Legislative Update 1/8/2021: COVID-19 Relief Package, Telehealth Week Recap

Nebraska capitol

This is the legislative update for February 8, 2021. View all updates here.



The February 8, 2021 legislative update includes highlights from both federal and state legislatures.

Federal Updates

Congress

Beginning Tuesday, February 8, the Senate will be focused on the second impeachment trial of President Donald Trump.

Meanwhile, the House is moving swiftly to produce a committee markup on President Joe Biden’s COVID-19 relief package, which has been named the American Rescue Plan Law.

Among the many provisions, the package includes:

  • $1,400 payment to Americans
  • $130 billion to reopen schools
  • $350 billion for state and local governments
  • $160 billion for vaccine testing and equipment
  • $50 billion for small businesses
  • $30 billion for rent and utility funds
  • $400 in unemployment benefits per week through September, 2021
  • Raise minimum wage to $15 per hour
  • Up to $3,600 tax credit per child for qualifying households

Learn more about the American Rescue Plan Law/a>.

This past week, both the House and the Senate approved the legislation necessary to pass this package through a process known as reconciliation.

Reconciliation streamlines the passage of legislation by allowing it to pass with a simple majority, without being subject to a filibuster(Translation: type of tactic used to block or delay legislation). Reconciliation only requires 51 votes in the Senate. The Senate is split 50-50 between Republicans and Democrats, with democratic Vice President Kamala Harris having the tie-breaking vote.

Children’s Hospital Association and Reconciliation

Throughout the relief package’s development, the Children’s Hospital Association (CHA) GR Subcommittee has been meeting nearly every day to discuss the priorities that we want to be included in the reconciliation process.

The three priorities being sent to the Hill today are:

  1. Financial sustainability for pediatric providers.
  2. Target health needs of children/adolescents/teens in COVID relief plans.
  3. Financial sustainability for mental and behavioral health services.

Hearings on Capitol Hill this week include:

Monday, Feb. 8 Tuesday, Feb. 9 Wednesday, Feb. 10 Thursday, Feb. 11 Friday, Feb. 12
House Committee on the Budget: Consideration of Rules of the Committee on the Budget for the 117th Congress House Committee on Homeland: Assessing Cyber Threats and Building Resilience

340B Drug Pricing Program

The 340B Drug Pricing Program provides financial assistance to hospitals that serve vulnerable communities, in order to manage the rising costs of prescription drugs. The program requires pharmaceutical manufacturers that participate in Medicaid to sell outpatient drugs at discounted prices to healthcare organizations — including children’s hospitals — that provide care for many low-income and uninsured patients.

Learn more about the 340B Drug Pricing Program.

At the end of 2020, CHA joined the American Hospital Association (AHA) and other hospital organizations to file a lawsuit against Health and Human Services (HHS). The suit cited a lack of enforcement to Pharmacy Benefit Managers (PBMs) and pharmacies that have been refusing to participate in 340B drug discounts to providers.

Learn more about the lawsuit against HHS.

The first hearing on the motion to dismiss oral arguments will begin today (Tuesday, February 9) at 4 p.m. Central Standard Time. It is the second in line to be heard.

You can stream that hearing here: https://www.cand.uscourts.gov/judges/gonzalez rogers-yvonne-ygr/.

State Updates

Nebraska Legislature

Telehealth Bills

Last week, the Nebraska Legislature held a “telehealth theme,” with multiple bills about telehealth heard by their committees.

On Monday, the Banking, Commerce, and Insurance Committee listened to two telehealth parity bills (Translation: Mandates that fully-insured private plans reimburse and cover telehealth services equally to how they would do so for in-person visits).

The LB314 bill focused on parity for reimbursement for all services provided via telehealth, and LB487 (by Senator Arch) focused specifically on behavioral health parity. While payors and the Department of Insurance came to the hearing in opposition, the comments were considerably favorable for outcomes their consumers have seen via telehealth.

On Friday, LB400 was the final telehealth bill heard before the HHS Committee, allowing three relaxed regulations to remain after the public health emergency (PHE):

  1. Flexibility of originating site, allowing the patient to receive services at home or in a clinic/hospital setting.
  2. Waive the requirement that a written consent form be obtained before a telehealth service can be provided — a requirement that inhibits the swift connection to a provider via telehealth if a patient is experiencing a mental or behavioral health emergency.
  3. Allow audio-only services for behavioral health only.

Rebecca Ohlinger, manager of telehealth, testified on behalf of Children’s and the Nebraska Hospital Association (NHA). Others in support of the bill include:

  • Nebraska Medical Association (NMA)
  • Nebraska Association of Behavioral Health Organizations (NABHO)
  • CHI Health Center
  • Nebraska Medicine
  • One World Community Health Center
  • The Platte Institute

The Nebraska Department of Health and Human Services (DHHS) came in opposition regarding the audio-only piece. Senator Arch hopes to amend LB400 to his behavioral health parity for reimbursement bill, LB436 and will need to work with DHHS and providers to make that possible. We will continue to work with the senator as he drafts an amendment.

