Health Care Watch: August 2, 2021
The following FHP Weekly Health Care Watch provides a summary of legislative and regulatory health care activities from July 26 – August 1. Where available, hyperlinks are included to the relevant documents. Please let us know if you have any questions or would like additional information on the items below.
NON-CORONAVIRUS LEGISLATIVE UPDATE
House
On July 27, the Veterans' Affairs Health Subcommittee held a hearing entitled Aging in Place: Examining Veterans' Access to Home and Community Based Services. Witnesses included: Scotte Hartronft, MD, Executive Director, Geriatrics and Extended Care, Veterans Health Administration (VA); Catherine Kelso, MD, Geriatrics and Extended Care, VA; Rashi Romanoff, Vice President for Program & Partnerships, Elizabeth Dole Foundation; and Roscoe Butler, Associate Legislative Director, Paralyzed Veterans of America.
On July 29, the Energy & Commerce Health Subcommittee held a hearing entitled The Path Forward: Advancing Treatments and Cures for Neurodegenerative Diseases. Chairman Frank Pallone (D-NJ) voiced his support for the discovery and development of safe and effective treatments and cures, and to provide quality, affordable, and equitable care to patients and their families. Subcommittee Chair Anna Eshoo (D-CA) argued that the Food & Drug Administration (FDA) has been inconsistent in applying the flexibilities granted through the 21st Century Cures Act, allowing the FDA to grant modified regulatory clearance for drugs that show marginal, incremental benefit for neurological diseases. Witnesses included: Patrizia Cavazzoni, MD, Director, Center for Drug Evaluation and Research, FDA; Richard Hodes, MD, Director, National Institute on Aging, National Institute of Health (NIH); Walter Koroshetz, MD, Director, National Institute of Neurological Disorders and Stroke, NIH; Jinsy Andrews, MD, Director of Neuromuscular Clinical Trials Neurological Institute of New York, Associate Professor of Neurology, Columbia University Vagelos College of Physicians and Surgeons; Kala Booth, Huntington's Disease Caregiver and Patient; Merit Cudkowicz, MD, Director, Sean M. Healy and AMG Center for ALS, Chief, Neurology Department, Massachusetts General Hospital, Julianne Dorn Professor of Neurology, Harvard Medical School; Cartier Esham, Executive Vice President, Emerging Companies, Senior Vice President, Science and Regulatory Affairs, Biotechnology Innovation Organization; Yvonne Latty, Caregiver; and Brian Wallach, Co-Founder, I AM ALS.
On July 29, the House passed H.R. 4502 (219-208), the seven-bill minibus Fiscal Year (FY) 2022 spending bill, including $253.8 billion for the Departs of Labor, Health & Human Services (HHS), Education and Related Agencies and $3.47 billion in FY 2022 appropriations for the FDA. A fact sheet on the Labor, HHS, Education and Related Agencies spending is available here. A summary of the Agriculture-Rural Development-FDA spending is available here. On July 27, Sen. Bernie Sanders (I-VT) predicted that the FY 2022 budget resolution will be on the Senate floor in early August.
On July 29, Reps. Suzan DelBene (D-WA), Jeff Duncan (R-SC), and Peter Welch (D-VT) introduced a bill to remove cost-sharing responsibilities for chronic care management services under Medicare.
The House is schedule to resume its Committee Work on August 31 and return to Washington on September 20. However, it is possible that the House will return to Washington to vote on an infrastructure and/or budget deal this month.
Senate
On July 26, Sens. Amy Klobuchar (D-MN), Chuck Grassley (R-IA), Angus King (I-ME) and Susan Collins (R-ME) urged HHS Secretary Xavier Becerra to support policies allowing for the personal importation of safe and affordable prescription drugs from Canada.
On July 26, Sen. Elizabeth Warren (D-MA) and Rep. Lloyd Doggett (D-TX) requested information from the Department of Defense (DoD) Secretary regarding the DoD’s efforts to implement congressional directives from the National Defense Authorization Act for FY 2018 Report requiring the Department to reduce the prices of DoD-funded drugs, vaccines, and medical equipment.
