Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections
November 28, 2014

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November 26, 2014

Smoking Rate Declines But Some Groups are Prone to Continue Puffing

The Centers for Disease Control and Prevention this week reports that the level of adults smoking cigarettes is at the lowest level since record keeping began in 1965. The CDC has been surveying regular declines in smoking rates and the agency’s current survey notes a decline in cigarette smoking from 20.0 percent of the population in 2005 to 17.8 percent in 2013. The CDC survey also highlights some population groups that are still particularly prone to smoking, including males, Southerners, American Indians/Alaska Natives, people with disabilities and those who are lesbian/gay/bisexual.

CQ HealthBeat’s (@CQHealthTweet) John Reichard reported (subscription) Tuesday on a various studies that indicate that one group, who reportedly smoke nearly 30 percent of all cigarettes, are people with mental illnesses. Federal officials from the Substance Abuse and Mental Health Services Administration this week noted that only one in four of the nation’s mental health treatment facilities have smoking cessation programs.



November 25, 2014

FDA Issues Restaurant Menu Nutrition Label Regulations

Today, the FDA unveils final regulations mandated by the Affordable Care Act on restaurant menu and food vending machine labeling of nutrition information. The rules have been under development for several years and were subject to intensive lobbying from nutrition groups, grocery stores, movie theaters and pizza delivery chains.

CQ Roll Call’s Georgina Gustin reports (subscription) that the FDA sifted through over a 1,000 comments that addressed complex details on the scope of the menu label regulations. Grocery stores complained that the rule would force supermarket chains to label as many as 15,000 additional items. Pizza chains objected to menu boards at retail locations that primarily offer pizza through a delivery service. The FDA released the text of the final menu label and vending machine rules early this morning. The regulations will be officially published on Dec. 1



By Paul Jenks Posted at 1:13 p.m.

Bipartisan Duo Seeks Evidence-Based Policy Policymaking

The difficulty of implementing and reviewing provisions of the Affordable Care Act and parsing the details of the Medicare provider payment process illustrates the extreme complexity of many federal programs. Congress in the past has recognized the need for some assistance. The Congressional Budget Office advises lawmakers on fiscal impact of legislation and the Medicare Payment Advisory Commission has long advised Congress on possible adjustments to Medicare payments. However, guidance on gauging the likely effectiveness of most federal programs is largely left to lawmakers to sift through conflicting studies and analysis.

Last week, Washington Democratic Sen. Patty Murray and Wisconsin Republican Rep. Paul D. Ryan introduced a measure  (S 2952) seeking to establish a new commission to study ways to improve the analysis of program effectiveness and to consider a possible clearinghouse for federal program data and surveys. The concept takes a page from rigorous analysis used for medical research and seeks to apply a similar evidence-based approach to policy making. The proposed commission is a long way away from any formal congressional policy effectiveness agency but the effort seeks find a more rigorous approach to examining the complexities of policy options. However, the new board is not charged with addressing a way to vet the political factors that influence the creation and ongoing maintenance of federal programs.



November 24, 2014

Look Ahead: Spending Bill Action and Tavenner and Gruber Testimony

Congress and much of Washington, DC pauses this week for the Thanksgiving holiday. Lawmakers will return next week to finalize decisions on an extension of current year funding for federal agencies. Meanwhile, a House committee on Dec. 9 is seeking to grill Centers for Medicare Services Administrator Marilyn Tavenner regarding inaccuracies in reporting on health insurance exchange enrollment statistics. The committee is also seeking testimony from embattled health care overhaul law adviser Jonathan Gruber regarding a series of past comments on the development of the health care law.

House committees have been active in delving into the details of the implementation of the health care law. Republican control of Senate starting next year, offers the opportunity for increasing the number Senate committee hearings on the health law.

Meanwhile, a bill (HR 669) seeking to expand data collection on sudden infant deaths quickly passed the Senate last week. The amended bill requires a final House vote, which is possible before the end of year. The added data on deaths hopes to aid research on more than 4,800 sudden unexpected deaths of babies or children under the age of 4 who die without any clear cause.


November 21, 2014

Week In Review: Ebola Response

Congressional committees this week wrapped up a series of  Ebola response review hearings and advanced bills authorizing international aid funding and streamlining Ebola drug research. Panels examined the Ebola response in West Africa, following Centers for Disease Control and Prevention action this week expanding traveler screening to persons arriving in the U.S. from Mali.

