Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2025 Appropriations
Lawmakers are working to advance a stopgap funding patch by the Fiscal Year 2025 (FY2025) deadline on September 30. The Democrat majority Senate and Republican majority House of Representatives advanced party-line proposals in July, but no overarching bipartisan budget framework emerged, threatening the possibility of a government shutdown on October 1. Appropriators are expected to call for a continuing resolution (CR) that extends FY2024 funding levels through autumn to buy more time to negotiate on the spending proposals and advance a bipartisan spending package after the November general elections.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Senator Welch Introduces 340B PATIENTS Act
Senator Welch (D-VT) introduced the 340B Pharmaceutical Access To Invest in Essential, Needed Treatments & Support (PATIENTS) Act. The bill is being led by Representative Doris Matsui (D-CA-07) in the House. The legislation seeks to:
- “Clarify that manufacturers are required to offer 340B discount prices to covered entities regardless of the manner or location in which a drug is dispensed, including if a covered entity uses a contract pharmacy to dispense 340B drugs to the entity’s patients.
- Ensure that manufacturers cannot place conditions on the ability of a covered entity to purchase and use 340B drugs, regardless of the manner or location in which the drug is dispensed, including through contract pharmacies.
- Impose civil monetary penalties on manufacturers that violate these statutory requirements and prohibition.”
NASTAD will continue to monitor and provide updates on this legislation.
Administration Activities
NASTAD Submits Comment in Support of CMS Proposal to Expand Access to HBV Vaccine through Medicare
On September 9, NASTAD submitted comments supporting the Centers for Medicare and Medicaid Services (CMS) proposal to leverage the 2025 Medicare Physician Fee Schedule (MPFS) rulemaking process to expand the mass immunizer program to include hepatitis B virus (HBV) preventive vaccines. HBV vaccines are the only preventive vaccine covered under Medicare Part B that are excluded from the mass immunizer program and require a physician order, posing barriers to vaccine access. NASTAD highlighted the proposed expansion as a critical step towards achieving HBV elimination goals in the US.
CDC Observes National HIV/AIDS and Aging Awareness Day
September 18 is National HIV/AIDS and Aging Awareness Day, an opportunity to raise awareness about HIV, address stigma and other barriers to care, and encourage older adults to get tested and know their status. More than half of people living with diagnosed HIV in the United States and dependent areas are aged 50 and older. Some were diagnosed later in life, while others have lived with HIV for many years. NHAAD aims to focus on the increasing number of people who, because of major advancements in HIV treatment, are living long, full lives with HIV. Share these social media posts to help raise awareness about HIV, address stigma and other barriers to care, and encourage older adults to get tested and know their status.
HHS Proposes Rule to Remove Certain Barriers to Organ Transplantation for PLWH
On September 12, the Department of Health and Human Services (HHS), through the Office of the Assistant Secretary for Health (OASH) and the Health Resources and Services Administration (HRSA), issued a proposed rule that would remove clinical research and institutional review board (IRB) requirements for transplantation of kidney and livers from donors with human immunodeficiency virus (HIV) to recipients with HIV. The rule change would allow more transplant centers to conduct these types of transplants and will help to reduce the stigma and transplant disparities for PLWH. Comments are due on October 15.
CMS Extends Deadline for PHE "unwinding" Renewals
CMS released an informational bulletin late last month extending the deadline for states to complete unwinding-related renewals by the end of 2025. CMS has also given states flexibility to redistribute their non-unwinding-related caseload to ensure a more even distribution of redeterminations across months. States seeking additional time under this guidance must meet certain conditions, such as ensuring that renewals occur no more frequently than every 12 months and continuing attempts to update enrollee contact information. States are expected to resume normal renewal processes and timelines beginning Jan. 1, 2026.
Additionally, the guidance gives states two options for handling unwinding renewals that have been pending for more than six months. If an enrollee returned a renewal and all requested documentation, but their renewal has been pending for 6+ months, states have the option to either: renew the enrollee for the remainder of their 12-month eligibility period, or restart the renewal process for the case by attempting a new ex parte renewal.
Here's a short and sweet summary from the Center on Budget. There's also a CMS slide deck explaining the bulletin, and outlining strategies that states can use to address backlogs and distribute renewals.
