Washington Update - December 8, 2017

On the Horizon


  • On Dec. 12, the House Energy and Commerce Committee will hold a hearing on addiction treatment fraud.
  • Also on Dec. 12, the Senate HELP Committee will hold a hearing on prescription drug costs.
  • On Dec. 13, the Health Subcommittee of the House Energy and Commerce Committee holds a hearing to examine the drug supply chain.
  • Also on Dec. 13, the Senate HELP Committee will hold a hearing on implementing the 21st Century Cures Act to respond to mental health needs.
  • During the week of Dec. 11, the Senate Finance Committee is expected to hold a nomination hearing on Alex Azar to be the Secretary of the U.S. Department of Health and Human Services.


Washington Update - Full Report

Download this week's report(2 page PDF).

Take Action

Student Members Lead Tax Reform Advocacy Actions

In November 2017, AAFP members collectively sent over 530 emails to their legislators using the Speak Out advocacy tool. Student members took the lead and urged Congress to preserve the student loan interest deduction in the tax reform bill. Over the next two weeks, Congress will continue to negotiate what final provisions will be included in the bill. There is still time to Speak Out and tell Congress to protect Medicare, maintain health care coverage and retain the student loan interest deduction in final tax legislation.

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U.S. Congress

Senate Approves Temporary Spending Bill

The House on Thursday, December 7 passed (235-193(clerk.house.gov)) a short-term funding bill (H.J.Res. 123(www.congress.gov)) to keep the government open until December 22 and prevent a looming shutdown. Senators quickly followed, approving the measure 81-14(www.senate.gov). The two-week “continuing resolution” includes a provision allowing the redistribution of Children’s Health Insurance Program (CHIP) funds to states during the first quarter of fiscal year 2018.

Congress Empanels Conference Committee to Negotiate Differences in GOP Tax Plan

The House and Senate appointed a conference committee to resolve differences between the House and Senate versions of the GOP tax plan (both bills are called the Tax Cuts and Jobs Act). GOP leaders hope to have a bill signed into law before Christmas. Significant differences between the two bills remain. Unlike the House version, the Senate bill repeals the individual mandate of the Affordable Care Act. The House bill repeals the student loan interest deduction, while the Senate bill does not. The conferees—along with substantial input from Congressional leadership and the White House—could reach agreement on a conference report next week.

MedPAC Prepares 2019 Recommendations for Congress on Physician Payment

On Thursday, December 7, the Medicare Payment Advisory Commission (MedPAC) publicly reviewed the Medicare Part B physician payment system. The 17-member commission discussed two draft recommendations: first, that Medicare increase payment rates for physician services by the amount specified in current law for CY2019, and second, the elimination of the Merit-based Incentive Payment System (MIPS), to be replaced by a “voluntary value program.” The Commission will refine and vote on the two recommendations in 2018. 

Centering on the States

Joint Principles of Section 1115 Waivers Adopted by the Group of Six

On December 8, six frontline physician organizations, (AAFP, American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists, American College of Physicians, American Osteopathic Association, American Psychiatric Association, sent a set of principles(5 page PDF) to the U.S. Department of Health and Human Services urging consideration of recommendations(www.acponline.org), before approving Section 1115 demonstration waivers. The Joint Principles for Section 1115 Waivers affirm that state waivers must maintain and/or strengthen affordability protections, benefits, and access to any qualified provider. Additionally, waivers must preserve and enhance existing funding mechanisms, sustain and strengthen waiver transparency, stakeholder engagement, and evaluation, and waivers cannot limit barriers to eligibility and coverage. The AAFP has also joined a Waiver Task Force to better share information related to these waiver proposals. As of September 2017, there are 21 state waiver requests pending with CMS.

Lack of CHIP Funding Continues to Affect States

On November 29, the National Governors Association sent the following letter(www.nga.org) to Congressional leadership urging immediate action on the Children’s Health Insurance Program (CHIP). On December 7, the Partnership for Medicaid (AAFP is a member) released a statement(www.partnershipformedicaid.org) calling on Congress to include a five-year CHIP extension in any early December spending bill. So far, 16 states and DC have received contingency CHIP funds from CMS. CHIP programs in Virginia, Connecticut, Colorado and Montana are among those slated to run out of money by the end of January.

Register for Chapter Advocacy Webinar

The AAFP is hosting a chapter advocacy webinar(register.gotowebinar.com) on scope of practice issues with nurse practitioners on December 13, 2017, at 2:00 p.m. EST. 

Executive Branch

AAFP Comments to FDA on Regulatory Policies

On December 6, the AAFP sent the FDA a letter in response to a request for public comments to help identify existing regulations and related paperwork requirements that could be modified, repealed, or replaced to achieve meaningful burden reduction. The AAFP encouraged the FDA to take the following actions:

  • Enforce food labeling laws
  • Regulate all nicotine delivery devices
  • Develop effective state prescription drug monitoring programs
  • Pursue safe and effective drugs and devices

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