Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2024 Appropriations
Congress adjourned for the holiday recess without advancing a fiscal year 2024 (FY2024) spending package. As a result, appropriators must work quickly in 2024 to build bipartisan consensus for a spending package ahead of the “laddered” funding deadlines set in place by a November 17 continuing resolution (CR) (H.R.6363): some federal agencies and programs face a January 19 funding deadline, but larger agencies, including those funded through the Labor, Health and Human Services, Education, and Related Agencies (LHHS) bill, will face a February 2 deadline.
Democrats insist that topline spending levels were already negotiated during the June 2023 debt ceiling compromise, but some Republicans are calling for deeper spending cuts and policy riders, including elimination of key HIV prevention programs like Ending the HIV Epidemic Initiative. House Speaker Johnson (R-LA-04) suggested the possibility of a full-year CR as a back-up plan, which was rebuked as a non-starter by the Senate Appropriations Chair, Senator Patty Murray (D-WA).
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Administration Activities
CMS Urges PBMs, Insurers to Ensure Adequate Payment for and Access to Preventive Services
On December 14, the Centers for Medicare and Medicaid Services (CMS) sent a letter to pharmacy benefit managers (PBMs), Medicare Part D plans, Medicaid managed care plans, and private insurance plans outlining reported practices that threaten the sustainability of pharmacies, increase burden on healthcare providers, and impede care delivery. CMS called on PBMs and insurers to review payment practices that may disincentivize vaccine administration and take immediate steps to ensure adequate payment for and access to vaccines. Additionally, CMS urged insurers and PBMs to check their processes and systems to ensure they are providing full coverage, without cost sharing, of preventive services, as required by federal law.
Resources
CDC NCHHSTP: Connections Newsletter (December 2023-January 2024)
CDC MMWR: Notes from the Field: Transmission of Mpox to Nonsexual Close Contacts
“Among 662 individuals who had nonsexual close contact with an mpox patient, 10 experienced mpox signs and symptoms within 21 days of exposure.”
Harm Reduction Therapeutics: First Shipment of RiVive Brings Life-saving OTC Naloxone Nasal Spray One Step Closer to Those Who Need it Most
“Harm Reduction Therapeutics (HRT), Inc., a 501(c)(3) nonprofit pharmaceutical company, has shipped its first order of over-the-counter (OTC) RiVive™ (naloxone HCl nasal spray 3 mg) for the emergency treatment of opioid overdose…Earlier this year when FDA approved RiVive, it was announced that HRT is donating 200,000 doses (10% of projected initial annual product production) to Remedy Alliance which will supply RiVive to those who need it most, including people who use drugs, through community harm reduction organizations. Remedy Alliance has also made an additional purchase of about 28,000 twin packs of RiVive.”
“As part of its effort to lower prescription drug prices for America’s seniors and people with disabilities, the U.S. Department of Health and Human Services (HHS) today issued a new report that provides an in-depth review of the 10 drugs selected for the first cycle of Medicare drug price negotiations under President Biden’s Inflation Reduction Act (IRA)…Finally, the Administration for Strategic Preparedness and Response (ASPR) is making fair pricing a standard part of contract negotiations for medical products developed or purchased as part of its commitment to obtain best value for the US taxpayer.”
Job Postings
Viral Hepatitis Prevention Coordinator – Austin, TX
Under direction of the Prevention Unit, provides highly advanced, senior-level consultative services and technical assistance as the DSHS viral hepatitis prevention coordinator. Oversees implementation and maintenance of viral hepatitis prevention efforts by identifying ways to integrate viral hepatitis prevention, vaccination, testing, and linkage to care into existing public health, clinical care, and community settings. Responsible for developing a DSHS viral hepatitis prevention plan as well as legislatively-mandated plans, including working with branch staff to solicit input from the public, including experts on Hepatitis, on the tenets of the plan.
Program Content and Training Specialist, Supporting Harm Reduction Programs (SHaRP) – University of Washington
This position is part of a cooperative agreement award from the Centers for Disease Control and Prevention to provide technical assistance about monitoring and evaluation to syringe services programs (SSPs) as part of the National Harm Reduction Technical Assistance Center. One of the primary projects of this award is to provide technical assistance (TA) to SSPs for monitoring and evaluation activities. The University of Washington is working in collaboration with the CDC, SAMHSA, NASTAD, the National Harm Reduction Coalition, and other TA partners to provide a suite of technical assistance support to individual programs.
Communicable Disease Epidemiologist – Cheyenne, Wyoming
This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program. Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, and analyzing exposure data utilizing epidemiological and statistical methods.
Open Positions – New York State
The New York State Department of Health, in partnership with Health Research, Inc., has various job openings, including some within the AIDS Institute. Please visit this link to learn about their current opportunities.
News Bulletin
‘Sex Is a Normal Activity and Part of Our Human Experience’
“Despite all this, the longtime public health official — who stepped down from his federal post at the end of November — is resolutely optimistic. Amid the dire statistics, he insists, are glimmers of hope, including a new drug highly effective at stopping STD transmission after unprotected sex and better at-home STD tests for people unable or unwilling to go to a clinic. Still, the Dominican-born Mena has known for decades that even the most groundbreaking medical innovations are useless if they don’t get into the hands of the people who need them the most.”
There are Many Reasons to Fear HIV Molecular Surveillance: Interview with Kae Greenberg
“Within the HIV movement, the federal government’s collection and tracking of the molecular data of people diagnosed with HIV as part of public health efforts is a hot-button issue. Many advocates worry that these data could be used by states to prosecute community members. Others argue that there are bigger issues to worry about―like the threat of HIV funding being cut―or that the practice is harmless and will never be used against people living with HIV. “For a deeper understanding of what HIV molecular surveillance entails, TheBody spoke with Kae Greenberg (he/him), a staff attorney at the Center for HIV Law and Policy (CHLP).
‘Stalemate’ on AIDS relief to drag into 2024
“The top Republican working to extend the United States’ global HIV/AIDS relief work admitted negotiations are deadlocked, jeopardizing one of the most successful U.S. foreign interventions of this century… But he has been unable to bridge the divide between his Republican colleagues who accuse the Biden administration of using PEPFAR to fund abortion providers overseas and House Democrats who refuse to reinstate Trump administration rules that prohibited foreign aid going to groups that provide or counsel on abortions.”