On July 28, a bipartisan group of senators reached an agreement on a $1.2 trillion infrastructure package and the Senate voted 67-22 to begin consideration of the bill. On July 30, the Senate voted 66-28 on a motion to proceed to the amendment process. On August 1, text of the legislation was released. Notably, the bill would delay the Medicare prescription drug rebate rule until 2026, extend the 2% Medicare sequestration cuts through FY2031, and give HHS the authority to require drug manufacturers to pay back the government for unused drugs that were packaged in single use vials beginning in 2023. Despite earlier rumors, the legislation does not rescind any unused Provider Relief Fund money. Majority Leader Chuck Schumer (D-NY) hopes to vote on this package and an FY22 Budget Resolution with reconciliation instructions before breaking for August recess.
On July 29, the Judiciary Committee held a markup considering the following pieces of legislation, all of which were adopted by voice vote:
On July 27, the Finance Committee held a hearing entitled Implementation and Enforcement of the United States – Mexico – Canada Agreement: One Year After Entry into Force. Chairman Ron Wyden (D-OR) highlighted the issues around the international trade agreement and supporting U.S. businesses in their business in foreign countries. Witnesses included: Benjamin Davis, Director of International Affairs, United Steelworkers; Allan Huttema, Chairman, Northwest Dairy Association/Darigold Board of Directors; Michelle McMurry-Heath, MD, PhD, President and CEO, Biotechnology Innovation Organization, Beth Lowell, Deputy Vice President, U.S. Campaigns, Oceana.
NON-CORONAVIRUS REGULATORY UPDATE
On July 27, the FDA issued two drug related notices: the Biosimilar User Fee Rates for FY 2022 and Generic Drug User Fee Rates for FY 2022.
On July 28, HHS released the Semiannual Regulatory Agenda summarizing information about upcoming regulatory actions.
On July 28, the Centers for Medicare & Medicaid Services (CMS) Advisory Panel on Outreach and Education held a virtual meeting to advise and make recommendations to the HHS Secretary and CMS Administrator on opportunities to enhance the effectiveness of consumer education strategies for the Affordable Care Act Marketplace, Medicare, Medicaid, and CHIP.
On July 28, the FDA approved first interchangeable biosimilar product, Viatris’ Semglee (insulin glargine-yfgn) for treatment of diabetes, which is biosimilar to and interchangeable with its reference product, Sanofi’s Lantus (insulin glargine). Acting FDA Commissioner Janet Woodcock, M.D. stated that the approval represented a “momentous day for people who rely daily on insulin for treatment of diabetes, as biosimilar and interchangeable biosimilar products have the potential to greatly reduce health care costs.”
On July 29, CMS issued a final rule entitled, Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) for Federal Fiscal Year 2022 and Updates to the IRF Quality Reporting Program; Payment for Complex Rehabilitative Wheelchairs and Related Accessories (Including Seating Systems) and Seat and Back Cushions Furnished in Connection with Such Wheelchairs. The final rule updates the prospective payment rates for IRFs for FY 2022. The rule also includes the classification and weighting factors for the IRF PPS’ case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2022. Additionally, the rule includes updates for the IRF Quality Reporting Program (QRP). Finally, CMS is finalizing a Medicare provision adopted in previous interim final rule related to fee schedule adjustments for wheelchair accessories as well as changes to the regulations related to the Further Consolidated Appropriations Act of 2020 governing payment for these and other items. A summary of the rule is available here.
On July 29, CMS issued a final rule entitled FY 2022 Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS) and Quality Reporting Updates for FY Beginning October 1, 2021. The final rule updates the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by IPFs. This rule also updates and clarifies the IPF teaching policy with respect to IPF hospital closures and displaced residents and finalizes a technical change to one of the 2016-based IPF market basket price proxies. In addition, the rule finalizes proposals on quality measures and reporting requirements under the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program. A summary of the rule is available here.
On July 29, CMS issued a final rule entitled FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements. The final rule updates the hospice wage index, payment rates, and aggregate cap amount for FY 2022. The rule makes changes to the labor shares of the hospice payment rates and finalizes clarifying changes to the election statement addendum that was implemented on October 1, 2020. The rule also makes permanent selected regulatory blanket waivers that were issued to Medicare-participating hospice agencies during the COVID-19 public health emergency (PHE) and updates the hospice conditions of participation. Finally, the rule updates the Hospice Quality Reporting Program and finalizes changes beginning with the January 2022 public reporting for the Home Health Quality Reporting Program to address exceptions related to the COVID-19 PHE. A summary of the rule is available here.
