WASHINGTON – U.S. Sen. Mark R. Warner (D-VA), Chairman of the Senate Intelligence Committee, released the following statement today after the Department of Health and Human Services (HHS) issued new voluntary cybersecurity guidance for health care organizations looking to bolster their cybersecurity:

“As cyber criminals continue to target health systems in order to steal or hold for ransom the sensitive medical data of American patients and jeopardize the daily operations of health care providers, I am pleased to see the Department of Health and Human Services issue new voluntary guidance to bolster health care cybersecurity. I applaud the Health Sector Coordinating Council Cybersecurity Working Group for working to translate cyber practices into appropriate standards for providers in the health care space. I look forward to continuing to work with cyber experts, health stakeholders, and officials in the Biden Administration to determine which voluntary measures we need to start requiring to ensure patient safety.”  

Sen. Warner, co-chair of the Senate Cybersecurity Caucus and a former technology entrepreneur, has long sounded the alarm about the importance of safeguarding our nation’s critical infrastructure – including our health care systems. In November, he authored and published a policy options paper outlining current cybersecurity threats facing health care providers and systems and offering for discussion a series of policy solutions to improve cybersecurity across the industry. 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA), joined by Sens. Tim Kaine (D-VA), Joe Manchin (D-WV), Sherrod Brown (D-OH), Bob Casey (D-PA), John Hickenlooper (D-CO), and John Fetterman (D-PA), urged the Government Accountability Office (GAO) to evaluate the adequacy of black lung benefits to meet the income and health care needs of disabled miners and their families. In a letter to Comptroller General of the United States Gene L. Dodaro, the Senators explained that the study is critical to informing policy aimed at helping coal miners and their families in the Appalachian region. 

“Many recipients of black lung benefits are living month-to-month on limited and fixed incomes,” the Senators wrote. “Though this has historically been true, many miners sick with black lung disease who are applying for benefits today are contracting the disease at a much earlier age. These benefits, therefore, are not just supplementing an early retirement—they are replacing an income for many years that may need to support children and a household, aging or sick parents, and college and retirement.”

Decades ago, Congress established the Black Lung Benefits Act in conjunction with the Federal Coal Mine Health and Safety Act of 1969 to provide monthly compensation and medical coverage for coal miners who develop black lung disease and are totally disabled as a result. However, many miners and their families have been subjected to drawn out legal challenges after being awarded black lung benefits. Frequently, these benefits are appealed by employers and, if the benefit determination is overturned, recipients must pay back the money. In some cases, these challenges have taken years to resolve, causing undue stress to families that rely on these benefits to survive.

The Senators continued, “We have also heard from miners’ attorneys that almost all of the miners and families that they represent raise the fear of repayment with them and it frequently deters these families from using any of their interim benefits that they desperately need, regardless of how strong their respective cases are because they cannot afford to take the risk of being forced to repay a large sum of money. Since these cases can last for so long, many miners die from black lung disease before they are able to confidently spend their benefits without fear of a future repayment.”’

To help ensure that adequate benefits are provided, the senators are requesting a study that answers the following questions:

1. What are the state and Federal disability benefits that coal miners and their families can receive as a result of black lung?
2. What challenges have miners and their families faced in obtaining black lung disability benefits, including but not limited to recoupment?
3. How do these benefits affect the health and financial well-being of miners and their families, and what, if any, changes are needed?

Last year, Sens. Warner, Kaine, Casey, Brown, and Manchin introduced The Black Lung Benefits Improvement Act, legislation to make needed updates to the Black Lung Benefits Act to ensure Congress is fulfilling its commitment to the nation’s coal miners. To help fulfill those promises, in August of 2022, Congress approved a permanent extension of the black lung excise tax to fund the Black Lung Disability Trust Fund (BLDTF) that provides health insurance and a living stipend for those impacted by black lung as part of the Inflation Reduction Act.

"The UMWA has been at the forefront of battling black lung disease for more than fifty years. Enacted by Congress in 1969 as part of the Federal Mine Health and Safety Act, the black lung benefits system has been helpful to thousands of miners and their families. But more needs to be done. The cost of living has dramatically increased since 1969, miners are contracting the disease at younger ages and there are more severe forms of the disease. This GAO study will bring important answers on how to improve the benefit system so that all miners and their families receive the benefits they deserve,” said Cecil E. Roberts, International President of the United Mine workers of America.

"The black lung benefits system was created over fifty years ago and since its creation has served as a lifeline for so many mining families," said Rebecca Shelton, Director of Policy for Appalachian Citizens' Law Center. "But a lot can change in fifty years. We know that the cost of living has increased, that more miners have severe forms of the disease, and that miners are getting sick at younger ages. This GAO study asks critical questions to determine whether the benefits system is still adequately serving families in spite of these and many other changes and will ensure that the benefits system continues to serve mining families as it was meant to."

“Miners disabled by black lung deserve more than what they are currently receiving — $738 per month even for those with total disability,” said Appalachian Voices Legislative Director Chelsea Barnes. “We believe this GAO study will show that black lung disability benefits should be significantly increased to meet the needs of miners who are no longer able to work and provide for their families as a result of this debilitating disease.”

