Issue: Health Care

Walorski Testifies on Opioid Crisis Before House Subcommittee

Walorski Testifies on Opioid Crisis Before House Subcommittee

Outlines Policy Priorities for Treating Chronic Pain and Ending Epidemic of Opioid Abuse

WASHINGTON – U.S. Rep. Jackie Walorski (R-Ind.) today testified before the House Energy and Commerce Subcommittee on Health about the nationwide opioid epidemic and the related problem of chronic pain.

“Pain is the number one reason why Americans seek health care, the number one cause of disability, and costs the U.S. economy more than $600 billion in direct health care costs and lost productivity,” Congresswoman Walorski said. “The veteran population is particularly impacted by the chronic pain crisis, with more than 50 percent of VA patients reporting chronic pain. We can reduce demand by more effectively treating chronic pain and providing better access to FDA-approved non-opioid pharmaceuticals, advanced medical devices, and integrated alternative therapies.”

At the hearing, Walorski outlined three policy priorities for addressing the related problems of opioid abuse and chronic pain: recognizing the importance of a multi-disciplinary approach to pain management; promoting cutting-edge research to encourage effective alternatives to opioids; and advancing best practices in pain management within Medicare.

Congress last year passed into law the Comprehensive Addiction and Recovery Act, bipartisan legislation to address the nationwide opioid epidemic. Congresswoman Walorski served on the conference committee that negotiated the final bill, which included two provisions she authored. One requires the Department of Veterans Affairs (VA) to participate in state prescription drug monitoring programs (PDMPs), and the other allows the VA to use FDA-approved medical devices and other non-opioid therapies to treat chronic pain.

Walorski recently questioned Medicare’s top fraud prevention official at a Ways and Means Committee hearing about how safeguards failed to prevent a doctor in Indiana from prescribing more than $1 million in opioids to 108 patients under Medicare’s prescription drug program.

Video of Walorski testifying before the subcommittee is available here, and the text of her written testimony is below.

Thank you Chairman Burgess and Ranking Member Green for holding this hearing on the opioid crisis.

America is facing two inter-related public health epidemics: chronic pain and opioid addiction, misuse, and abuse. A long-term solution to the opioid epidemic will not be achieved without addressing the challenge of appropriately treating chronic pain.

According to the Institute of Medicine (IOM), 100 million Americans suffer from chronic pain. Pain is the number one reason why Americans seek health care, the number one cause of disability, and costs the U.S. economy more than $600 billion in direct health care costs and lost productivity. The veteran population is particularly impacted by the chronic pain crisis, with more than 50 percent of VA patients reporting chronic pain.

Thousands of lives are lost to both opioid-related overdose and chronic pain-related suicide. Furthermore, 80 percent of heroin users started with prescription opioids. Reducing the supply of or access to opioids will not by itself solve this crisis. We can reduce demand by more effectively treating chronic pain and providing better access to FDA-approved non-opioid pharmaceuticals, advanced medical devices, and integrated alternative therapies.

As we look to develop policy, we should:

  1. Recognize the importance of a multi-disciplinary approach to pain management as a key component of overcoming the opioid crisis. Chronic pain is a pervasive and largely unaddressed public health crisis. Solving it is a crucial part of solving the larger opioid epidemic.
  2. Promote cutting-edge pain research to encourage effective opioid alternatives. High-quality evidence is urgently needed to help clinicians and patients make informed decisions about how to manage chronic pain safely and understand the causes and mechanisms of chronic pain.
  3. Advance best practices in pain management within Medicare. In 2016, one in three Medicare Part D beneficiaries received a prescription opioid. The GAO should conduct a study of the coverage options offered within Medicare for evidence-based pain management as an alternative to opioid prescriptions. Also, there should be a review of the Graduate Medical Education program’s training and education of providers on pain management and opioid prescriptions.

I hope these ideas will be helpful for in future policy discussions to reduce the abuse of opioids in our communities. Thank you for the time, and I yield back.

Walorski represents the 2nd Congressional District of Indiana, serving as a member of the House Ways and Means Committee.

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Medicare 101

medicare101_poster

The Medicare enrollment period is coming up, and we want to help answer your questions.

On October 10th, 11th, and 17th, a member of my staff and a Medicare specialist from Indiana’s State Health Insurance Program (SHIP) will hold “Medicare 101” educational sessions throughout the 2nd District to answer questions about Medicare.

Medicare is a sacred commitment we have made to our seniors, and part of keeping that promise is ensuring Hoosiers have all the information they need to secure their benefits.

