Proposed Medicare Payment Model Based on International Drug Prices Would Lower Patient Costs
On October 25, 2018, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar announced an advanced notice of proposed rulemaking (ANPRM) calling for a demonstration project to more closely align Medicare payment for certain Medicare Part B drugs and biologics with international prices, which an HHS analysis showed to be 1.8 times lower on average than in the United States. The proposal is a follow-up to the president’s prescription drug blueprint and HHS request for information to reduce patient out-of-pocket costs for prescription drugs. HHS estimates a savings of $17.2 billion over five years.
Dems Take House; GOP Expands Senate; Science in Midterms
After an arduous campaign season, the midterm election results are mostly as anticipated. The Democrats gained seats in the House of Representatives, giving the party the majority in the lower chamber starting in January 2019. The Dems say their focus for the next congressional session will focus on health policy and high drug prices. Although the jury is still out over what the midterm elections meant, most experts agree that health care was the driving political issue for voters, regardless of party.
How I Celebrated NCC and Advocated for the Nursing Workforce
On September 12, 2018, I had the honor of attending the Nursing Community Coalition’s (NCC’s) 10th Anniversary Celebration as an ONS representative, joining members of ONS’s health policy staff. NCC is a 61-member coalition, working to further nursing education, training, and support through united advocacy efforts.
President Trump Enacts FY 2019 Labor/HHS Funding Package for Nursing and Cancer Research
Budget season on Capitol Hill is always a complicated time. It’s a tug-of-war between funding priorities and fiscal responsibility. Often, budget debates end up in a stalemate and the government shuts down. However, for the first time in 22 years, the president signed the fiscal year 2019 Labor Department of Health and Human Services Appropriations package before the September 30 budget deadline.
President Trump Signs Opioids Legislation Into Law
Developed to combat the nation’s opioid crisis, a comprehensive opioid addiction bill has finally made its way to the president’s desk. On October 25, 2018, President Trump signed the opioid package into law. The new law allots more than $8 billion to address addiction, drug trafficking, and recovery issues.
How ONS Contributes to the Value of Healthcare Coalitions
ONS, like so many membership organizations with dedicated healthcare interests, oils the gears that move the public policy machine forward. Each shift represents another opportunity for success. One such tactic is working in coalitions, and ONS is a vital member of health advocacy groups in Washington, DC, usually as the only nursing society at the table.
When ONS Speaks, People Listen
As this important midterm election approaches, my hope is that all ONS members recognize the importance of raising our collective voices as we elect our next leaders at the local, state, and federal level on November 6. In the words of former First Lady Michelle Obama, “It is more important than ever that we show up to vote, not just this year, but every year and in every election. Every voice must be heard, and every vote must be counted.”
Lower Drug Prices; Democrat Dealmakers; Republicans Support Medicare Expansion
Fighting the cost of soaring prescription medications is a winning issue with tremendous bipartisan support. And reigning in exorbitant drug prices means patients will be the real winners. Recently, President Trump lauded his administration’s work to fight against high prescription drug costs, citing new efforts to reduce other countries from taking advantage of drug pricing.
Oncology Nurses Make Impact During ONS’s Hill Days
The breadth of understanding that can come from a face-to-face conversation is hard to underestimate. More than 100 oncology nurses discovered the power of advocacy, education, and one-on-one conversations during ONS’s 2018 Capitol Hill Days in Washington, DC.
An Oncology Nurse’s Primer on the Palliative Care and Hospice Education and Training Act
When Senator John McCain (R-AZ) passed away in August 2018 from aggressive glioblastoma just one day after his family announced he stopped treatment, it put a poignant highlight in Washington on a need of which oncology nurses are far too aware: palliative care and hospice. Ideally, palliative care begins at the time of a cancer diagnosis and is aimed at managing symptoms throughout the cancer journey. Hospice begins when a patient’s prognosis is six months or less, yet in most cases, as McCain’s illustrates, patients begin hospice far too close to death. Many point to a lack of awareness and education—for patients and the public as well as oncology nurses and other palliative care providers.
NCI Releases Annual Strategic Plan and Budget Proposal
Every federal agency is required to submit a plan and proposal to Congress outlining its budget for the next fiscal year—or years—as well as justifications for how and why the department needs the requested allotment. In September 2018, the National Cancer Institute (NCI) released its Annual Plan and Budget Proposal for Fiscal Year 2020.