On July 29, CMS issued a final rule entitled Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs); Updates to the QRP and Value-Based Purchasing Program for Federal FY 2022; and Technical Correction to Long-Term Care Facilities Physical Environment Requirements. The rule updates the payment rates used under the PPS for SNFs for FY 2022. The final rule also includes a forecast error adjustment for FY 2022, updates the diagnosis code mappings used under the Patient Driven Payment Model (PDPM), rebases and revises the SNF market basket, implements a recently-enacted SNF consolidated billing exclusion along with the required proportional reduction in the SNF PPS base rates, and includes a discussion of a PDPM parity adjustment. In addition, the final rule includes updates for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program. Finally, the rule includes a technical correction to the physical environment requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. A summary of the rule is available here.
On July 30, HHS Secretary Becerra and CMS Administrator Chiquita Brooks-LaSure celebrated the 56th anniversary of the Medicare and Medicaid programs.
CMS will hold a virtual meeting on August 23 of the Advisory Panel on Hospital Outpatient Payment to advise the HHS Secretary and CMS Administrator concerning the clinical integrity of the Ambulatory Payment Classification groups and their associated weights, and supervision of hospital outpatient therapeutic services.
The Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) will hold a public meeting on September 22 to examine relevant health outcomes in studies for cerebrovascular disease treatment, with a particular focus on new technologies of interest to CMS.
The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices will hold a meeting on September 29 and 30 to review and revise the list of vaccines for administration to vaccine-eligible children through the Vaccines for Children program.
NON-CORONAVIRUS WHITE HOUSE UPDATE
On July 28, the White House issued a proclamation entitled Made in America Week (Proc. 10234) to increase U.S. content in the products the federal government buys and support the domestic production of products critical to national and economic security. The proposed rule directs the following changes to Buy American requirements:
“Make Buy American Real” and close loopholes by raising the domestic content threshold;
Strengthens domestic supply chains for critical goods with new price preferences;
Increases transparency and accountability in Buy American rules;
A fact sheet on the proclamation is available here.
CORONAVIRUS UPDATE
House
On July 26, Rep. Clay Higgins (R-LA) announced he, his wife, and son tested positive for COVID-19 for the second time.
On July 26, Select Subcommittee on the Coronavirus Crisis Chair James Clyburn (D-SC) advanced the committee’s investigation into the federal government’s response to COVID-19 and potential political interference. The committee requested documents and interviews from former Trump Administration political appointees and current and former public health officials from the CDC and HHS who were involved in the prior Administration’s response efforts, including:
Former CDC Chief of Staff Kyle McGowan;
CDC Acting Chief of Staff and Senior Advisor Nina Witkofsky;
Former CDC National Center for Immunization and Respiratory Diseases Director Nancy Messonnier;
Former CDC Principal Deputy Director Anne Schuchat;
CDC Deputy Director of Infectious Diseases Jay Butler;
CDC Morbidity and Mortality Weekly Report Editor Christine Casey;
CDC Deputy Director for Communications Kate Galatas;
HHS Deputy Assistant Secretary for Public Affairs Bill Hall;
CDC Director of Center for Surveillance, Epidemiology, and Laboratory Services Michael Iademarco; and
HHS Deputy Assistant Secretary for Public Affairs Mark Weber.
The Select Subcommittee released new documents related to the investigation that can be found here.
Senate
On July 27, the HELP Committee held a hearing entitled The Path Forward: Building on Lessons Learned from the COVID-19 Pandemic. Chair Patty Murray (D-WA) urged for greater investments to modernize health departments, address inequities, support and expand public health and health care workforce, and support public health preparedness. Witnesses included: Les Becker, Deputy Secretary of Innovation, Washington State Department of Health; Phyllis Arthur, Vice President, Infectious Diseases and Diagnostics Policy, Biotechnology Innovation Organization; David Janz Director, MD, Medical Critical Care Services, University Medical Center New Orleans; and Anita Cicero, Deputy Director, Center for Health Security, Johns Hopkins Bloomberg School of Public Health.