A copy of the letter can be found here and below.

Dear Comptroller General Dodaro,

Thank you for your continued partnership with Congress and the Federal government to help ensure government works effectively and efficiently for our constituents. We write to request that the Government Accountability Office (GAO) conduct a study to evaluate the adequacy of black lung benefits to meet the living and health care needs of disabled miners and their families. We believe such a report is critical to informing policy aimed at helping coal miners and their families in the Appalachian region. 

Coal workers’ pneumoconiosis, commonly known as black lung disease, is a fatal, incurable condition caused by long-term exposure to coal dust in and around coal mines. The U.S. Department of Labor has estimated that black lung has killed more than 76,000 people since 1968. However, the number of miners with black lung is likely much higher, given the difficulty in and hesitancy about getting diagnosed within mining communities.

In 1972, Congress passed the Black Lung Benefits Act (BLBA) to provide monthly benefits to disabled miners and eligible surviving family members of coal miners whose deaths were due to black lung disease. Benefits are either paid for by the coal mining company or the Black Lung Disability Trust Fund but the claims process is arduous and often takes many years, even decades. Miners and their families or survivors apply for and rely on these benefits for health care and as a source of income once they are disabled. 

Currently, federal black lung benefit rates are set at 37.5% of the base salary federal employees in grade GS-2, step 1. These employees are on the second lowest pay grade for federal employees.  Therefore, a miner without any dependents or a survivor of a miner, for instance, receives approximately $4.24 per hour, $738 a month, or about $8,856 annually, even if they prove total disability or death due to pneumoconiosis. Considering that the federal minimum wage is set at $7.25 per hour, disabled miners receive nearly half this amount in Black Lung disability benefits.

Anecdotally, we have learned that black lung benefits are a primary or sole source of income for many families. Many recipients of black lung benefits are living month-to-month on limited and fixed incomes. Though this has historically been true, many miners sick with black lung disease who are applying for benefits today are contracting the disease at a much earlier age. These benefits, therefore, are not just supplementing an early retirement—they are replacing an income for many years that may need to support children and a household, aging or sick parents, and college and retirement. We have also heard from miners’ attorneys that almost all of the miners and families that they represent raise the fear of repayment with them and it frequently deters these families from using any of their interim benefits that they desperately need, regardless of how strong their respective cases are because they cannot afford to take the risk of being forced to repay a large sum of money. Since these cases can last for so long, many miners die from black lung disease before they are able to confidently spend their benefits without fear of a future repayment.

The purpose of the Black Lung Benefits Act is to provide benefits, in cooperation with the States, to coal miners who are totally disabled due to pneumoconiosis and to the surviving dependents of miners whose death was due to such disease. To help ensure that adequate benefits are provided to coal miners and their dependents in the event of their death or total disability due to pneumoconiosis, we request a study that describes:

Ensuring that benefits are sufficient to meet the economic and health care needs of mining families has always been critical, and we appreciate your consideration of this request.

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) today released the following statement on a new proposed rule by the Drug Enforcement Agency (DEA) governing the use of telemedicine to prescribe controlled substances:

“Given the dramatic shortage of mental health providers nationwide, expanded access to prescribers through telehealth is key to making sure that patients can continue getting their medications, including those that treat opioid use disorder, as they have for the past three years. More than half of U.S. counties don’t have a single psychiatrist. While folks once had to take time off work, commute to a medical facility, and sit in a waiting room, they now can get in front of a prescriber quickly, from nearly any location, and through a single click thanks to pandemic-era telehealth flexibilities.

“Unfortunately, despite what Congress has been directing it to do since 2008, the rule proposed by the DEA once again neglects to set up a special registration allowing specially certified and trained prescribers to continue to safely prescribe controlled substances virtually without requiring an in-person visit. I worry that this rule, as written, overlooks the key benefits and lessons learned during the pandemic, and could counterproductively exacerbate the opioid crisis and encourage more risky behavior by pushing patients to seek dangerous alternatives to proper health care, such as self-medicating, if they cannot access an in-person appointment with a specialized provider.”

During COVID-19, patients widely adopted telepsychiatry as a convenient and accessible way to get psychiatric care remotely. This was made possible by the COVID-19 Public Health Emergency, which allowed for a number of flexibilities, including utilizing an exception to the in-person medical evaluation requirement under the Ryan Haight Online Pharmacy Consumer Protection Act, legislation regulating the online prescription of controlled substances. With the Public Health Emergency set to expire, patients will soon lose the ability to reap the benefits of a mature telehealth system whose responsible providers know how to take care of their patients remotely when appropriate.  

Since 2008, Congress has directed the DEA to set up a special registration process, another exception process under the Ryan Haight Act, that would open up the door for quality health care providers to evaluate a patient and prescribe these medications over telehealth safely, as they’ve done during the pandemic. This special registration process has yet to be established, and DEA wrote they believe this proposed rule fulfills those Congressional mandates, despite not proposing such a registration.