CMS Administrator Shares Three Points to Bolster Medicaid
During a recent speech at the 2018 Medicaid Management Care Summit, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma expressed a continued commitment to Medicaid’s legacy of supporting Americans in need.
Opioid Package Passes; Cheap Insurance Policies; Drug Patent Laws
For months, bipartisan lawmakers have worked together to build an opioid package aimed to tackle the nation’s abuse epidemic. After rounds of revisions and finally making it through both chambers of the House and Senate, the legislation is on its way to the president’s desk. The bill focuses funding efforts on addiction recovery programs and cracking down on the illegal medication trafficking.
Unexpected Medical Costs; Senate Passes Opioid Bill; FDA E-Cigarette Regulation
The financial toxicity associated with cancer care is becoming a widely known side effect of cancer treatment. Beyond the disease's physical impact, patients are suffering from overwhelming medical costs, high prescription drug prices, and unforeseen, expensive complications. Those issues, often coupled with the inability to work, are leading to many patients quickly depleting their savings or slipping into debt.
Moonshot Moves Forward Thanks to Biden Initiative
Like all great adventures, it began as an idea. What if the United States could make huge advancements in the fight against cancer in a short amount of time? How could that be accomplished? What are the metrics? How much would it cost? Who could direct such an effort?
Obamacare Premiums Stabilize; Senate Opioid Package; Medicare for All Questions
Millions of Americans depend on the Affordable Care Act (ACA) marketplace for their health insurance. In the past, costs have been unstable, seeing insurance premiums rise and competition flee. However, new reports estimate that Americans who receive health coverage from ACA will only see moderate increases to their premiums for 2019. During earlier repeal and replace efforts of Obamacare—otherwise known as ACA—the healthcare marketplace was volatile for consumers. Some insurers pulled out of the marketplace, leaving those that remained able to sharply increase premiums.
CMS Proposes Changes to Medicare and Doctor-Patient Relationships
One of the biggest challenges in medical practice is finding a way to spend enough time with each patient amid all the regulatory paperwork. To streamline workflows and encourage better provider-patient relationships, the Centers for Medicare and Medicaid Services (CMS) proposed new reforms to roll back certain regulatory efforts that were saddling clinicians with cumbersome paperwork. As part of those efforts, CMS reevaluated some of its reimbursement methods to improve efficiency with its required paperwork.
Oncology Nurse Educates Congressional Staff About the Importance of Palliative, Hospice Care
As a hematology and oncology nurse, I’ve seen countless patients in treatment and recovery, and I’ve seen some lose their fight against cancer. In June 2018, I had the privilege to represent ONS as the sole nurse selected to advocate for palliative care with one of ONS’s coalition partners, the Patient Quality of Life Coalition (PQLC), where I was able to share my perspective and the many aspects of my role as a nurse with congressional staff. As the sole practitioner in the five congressional meetings, I provided insight about how nurses interact with patients, particularly during cancer treatment.
FDA Commissioner Addresses Chronic Pain and Opioid Use
As the opioid epidemic ravages American lives, every federal agency with an opportunity to review access is stepping up efforts to find appropriate lines between offering proper care and potentially enabling abuse. In a recent statement, U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, acknowledged the challenge of balancing quality care efforts with overprescribing medications and the potential ease of access to opioids.
GOP Pre-Existing Conditions Bill; Biden in Pittsburgh; McCain’s Healthcare Legacy
As the Affordable Care Act is challenged in court, 12 Republican Senators signed a letter insisting that pre-existing conditions be covered in any new healthcare laws moving forward. Despite initial praise for the GOP, many patient advocacy groups, including the American Cancer Society Cancer Action Network, have voiced concerns about the efforts being far too little and far too late. On September 4, 2018, more than 25 patient advocacy groups came together and released a statement condemning a recent Republican bill stating it didn’t provide enough protections for pre-existing conditions, compared to what’s currently covered under the ACA. The advocacy groups noted the bill's outlying weaknesses and pushed for stronger reassurances.