Regulatory
On July 26, FDA requested for Pfizer and Moderna to expand their COVID-19 vaccine trials with children between 5 and 11 to assess whether myocarditis, a rare heart inflammation condition that has been seen in young adults, is a risk in children. Both companies announced that they intend to expand the trials.
On July 27, the CDC issued updated guidance that all people, regardless of vaccination status, wear a mask indoors in public in areas of substantial or high transmission, to reduce the risk of being infected with the Delta variant. The guidance also revises guidance recommending testing for fully vaccinated people, even if they do not have symptoms. The CDC noted that 69.3% of U.S. counties have COVID-19 transmission rates high enough to justify indoor mask wearing in public places.
On July 27, the Department of Veterans Affairs (VA) announced it will require COVID-19 vaccinations for health care personnel. The VA is the first federal agency to implement a COVID-19 vaccine requirement. On July 29, DoD announced it will require COVID-19 vaccinations for service members or be required to wear a mask, physically distance, comply with a regular testing requirement and be subject to official travel restrictions.
On July 28, the FDA extended the shelf life of Johnson & Johnson’s (J&J) COVID-19 vaccine from four and a half months to six months.
On July 29, the FDA authorized Emergent BioSolutions manufacturing facility to resume production of J&J’s COVID-19 vaccine, following contamination issues in the facility in April.
On July 29, the FDA expanded the emergency use authorization for Eli Lilly's COVID-19 drug baricitinib, to allow for treatment without remdesivir.
On July 29, an internal CDC document highlighted the need to improve the public’s understanding of breakthrough infections and improve communications around individual risk among vaccinated people. The document also suggested considering a vaccine mandate for health care providers, universal masking, and other community mitigation strategies.
On July 30, the CDC released a report that 74% of 469 COVID-19 cases from a study of large gatherings in Massachusetts were among fully vaccinated people, supporting the theory that vaccinated people have high viral loads and may still transmit the Delta variant. This data supports the CDC’s revised masking guidance.
The COVID-19 Health Equity Task Force will hold a virtual meeting on July 30 to consider interim recommendations addressing future pandemic preparedness, mitigation, and resilience needed to ensure equitable response and recovery in communities of color and other underserved populations.
COVID-19 information released by CMS is posted here; specific waivers are available here.
White House
On July 26, President Biden announced that “long” COVID-19, the long-term symptoms resulting from a COVID-19 infection, could be considered a disability under the Americans with Disabilities Act.
On July 26, White House Press Secretary Jen Psaki announced that the U.S. will maintain its current travel restrictions due to the rise in COVID-19 cases from the Delta variant.
On July 29, President Biden announced that federal employees and contractors must disclose their COVID-19 vaccine status, or be required to submit to regular testing, physically distancing, and travel restrictions. President Biden also called for states, territories, and local governments to do more to incentivize vaccination, including offering $100 to those who get vaccinated, and that small- and medium-sized businesses will now be reimbursed for offering their employees paid leave to get their family members, including their kids, vaccinated.
Other
On July 26, the World Bank and COVAX announced that COVAX will be able to make advanced purchases at lower prices from vaccine manufacturers, based on aggregate demand across countries.
On July 26, Japanese Company Shionogi & Co. began a Phase I clinical trial of an orally administered antiviral COVID-19 treatment.
On July 26, California announced that state employees and health care workers must show proof of COVID-19 vaccination or get tested regularly. New York City also expanded their COVID-19 vaccine and testing requirement from health workers to all municipal workers, beginning September 13.
On July 27, Israel authorized the Pfizer COVID-19 vaccine for vulnerable children with underlying conditions between five and 11 years old.
On July 27, a study published in the Lancet found that the risk of blood clots does not increase after the second dose of the AstraZeneca COVID-19 vaccine and noted that the majority of blood clotting incidents occurred two weeks after the first dose.
On July 27, Moderna announced that its foreign COVID-19 vaccine manufacturing partners are facing delays due to laboratory testing issues. The company noted that the issues were able to be resolved but will impact foreign distribution.