Sen. Warner, a former tech entrepreneur, has been a longtime advocate for increased access to telehealth. He is an original cosponsor of the CONNECT for Health Act, which would expand coverage of telehealth services through Medicare, make COVID-19 telehealth flexibilities permanent, improve health outcomes, and make it easier for patients to safely connect with their doctors. He previously wrote to both the Biden and Trump administrations, urging the DEA to finalize regulations long-delayed by prior administrations allowing doctors to prescribe controlled substances through telehealth. Sen. Warner also sent a letter to Senate leadership during the height of the COVID-19 crisis, calling for the permanent expansion of access to telehealth services.

In 2018, Sen. Warner included a provision to expand financial coverage for virtual substance use treatment in the Opioid Crisis Response Act of 2018. In 2003, then-Gov. Warner expanded Medicaid coverage for telemedicine statewide, including evaluation and management visits, a range of individual psychotherapies, the full range of consultations, and some clinical services, including in cardiology and obstetrics. Coverage was also expanded to include non-physician providers. Among other benefits, the telehealth expansion allowed individuals in medically underserved and remote areas of Virginia to access quality specialty care that isn’t always available at home.

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WASHINGTON – U.S. Sens. Mark R. Warner (D-VA) and Marsha Blackburn (R-TN) led more than a dozen senators from both parties in urging for the extension of a policy that allows rural hospitals to continue delivering quality care to their communities. In a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, the senators formally requested a four-year extension of the Low Wage Index Hospital Policy, which allows hospitals in rural areas to compete for, and retain, high-quality staff by increasing reimbursements to hospitals in rural areas with lower overall wages. Without action, Medicare payments to these hospitals will reduce after September 30, 2023.

In their letter, the lawmakers pointed out that extenuating circumstances, including the COVID-19 pandemic, have not allowed for adequate evaluation of the Low Wage Index Hospital Policy. They argue that extending the policy will allow CMS to better assess its impact on the benefiting hospitals ability to recruit and retain health care staff.

“Unfortunately, due to disruptions in the marketplace caused by the COVID-19 pandemic, we have not had the opportunity to see the true impact of the Low Wage Index Hospital Policy envisioned by CMS,” the Senators wrote. “Extending the Low Wage Index Hospital Policy for four additional years will allow hospitals and the agency to better understand the policy’s true impact in a more normal environment.”

In addition to Sens. Warner and Blackburn, the letter was signed by Sens. Tim Kaine (D-VA), Tommy Tuberville (R-AL), Joe Manchin (D-WV), John Boozman (R-AR), Shelley Moore Capito (R-WV), Roger Wicker (R-MS), Cindy Hyde-Smith (R-MS), Bill Hagerty (R-TN), James Lankford (R-OK), Tim Scott (R-SC), Tom Cotton (R-AR), and Katie Boyd Britt (R-AL).

Sens. Warner and Blackburn are also the lead sponsors of the Save Rural Hospitals Act, which would establish an appropriate national minimum to the Medicare Area Wage Index to ensure that rural hospitals receive fair payment for the care they provide, while preserving the existing reimbursements for urban hospitals. The legislation, which was introduced in the last several Congresses, will be reintroduced in the 118^th Congress.

A copy of the letter can be found here and below.

Dear Administrator Brooks-LaSure:

Thank you for your continued commitment to ensuring all health care providers have the resources they critically need to provide quality health care to Medicare beneficiaries. We write to you regarding the Medicare hospital area wage index (AWI) in the Inpatient Prospective Payment System (IPPS). Specifically, we urge you to include a four-year extension of the Low Wage Index Hospital Policy, also known as the Lowest Quartile Adjustment (LQA) policy, in the upcoming Fiscal Year (FY) 2024 IPPS rule.

In August 2019, the Centers for Medicare and Medicaid Services (CMS) first included a four-year AWI adjustment to bottom quartile hospitals as part of the FY2020 IPPS (CMS-1716-F). At the time, CMS stated that the policy “reflected a common concern that the current wage index system perpetuates and exacerbates the disparities between high and low wage index hospitals.”[1] To address this concern, CMS increased the wage index for hospitals with a wage index value below the 25th percentile. The additional assistance has been a valuable lifeline for more than 800 hospitals in 23 states throughout FY2020, FY2021, FY2022, and now FY2023.

Unfortunately, due to disruptions in the marketplace caused by the COVID-19 pandemic, we have not had the opportunity to see the true impact of the Low Wage Index Hospital Policy envisioned by CMS. Extending the Low Wage Index Hospital Policy for four additional years will allow hospitals and the agency to better understand the policy’s true impact in a more normal environment. In its original August 2019 rule, CMS appeared to acknowledge that more time may be needed to implement the policy when it stated, “this policy will be effective for at least 4 years.” We applaud CMS for that foresight and encourage it to extend the policy for four additional years.

The continuation of this critical policy will allow hospitals to recruit and retain health care staff and protect access to care for millions of Americans.

Sincerely,

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WASHINGTON – Today, U.S. Sen. Mark R. Warner joined Sens. Tammy Baldwin (D-WI), Chris Murphy (D-CT) and a group of 31 colleagues in a letter urging the Department of Health and Human Services (HHS) to take immediate action and address short-term limited duration insurance (STLDI) plans, or junk plans, which fail to provide adequate, comprehensive health insurance coverage.