CQ HealthBeat’s (@CQHealthTweet) John Reichard reported (subscription) that aid groups in Africa noted a slowing in the outbreak in West Africa (except for Sierra Leone) but that the international response is hindered by shortages of medical workers and protective gear. Other committees examined the limits of domestic preparedness in combating the virus and efforts speed drug and vaccine development.

Meanwhile, the Senate Health, Education, Labor and Pensions Committee on Wednesday quickly approved a measure (S 2917) allowing Ebola drug research in an existing FDA program that expedites drug research for tropical diseases. On Thursday, the House Foreign Affairs Committee, in a voice vote, advanced a measure authorizing $1.8 billion in emergency Ebola response aid through the U.S. Agency for International Development.

The White House has requested $6.2 billion in emergency funding for domestic and international efforts to help combat the Ebola epidemic. After the Thanksgiving holiday recess, lawmakers will return to craft a year-end spending package, which will likely include some of the requested Ebola response funding.


By Paul Jenks Posted at 11 a.m.

November 20, 2014

Ebola Drug Development and Sudden Infant Death Reporting Bills Advance

The Senate Health, Education, Labor and Pensions Committee on Wednesday quickly approved a bill (S 2917) that adds Ebola drug research to an existing FDA drug development program for tropical diseases. The measure now heads toward possible final Senate action before the end of the year. A companion House measure (HR 5729) was introduced earlier this week.

Additionally, retiring committee chairman, Iowa Democratic Sen. Tom Harkin on Wednesday announced committee approval of a measure (HR 669) expanding reporting and data about sudden and unexpected infant deaths. The additional data collection hopes to bolster federal programs and research on the tragic deaths. A possible final Senate vote on the bill this year would complete congressional action on the bill.


November 19, 2014

Heavy Pot Use May Harm the Brain, Study Shows

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A woman smokes marijuana rolled as a blunt. Photo by CQ Roll Call

In the wake of states voting to legalize marijuana across the country – and even in Washington’s own backyard – a new study funded by the National Institute on Drug Abuse found that heavy pot use may actually harm the brain.

“We have seen a steady increase in the incidence of marijuana use since 2007,” said one of the study’s authors, Francesca Filbey, in a press release. Filbey, director of cognitive neuroscience research in addictive disorders at the Center for BrainHealth, added that “research on its long-term effects remains scarce despite the changes in legislation surrounding marijuana and the continuing conversation surrounding this relevant public health topic.”

Supporters of loosening marijuana laws have long argued that the drug has little long-term effect on cognition and is less harmful and addictive than cigarettes or alcohol. But the NIDA-funded research suggests that using pot can have a negative impact on the brain, depending on duration and age of first use.

The study found that chronic marijuana use, which is defined as at least four times per week over the past six months, is correlated to adverse changes in the areas of the brain linked to reward, decision making and motivation.  Researchers noticed the impact was greater in individuals who started using pot at an earlier age, implying that developing brains are more susceptible to marijuana’s negative effects.

On the flip side, the study also found that long-term marijuana use can enhance some brain circuits, although researchers acknowledged that the brain could just be compensating for reduced function in other regions as a result of the drug.

NIDA said additional studies are still needed to determine if heavy marijuana use directly caused these effects, but it remains to be seen whether lawmakers will seize on the research in an effort to block recently passed legislation in DC to legalize pot.  Some Republicans have already signaled they would use the annual appropriations process to prevent the District’s marijuana laws from moving forward.

November 13, 2014

Ebola Drug Priority Bill Races Toward Senate Action; Sudden Infant Death Reporting Bill Too

Last month, the two leaders of the Senate Health, Education, Labor and Pensions committee signaled interest in new legislation to speed the development of Ebola drugs. On Wednesday, Democratic Sen. Tom Harkin of Iowa and Tennessee Republican Lamar Alexander announced plans to markup a bill next week that would allow funding for Ebola drug research through an existing FDA program designed to expedite the development of drugs to combat neglected tropical diseases.

The bipartisan effort by the two committee leaders and the scheduled committee meeting on the measure indicates possible action on the bill prior to end of the current congressional session. Also, the committee next week is likely to approve a separate measure creating a grant program for monitoring sudden unexplained infant deaths (HR 669), which the House approved by voice vote in September. A Senate committee vote on the bill also signals possible final Senate action on the bill before the end of the year.


