The Ways and Means Committee June 26 convened a markup and advanced several pieces of key legislation, including the Opioid Workforce Act of 2019 (H.R. 3414), the Protecting Access to Information for Effective and Necessary Treatment (PATIENT) Act of 2019 (H.R. 3439) and the Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act (H.R. 3417).
In a statement, Darrell G. Kirch, MD, AAMC president and CEO, praised the outcome saying, “The AAMC commends Chairman Richard Neal and the House Ways and Means Committee for passing legislation that will help the nation have more physicians necessary to address the opioid crisis. We also applaud the Committee for acting to reauthorize PCORI, whose research will aid providers and patients in determining which treatment options work best for them.”
Opening the markup Chair Richard Neal (D-Mass.) struck a bipartisan tone, stating that he was pleased that, “In the past, these extender provisions have been bipartisan, and I am pleased that — apart from one extender — we are continuing in that tradition of bipartisan collaboration and support.” Ranking Member Kevin Brady (R-Texas) concurred, stating that he was glad that Democrats “chose to work with Republicans on commonsense, needed reforms to improve health care for our seniors, veterans, and medical providers.”
In the markup, the Committee approved the Opioid Workforce Act of 2019 — bipartisan legislation that would increase the number of Medicare-supported graduate medical education (GME) positions by 1,000 slots for hospitals with established, or in the process of establishing, addiction medicine, addiction psychiatry, or pain medicine programs. The AAMC submitted a letter of support, and led a sign-on letter with over 50 signers.
The Committee also approved the PATIENT Act, a 7-year reauthorization of the Patient-Centered Outcomes Research Institute (PCORI) and its funding mechanism. Since its inception in 2010, PCORI has developed a national infrastructure for clinical comparative effectiveness research through a process that engages patients and other stakeholders, standardizes methodologies, and identifies important research questions to help inform medical decision-making by patients and clinicians. The AAMC is among nearly 200 organizations supporting a long-term PCORI reauthorization.
In addition to reauthorizing PCORI for seven years, the bill also directs PCORI to include among its national priorities “research with respect to substance use (including opioid use disorders), mental health, and maternal morbidity and mortality.” The committee approved an amendment in the nature of a substitute that made technical corrections to the bill, but rejected along party lines two GOP amendments: one that would convert the institute’s funding to an annual appropriation through a five-year authorization, and a second amendment that would discontinue the fee that insurance plans contribute to the Patient-Centered Outcomes Research Trust Fund.
Additionally, the Committee unanimously approved the BETTER Act, which contains several bills focused on improving care in the Medicare program. Included in the BETTER Act was the bipartisan Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 1358) that would address a provision in the Medicare GME regulations that negatively impacts hospitals that have inadvertently, and often unknowingly, triggered the establishment of very low permanent GME resident “caps” and associated payment levels because they served as a rotation site for small numbers of residents. By correcting these technical errors, the legislation would make it possible for affected nonteaching hospitals to establish their own full-time residency programs and make it easier for community hospitals to train more residents.