In 2018, in an effort to sabotage the Affordable Care Act (ACA), the Trump Administration made junk plans more widely available to consumers. Since then, these plans have continued to expand, however, they are not required to adhere to important standards, including prohibitions on discrimination against people with pre-existing conditions, coverage for the 10 essential health benefit (EHB) categories, and annual out-of-pocket maximums.

“Now, more than ever, the Department of Health and Human Services must act. Beginning in April, millions of Americans will likely lose the Medicaid coverage that they have relied upon during the COVID-19 pandemic. We must protect those who will be looking for coverage in the near future, and take steps to ensure that these plans are not allowed to further proliferate,” wrote the Senators. “It is past time for your Department to step up and address the expansion and proliferation of junk plans.”

In addition to Sens. Warner, Baldwin, and Murphy, the letter was signed by Richard Blumenthal (D-CT), Cory Booker (D-NJ), Sherrod Brown (D-OH), Ben Cardin (D-MD), Bob Casey (D-PA), Christopher Coons (D-DE), Catherine Cortez Masto (D-NV), Tammy Duckworth (D-IL), Richard Durbin (D-IL), Dianne Feinstein (D-CA), Maggie Hassan (D-NH), Martin Heinrich (D-NM), John Hickenlooper (D-CO), Timothy Kaine (D-VA), Angus King (I-ME), Amy Klobuchar (D-MN), Ben Ray Luján (D-NM), Edward Markey (D-MA), Robert Menendez (D-NJ), Jeff Merkley (D-OR), Patty Murray (D-WA), Alex Padilla (D-CA), Gary Peters (D-MI), Jack Reed (D-RI), Jeanne Shaheen (D-NH), Tina Smith (D-MN), Debbie Stabenow (D-MI), Chris Van Hollen (D-MD), Raphael Warnock (D-GA), Elizabeth Warren (D-MA), and Peter Welch (D-VT).

Full text of the letter can be found here and below.

Dear Secretary Becerra,

As we celebrate the State of the Union and the important gains that we have made when it comes to expanding the availability of comprehensive, affordable health care coverage, we write once again to urge you to take immediate action and address short-term limited duration insurance plans, or, junk plans. Now, more than ever, the Department of Health and Human Services must act. Beginning in April, millions of Americans will likely lose the Medicaid coverage that they have relied upon during the COVID-19 pandemic. We must protect those who will be looking for coverage in the near future, and take steps to ensure that these plans are not allowed to further proliferate.

The Families First Coronavirus Response Act (Families First) (P.L. 116-127) provided additional federal Medicaid funding to states during the COVID-19 public health emergency in exchange for maintaining coverage, specifically by meeting certain maintenance-of-effort requirements. These requirements barred states from lowering income eligibility levels, imposing new premiums or other barriers to enrollment, and involuntarily disenrolling individuals from their programs. According to federal data, Medicaid enrollment has increased by over 30 percent since February of 2020, an additional 19.5 million people. Congress has also worked to provide additional financial support for those who purchase ACA marketplace plans, and in August, passed the Inflation Reduction Act, which extended the additional financial support first enacted as part of the American Rescue Plan. As a result of this additional support, consumers saved an average of $800 on their premiums in 2021, and will continue to see savings through 2025.

As part of the Fiscal Year 2023 (FY23) omnibus, Congress took steps to uncouple the maintenance-of-effort requirements included in Families First from the public health emergency in order to avert both a Medicaid coverage and funding cliff. Starting on April 1, 2023, states will be able to begin conducting Medicaid eligibility redeterminations and enhanced federal funding will gradually phase out from April through December 2023. In order to receive enhanced funding during this period, states must follow all federal requirements related to redeterminations, update beneficiaries’ contact information, and use multiple methods to contact individuals when they have moved and have an out-of-date mailing address. States will also be required to submit monthly reports on unwinding, including information indicating where beneficiaries are experiencing challenges.

Congress worked to make sure that the FY23 omnibus gave state Medicaid programs a roadmap for the months ahead and enacted the Inflation Reduction Act to provide additional financial support for those enrolling in health coverage through the marketplace. It is now time for the Administration to do its job and act to protect those who will be seeking to enroll in coverage in the coming months.

According to estimates from your Department, approximately 15 million individuals will lose Medicaid or CHIP coverage in the coming year and will therefore require affordable health care coverage. Millions will be eligible for significant financial assistance to purchase comprehensive coverage on the marketplace. But without additional protections, many Americans could find themselves enrolled in junk plans that do not provide comprehensive coverage or protection for individuals with pre-existing conditions. These plans, which were actively promoted by the previous Administration and remain unchecked, are not required to comply with consumer protections that limit out-of-pocket costs or coverage of essential health benefits, including mental health services, treatment for substance-use disorder, prescription drug benefits, and maternity care. Furthermore, these plans engage in the type of discriminatory practices, such as retroactive coverage rescissions, medical underwriting, and lifetime and annual caps, which were commonplace before the Affordable Care Act.

Since President Biden took office, he has prioritized expanding access to comprehensive, affordable health coverage. Congress has supported these efforts. It is past time for your Department to step up and address the expansion and proliferation of junk plans.