Trump Administration Forced to Help to ACA; As Dems Campaign on Pre-Existing Conditions, Republicans Move In; Incidence of Pre-Existing Conditions Varies Across the United States
Under the Affordable Care Act (ACA), each state has the right to create its own basic healthcare system within its own jurisdictions. Currently, only New York and Minnesota have made such systems available to residents who are just over the limit to qualify for Medicaid. Those individuals receive their health care from the state—until the Trump administration eliminated certain aspects of ACA that provided federal funding for these programs. After suing to overturn the administration’s ruling, the Department of Health and Human Services announced a settlement that would pay close to half a billion dollars to New York and Minnesota to support the affected plans.
Oncology Nurses Must Share Experiences, Perspectives to Advocate for Change
As an oncology nurse, I’m grateful to work alongside so many colleagues who bring dedication, grace, and skill to their work. No other industry in the world shares the same frustrations or emotional tolls as nursing, but we continue to bring enthusiasm, optimism, and devotion to our daily work. Nurses strive to ensure the best for their patients. It’s the call to patient advocacy that is at nursing’s core.
HHS Secretary Directs FDA to Create Drug Importation Working Group
The rising price of prescription drugs is an ongoing priority for the Trump administration. As part of the president’s blueprint to lower drug costs, the Department of Health and Human Services (HHS) secretary, Alex Azar, elevated the prescription cost issue throughout many federal agencies to help determine a new course of action.
If You Are Young and Have Cancer, Help Can Be Hard to Find; Health Secretary Says Agency Has Power to Eliminate Drug Rebates; Trump Administration Needs to Step Up on Obamacare
A cancer diagnosis at a young age can lead to serious hardship after completing treatments and moving into survivorship. Such was the case for Matthew Zachary after his cancer diagnosis at age 21. An interesting component to Zachary’s story—and that of many others like him—is that despite the higher number of insured Americans after the Affordable Care Act, costs and complications still plague patients. Access to health care can be a double-edge sword. It means more people are seeing providers, but it doesn't mean that people can afford those treatments.
McCain Announcement Sheds Light on Nurses’ Role in Advance Care Planning
Senator John McCain’s (R-AZ) family announced on August 24, 2018, that McCain has elected to stop treatment for his glioblastoma, a rare and aggressive form of brain cancer. Although his health had surpassed his original prognosis for many months, “the progress of disease and the inexorable advance of age render their verdict. With his usual strength of will, he has now chosen to discontinue medical treatment,” his family explained.
Advocating at the State Level for Tobacco Control and Smoking Cessation
In May 2018, I participated in the American Cancer Society’s (ACS’s) Cancer Action Week in my role as a legislative volunteer for ACS’s Cancer Action Network (CAN). In this role, I advocate on the state level for various key legislative efforts for people with cancer in New Jersey.
Medical Aid in Dying Patient Chooses His Last Day; Arkansas Medicaid Work Requirements Could Cost Thousands Coverage; CVS Launches Program in Response to Trump Administration Blueprint to Lower Drug Costs
With more states legalizing medical aid in dying options for patients, the process is often vague and misunderstood. One patient, Aaron McQ, shared his story as he prepared to self-administer his life-ending medication. His story explains the nurse's key role in education and shared decision making to address the concerns of the patient.
At Stake in the 2018 Midterms: Medicaid Expansion; Health Groups Call on FDA to Speed Up Regulation of E-Cigarettes, Cigars; New Study Ignites Debate Over Cost of Medicare for All
Healthcare reform has been a hot political topic since before the introduction of the Affordable Care Act. Potential changes in the American healthcare system will be at the hands of which party controls the House of Representatives and the Senate. The upcoming midterm elections in November 2018 could determine a shift in power and potentially add further Medicaid expansion to the list of incoming health care changes.
Key Federal Health Policy Legislation Updates for 2018
’Tis the season. Well, at least in DC, it’s an exciting time. A political year. A long summer recess. A host of bills that are on the verge of passing. We are all aflutter with anticipation of the possibilities. But legislators need to remember who sent them to Washington and for what reason. Advocacy begins at home, and elected officials are heartened by what their constituents request, especially when that legislation is bipartisan and emotional and can affect people’s lives.