November 12, 2014

Nurses Begin Strikes Across Globe for Better Ebola Protections

A wave of hospital vigils, rallies and strikes are beginning to snake across the globe today, as 100,000 registered nurses press for greater protections for health care workers treating the deadly Ebola virus.

In Washington, DC, National Nurses United will hold a vigil and press conference outside of the White House later this afternoon, in conjunction with strikes and rallies at hospitals and federal buildings already taking place throughout the country. Similar events will also be held in Canada, Australia, Spain, Ireland and the Philippines, in what the organization is calling “Global Ebola Awareness Day.”

“The lack of concern for nurses and patients in a world where corporations have taken over our community health care has been magnified during this deadly Ebola crisis,” said National Nurses United Executive Director Rose Ann DeMoro in a press release.

The push comes in the wake of news that health care workers being treated for the virus in New York and Texas are now Ebola-free. But the group still has lingering concerns over the quality of protections for health workers and the preparedness of U.S. hospitals if another case were to enter the borders.

The nurses are seeking full-body hazmat suits and powered air purifying respirators for all caregivers dealing with Ebola patients, as well as continuous and interactive training for health workers who might encounter the virus.

“Nurses are demanding patient safety.  They are heroes,” DeMoro said. “Hospitals should be forced to spend the money on patient safety that they spend on public relations.”

Meanwhile, lawmakers returning to Capitol Hill on Wednesday kicked off the lame-duck session with the first in a string of several Congressional hearings to examine international efforts to combat Ebola and assess the administration’s emergency request for funding.


By Melanie Zanona Posted at 12:51 p.m.

NY Ebola Patient Released But Nurses Press for Improved Preparedness

A Senate committee today focuses on the administration’s Ebola response plans and new $6.18 billion funding request. The session (view Roll Call’s live stream site), plus other scheduled congressional hearings on the topic coincide with the release in New York City on Tuesday of the last  U.S. patient currently being treated for the Ebola virus.

However, a national nurses group today is planning a White House vigil and national protest rallies to call attention to shortcomings in domestic preparedness for fighting the Ebola virus. Also, the White House’s Ebola Response Czar, Ron Klain, noted in a television interview on Tuesday that the New York City case will likely not be last domestic Ebola virus case.


By Paul Jenks Posted at 7:39 a.m.

November 11, 2014

HHS Offers a Reminder on HIPAA Privacy Waivers During Emergencies

Strict federal patient privacy protections are a major regulating element of the U.S. health care delivery system. The privacy rules, enacted through the Health Insurance Portability and Accountability Act (HIPAA), limit the disclosure of individually identifiable patient health information and are balanced with allowances for health care communications.

However, a public health emergency could stress the rigid enforcement of the privacy rules. Recent domestic cases of the Ebola virus prompted the Department of Health and Human Services on Monday to issue a bulletin explaining how the privacy rules include waiver provisions in the event of a declared official emergency. If the President announces an emergency, the Secretary of Health and Human Services may waive enforcement of several notable HIPAA requirements, including:

  • Gaining a patient’s agreement to speak with family members
  • Requests to opt out of a listing in a hospital or health facility’s directory
  • Distribution of a notice of privacy practices
  • Requests on the distribution and disclosure of protected health information
  • Requests for confidential methods for communications of health information






VA Raced Toward Health Care System Improvements by Veterans Day

The embattled Department of Veterans Affairs targeted today, Veterans Day, as the delivery date for improvements to the VA’s delivery of health care services. The crash reorganization effort hopes to quickly implement improvements following reports and congressional recriminations over delays in treatment services and staff manipulation of patient wait time statistics.

Since passage of new legislation in September giving the VA additional funding and authority to expand health care treatment options, the agency has raced to develop expanded allowances for veterans’ health treatment services at non-VA facilities. The legislation provides $10 billion in additional funding for non-VA treatment services, plus $5 billion to hire more doctors, nurses and medical staff.

Last week the agency announced regulatory changes allowing access and VA payment for health services outside of the VA system and a new ID card enabling veterans to get alternative treatment services. CQ Roll Call’s Connor O’Brien reported (subscription) that VA Secretary Robert McDonald on Monday extolled the new treatment access provisions, plus improved customer service operations in a VA reorganization announcement.