Sincerely,

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WASHINGTON – This evening, U.S. Sen. Mark R. Warner (D-VA) is welcoming Mrs. Marguerite Bailey Young to his Washington, D.C. office ahead of the President Joe Biden’s State of the Union address. Mrs. Young, a 94-year-old widow and retired school system administrator from Fredericksburg, is joining Sen. Warner as he highlights how seniors all across Virginia have begun to benefit from historic measures enacted under President Biden to lower the price of insulin and other prescription drugs.

“As a Senator and former Governor, I’ve met countless seniors over the years who have pleaded for the government to do something about the out-of-control costs of prescription drugs. This includes basic and lifesaving medicines like insulin, which has skyrocketed in price despite having been around for a century. It’s an incredible honor to welcome Mrs. Young to the U.S. Capitol and get to hear how the Inflation Reduction Act has made her health care more accessible and her insulin more affordable,” said Sen. Warner

“I’m 94 years young, and I don’t know anything that needs to be affordable more urgently than health care. During my years working in health care, there were many people I knew who had to ask for a fourth of a prescription so that they could get the medicine they needed and still afford to stay in their homes and feed their families,” said Mrs. Young. “As a diabetic and someone living on a fixed income, and as someone who didn’t make a whole lot of money back in the day as a teacher, I’m delighted to be saving close to two thousand dollars a year on my medicines, especially insulin.”  

Mrs. Young, an Accomack County native who lives independently and on a fixed income, relies on several daily medicines, including two types of insulin. Like many seniors across the country, Mrs. Young has seen the cost of her insulin drop dramatically thanks to a provision in the Inflation Reduction Act that caps insulin at $35 per month for Medicare recipients.

Mrs. Young has been an active advocate for access to health care for underserved persons in her region. She previously served as a board member of Central Virginia Health Services, a federally qualified health center with more than 15 practice sites throughout Central Virginia. She spent more than 30 years championing healthcare access and equity within her own community, first as a Board Trustees on the Mary Washington Healthcare Board, then as a citizen member on the health system’s board-level committees before retiring just last year.

The Inflation Reduction Act is a historic piece of legislation supported by Sen. Warner, passed by Congress, and signed into law in August of 2022. The Inflation Reduction Act will continue lowering the cost of prescription drugs and health care by capping out-of-pocket costs for seniors, allowing Medicare to negotiate prescription drug prices, and extending the expanded Affordable Care Act subsidies for three years, among a number of other key provisions.  

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WASHINGTON—A bipartisan group of Senators introduced a pair of bills that would cement and build on the important progress that has been made to prevent and effectively treat Alzheimer’s disease.

Alzheimer’s costs our nation an astonishing $321 billion per year, including $206 billion in costs to Medicare and Medicaid. If we continue along this trajectory, Alzheimer’s is projected to claim the minds of 12.7 million seniors and nearly surpass $1 trillion in annual costs by 2050.  In 2021, family caregivers provided 16 billion hours of unpaid care for loved ones with dementia.  Nearly half of baby boomers reaching age 85 will either be afflicted with Alzheimer’s or caring for someone who has it.

In 2011, Senator Susan Collins (R-ME) authored the National Alzheimer's Project Act (NAPA) with then-Senator Evan Bayh (D-IN).  NAPA convened a panel of experts, who created a coordinated strategic national plan to prevent and effectively treat Alzheimer’s disease by 2025.  The law is set to expire soon and must be reauthorized to ensure that research investments remain coordinated and their impact is maximized.

The NAPA Reauthorization Act—authored by Senator Collins and co-led by Senators Mark Warner (D-VA), Shelley Moore Capito (R-WV), Ed Markey (D-MA), Jerry Moran (R-KS), Bob Menendez (D-NJ), Lisa Murkowski (R-AK), and Debbie Stabenow (D-MI)—would reauthorize NAPA through 2035 and modernize the legislation to reflect strides that have been made to understand the disease, such as including a new focus on promoting healthy aging and reducing risk factors.

The Alzheimer’s Accountability and Investment Act—authored by Senators Collins, Markey, Capito, Warner, Moran, Menendez, Murkowski, and Stabenow—would continue through 2035 a requirement that the Director of the National Institutes of Health submit an annual budget to Congress estimating the funding necessary to fully implement NAPA’s research goals. Only two other areas of biomedical research – cancer and HIV/AIDS – have been the subject of special budget development aimed at speeding discovery.

“We have made tremendous progress in recent years to boost funding for Alzheimer’s research, which holds great promise to end this disease that has had a devastating effect on millions of Americans and their families,” said Senator Collins, a founder and co-chair of the Congressional Task Force on Alzheimer’s Disease.  “The two bills we are introducing will maintain our momentum and make sure that we do not take our foot off the pedal just as our investments in basic research are beginning to translate into potential new treatments. We must not let Alzheimer’s define our children’s generation as it has ours.”