On July 28, Pfizer announced that it plans to submit data on its COVID-19 booster to the FDA by August 16. Pfizer also released additional data supporting its COVID-19 vaccine, showing that it continues to provide 91% efficacy against COVID-19 after 6 months.
On July 29, Israel announced that it will give adults over age 60 a third COVID-19 vaccine “booster” dose beginning next week.
On July 29, AstraZeneca announced it intends to pursue standard approval of its COVID-19 vaccine, not an emergency use authorization, and submit for approval before the end of 2021.
On July 30, West Virginia announced it will begin testing for COVID-19 antibodies in vaccinated nursing home residents beginning in August to determine whether immunity levels have decreased and whether COVID-19 booster shots are necessary.
On July 30, the Kaiser Family Foundation released a report that found that though half the states reported some data on COVID-19 breakthrough cases, hospitalizations and deaths are extremely rare events among those who are fully vaccinated.
As of July 30, more than 191 million people in the U.S. have received the first dose of COVID-19 vaccines (nearly 165 million have received both doses) and more than 400 million doses have been distributed, according to the CDC COVID Data Tracker.
As of July 30, the U.S. had more than 34.9 million confirmed COVID-19 cases resulting in 613,006 deaths, according to the Johns Hopkins University & Medicine Coronavirus Resource Center. The CDC announced that the Delta variant now comprises 82.2% of all COVID-19 cases.
RULES AT THE WHITE HOUSE OMB
HHS-CMS
Modification of Limitations on Redesignation by the Medicare Geographic Classification Review Board (CMS-1762); Interim Final Rule; Received 2/26/21
Basic Health Program; Federal Funding Methodology for Program Year 2022 (CMS-2438); Final Rule; Received 5/12/21
Reporting Requirements Related To Air Ambulance and Agent and Broker Services and HHS Enforcement Provisions; Proposed Rule; 7/7/21
Most Favored Nation (MFN) Model (CMS-5528); Proposed Rule; 7/7/21
HHS-FDA
Drug Supply Chain Security Act Implementation: Identification of Suspect Product and Notification; Guidance for Industry; Availability; Notice; 5/11/21
Definitions of Suspect Product and Illegitimate Product for Verification Obligations Under the Drug Supply Chain Security Act; Draft Guidance for Industry; Availability; Notice; Received 5/11/21
Product Identifiers Under the Drug Supply Chain Security Act Questions and Answers; Guidance for Industry; Availability; Notice; 5/11/21
Enhanced Drug Distribution Security at the Package Level Under the Drug Supply Chain Security Act; Draft Guidance for Industry; Availability; Notice; 5/11/21
Remanufacturing of Medical Devices; Draft Guidance for Industry and Food and Drug Administration Staff; Prerule; Received 5/26/21
REPORTS
HHS Office of Inspector General (OIG)
On July 29, OIG released a report entitled States' Backlogs of Standard Surveys of Nursing Homes Grew Substantially During the COVID-19 Pandemic. The report found that States' Medicare/Medicaid-certified nursing home review backlogs grew substantially during COVID-19. OIG found that 71% of nursing homes had gone at least 16 months without a standard survey as of May 31, 2021, nationally, ranging from 22% to 96% by state. A summary of the report is available here.
Congressional Budget Office (CBO)
On July 30, CBO released a report entitled An Analysis of Certain Proposals in the President’s 2022 Budget. CBO estimated that the deficit of $3 trillion is $0.7 trillion less than the Administration’s baseline estimate. Under the President’s proposals, discretionary spending would be $225 billion more than it is in CBO’s baseline projections. The proposals would increase mandatory outlays by $1.2 trillion, $14 billion less than the Administration estimates. A summary of the report is available here.
Government Accountability Office (GAO)
On July 26, GAO released a report entitled COVID-19 Contracting: Actions Needed to Enhance Transparency and Oversight of Selected Awards. The report found issues with how agencies reported some of the awards for vaccine development and manufacturing in the federal procurement database. The Departments of Defense, HHS, and Homeland Security (DHS) did not properly identify at least $1.6 billion of the $12.5 billion as COVID-19-related agreements. GAO also found that DHS and HHS policies on other transaction agreements did not address the requirement for enhanced oversight of certain activities that consortium management firms may perform, potentially posing risks to the government. GAO noted that agencies need to report award information accurately to ensure federal spending is transparent. OIG recommended that agencies improve how these awards are reported. A summary of the report is available here.