Resources
NHAHC Mini-Conference: Beyond the Regs
Date: Sunday, October 20 – Monday, October 21
Please join the National HIV/AIDS Housing Coalition (NHAHC) for a mini conference, Beyond the Regs, in Washington, D.C. prior to HUD’s HOPWA Institute. The workshop topics include braiding streams of funding for housing, prevention and housing models, and a closing housing advocacy panel featuring Rep. Jerry Nadler.
By 2022, no 2025 goal was met for PWH aged ≥50 years. If recent trends continue, goals are unlikely to be met. Although no goal was met for PWH aged ≥50 years overall, the goal for reducing hunger or food insecurity was met for those aged ≥65 years.
Health care providers who provide care for American Indian and Alaska Native infants should consider using DTaP-IPV-Hib-HepB as an option for the primary series at ages 2, 4, and 6 months; this product should not be used for booster doses.
CDC CME: Pre-Exposure Prophylaxis Among Transgender Women Without HIV Infection: US National Survey 2019-2020
This activity is intended for primary care clinicians, infectious disease specialists, nurses, pharmacists, and other healthcare professionals who care for transgender patients. The goal of this activity is for learners to be better able to evaluate the use of PrEP among transgender women and variables associated with higher use of PrEP.
GU O’Neill Institute: 2024 State Legislative Round-Up
This overview includes legislation on opioid litigation expenditures, medication for opioid use disorder (MOUD), Opioid Treatment Programs, naloxone, Syringe Service Programs, fentanyl test strips, MOUD in carceral settings, and enhanced sentencing.
GU O’Neill Institute: People with HIV As Community Health Workers
The HIV advocacy movement in the U.S. has transformed how public health efforts respond to and support marginalized and underserved populations. From the beginning, the HIV response has been set apart by the active role of community. People with HIV have been on the frontlines of shaping program and policy implementation around the communities most impacted.
HRSA HAB Webinar: An Innovative Approach for Improving STI Screening and Treatment Among Those with or Vulnerable to HIV Acquisition
Date: Thursday, September 18, 2024, 2:00-3:00 PM ET
“Join us for an exciting webinar featuring a groundbreaking intervention, Addressing STIs: Ask. Test. Treat. Repeat., designed to improve routine screening, testing, and treatment of common STIs. This initiative integrates evidence-based interventions into routine, primary HIV care without adding extensive burden to the clients and clinical team. CE credit is available for individuals who attend the live webinar. Click here to learn more about CE credits offered through the IHIP webinar series.”
Job Opportunities
Senior Policy Advisor, Bureau of Hepatitis, HIV, and STI – Queens, New York
The NYC Health Department’s Bureau of Hepatitis, HIV, and Sexually Transmitted Infections (BHHS) Policy and External Affairs Program seeks a Senior Policy Advisor to lead its health systems policy efforts and support its HIV, STI, and viral hepatitis policy advocacy more broadly. The Senior Policy Advisor will report to the Director of Policy and External Affairs and oversee BHHS’s health systems policy efforts, including monitoring, researching, and responding to Medicaid, Medicare, 340B program, Ryan White HIV/AIDS Program, New York State of Health Marketplace, New York City HIV/AIDS Services Administration (HASA), patient assistance programs, and commercial health insurance activity relevant to New Yorkers affected by HIV, STIs, and viral hepatitis.
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, 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
Trump on ObamaCare repeal: ‘I have concepts of a plan’
“Former President Trump said during Tuesday night’s debate he was interested in trying to repeal ObamaCare again, but indicated he doesn’t have a plan to replace it. ‘We are working on things. We’re going to do it. We’re going to replace it,’ Trump said.”
Biden administration finalizes rule to strengthen mental health parity law
“The Biden Administration said on Monday it had finalized a regulation to help ensure that the 175 million Americans with private health insurance have access to affordable mental health services. The 2008 Mental Health Parity and Addiction Equity Act already requires insurers and corporate-backed health plans to provide access and payment structures for mental health care services on par with other medical services.”
WHO clears Bavarian Nordic's vaccine for mpox, sets up access scheme
“The World Health Organization and partners on Friday set up a scheme to help bring mpox vaccines, tests and treatments to the most vulnerable people in the world’s poorest countries, similar to efforts during the COVID-19 pandemic, after earlier approving the first shot for the fast-spreading disease. Both steps should make it easier for badly-hit African countries to access the vaccine, as a new type of the mpox virus spreads from the Democratic Republic of Congo to its neighbours. The WHO has declared the outbreak a global public health emergency.”