Candidates’ Position Will Matter to Voters, Especially Health Care; Senate Confirms Robert Wilkie as Veterans Affairs Secretary; Trump Battle Over Drug Prices Heats Up
The Kaiser Family Foundation released a report stating that coverage for pre-existing conditions ranks highest among healthcare campaign issues for American voters. According to the report, the issue cuts across all parties, including Democrats, Republicans, and voters living in battleground states. Since attempting to repeal and replace the Affordable Care Act, 58% of those polled say that President Trump’s administration and the Republicans in Congress are responsible for problems with the healthcare law moving forward.
AHRQ Shutters National Guideline Clearinghouse Because of Budget Cuts
As of July 16, 2018, the Agency for Healthcare Research and Quality (AHRQ) through the U.S. Department of Health and Human Services ceased maintenance on guideline.gov, the website that housed the National Guideline Clearinghouse. The website had been a resource for healthcare providers for more than 20 years.
U.S. House Passes Two ONS Priority Bills to Advance Palliative Care and Strengthen Nursing Workforce
On July 23, 2018, the U.S. House of Representatives passed by voice vote two ONS priority bills that would provide palliative care training, awareness, and research and funding to build the nursing workforce.
GOP Chairman in Talks With Trump Officials on Restarting Key Obamacare Payments; Oklahoma Medicaid Approved for Drug Pricing Experiment; House Panel Advances Bill That Would Temporarily Halt Obamacare’s Employer Mandate
On July 16, 2018, Kevin Brady (R-TX), House Ways and Means Committee chair, announced that he’s working with the Trump administration to restore funding to key Affordable Care Act (ACA) payments. Previously, the White House suspended more than $10.4 billion in payments to insurers, which brought criticism from Democrats and stern warnings of rising healthcare premiums.
FDA Advance Notice of Proposed Rulemaking Triggers ONS Response to Reduce Nicotine, Ban Flavors, and Regulate Premium Cigars
In response to the U.S. Food and Drug Administration’s (FDA’s) Advanced Notice of Proposed Rulemaking (ANPRM) on setting a tobacco standard for nicotine levels in combusted cigarettes, ONS submitted comments urging the agency to lower nicotine levels in combusted cigarettes and all tobacco products. Specifically, ONS recommended lowering the level of nicotine to a maximum of 0.4 mg or lower and that the ratio of tar to nicotine stay around 1 to reduce addiction. ONS pointed out that even lower levels of nicotine are harmful to health. ONS also cautioned the agency about the harm of additives in tobacco, including sugar, that counteract reduced nicotine levels.
HHS Drug Reform RFI Aims to Help Patients Better Afford Cancer Drugs
ONS shared the perspective of nurses caring for patients who may struggle to afford cancer drugs in comments submitted to the Department of Health and Human Services (HHS) on its Prescription Drug Reform Request for Information.
HHS Releases Blueprint for Affordable Prescription Drugs
Health care is arguably the top domestic policy issue and of major concern to most Americans. Coverage, access, and, most importantly, affordability are not abstract political concepts discussed in elite coffeehouse circles but rather are real-world problems that people struggle with daily. Do I need to see a physician for this problem? What impact will a diagnosis have on my life? Can I afford the medication?
Trump Officials Again Slash Funding for Obamacare Outreach Groups; Pfizer Postpones Price Hikes After Trump Criticism; Medicare for All Is New Democratic Mantra in Congressional Races
Previously, reports had emerged that the Trump administration was considering cuts to funding for Affordable Care Act (ACA) outreach groups whose aim has been to educate and assist Americans interested in enrolling in the healthcare program. On July 10, 2018, the administration officially announced funding cuts to the outreach programs, reducing their funding from $36 million to $10 million for 2019.
Trump Officials Considering Cuts to Obamacare Outreach Groups; Those Who Don't Qualify for Government Aid Aren't Buying Obamacare Plans; Judge Blocks Kentucky Medicaid Work Requirement Hours Before Implementation
An initial proposal from the Trump administration might cut funds for outreach related to the Affordable Care Act (ACA). As of yet no decisions are finalized and funding may still remain consistent, but limiting funding for outreach of the ACA, known to most as Obamacare, isn't a new move for the current administration. In 2017, it cut funding for navigators who educated and enrolled Americans in the ACA marketplace, leading to confusion among potential applicants and lower enrollment numbers. If funding is cut again this year, new or returning enrollees are unlikely to find success when looking for coverage.