“I lost my mother to Alzheimer's after a 10-year battle with the illness, and I saw firsthand the challenges of this terrible disease,” said Senator Warner, co-chair of the Congressional Task Force on Alzheimer’s Disease. “While we have made great strides in research, this legislation seeks to build on that progress as we continue to seek new ways to prevent and treat Alzheimer’s. On behalf of the millions of American families who have been touched by Alzheimer’s, we will continue to fight for a cure.”

“More than a decade ago, I cosponsored the National Alzheimer's Project Act, and since becoming law, it has played a major role in ensuring Alzheimer’s disease and related dementias are a priority at NIH and other federal agencies,” Senator Capito said. “More than ever before, Americans and their families are living with the effects of Alzheimer’s, something that I have personally experienced. We must build on this momentum, continue to make critical research investments, and fight for all those impacted by this disease. Both of these bipartisan bills work toward our shared goals, and I’m proud to reintroduce them with my colleagues.”

“I am proud to have worked across chambers and across the aisle throughout my time in Congress to create a whole of government strategy for curing Alzheimer’s Disease and supporting families living with this disease. We’ve made significant progress in prevention, treatment, and supporting caregivers,” said Senator Markey, a founder and co-chair of the Congressional Task Force on Alzheimer’s Disease. “We’ve delivered resources and breakthroughs that I wish my family had when my mother was living with Alzheimer’s. But the work is not done until we’ve ended Alzheimer’s for good. I will continue to fight for major investments to advance research for a cure.”

“Our understanding of Alzheimer’s disease and the development of new treatments have made significant progress since the National Alzheimer’s Project Act was first signed into law in 2011,” said Senator Moran. “As our senior population expands, more research and treatment will be required to treat patients with Alzheimer’s disease. It’s important that we continue the work of NAPA and invest in further research of this horrible disease.”

“No family deserves to go through the pain of watching their loved ones fade away to this awful disease as I experienced with my mother,” said Senator Menendez. “Congress must do more to make sure the U.S. is leading the way in understanding Alzheimer’s and reducing risk factors, as well as expanding early diagnosis and providing assistance to patients and their families. I’m proud to continue fighting for this cause in my mother’s name by cosponsoring and advancing these bills to ensure one day we have a world without Alzheimer’s.”

“Alzheimer’s is unforgiving and devastating for families. And the impacts of this disease, both emotional and financial, require continued efforts,” said Senator Murkowski. “We’ve made progress by providing support and hope to those affected by this condition, but we must expand upon previous legislation to invest further in Alzheimer’s research. These bipartisan efforts will aid in the goal of developing better treatments and eventually finding a cure.” 

“Receiving an Alzheimer’s diagnosis is heartbreaking for patients and their families. Yet we’ve taken major steps toward understanding and fighting Alzheimer’s thanks to increased research investments,” said Senator Stabenow.  “This legislation will help ensure that we keep making progress toward the goal we all share: being able to prevent, treat, and cure Alzheimer’s disease.”

“With the National Alzheimer’s Project Act (NAPA) set to expire by 2025, passing the NAPA Reauthorization Act and the Alzheimer’s Accountability and Investment Act is urgently needed. These bipartisan pieces of legislation would continue the critical work of the National Plan to Address Alzheimer’s Disease to support Alzheimer’s research and improve the delivery of clinical care and services for people living with Alzheimer’s and their families,” said Robert Egge, Alzheimer's Association chief public policy officer and AIM executive director. “The Alzheimer’s Association and AIM are deeply grateful to the sponsors for reintroducing this important legislation to help improve the lives of those impacted by Alzheimer’s throughout the nation. We look forward to working with these bipartisan congressional champions to swiftly pass these bills.”

“By making these her first two bills of the new Congress, Senator Collins has once again demonstrated her unwavering commitment to ending Alzheimer’s. The National Alzheimer’s Project Act has played a major role in the advancements we are seeing today but the fight is far from over, which makes these two bills so important” said George Vradenburg chair and co-founder of UsAgainstAlzheimer’s. “Research is key to understanding, preventing, treating, and ultimately curing Alzheimer’s. People living with Alzheimer’s and their loved ones are grateful for champions like Senator Collins and her colleagues who stand with us in our fight to end this terrible disease.”

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine released the following statement regarding key health and climate provisions from the Inflation Reduction Act —legislation the senators helped pass in August to help Virginia lower drug and energy costs, imrove access to health care, and tackle cllimate change—that will go into effect on January 1, 2023:

“This year, we were proud to have helped pass the Inflation Reduction Act, historic legislation that will lower costs for Virginians while also tackling climate change, which is wreaking havoc on Virginia communities. We are thrilled that essential pieces of this law will go into effect on January 1 to help bring down health and long-term energy bills for families across the Commonwealth, by increasing access to affordable health care and helping Virginians diversify their energy sources.”

