House Passes Bill Barring Use Of QALY Metric In Federal Health Programs
The legislation would ban the use of quality-adjusted life years indexes when valuing medicines for federal health programs such as Medicaid, Medicare Advantage, and VA Health Care.
Axios:
House Approves Ban On Disputed Measure For Valuing Treatments
A divided House of Representatives on Wednesday endorsed banning quality-adjusted life years from being used as a metric for determining a drug's value in federal health programs. QALYs are viewed as a key tool in comparative effectiveness studies, but have been held up as discriminatory against people with disabilities — and are unevenly applied across federal programs. (Knight, 2/8)
Roll Call:
Lawmakers’ Retirements Risk Leaving Doctor Pay Fix Unfinished
Physician groups and other advocates for overhauling the Medicare payment system will lose three of their biggest Capitol Hill supporters to retirement next year, raising questions about next steps for long-term changes to the Medicare payment program. Republican Reps. Larry Bucshon of Indiana, Michael C. Burgess of Texas and Brad Wenstrup of Ohio, all members of the GOP Doctors Caucus, have been vocal in pushing for changes to the way Medicare pays physicians. The current system has been fraught with controversy, with doctors complaining their rates don’t keep up with inflation and with requirements that payments be budget-neutral, resulting in cuts to doctor pay. Meanwhile, a near decadelong push to embrace value-based care has not panned out. (Hellmann, 2/8)
In related news —
Axios:
Health Insurers Balk At Proposed Medicare Advantage Rates
CVS Health and Centene executives say newly proposed Medicare Advantage rates for 2025 aren't "sufficient" and hinted they could cut benefits if the federal government finalizes the rates as is. More than half of Medicare enrollees are in private Medicare Advantage plans. The specter of potential cuts to seniors' health care benefits in an election year could put pressure on the Biden administration. (Reed, 2/8)
Stat:
Medicare Advantage Plans Can’t Deny Care With AI, CMS Warns
In recent months, the federal government has repeatedly told Medicare Advantage insurers that they cannot use artificial intelligence or algorithms to deny medical services the government routinely covers. But in finalizing a rule to that effect, it also stepped into a thicket of questions from insurers about a technology that is especially difficult to pin down: What is AI? Can it be used at all to make decisions about the coverage of older patients? If so, how? (Ross and Herman, 2/7)
In news about children's health —
The Hill:
Hundreds Of Families Urge Schumer To Pass Children’s Safety Bill
Hundreds of parent advocates urged Sen. Majority Leader Chuck Schumer (D-N.Y.) to pass the Kids Online Safety Act in a letter and full-page Wall Street Journal ad published Thursday. The call to action builds on pressure from parents at last week’s Senate Judiciary Committee hearing with the CEOs of Meta, TikTok, Discord, Snap and X, the company formerly known as Twitter. “We have paid the ultimate price for Congress’s failure to regulate social media. Our children have died from social media harms,” the parents wrote in the letter. (Klar, 2/8)
The Hill:
White House Announces Partnership With NFL, NBA To Promote Health And Wellness For Kids
The White House announced it is partnering with the National Football League (NFL), National Basketball Association (NBA) and 12 other major sports leagues and players associations to promote physical activity, nutrition and healthy lifestyles. As part of the partnership, the NFL will build on its Play 60 initiative, which encourages children to get physically active for at least 60 minutes a day and has them learn about nutrition, second gentleman Doug Emhoff announced. (Gangitano, 2/8)