The “Medicare 101” events will take place in Elkhart, Goshen, La Porte, Plymouth, South Bend, and Wabash.

If you are at or near retirement or are a caregiver for a Medicare beneficiary and you want to learn more about the program, I encourage you to attend our “Medicare 101” educational sessions to learn the basics of Medicare and have your questions answered by experts.

Information about the “Medicare 101” sessions can be found below:

Tuesday, October 10th, 1:00 – 3:00 p.m. ET
Wabash Public Library
Program Room
188 West Hill St.
Wabash, IN 46992

Tuesday, October 10th, 4:00 – 5:45 p.m. ET
Plymouth Public Library
Laramore Room A
201 North Center St.
Plymouth, IN 46563

Wednesday, October 11th, 11:00 a.m. – 1:00 p.m. ET
The Salvation Army Ray & Joan Kroc Corps Community Center
900 W. Western Ave.
South Bend, IN 46601

Wednesday, October 11th, 2:00 – 4:00 p.m. ET (1:00 – 3:00 p.m. CT)
La Porte Park & Recreation
250 Pine Lake Ave.
La Porte, IN 46350

Tuesday, October 17th, 1:00 – 3:00 p.m. ET
Elkhart Public Library
Rooms 5/6
300 S. Second St.
Elkhart, IN 46516

Tuesday, October 17th, 4:00 – 6:00 p.m. ET
Goshen Public Library
Auditorium
601 S. 5th St.
Goshen, IN 46526

Walorski Introduces Bill to Help Medicare Patients Pay Hospital Bills

Walorski Introduces Bill to Help Medicare Patients Pay Hospital Bills

Expands Use of Patient-Centered Financing Arrangements to Improve Seniors’ Access to Care, Reduce Medicare Bad Debt Claims

WASHINGTON – U.S. Rep. Jackie Walorski (R-Ind.) today introduced H.R. 3920, legislation to expand the use of interest-free payment arrangements in order to improve Medicare patients’ access to care and help ease the financial burden of costly hospital bills.

“Health care providers in northern Indiana have led the way in finding innovative solutions to keep patients healthy, both physically and financially,” Congresswoman Walorski said. “I’ve seen firsthand how interest-free payment plans like those offered at Elkhart General Hospital and Memorial Hospital of South Bend can ease financial burdens for patients. My bill will build on the success of these programs by helping us better understand their impact on access to care, health outcomes, and Medicare bad debt claims.”

BACKGROUND

Amid rising medical costs, seniors on fixed incomes too often forgo much-needed treatment over concerns about paying medical bills. Many hospitals are using innovative agreements with third-party financing companies to offer patients flexible, interest-free payment options. These payment arrangements give patients greater flexibility in paying their deductibles and coinsurance under Medicare Part A and help reduce claims for Medicare bad debt.

H.R. 3920 would require the Centers for Medicare and Medicaid Services (CMS) to implement a demonstration program on the use of these payment arrangements. The three-year demonstration program in five states would examine the impact of third-party interest-free payment arrangements on patient engagement, satisfaction, health outcomes, and claims for Medicare Part A bad debts.

Walorski in August 2015 visited Elkhart General Hospital, part of South Bend-based Beacon Health System, to learn how the hospital uses a patient-centered financing program through CarePayment to improve access to care.

Walorski represents the 2nd Congressional District of Indiana, serving as a member of the House Ways and Means Committee.

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Walorski Statement on Opioid Emergency Declaration

Walorski Statement on Opioid Emergency Declaration

President Trump Declares Opioid Epidemic a National Emergency

MISHAWAKA, Ind. – U.S. Rep. Jackie Walorski (R-Ind.) today released the following statement after President Trump declared a national emergency over the opioid crisis:

“Opioid abuse is having a devastating impact on our communities, and President Trump’s declaration of a national emergency treats this epidemic with the urgency it requires. I will continue working with my colleagues and the administration to make sure first responders, law enforcement, medical professionals, treatment providers, and families in our communities have the tools and resources needed to solve this crisis.”

BACKGROUND

Congress last year passed into law the Comprehensive Addiction and Recovery Act, bipartisan legislation to address the nationwide opioid epidemic. Congresswoman Walorski served on the conference committee that negotiated the final bill, which included two provisions she authored. One requires the Department of Veterans Affairs (VA) to participate in state prescription drug monitoring programs (PDMPs), and the other allows the VA to use FDA-approved medical devices and other non-opioid therapies to treat chronic pain.

Walorski recently questioned Medicare’s top fraud prevention official at a committee hearing about how safeguards failed to prevent a doctor in Indiana from prescribing more than $1 million in opioids to 108 patients under Medicare’s prescription drug program.

