Cash, MUSC Children’s Hospital
  • Havi Glaser, Children’s Hospital of Philadelphia
  • Liz Lyons, Children’s Hospital & Medical Center

We want to thank the members of the subcommittee whose terms will come to an end on Dec. 31 for their time and commitment to children’s health care: 

  • Jane Baird, Connecticut Children’s Medical Center
  • Russ Molloy, Hackensack Meridian Health

Finally, we especially want to thank Suzanne Petersen Tanneberg, Seattle Children’s, who has served as GR Subcommittee Chair for the past two years. Over this time, Suzanne has represented the GRs on the Public Policy Committee and worked closely with CHA staff and hospital GRs on a host of complex issues. Jim Kaufman


Register now for Oct. 8 state roundtable call on policies supporting children’s healthy lives
Children’s hospital GRs are invited to participate in a state policy roundtable call Oct. 8, 12:00 – 1:00 p.m. ET, focused on children’s hospitals’ state-level advocacy to promote children’s healthy living—specifically as it relates to early childhood development, food security and obesity prevention. The roundtable discussion will be kickstarted by GRs from Arkansas Children’s Hospital, Children’s Minnesota and Seattle Children’s, who will share their experiences and lessons learned from their efforts in their own states. There will be ample time for a conversation among all call participants about challenges and opportunities related to advancing state policies that promote children’s health and wellbeing. Please register in advance. Jan Kaplan

Register for Oct. 22 webinar: Advancing Accountability, Value, and Social Needs in a State Medicaid Program
CHA is hosting a webinar on Oct. 22, 2:00 – 3:00 p.m. ET, focused on advancing accountability, value, and social needs within a state Medicaid program. Hear how Children’s Minnesota is responding and retooling in light of the state’s efforts to promote innovation in value-based models to broaden provider accountability for outcomes related to social factors within an expanded set of services. The webinar will also provide insights into how the state and the hospital are working to identify appropriate payment methodologies that reduce health disparities. Please register in advance. Anne Barsanti