By Marilyn Singleton, MD, JD
Congresspersons are out trolling for votes so they haven’t been in Washington working on legislation. The House Energy and Commerce Committee has summarized bipartisan legislation channeled through its committee that was passed by 113th Congress and signed into law or is awaiting action by the Senate. Some health related bills are listed below.
Pandemic Preparedness
One particularly ironic law is the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, H.R. 307 signed by the President in March 2013. Did you know that since 2006 HHS had an Assistant Secretary for Preparedness and Response? Since 2009, that person has been Nicole Lurie, M.D., M.D.P.H. Why was she not the public voice of the Ebola crisis? Why did she not provide the leadership we sorely needed? Why did we need a non-medical political tool as an “Ebola Czar” from whom we have yet to hear?
The Act requires the Assistant Secretary for Preparedness and Response “to provide integrated policy coordination and strategic direction with respect to all matters related to federal public health and medical preparedness and execution and deployment of the federal response for public health emergencies and incidents covered by the National Response Plan before, during, and following public health emergencies.” Full text: https://www.congress.gov/bill/113th-congress/house-bill/307.
What good are these laws if these political appointees do not follow through with their duties?
Other Health-related Bipartisan Laws
The bills that were easily signed into law are the kinds that would make lawmakers look heartless if they did not vote for them. The bills regarding SGR and the Affordable Care Act passed the House by close votes and clearly will go nowhere.
The School Access to Emergency Epinephrine Act, S.1503, is designed to help children by encouraging schools to keep emergency supplies of epinephrine available in case a child suffers a life-threatening allergic reaction. States that keep epinephrine will be allowed preference in receiving funds from Children’s Asthma Treatment Grants Program administered by the Department of Health and Human Services and allows a preference in awarding asthma grants to states with emergency epinephrine programs that meet specific requirements. The state must allows self-administration of asthma and anaphylaxis medication and makes a certification concerning the adequacy of the state’s civil liability protection law to protect trained school personnel who may administer epinephrine to a student reasonably believed to be having an anaphylactic reaction. Full text: https://www.govtrack.us/congress/bills/113/s1503.
The HIV Organ Policy Equity Act, S.330, permits research on and eventually the transplantation of organs from one HIV patient to another HIV patient. Full text: https://www.govtrack.us/congress/bills/113/s330.
The PREEMIE Reauthorization Act, S.252, seeks to strengthen the ongoing effort to reduce preterm labor and delivery and the risk of pregnancy-related deaths and complications due to pregnancy, and to reduce infant mortality caused by prematurity. This law also provides for the creation of the National Pediatric Research Network to facilitate research to help children with rare and genetic diseases. Full text: https://www.govtrack.us/congress/bills/113/s252.
The Drug Quality and Security Act, H.R. 3204, was passed after a year-long investigation in response to the meningitis outbreak in 2012. The law protects traditional pharmacies and clarifies laws related to human drug compounding. It will also strengthen the prescription drug supply chain in order to defend against counterfeit drugs and protect jobs. Full text: https://www.govtrack.us/congress/bills/113/hr3204/text.
The Improving Trauma Care Act, H.R. 3548, a one-page law (they all should be) amends the Public Health Service Act to include in the definition of “trauma” injuries resulting from thermal, electrical, chemical, or radioactive agents, thus making burn centers eligible for trauma center grants and trauma research programs. Full text: https://www.govtrack.us/congress/bills/113/hr3548.
The Autism Collaboration, Accountability, Research, Education, and Support Act of 2014 or the Autism CARES Act of 2014, H.R. 4631, extends the Combating Autism Reauthorization Act of 2011 to continue federal research, early identification and intervention, and education related to autism as well as the activities of the Interagency Autism Coordinating Committee. The Act extends through FY2019: (1) the developmental disabilities surveillance and research program; (2) the autism education, early detection, and intervention program; and (3) the Interagency Committee. Full text: https://www.govtrack.us/congress/bills/113/hr4631#overview.
Bipartisan Passage in the House, Awaiting a Senate Vote:
H.R. 4067 – To provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014. This bill requires the Secretary of Health and Human Services to continue to instruct Medicare contractors not to enforce requirements for direct physician supervision of outpatient therapeutic services in critical access and small rural hospitals through 2014. Full text: https://www.govtrack.us/congress/bills/113/hr4067.
H.R. 669 – The Sudden Unexpected Death and Data Enhancement and Awareness Act requires the Director of the Centers for Disease Control and Prevention (CDC) to continue activities relating to stillbirth, sudden unexpected infant death (SUID), and sudden unexpected death in childhood (SUDC). The bill requires the CDC (1) to provide for collection of epidemiologic information on stillbirths, including through existing surveillance system; (2) to develop and periodically update a standard data collection protocol and guidelines for postmortem stillbirth evaluation; (2) to provide for collection of sociodemographic, death scene investigation, clinical history, and autopsy information on SUID and SUDC cases through the review of existing records. Full text: https://www.govtrack.us/congress/bills/113/hr669.