Walorski represents the 2nd Congressional District of Indiana, serving as a member of the House Ways and Means Committee.

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In the News: Ripon Advance: Walorski bill would ensure air medical service availability, quality in rural areas

Walorski bill would ensure air medical service availability, quality in rural areas

Medicare reimbursement rates for air medical service providers would be updated to ensure rural areas have continued access to critical emergency services under bipartisan legislation that U.S. Rep. Jackie Walorski (R-IN) recently introduced.

Currently, ground and air ambulance service providers are among the only providers that do not report cost data to the Centers for Medicare and Medicaid Services (CMS), and air ambulance reimbursement rates are far below the costs of providing the services.

To address the issue and ensure continued air ambulance service coverage, the Ensuring Access to Air Ambulance Services Act, H.R. 3378, would require providers to begin reporting cost data in 2019. Rates would be periodically increased through 2021, and the Department of Health and Human Services (HHS) would then determine reimbursement rates based on the two years of available cost data.

“In critical medical emergencies, the difference between life and death is often a matter of minutes, which is why air ambulance services save lives,” Walorski said. “Unfortunately, outdated Medicare reimbursement rates that don’t fully address the costs of air medical transport put these services at risk. This bipartisan bill ensures Hoosiers, especially those in rural areas, continue to have access to the air ambulances they depend on for emergency medical care.”

Read the full story here.

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In the News: Elkhart Truth: Walorski introduces bill to help air medical service providers

Walorski introduces bill to help air medical service providers

By Ben Quiggle

U.S. Representative Jackie Walorski has introduced a bill that she says will improve access to air medical service in rural areas.

The Ensuring Access to Air Ambulance Services Act would update Medicare reimbursement rates for air ambulance service providers based on actual cost data, according to a press release.

Walorski learned of the issues surrounding Medicare reimbursement rates and air medical transport during a visit with Lutheran Air at the Wabash Municipal Airport, one of two sites where Lutheran Air operates.

“In critical medical emergencies, the difference between life and death is often a matter of minutes – which is why air ambulance services save lives,” said Walorski. “Unfortunately, outdated Medicare reimbursement rates that don’t fully address the costs of air medical transport put these services at risk. This bipartisan bill ensures Hoosiers, especially those in rural areas, continue to have access to the air ambulances they depend on for emergency medical care.”

 

Read the full story here.

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Walorski Demands Answers After Indiana Prescriber Writes $1.1 Million in Opioid Prescriptions for 108 Medicare Patients

Walorski Demands Answers After Indiana Prescriber Writes $1.1 Million in Opioid Prescriptions for 108 Medicare Patients

Questions Top Medicare Fraud Prevention Official About Steps Being Taken to Prevent Fraud and Abuse in Part D

WASHINGTON – U.S. Rep. Jackie Walorski (R-Ind.) today questioned Medicare’s top fraud prevention official about how safeguards failed to prevent a doctor in Indiana from prescribing more than $1 million in opioids to 108 patients under Medicare’s prescription drug program.

At a hearing of the House Ways and Means Oversight Subcommittee, Walorski asked Jonathan Morse, Acting Director of the Center for Program Integrity in the Centers for Medicare and Medicaid Services (CMS), about a recent Department of Health and Human Services (HHS) Office of Inspector General report on questionable prescribing patterns under Medicare Part D that cited an Indiana prescriber who in 2016 “wrote an average of 24 opioid prescriptions each for 108 beneficiaries who received extreme amounts,” at a cost to taxpayers of $1.1 million.

“What processes does CMS have in place to flag and investigate suspicious prescribing practices like this, and what do you think needs to be done to improve the system?” Congresswoman Walorski asked. “Obviously the filters that you’re talking about didn’t catch this. … As a result of these egregious violations, what new things are going into play now?”

“Well, we’re actually very pleased that the CARA [Comprehensive Addiction and Recovery Act] legislation from about a year ago was passed, and CMS is working to implement the Medicare lock-in program,” Acting Director Morse said. “Lock-in is something that’s been used very effectively by both state Medicaid programs, as well as by private payers, to be able to lock in a single beneficiary and a single prescriber. So essentially it helps monitor that overutilization and it helps sort of prevent that abuse from happening.”

The HHS Inspector General report also found “one in three Medicare Part D beneficiaries received a prescription opioid” last year, including 500,000 beneficiaries who received large amounts.

Video of Walorski questioning Morse at the hearing is available here. The text of their exchange is below.

