This week's (initial*) doses
*Due to internal schedule changes, we will be publishing this week's checkup earlier than usual. We will reopen as scheduled next Friday, April 26th.
- House Energy, Commerce and Health Subcommittee Holds Hearing on Cybersecurity. In the wake of the Change Healthcare cybersecurity attack, members debated cybersecurity standards and called for an investigation into healthcare mergers and acquisitions.
- House Energy and Commerce Oversight and Investigations Subcommittee Holds Hearing on Improper Payments. The hearing focused on potential solutions to reduce inappropriate payments in the Medicare and Medicaid programs.
- House Energy, Commerce, Innovation, Data and Commerce Subcommittee Holds Legislative Hearing on Data Privacy. This hearing considered how Congress can enact strong data privacy and security standards to protect individuals.
- Senate Select Committee on Aging holds hearing on long-term care workforce. Members discussed the need for additional support and reforms to the long-term care workforce.
meeting
House Energy, Commerce and Health Subcommittee Holds Hearing on Cybersecurity. The hearing found bipartisan concerns about UnitedHealth Group's response to the Change Healthcare cyberattack and consensus on the need for improved cybersecurity standards. Members also called on the Federal Trade Commission and the U.S. Department of Justice to investigate healthcare mergers and acquisitions, and expressed concern about the impact of vertical integration on vulnerability to cyberattacks.
Prior to the hearing, bipartisan committee leaders sent a letter to UnitedHealth Group regarding the Change Healthcare cyberattack. This letter provides information about UnitedHealth Group's efforts to protect Change Healthcare's systems and the efforts being made to restore system functionality and support patients and healthcare providers affected by the attack. I'm looking for it. The letter seeks answers to questions regarding the status and impact of cyberattacks and system recovery, identification and immediate response to cyberattacks, cybersecurity protocols and dedicated resources, and response and recovery for the medical community. Responses are required by April 29th. Energy and Commerce Chairman McMorris Rogers (R-Wash.) said UnitedHealth recently briefed the committee and has agreed to appear at future hearings.
In related news, Senate Finance Committee Chairman Wyden (D-Ore.) has scheduled a hearing in the near future, during which the CEO of UnitedHealth Group will be invited to testify. It's planned.
House Energy and Commerce Oversight and Investigations Subcommittee Holds Hearing on Improper Payments. During the hearing, the Subcommittee heard testimony from the U.S. Government Accountability Office (GAO), the U.S. Department of Health and Human Services (HHS) Office of the Inspector General, the Chair of the Medicare Payment Advisory Committee, and the Commissioner of Medicaid and Medicaid. CHIP Payment and Access Committee.
Witnesses and Commissioners emphasized the need for transparency in reducing unfair payments within the Medicare and Medicaid programs. Democrats raised concerns about overpayments and large numbers of prior authorization denials in Medicare Advantage plans. Witnesses and members noted that improper Medicare and Medicaid payments can occur due to administrative errors, duplicate enrollment or death, and some malicious actors. . The hearing discussed how advances in technology and data analytics can be used to enhance detection and prevention of improper payments in Medicare and Medicaid.
GAO released a report titled “Medicare and Medicaid: Additional Actions Needed to Strengthen Program Integrity and Save Billions of Dollars'' as written testimony at the hearing. The report found that total improper payments in the Medicare and Medicaid programs in fiscal year 2023 totaled more than $100 billion, representing 43% of the total estimated government-wide improper payments reported by agencies in the same fiscal year. .
House Energy, Commerce, Innovation, Data and Commerce Subcommittee Holds Legislative Hearing on Data Privacy. During the hearing, there was bipartisan support for the U.S. Privacy Rights Act. Several witnesses shared concerns that the bill requires additional data privacy protections that were originally included in the U.S. Data Privacy and Protection Act of 2022, passed by the Energy and Commerce Committee. Members and witnesses highlighted concerns for the safety of children due to the lack of data privacy protections. We spoke about the importance of protecting privacy and shared our support for HR 7890, the Children and Youth Online Privacy Protection Act. There was also discussion about the need for legislation to strike a balance that allows for innovative biomedical research to be carried out for the benefit of patients.
Senate Select Committee on Aging holds hearing on long-term care workforce. During the hearing, Chairman Casey (D-Pennsylvania) called for a generational investment in the direct care workforce by supporting pathways into the workforce, improving compensation, and ensuring a safe working environment. announced the introduction of the Long-Term Care Workforce Support Act. and provides opportunities for effective recruitment and training strategies that promote retention. Witnesses emphasized the need for additional support and reform for the evolving needs of the direct care workforce and highlighted the obstacles and burdens faced by workers.
House Energy, Commerce and Health Subcommittee Holds HHS Budget Hearing. This week, the House Energy, Commerce and Health Subcommittee will also hold a hearing on Secretary Becerra and HHS's 2025 budget request. Expect discussions about prescription drugs, cybersecurity, and health care costs.
management
Government releases global health security strategy. The new strategy will drive action across federal agencies and mobilize support from other countries, the private sector, and civil society to better prevent, detect, respond to, and recover from infectious disease threats. This strategy outlines her three goals:
- Strengthening global health security capacity through bilateral partnerships.
- Foster political engagement, funding, and leadership to achieve health security.
- Strengthen collaboration between health security and complementary programs to maximize effectiveness.
You can read the HHS press release here and the strategy fact sheet here.
Pending regulations. Final Medicaid access, Medicaid managed care, and nurse staffing ratio final rules are expected to be released soon. If these rules are published this week, we will provide an update on those rules in our next publication.
quick hit
- GAO releases report on PBM. GAO examined five states with laws regulating pharmacy benefit managers (PBMs) and found that all five states limit companies' use of manufacturer rebates and their ability to pay pharmacies less than health plans. It was discovered that the government is regulating drug pricing by companies and payments to pharmacies. You will be charged.
- CBO releases report on ACOs. This Congressional Budget Office (CBO) report found that accountable care organizations (ACOs) led by independent physician groups, ACOs with a higher proportion of primary care providers, and initial baseline spending higher than the regional average ACOs were found to lead to greater savings. The report also identifies factors limiting ACO savings as weak incentives for ACOs to reduce spending, a lack of resources necessary for providers to participate in the ACO model, and providers' anticipated It also clarified that these include the ability to selectively participate in or withdraw from the program based on financial status. Profit or loss?
next week's diagnosis
Congress is scheduled to go into recess next week and return the week of April 29th. As mentioned above, we expect a hearing on the Change Healthcare cybersecurity attack to be held soon after Congress returns.