House Overwhelmingly Passes Final Opioid Package; Texas v. the United States Could Impact Patients With Preexisting Conditions; Lawmakers Who Forged ACA Look Back
Through tremendous bipartisan support, the House of Representatives passed comprehensive opioid legislation to address the national abuse epidemic in the United States on June 22, 2018. For many healthcare advocates, an opioid legislation package has been a long time coming. The opioid crisis has been in the news since before the 2016 presidential election but was brought to the forefront during that campaign.
Two ONS Priority Health Bills Make Progress Out of House Energy and Commerce Subcommittee on Health
On June 27, the House Energy and Commerce Subcommittee on Health passed by voice vote two health bills that have been among ONS’s top legislative priorities: the Palliative Care and Hospice Education and Training Act ([PCHETA], H.R. 1676) and the Title VIII Nursing Workforce Reauthorization Act (H.R. 959). The bills are now poised for consideration by the full House Energy and Commerce Committee.
In Reversal, Trump Orders Halt to His Family Separation Rule; New York Moves Toward Legal Marijuana With Health Dept. Endorsement; Cigarettes Have to Be Labeled 'Deadly' Now. Here's Why
Recently, immigration policies have come front and center in the news. The issue of separating children from their parents at the border was elevated to a public health issue, as the American Academy of Pediatrics—among other healthcare organizations—decried the Trump administration’s policies, noting the potential for irreparable harm to children. ONS was one of the many provider groups that sent formal letters to the Department of Homeland Security, encouraging change to immigration policies that separate children from their parents.
HHS Pain Task Force Examines Opioid Epidemic Impact on Patients, Providers
The Department of Health and Human Services (HHS) Pain Management Best Practices Inter-Agency Task Force held its first public meeting from May 30–31, 2018, in Washington, DC. Convened as part of 2016’s Comprehensive Addiction and Recovery Act, the task force has been charged to address the nation’s continued opioid abuse crisis. During the two-day meeting, the 28-member task force deliberated on the goals of an upcoming study, set to be released July 2019, that aims to update best practices and clinical guidelines, while also addressing gaps and inconsistencies in chronic and acute pain management.
Health Policy Advances Cancer Treatment Options in the Era of Biosimilars
Options and cost are a double-edged sword as biomedical research marches forward and the list of approved drugs expands. More targeted drugs for specific diseases means that more patients have treatment plans that can directly fight their specific disease, possibly resulting in cures.
National Capital Chapter Members Focus on Advocacy and Research Funding in DC
In our nation’s capital, healthcare policy meetings occur weekly for various government and private organizations whose aim is to improve care and conditions for patients with cancer. The ONS National Capital Chapter members are involved in lobbying on the Hill and attending meetings about improving cancer care through the ONS Capitol Hill Gang.
House and Senate Pass the Childhood Cancer STAR Act
On May 22, the U.S. House of Representatives passed S.B. 292, the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act. The legislation will improve efforts to identify and track childhood cancer incidence, improve quality of life for childhood cancer survivors, ensure pediatric expertise at the National Institutes of Health by requiring the National Cancer Advisory Board to have at least one pediatric oncology expert on its board, and identify opportunities to increase childhood cancer research to better treat the 10,270 children diagnosed with cancer in the United States every year.
Federal Officials Say No to Lifetime Limits on Medicaid; Empowered Patients Are the Future of Health Care; Healthcare Jobs Continue to Grow Faster Than Jobs in the General Economy
On May 7, 2018, the White House told the Department of Health and Human Services to overturn Kansas’s new lifetime limit restrictions on Medicaid. Kansas has been leading the way for states looking to implement restrictions to federal benefits. The state previously implemented work requirements for Medicaid recipients and was trying to impose time limits for how long recipients could receive Medicaid for some time. Had its efforts stood, this would mark a fundamental shift in how the federal program is implemented at the state level.
ONS Greater Baltimore Chapter Advocates at the State Level
In today’s increasingly fractured political environment, with heightened partisanship, Washington, DC, has become toxic. New ideas and common-sense solutions are rare and promoting issues without politicization is literally a full-time job. Interest groups are now finding policy opportunities for success in the state capitals. Some advocacy initiatives have found easier, and faster, wins for their organizational efforts at the state legislature level.