McDonald on Monday also touted improvements since September through three objectives: to improve trust, offer better service delivery and implement a long-term overhaul of the VA organization. McDonald described improvements in appointment scheduling and access to outside treatment services in a speech at the offices of the Washington Post:

We’ve made progress on all three, but we still have work to do. From June to September, we’ve completed over 1 million more appointments in our facilities than in the same months last year. We’ve also authorized over 1 million veterans to receive care outside the V.A., a 46 percent increase over last year. We’ve developed something we call the blueprint for excellence to reestablish V.A.’s leadership in health care. And we’ve begun what may become the largest restructuring in the department’s history.


By Paul Jenks Posted at 8:30 a.m.

November 10, 2014

Health Law Repeal Obstacles Remain, But Some Support Exists for the Repealing the Medical Device Tax

Republicans gaining control of the Senate starting in January opens up the prospect for advancing legislation on changes to the Affordable Care Act. However, Senate Republicans will still have to wrestle with minority Senate Democrats to consider any health law repeal or adjustment bills. An attempt to completely repeal of the law would likely be opposed by Senate Democrats and would face a certain White House veto. However, some changes the health law could find some bipartisan support.

A medical device tax, which was inserted into the health care bill primarily to raise money to fund other parts of the law, offers one opportunity. Repealing the health law’s imposition of a 2.3 percent excise tax on medical devices has long fostered some Democratic lawmaker interest, particularly from states and districts that are home to major medical device manufactures. CQ Roll Call’s Melissa Attias reported (subscription) last week that Utah Republican Sen. Orrin G. Hatch and Minnesota Democratic Sen. Amy Klobuchar have pegged the repeal of the tax as a priority and Sen. Hatch’s possible new role as chief of the Senate Finance Committee could spur action on bill.

The IRS has struggled to collect the medical device tax but Congress will be challenged to recoup lost expected funding. Separately, the Congressional Research Service last week weighed in with an economic analysis of the tax noting that an excise levy is not an efficient way to raise revenue and most of the impact of the tax will fall on consumers. The report also notes the tax will likely have a minimal impact increasing overall health spending.

November 7, 2014

‘Senior Statesman for Medicine and Computers,’ NIH’s Lindberg to Retire in 2015

lindbergbw2000 Senior Statesman for Medicine and Computers, NIHs Lindberg to Retire in 2015

Don Lindberg (Courtesy of NIH)

Don Lindberg, who has been the director of the National Library of Medicine for more than 30 years, plans to retire in March 2015, the National Institutes of Health said.

In a statement, NIH Director Francis S. Collins said that, as the first president of the American Medical Informatics Association, Lindberg has a reputation as “the country’s senior statesman for medicine and computers.”

“Think about it—when Don began, NLM had no electronic journals in its collection, few people owned personal computers, and even fewer had access to the Internet,” Collins said in a statement.

Lindberg’s work has “changed fundamentally the way biomedical information is collected, shared, and analyzed,” Collins said. His landmark projects include the MedlinePlus site for the general public and,according to a statement from NIH. Lindberg also created the National Center for Biomedical Information, which has been a focal point for “Big Data” in research. It has provided quick access to the data from  the Human Genome Project and to follow-on genetic sequence data.

By Kerry Young Posted at 11:41 a.m.

November 6, 2014

Veterans Gain Access to Non-VA Treatment Services

The Department of Veterans Affairs on Wednesday began mailing out veterans’ health care access cards that give veterans’ additional options for obtaining health care outside of the VA health system. The new cards, part of a program dubbed Veterans’ Choice, are a direct response to legislation enacted in August that seeks to improve veterans’ health care access and added $10 billion in emergency funding for non-VA treatment services.

The legislation was prompted by revelations of treatment wait list tampering by staff at various VA medical centers. The objective of the program, which adds to an existing allowance for external treatment options, is to speed the delivery of immediate health care treatment and tests by offering veterans the option of going to non- VA facilities. The giant VA health system has more than 9 million enrolled veterans and long-wait times have continuous plagued the system.

Also on Wednesday, the VA published regulations on the Veterans Choice Program, which includes individual and health provider eligibility requirements and provider payments rates. The VA on Wednesday also issued a notice on a revamped process for publishing wait list times.





By Paul Jenks Posted at 4:36 p.m.

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