As of the most recent count, approximately 60 SORH attendees will participate in the National Rural Health Association’s Annual Policy Institute. NOSORH will provide a member and partner brief with Legislative Liaison Andrew Coats (Hall Render) and convene the State Office Council on Monday, February 5 at 6:00 PM.

NOSORH is asking SORH and their partners to request to pass Senate Bill 2278, please introduce a House companion bill to support for reauthorization of the State Office of Rural Health Program and for level funding for the SORH appropriation. A fact sheet is available for all SORH and their partners to print and include in their visit packets during the Policy Institute or to make a simple contact by email.  Printed copies of the fact sheet will be available at the NOSORH members meeting.

The following update was provided for our members by Hall Render, NOSORH Legislative Liaison:

Congress Votes to End Government Shutdown – What’s Next?
After a three-day government shutdown, the Senate voted 81-18 on January 22 to fund the government through February 8, 2018. The continuing resolution (CR) was then sent to the House, where it passed 266-150. President Trump subsequently signed the bill into law on January 22. The three-week CR includes a six-year funding renewal of the Children’s Health Insurance Program (CHIP). The bill also delays the Affordable Care Act’s medical device tax and Cadillac tax on high-cost health insurance plans for two years and its tax on health insurance providers for one year.

Despite passing the CR, lawmakers remain under increasing pressure to reach a long-term budget agreement. In order to strike such a deal, Republicans will need support from at least nine Senate Democrats. While CHIP now has long-term financial support, funding for many other health programs, including “Medicare extenders” and DSH, expired at the end of September but were not included in the most recent CR. In a meeting with senior health care policy staff on Capitol Hill, Hall Render attorneys were told that lawmakers plan to include money for Medicare extenders and DSH in the next government funding bill that must be passed before February 8, if offsets can be found to cover the costs. Historically, Congress has covered such costs by implementing new cuts for providers, and it is expected that lawmakers will do so again in this case.

340B Remains Active Topic in Congress
On January 17, Sen. Bill Cassidy (R-LA) introduced a bill (S. 2312) that seeks to prevent certain hospitals from entering the 340B drug discount program until certain transparency measures and reporting requirements are strengthened. The Cassidy bill is the Senate version of the recently introduced 340B Pause Act and can serve as another reason for the Senate Health Education Labor and Pensions (HELP) Committee to hold future 340B oversight hearings.

The measure would create a moratorium on new DSHs from entering the 340B program for at least two years or until the Health Resources and Services Administration (HRSA) writes regulations for the 340B program with additional transparency measures and reporting requirements for hospitals. The bill would also require hospitals to use CMS’s new 340B claims modifier on drugs purchased through the program.

Under the Cassidy bill, critical access hospitals, rural referral centers, sole community hospitals, grantees and PPS-exempt children’s or cancer hospitals would still be able to enroll in the 340B program. The bill also exempts grantees and rural and critical access hospitals from most of the bills reporting requirements.

On January 10, the House Energy and Commerce Committee released a report following a broad review of the 340B program and several oversight hearings held in 2017. While the report highlights the strong bipartisan support of the program, the report also includes its perceived weaknesses such as the lack of transparency and oversight. The report concluded HRSA lacks sufficient regulatory authority to adequately oversee the program and the audit process in place is inadequate. The report also claims there is a lack of reliable data on how program savings are used because the 340B statute does not include reporting requirements for covered entities.

 Azar Confirmed as HHS Secretary
The Senate confirmed Alex Azar as the next Secretary of Health and Human Services in a 55-43 vote. Six Senate Democrats and Independent Angus King (I-ME) joined nearly all Republicans in backing Azar’s nomination. Sen. Rand Paul (R-KY) was the only Republican to oppose Azar, which he said was due to his disagreement with Azar over drug re-importation. As the country’s top health official, Azar has pledged to prioritize lowering drug prices.

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