Provisions in the Inflation Reduction Act to lower prescription drug costs, help more seniors and low-income Virginians get access to the vaccines they need to stay healthy, and help more Virginians get health care coverage:

On January 1, 2023:

• Penalties on drug manufacturers that increase prices: Starting in 2023, manufacturers will be required to keep the increase in the cost of their drugs at or below inflation.
• Free vaccines for Medicare recipients: Starting in 2023, people with Medicare will not have to pay to receive vaccines under Medicare Part D, which includes vaccines for shingles, HPV, MMR, diphtheria, and pertussis. 4.1 million people with Medicare received a vaccine under Medicare Part D in 2020, including 85,000 Virginians.
• A $35 cap on the cost of insulin: Starting in 2023, out-of-pocket costs for insulin—regardless of how much a patient needs—will be capped at $35 per month under Medicare. As of 2020, over 74,000 Virginians with Medicare Part D used insulin and paid, on average, approximately $51 per month out-of-pocket to purchase the drug. Some people are currently paying up to $900 a month for the insulin they need to stay alive.
• Extension of ACA subsidies: During the pandemic, Congress enhanced subsidies under the Affordable Care Act (ACA) to help lower health care premiums for millions of Americans. Beginning on January 1, the Inflation Reduction Act will extend these enhanced subsidies through 2025 to help make Virginians’ health insurance more affordable. Over 300,000 Virginians were covered by the ACA in 2022.

On April 1, 2023:

• Limits to inflation effects on certain drugs: Starting April 1, 2023, people with Medicare may pay a lower coinsurance for some Part B drugs if the drug’s price increased faster than the rate of inflation.

On October 1, 2023:

• Free vaccines for Medicaid recipients: Medicaid and CHIP will cover vaccines for all Medicaid-covered adults. Currently, vaccine coverage is optional for states.

Provisions in the Inflation Reduction Act that kick in on January 1, 2023 to address climate change by helping cut dangerous pollution across Virginia:

• Boosts to clean energy investments: An expanded tax credit for clean energy manufacturers will incentivize investment in and production of renewable energy technologies like solar power and offshore wind. $4 billion of these investments have been reserved exclusively for use in coal communities. All clean energy tax credits include a bonus for meeting domestic manufacturing requirements related to steel, iron, or other manufactured components.
• Improvements to Home Energy Efficiency: Homeowners will be able to receive up to 30 percent back through tax credits for making energy efficiency improvements to their home—generally up to a maximum of $1,200 per year but potentially up to $3,200 if improvements include heat pumps, heat pump water heaters, or biomass stoves.
• Increased Access to Electric Vehicles: Qualified individuals will get up to a $7,500 consumer credit for the purchase of new electric vehicles. Incentives will also go into place to help ensure those vehicles are produced in North America. Qualified individuals will also be able to receive a tax credit of up to $4,000 for certain used electric vehicles and plug-in hybrids purchased through a dealership. In order to qualify for the full value of the credit, the vehicle must: have a battery capacity of at least 7kW hours; generally be a model at least two years old; and be sold by a participating dealer that is licensed in the jurisdiction. For new vehicles, eligible taxpayers include single filers with incomes under $150,000 annually and households with joint incomes under $300,000 annually if the head of household earns under $225,000 annually. The vehicle’s price is limited to $55,000 for compact vehicles and $80,000 for SUVs, vans, and pick-ups. For used EVs, single filers must have an income under $75,000 annually or $150,000 as a household, as long as the head of household makes under $112,500 annually. The used vehicle’s price is limited to $25,000.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) and Rep. Elissa Slotkin (D-MI) wrote to Sundar Pichai – the CEO of Alphabet Inc. and its subsidiary Google – urging him to curb deceptive advertisements and ensure that users receive accurate information when searching for abortion services on the platform. This letter comes on the heels of an investigation that reveals how Google regularly fails to apply disclaimer labels to misleading ads by anti-abortion clinics. It also follows a successful effort by Sen. Warner and Rep. Slotkin who previously urged Google to take action to prevent misleading search results for anti-abortion clinics. This push ultimately led Google to clearly label facilities that provide abortions and prevent users from being misled by fake clinics or crisis pregnancy centers.

“We are encouraged by and appreciative of the recent steps Google has taken to protect those searching for abortion services from being mistakenly directed to clinics that do not offer comprehensive reproductive health services. However, we ask you to address issues with misrepresentation in advertising on Google’s site and take a more expansive, proactive approach to addressing violations of Google’s stated policy,” wrote the lawmakers.

“According to an investigation by Bloomberg News and the Center for Countering Digital Hate (CCDH), depending on the search term used, Google does not consistently apply disclaimer labels to ads by anti-abortion clinics.  CCDH recently conducted searches that returned 132 misleading ads for such clinics that lacked disclaimers. Specifically, researchers found that queries for terms such as ‘Plan C pills,’ ‘pregnancy help,’ and ‘Planned Parenthood’ often returned results with ads that are not labeled accurately,” they continued. “Furthermore, the Tech Transparency Project found that some ads from ‘crisis pregnancy centers,’ even when they were properly labeled, the ads themselves included deliberately deceptive verbiage aimed at tricking users into believing that they offer abortion services.  For example, ads for ‘crisis pregnancy centers’ were found to contain language such as ‘Free Abortion Pill’ and ‘First Trimester Abortion.’ Such deceptive advertising likely reduces the effectiveness of labels and may lead to detrimental health outcomes for users who receive delayed treatment.”