Immunization Bills

Also last week, the HHS Committee heard from dozens of testifers in opposition to two immunization bills:

  • Senator Ben Hansen (R-Dist. 16, Blair) introduced LB643, a bill that would ensure no government entity or employer could require the COVID-19 vaccine. This bill was opposed by NHA, NMA and other provider associations.
  • Senator Machaela Cavanaugh (D-Dist. 6, Omaha) introduced LB447 on behalf of the NMA which requires daycare centers to report vaccine data electronically to the DHHS and removes the personal exemption for entry into a daycare. Children’s offered a letter of support focusing on the importance of rich, effective data, as well as vaccine compliance for the children in Nebraska.

While the hearing at times became contentious and required the Sergeant of Arms to get involved to calm the rowdy, unmasked crowd, the hearing continued late into the evening on Thursday with unknown pathways moving forward.

It will continue to be a priority to monitor these two bills as the seven HHS lawmakers hold an executive session — a process when they consider voting bills out of committee and onto the floor for full debate among all senators. If the HHS Committee decides the bill should not be voted out of committee due to opposing testifier’s points, the bill no longer has a pathway forward.

Another unique bill offered by Senator Cavanaugh would change the legal age for organ and tissue donation from 16 to 14 years of age. LB251, brought forward by a girl scout in her district, would allow those applying for their driver’s permit to select “yes” to organ donation and to have their ID reflect that choice. It has been confirmed that the parent’s right to make the ultimate decision exists for their children up to age 18. The permit is merely a reflection of the child’s wish. There was no opposition to the bill.

This week’s hearings include, but are not limited to:

Monday, Feb. 8 Tuesday, Feb. 9 Wednesday, Feb. 10 Thursday, Feb. 11 Friday, Feb. 12-
Recess Day
LB473(DeBoer)
Adopt the
Extraordinary Increase in Special Education Cost Act
LB322(Williams)
Adopt the School
Safety and Security Reporting System Act
LR29 (M. Cavanaugh) Creates a special
committee, The Eastern Service Area Child
Welfare Contract
Special Investigative and Oversight
Committee of the
Legislature
LB609 (Hilgers)
Change provisions
relating to the Uniform Credentialing Act
LB388(Friesen)
Adopt the Nebraska Broadband Bridge Act
LB673(Murman)
Adopt the Education Behavioral Awareness and Support Act and change the
determination and
certification of state aid to schools
LB86 (Bostelman)
Require registration for the prescription drug monitoring system
LB436 (B. Hansen)
Change provisions of the Athletic Training Practice Act
LB290(M. Cavanaugh) Adopt the Paid Family and Medical Leave Insurance Act LB642(Day)
Provide for
reimbursements to
school districts and educational service units for mental health expenditures
LB411 (Lathrop)
Require sharing of
information with the designated health
information exchange
LB390 (Murman)
Provide for credentials based on reciprocity and change
requirements for
credentials under the Uniform Credentialing Act
LB258 (Vargas)
Adopt the Healthy and Safe Families and
Workplaces Act
LB198 (Vargas)
Change provisions
relating to the Student Discipline Act
LB418 (Murman)
Adopt the Solemn
Covenant of the States to Award Prizes for Curing Diseases
compact
LB119 (M. Cavanaugh) Change provisions of the Healthy Pregnancies for Incarcerated
Women Act

If you personally are aware of a bill and would like to add your expertise, feedback, or questions, please contact Liz Lyons at llyons@childrensomaha.org.

Key Dates

Monday, January 25th First Day of Public Hearings – 9:00 a.m. start
Tuesday, February 16th Nebraska Forecasting Advisory Board Meeting
Thursday, March 4th Appropriations Budget due to the Legislature
Tuesday, March 16th Deadline for committee and senator priority bill designations
Thursday, April 29th Budget bills must be on General File
Wednesday, May 19th Budget bills must be passed
Thursday, June 10th Last Day of Legislative Session – Sine Die (Day 90)(tentative)
Sunday, June 13 - June 18th Children’s Hospital Association (CHA) Family Advocacy Day

Child Health Champion Advocacy Team

Please join the Children’s Child Health Champion Advocacy Team every Thursday at 7:30 a.m. for a 30-minute call.

Advocating for children is extremely important at all stages. This internal group of stakeholders — comprised of providers and experts across the continuum of care at Children’s — meets weekly to ensure we are leading the discussion on child advocacy in the region.

Learn more about our advocacy and legislative work in our community.

Advocacy & Outreach

If you are interested in joining the movement, contact Liz Lyons at llyons@childrensomaha.org for more information.


(Sources: CHA, AHA, The Hill, HHS, Peetz & Co., Nebraska Legislature, OWH)

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