On July 28, GAO released a report entitled Medicare Advantage (MA): Beneficiary Disenrollments to Fee-for-Service (FFS) in Last Year of Life Increase Medicare Spending. The report found that MA beneficiaries in the last year of life disproportionately disenrolled from their MA plan to enroll in FFS, indicating possible issues with their care, specifically potential limitations accessing specialized care under MA. GAO noted that shifting end-of-life costs to FFS increased Medicare spending by hundreds of millions of dollars. GAO found that FFS payments for such beneficiaries were $422 million higher than their estimated MA payments had they remained in MA in 2016, and $490 million higher for those that disenrolled in 2017. GAO recommended monitoring end-of-life MA disenrollments to identify and address potential quality of care concerns. A summary of the report is available here.
On July 29, GAO released a report entitled COVID-19 Pandemic: Actions Needed to Improve Federal Oversight of Assistance to Individuals, Communities, and the Transportation Industry. GAO testified about the critical roles the Federal Emergency Management Agency (FEMA), Departments of Transportation, and Departments of Treasury have played in the federal response to COVID-19. FEMA reported obligating over $79 billion from its Disaster Relief Fund to respond to COVID-19. GAO identified key lessons learned that could improve the federal response to emergencies, including to:
Coordinate, establish, and define roles and responsibilities among those responding to the crisis and address key capabilities gaps;
Provide clear, consistent communication;
Collect and analyze data to inform decision-making and future preparedness;
Establish mechanisms for accountability and transparency to help ensure program integrity and address fraud risks; and
Consider challenges posed by setting up new programs quickly.
A summary of the report is available here.
UPCOMING CONGRESSIONAL HEARINGS
House
None of note.
Senate
Senate Health, Education, Labor and Pensions (HELP) Committee
August 3, 12:00 a.m., TBD
Appropriations Committee
Markup of the Agriculture, Rural Development, FDA, and Related Agencies Appropriations Act, 2022
August 2, 5:45 p.m.
OTHER HEALTH POLICY NEWS
On July 26, a study published in JAMA Network found that Medicare eligibility was associated with reductions in racial and ethnic disparities in insurance coverage, access to care, and self-reported health across the US, but not mortality. The study also found that Black and Latino people are more likely to benefit from becoming eligible for Medicare than any other demographic group.
On July 26, 430 health groups urged Congressional leadership to permanently expand telehealth flexibilities implemented during COVID-19, including:
Removing geographic and originating site restrictions;
Expanding the list of eligible practitioners who may furnish clinically appropriate telehealth services;
Ensuring that HHS and CMS maintain the authority to add or remove eligible telehealth services, as supported by data and demonstrated to be safe, effective, and clinically appropriate;
Ensuring that Federally Qualified Health Centers, Critical Access Hospitals, and Rural Health Clinics can offer virtual services post-COVID and work with stakeholders to support fair and appropriate reimbursement; and
Rejecting in-person visit requirements, prior to a telehealth visit.
On July 26, a group of 14 hospitals and health systems, including the Hospital for Special Surgery in New York City, sued HHS over a calculation used to determine payments for physician training programs. The hospitals claim they have been underpaid for several years due to the regulation implementing the payment policy.
On July 27, California Governor Gavin Newsom (D) signed a A.B. 133, which allows all Californians over 50 to enroll in Medi-Cal regardless of immigration status beginning May 1, 2022. It is estimated that this would increase coverage to 235,000 people.
On July 28, the Kaiser Family Foundation published a report finding that 47% of Medicare beneficiaries did not have dental coverage in 2019 and 27% of beneficiaries did not have a dental visit within the past year, with people of color being less likely to have a dental visit in 2018.
On July 29, Lilly released Phase II data supporting its Alzheimer’s treatment, donanemab, which decreases the amount of tau protein buildup over time, slowing cognitive decline and decreasing disease progression.
On July 30, the state of Georgia announced it is further delaying its limited Medicaid expansion until the end of 2021.