Federal Health Policy & Politics Report. 114 th Congress 2015 Review/2016 Predictions

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Federal Health Policy & Politics Report 114 th Congress 2015 Review/2016 Predictions

30 Years of Combined Experience working with the health care provider industry in Washington Kyle Mulroy kmulroy@wscdc.com Mike Merola mike_merola@wswdc.com 9/18/17 Federal Health Policy & Politics Report 2

Agenda 114 th CONGRESS 2015 First Session Major Activities 2016 Second Session New Health Care Power Players Congressional Schedule Legislative Priorities Regulatory Priorities Presidential Politics 9/18/17 Federal Health Policy & Politics Report 3

2015 / 114 th Congress First Session 9/18/17 Federal Health Policy & Politics Report 4

114 th Congress: First Session Major Activities LEGISLATIVE SGR Repeal / Doc Fix CHIP Reauthorization Two Year Budget Agreement Medicare Seuestration Extension Ban on New Off-Campus Outpatient Departments Omnibus 9/18/17 Federal Health Policy & Politics Report 5

114 th Congress: First Session Major Activities REGULATORY One Year Imputed Floor Wage Index Extension Mandatory Hip / Knee Bundle Finalized 340B Mega Regulatory Guidance Proposed Two Midnight Rule Finalized RAC Program Enhancements 9/18/17 Federal Health Policy & Politics Report 6

2016 / 114 th Congress Second Session 9/18/17 Federal Health Policy & Politics Report 7

House of Representatives Health Care Leadership: New Faces, New Roles, New Priorities Paul Ryan (R-WI) Speaker of the House Policy wonk, committed to structural Medicare reform 9/18/17 Federal Health Policy & Politics Report 8

House of Representatives Health Care Leadership: New Faces, New Roles, New Priorities Kevin Brady (R-TX) Chairman Ways & Means Committee Fiscal conservative committed to hospital payment reform Pat Tiberi (R-OH) Chairman Ways & Means Health Subcommittee Moderate, bipartisan, centrist, new health care leadership role 9/18/17 Federal Health Policy & Politics Report 9

Senate Health Care Leadership: New Faces, New Roles, New Priorities Retiring Senate Minority Leader Harry Reid (D-NV) to begin transitioning power to Chuck Schumer (D-NY) Teaching hospitals have an ally in New York Sen. Charles E. Schumer and are likely to benefit if, as expected, he becomes the Senate s next Democratic leader Roll Call April 10, 2015 9/18/17 Federal Health Policy & Politics Report 10

Calendar Overview House and Senate in Session 2016 114 th Congress: Second Session Source: Bloomberg Government 9/18/17 Federal Health Policy & Politics Report 11

2016 114 th Congress: Second Session Top Five Legislative Health Priorities Drug Prices Mental Health Hospital Payment Reform Chronic Care 21 st Century Cures 9/18/17 Federal Health Policy & Politics Report 12

Drug Prices 2016 114 th Congress: Second Session Large majority of the public says prescription drug costs are unreasonable. Many point to drug company prices. In general, do you think the cost of prescription drugs is reasonable or unreasonable? Source: Kaiser Family Foundation Health Tracking Poll (conducted June 2-9, 2015) 9/18/17 Federal Health Policy & Politics Report 13

Drug Prices Presidential candidates weigh in 2016 114 th Congress: Second Session I'm going to address drug prices, starting with how we're going to try to control the cost of skyrocketing prescription drugs. Hillary Clinton These companies decide, We can get away with charging it, and so we do.' Marco Rubio 9/18/17 Federal Health Policy & Politics Report 14

Mental Health 2016 114 th Congress: Second Session In both the House (H.R. 2646) and Senate (S. 1945), legislation is under development to significantly reform mental health. 9/18/17 Federal Health Policy & Politics Report 15

Hospital Payment Reform 2016 114 th Congress: Second Session Indirect Medical Education / Graduate Medical Education Medicare / Medicaid DSH Site Neutral Payments Post Acute Medicare Audits & Appeals Rural Providers Readmissions Pay for Performance Rural / Imputed Floor Budget Neutrality 9/18/17 Federal Health Policy & Politics Report 16

Chronic Care Reform 2016 114 th Congress: Second Session Senate Finance Committee Chronic Care Working Group Orrin Hatch (R-UT) Senate Finance Chairman Johnny Isakson (R- GA) Working Group Chair Ron Wyden (D-OR) Senate Finance Ranking Member Mark Warner (D-VA) Working Group Chair 9/18/17 Federal Health Policy & Politics Report 17

21 st Century Cures In July the U.S. House overwhelmingly approved a comprehensive set of reforms designed to accelerate medical research and the approval of new drugs and devices. 2016 114 th Congress: Second Session 9/18/17 Federal Health Policy & Politics Report 18

Regulations 9/18/17 Federal Health Policy & Politics Report 19

Presidential Election 9/18/17 Federal Health Policy & Politics Report 20

What do we know in December? December 2007 Rudy Giuliani 23.7% Mike Huckabee 19.3% Mitt Romney 13.7% Tommy Thompson 11.9% John McCain 11.4% December 2011 Newt Gingrich 32.8% Mitt Romney 20.8% Ron Paul 9.5% Herman Cain 8% Rick Perry 7.3% December 2015 Donald Trump 28.7% Ben Carson 19.7% Marco Rubio 12.7% Ted Cruz 12% Jeb Bush 5.3% December 2007 Hillary Clinton 43.6% Barack Obama 25.1% December 2015 Hillary Clinton 55.8% Bernie Sanders 30.2% Martin O Malley 4.4% Source: RealClearPolitics Average 9/18/17 Federal Health Policy & Politics Report 21

Presidential Election Health Care Implications PROTECT AND EXPAND: Focus on cost containment and coverage for the remaining uninsured. REPEAL AND REPLACE: Health Savings Accounts, tax credits to purchase insurance, reform insurance regulations. 9/18/17 Federal Health Policy & Politics Report 22

THANK YOU! Kyle Mulroy kmulroy@wscdc.com Mike Merola mike_merola@wswdc.com 9/18/17 Federal Health Policy & Politics Report 23