OVERSEEING ORGAN REFORM — Surgeons and patient advocates warned House members Wednesday to be on the lookout for mismanagement and conflicts of interest within the organ transplant system amid a federal overhaul. A hearing held by the Energy and Commerce Oversight and Investigations Subcommittee examined which oversight might be needed in the Health Resources and Services Administration’s overhaul of the network that obtains and transplants organs. How we got here: Since the 1980s, one nonprofit, the United Network for Organ Sharing, has been in charge — which includes overseeing the federal network’s board of directors. Under a law enacted last year, the organ transplant network was decentralized by restructuring the system into manageable parts with multiple vendors. Here are three takeaways from the hearing: — Mismanagement in organ procurement organizations is a concern: Members were alarmed by allegations of Medicare and Medicaid fraud, as well as improper organ harvesting, by the nonprofits that collect organs for transplantation, called organ procurement organizations. The patient advocates and surgeons asked Congress to open a pathway for whistleblowers to safely report concerns. The Association of Organ Procurement Organizations pushed back on the claims in a statement before the hearing, calling them “a litany of false, misleading, and unsupported allegations.” — Competition could allow the system to innovate: The patient advocates and surgeons testified that a multicontract system would allow for more innovative technology that could keep organs to be transplanted viable longer. — Congress has questions about the board of directors: Members continued scrutiny over who might sit on the board of directors that will oversee the Organ Procurement and Transplantation Network. As POLITICO previously reported, the OPTN board was made independent from UNOS earlier this year. Some members of Congress, however, are concerned about how this will pan out. “In practice, it’s a good thing, but legacy board members come from UNOS,” patient advocate Greg Segal said. HEALTH BILLS MOVE THROUGH E&W — A House panel advanced three health care bills Wednesday, Ben reports. Here’s what the Committee on Education and the Workforce moved: Telehealth: The committee advanced an amended version of the Transparent Telehealth Bills Act from Rep. Aaron Bean (R-Fla.) in a 34-0 vote, which would prevent hospitals from charging what lawmakers see as unnecessary “facility fees” for care given virtually. The fees are often charged to help cover the costs of maintaining a physical facility. Ranking member Bobby Scott (D-Va.) said the original bill didn’t go far enough to prohibit such fees. Democrats and Republicans agreed to adopt an amended version. The Federation of American Hospitals and American Hospital Association opposed the legislation, saying it would curb telehealth access. The AHA said facility fees can allow payment for staff time, facility space and technology. Competition: The panel advanced legislation by voice vote from Rep. Michelle Steel (R-Calif.), which includes several provisions aimed at promoting competition and transparency, including allowing employers to contract with individual hospitals instead of being forced to deal with all facilities in their systems. FAH and the AHA oppose the legislation, with the AHA saying it would prevent hospitals from reaching “reasonable” agreements with insurers and could allow insurers to “avoid hospitals serving vulnerable communities.” Association health plans: The committee advanced along party lines a resolution to overturn the Biden administration’s move to rescind a Trump-era rule expanding access to association health plans. The rule made it easier for small businesses to team up to buy health insurance and avoid some regulation. MA SPENDING DOWN — Federal spending on Medicare Advantage bonus payments is expected to decline this year after huge increases between 2015 and 2023, according to a new analysis by health research group KFF. Total spending on bonus payments in 2024 is expected to drop by $1 billion to $11.8 billion in 2024, yet total spending on MA plan bonuses is expected to be higher in 2024 than every year between 2015 and 2022. Between 2015 and 2023, bonus payments increased 400 percent. Context: Pandemic-era policies that temporarily increased star ratings for some MA plans have expired, contributing to the decline. Why it matters: More than half of Medicare beneficiaries are enrolled in an MA plan, and enrollment is projected to grow in the next decade.
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