H.R. 4290, the Wakefield Act reauthorizes grant programs that support the expansion, improvement, and evaluation of emergency medical services for children through 2019. The program supports the training and education of EMS providers and identifies innovative models that can increase pediatric care in rural and tribal communities. Full text: https://www.govtrack.us/congress/bills/113/hr4290#overview.
H.R. 4701, the Vector-Borne Disease Research Accountability and Transparency Act establishes a working group to review federal activities at the Department of Health and Human Services related to Lyme and tick-borne diseases. https://www.govtrack.us/congress/bills/113/hr4701.
H.R. 1098, the Traumatic Brain Injury Reauthorization Act, reauthorizes programs through 2019 at the Centers for Disease Control and Prevention to track and reduce the incidence of traumatic brain injury (TBI) in those who were formerly in the military and to provide support programs for TBI patients and their families. Full text: https://www.govtrack.us/congress/bills/113/hr1098#overview.
H.R. 1281, the Newborn Screening Saves Lives Reauthorization Act, reauthorizes the Newborn Screening Saves Lives Act of 2008 to extend through FY2019 a grant program that assists states in screening, counseling, and other services related to heritable disorders that can be detected in newborns as well as ensuring laboratory quality and surveillance. The bill also continues research on newborn screening conditions at the National Institutes of Health. Full text: https://www.govtrack.us/congress/bills/113/hr1281#overview.
H.R. 4080, the Trauma Systems and Regionalization of Emergency Care Reauthorization Act, authored by Rep. Michael C. Burgess, M.D. (R-TX) and Rep. Gene Greene (D-TX), reauthorizes Trauma Care Systems Planning Grants, which support state and rural development of trauma systems. It also reauthorizes pilot projects to implement and assess regionalized emergency care The bill requires that not more than 50% of amounts remaining for a fiscal year after FY2014 (after allocation for administrative purposes or for improvement of emergency medical services in rural areas) be allocated for competitive grants to support pilot projects for emergency care and trauma systems. The bill also requires the inclusion of standards and requirements of the American Burn Association in trauma care modifications of a state plan for providing emergency medical services. Full text: https://www.govtrack.us/congress/bills/113/hr4080#overview.
H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010. (vote of 229-195). Repeals the Patient Protection and Affordable Care Act, effective as of its enactment. Full text: https://www.govtrack.us/congress/bills/113/hr45#overview.
H.R. 3350, Keep your Health Plan Act of 2013 (vote of 261-157). Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. Full text: https://www.govtrack.us/congress/bills/113/hr3350.
H.R. 3811, Health Exchange Security and Transparency Act of 2014 (vote of 291-122). Requires the Secretary of Health and Human Services (HHS) to notify an individual within two business days after discovery of any breach of security of any system maintained by a health care exchange established under the Patient Protection and Affordable Care Act which is known to have resulted in the theft of or unlawful access to the individual’s personally identifiable information.
https://www.govtrack.us/congress/bills/113/hr3811.
H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (vote of 238-181). Introduced by Michael Burgess, MD (R-TX). Of, course the better bill would be to repeal Medicare altogether. The bill would replace the SGR with a single conversion factor and directs MEDPAC to analyze the factors going into payment rates. Directs the Secretary of Health and Human Services (HHS) to establish a merit-based incentive payment system (MIPS) by consolidating (with certain revisions) the existing: (1) electronic health record (EHR) meaningful use incentive program, (2) quality reporting program, and (3) value-based payment program. Full text: https://www.govtrack.us/congress/bills/113/hr4015#overview.
H.R. 3522, Employee Health Care Protection Act of 2014 (vote of 247-167). The bill (1) permits a health insurance issuer that has in effect health insurance coverage in the group market on any date during 2013 to continue offering such coverage for sale through 2018 outside of a health care exchange established under the Patient Protection and Affordable Care Act; (2) treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. Full text: https://www.govtrack.us/congress/bills/113/hr3522.
H.R. 4709, the Ensuring Patient Access and Effective Drug Enforcement Act of 2014, addresses prescription drug abuse at the distribution level. The bill amends the Controlled Substances Act to provide that:
(1) a determination by the Attorney General that a registration to manufacture, distribute, or dispense a controlled substance is “consistent with the public health and safety” means that it has a substantial relationship to such Act’s purpose of preventing diversion and abuse of controlled substances; and (2) a finding of “imminent danger” by the Attorney General justifying immediate suspension of such a registration means that there is a significant and present risk of death or serious bodily harm that is more likely than not to occur in the absence of such a suspension. Full text:
https://www.govtrack.us/congress/bills/113/hr4709#overview.