REP. WALORSKI: Thank you, Mr. Chairman. Mr. Morse, according to this report, and many of us are talking about reports today, this is the HHS report, Office of Inspector General, on Medicare Part D, and it’s on this issue of opioids that you touched on just at the end of your testimony, and I appreciate that.

What I think is interesting about this and draws a red flag for me is one of the things they talk about here is a prescriber in my home state of Indiana wrote an average of 24 opioid prescriptions each for 108 beneficiaries in a year, costing Medicare Part D $1.1 million just to that Indiana physician. And I guess, I am not a health person, professional, it draws a red flag to me.

And I guess my question is, and I know you were probably getting to this on your statement, but what processes does CMS have in place to flag and investigate these suspicious prescribing practices like this, and what do you think needs to be done to improve the system, because I’m guessing that you’re going to say that, here’s what we do, and you’re going to say, yeah we need to do more, so my question is, what is the more, and whatever the filters are, to have gone through, one doctor in my state to be able to produce these kinds of records, I think is astounding. So just from your professional opinion, where do we go on this, what else has to happen, and then what do we do as Congress to help you get those filters?

MR. MORSE: Thank you. And we’ve reviewed that opioid report from the Inspector General’s office also, and it is quite concerning. We’ve got a number of efforts underway, in Medicare, both fee-for-service and in Medicare Part D, that try to address opioid prescribing abuses, as well as it’s obviously been a major focal point of this administration, of the secretary, of the past administration. CMS already has an opioid strategy that it published in January of 2017 on this very issue, and looking at sort of all the various levers that an agency as a payer can potentially be sort of pulling to help to address the opioid epidemic.

From the program integrity side, we have a number of things that we look at. We work with the Medicare program on the Overutilization Monitoring System that looks at it largely from the beneficiary perspective but looks at, does the beneficiary potentially have too many prescriptions, are there too many potentially in this case opioid prescriptions being prescribed in overlapping ways and how do we kind of make sure that is not –

REP. WALORSKI: Right, but obviously the filters that you’re talking about didn’t catch this. And so, from your perspective, if you had the magic wand and you could say, look, I’m over this, I studied this, I’m the professional, here’s exactly what we need to do, let’s at least try this, what would it be? Because the other thing disturbing about this, there’s a half a million beneficiaries receiving high amounts of opioids. So the filters aren’t working, so whatever was done prior to January of 2017 is not working, so we take that off the chart here, and we say that you say what is it that we’re not seeing here, and what can you in Congress do to help you get there?

MR. MORSE: We also have abusive prescribing authorities within Program Integrity at CMS.

REP. WALORSKI: Do you use them often?

MR. MORSE: We have used them only a handful of times at this point, because part of it is we need to be able to establish sort of that pattern and the practice, and when we see a pattern and practice it often is then referred to law enforcement.

REP. WALORSKI: How long is a pattern and a practice? So my Hoosier doc here that took this to the limit and over the top, so he’s writing an average of 24 prescriptions each for 108 people in a year, and it wasn’t flagged.

MR. MORSE: But when we do see something like that in our data, we flag it for law enforcement, so that’s how those cases begin, though. So in that case, there may have been data from CMS, in this particular case, there may have been data from CMS that we then flag for our law enforcement partners who then begin those investigations. So when the behavior is that egregious, if it’s something that we can see in our data, it is something that we need to be able to send to the inspector general’s office, to the state law enforcement, to DOJ, and then they begin sort of the more serious criminal and civil processes.

REP. WALORSKI: So what happens now as a result of this report? Because still what you’re describing is what’s happening pre-2017. As a result of these egregious violations, what new things are going into play now?

MR. MORSE: Well we’re actually very pleased that the CARA legislation from about a year ago was passed, and CMS is working to implement the Medicare lock-in program. So lock-in is something that’s been used very effectively by both state Medicaid programs as well as by private payers to be able to lock in a single beneficiary and a single prescriber. So essentially it helps monitor that overutilization and it helps sort of prevent that abuse from happening.

REP. WALORSKI: I appreciate it. Thank you, Mr. Chairman.

Walorski represents the 2nd Congressional District of Indiana, serving as a member of the House Ways and Means Committee.

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Walorski Statement on Anthem and MDwise Exiting Indiana Obamacare Exchange

Walorski Statement on Anthem and MDwise Exiting Indiana Obamacare Exchange

“This is the latest sign of Obamacare’s failure to ensure Hoosiers have access to quality, affordable health care.”

WASHINGTON – U.S. Rep. Jackie Walorski (R-Ind.) today released the following statement after Anthem and MDwise announced they will withdraw from Indiana’s Obamacare marketplace in 2018:

“This is the latest sign of Obamacare’s failure to ensure Hoosiers have access to quality, affordable health care. Now even more Hoosiers, already facing higher costs and fewer options, will be forced to look for new plans and new doctors. Obamacare is collapsing, and I am committed to replacing it with a patient-centered system that lowers costs, increases choices, and provides real protections.”

BACKGROUND

Premiums for individual insurance plans in Indiana have risen 74 percent under Obamacare, according to a recent report from the Department of Health and Human Services. Four of the eight insurers on Indiana’s exchange withdrew this year, and premiums increased by an average of 18 percent for all but one of the remaining options.

Walorski voted for the American Health Care Act (H.R. 1628), which would repeal and replace Obamacare, protect patients with pre-existing conditions, ensure access to quality, affordable health care, and give states flexibility to implement innovative reforms. The legislation passed the House in May and is now under consideration in the Senate.

Walorski represents the 2nd Congressional District of Indiana, serving as a member of the House Ways and Means Committee.

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Walorski Votes to Repeal and Replace Obamacare

Walorski Votes to Repeal and Replace Obamacare

American Health Care Act Protects Patients with Pre-Existing Conditions, Begins Stable Transition to Better System

WASHINGTON – U.S. Rep. Jackie Walorski (R-Ind.) today released the following statement after the House passed the American Health Care Act, a bill to repeal Obamacare and replace it with a patient-centered system that protects patients with pre-existing conditions and returns control over health care to individuals and families:

“Too many Hoosiers are facing higher premiums, fewer options, and a collapsing system under Obamacare. That’s why I made a promise to the people of Indiana’s 2nd District to repeal Obamacare and replace it with a patient-centered system that lowers costs, provides real protections, and gives individuals and families control over their health care again.

“Today the House delivered on that promise to fix our nation’s health care system. The American Health Care Act protects patients with pre-existing conditions, ensures access to quality, affordable health care, and gives states the flexibility they need to enact innovative reforms like those in Indiana.

“This bill ends Obamacare’s burdensome taxes and mandates, including a permanent repeal of the job-killing medical device tax that harmed innovative manufacturers and their employees across Indiana. It protects life by stopping the flow of taxpayer dollars to abortion providers like Planned Parenthood. And with today’s passage of additional legislation I co-sponsored, it will treat Members of Congress the same as everyone else.

“I look forward to working with my Senate colleagues to get the American Health Care Act to President Trump’s desk for his signature so we can build a health care system that puts patients first.”

BACKGROUND

The House passed the American Health Care Act (H.R. 1628) by a vote of 217 to 213. The House also unanimously passed H.R. 2192, which ensures Members of Congress are treated the same as all other Americans under the AHCA.

Together these bills will:

  • Protect patients with pre-existing conditions and allow young adults to stay on their parents’ health care plan until age 26;
  • Provide families and small businesses relief from nearly $900 billion in burdensome taxes and mandate penalties;
  • Ensure Americans have access to quality, affordable health care through tax credits, expanded health savings accounts (HSAs), and a Patient and State Stability Fund;
  • Give states flexibility to implement innovative reforms and tailor solutions to the needs of their own citizens, instead of one-size-fits-all policies from Washington;
  • Require states seeking a waiver of certain insurance coverage requirements to implement a system to ensure coverage for older and sicker patients; and
  • Begin a stable transition period to ensure no one has the rug pulled out from under them.

Walorski represents the 2nd Congressional District of Indiana, serving as a member of the House Ways and Means Committee.

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Walorski Co-Sponsors Bill to Prevent Health Care Exemption for Members of Congress

Walorski Co-Sponsors Bill to Prevent Health Care Exemption for Members of Congress

WASHINGTON – U.S. Rep. Jackie Walorski (R-Ind.) today signed onto legislation that would ensure Members of Congress are not exempted from the American Health Care Act (AHCA).

“Members of Congress should not be treated differently from any other Americans,” Congresswoman Walorski said. “As we continue working to provide relief to individuals and families facing higher premiums, fewer options, and a collapsing system under Obamacare, this common-sense fix will ensure Congress lives by the same rules as everyone else.”

BACKGROUND

H.R. 2192, which was introduced earlier this week by Rep. Martha McSally (R-Ariz.), would repeal the exemption of Members of Congress and their staff from certain waivers if the American Health Care Act becomes law. The text of the bill is available here.

Walorski represents the 2nd Congressional District of Indiana, serving as a member of the House Ways and Means Committee.

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