In addition to urging Google to rectify these issues, the lawmakers also requested answers to the following questions:

1. What specific search terms does Google consider related to “getting an abortion”?
2. What criteria does Google use to determine whether specific queries are related to “getting an abortion”?
3. What additional steps will Google take to identify and remove ads with misleading verbiage that violates Google’s policies against misrepresentation?

A copy of the letter is available here and full text of the letter can be found below:

Dear Mr. Pichai,

We write today regarding the responsibility that Google has to ensure users receive accurate information when searching for abortion services on your platform. We are encouraged by and appreciative of the recent steps Google has taken to protect those searching for abortion services from being mistakenly directed to clinics that do not offer comprehensive reproductive health services. However, we ask you to address issues with misrepresentation in advertising on Google’s site and take a more expansive, proactive approach to addressing violations of Google’s stated policy.

On June 17, 2022, we wrote to you, along with 19 other senators and representatives, regarding research that showed Google results for searches such as “abortion services near me” often included links to clinics that are anti-abortion, sometimes called “crisis pregnancy centers.”   We were extremely concerned with this practice of directing users toward “crisis pregnancy centers” without any disclaimer indicating those businesses do not provide abortions.

We were pleased to see the changes you have made in response to our letter, such as the new refinement tool that allows users to only see facilities verified to offer abortion services, while still preserving the option to see a broader range of search results.  The steps you have taken will help prevent users from mistakenly being sent to organizations that attempt to deceive individuals into thinking they provide comprehensive health services and instead, regularly provide users with disinformation regarding the risks of abortion.  As many states are increasingly narrowing the window between getting a positive pregnancy test and when you can terminate a pregnancy, every day counts.

But we find ourselves again asking that Google live up to its promises with regards to preventing misleading ads on its platform. According to an investigation by Bloomberg News and the Center for Countering Digital Hate (CCDH), depending on the search term used, Google does not consistently apply disclaimer labels to ads by anti-abortion clinics.  CCDH recently conducted searches that returned 132 misleading ads for such clinics that lacked disclaimers. Specifically, researchers found that queries for terms such as “Plan C pills,” “pregnancy help,” and “Planned Parenthood” often returned results with ads that are not labeled accurately.  We believe Google’s failure to apply disclaimer labels to these common searches appears to be a violation of your June 2019 policy that requires “advertisers who want to run ads using keywords related to getting an abortion” to go through a verification process and be labeled as a provider that “Provides abortions” or “Does not provide abortions.”

Furthermore, the Tech Transparency Project found that some ads from “crisis pregnancy centers,” even when they were properly labeled, the ads themselves included deliberately deceptive verbiage aimed at tricking users into believing that they offer abortion services.  For example, ads for “crisis pregnancy centers” were found to contain language such as “Free Abortion Pill” and “First Trimester Abortion.” Such deceptive advertising likely reduces the effectiveness of labels and may lead to detrimental health outcomes for users who receive delayed treatment. These ads appear to violate Google’s policy on misrepresentation, which prohibits ads that “deceive users.”  Your responsiveness to our first letter gives us hope that you are willing to see this issue through. We, therefore, would appreciate answers to the following questions:

1. What specific search terms does Google consider related to “getting an abortion”?
2. What criteria does Google use to determine whether specific queries are related to “getting an abortion”?
3. What additional steps will Google take to identify and remove ads with misleading verbiage that violates Google’s policies against misrepresentation?

We urge you to take proactive action to rectify these and any additional issues surrounding misleading ads, and help ensure users receive search results that accurately address their queries and are relevant to their intentions.

Thanks for your consideration, and we look forward to your timely response. 

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WASHINGTON – Today, Senate Select Committee on Intelligence Chairman Mark R. Warner (D-VA) published “Cybersecurity is Patient Safety,” a policy options paper, outlining current cybersecurity threats facing health care providers and systems and offering for discussion a series of policy solutions to improve cybersecurity across the industry.  

Over the last decade cyberattacks in the health care sector have risen exponentially, with attacks on providers reaching an all-time high in 2021. The white paper, assembled by Sen. Warner’s staff, drawing on input from health care and cybersecurity experts, argues that improving cybersecurity in the health care sector will require collaboration from both the public and private sectors, and calls for improving federal leadership, strengthening health care providers’ cybersecurity capabilities, and building a robust response system in order to efficiently recover from attacks.

“Unfortunately, the health care sector is uniquely vulnerable to cyberattacks and the transition to better cybersecurity has been painfully slow and inadequate. The federal government and the health sector must find a balanced approach to meet the dire threats, as partners with shared responsibilities,” wrote Sen. Warner.

Divided in three parts, the white paper is organized as follows:

1. Chapter one covers areas that the federal government needs to address to improve our national risk posture when it comes to cybersecurity in the health care sector. Specifically, it notes seven key challenges facing federal government agencies with jurisdiction over health care providers and cybersecurity, details the current state of play regarding cybersecurity threats, and outlines policy options for shoring up existing vulnerabilities.    
2. Chapter two covers ways that the federal government can help the private sector meet this threat through a combination of potential mandates and voluntary incentives to adopt best practices.
3. Chapter three covers policies that could help health care providers respond to attacks in the event of a cybersecurity failure. Specifically, it notes ways institutions can recover following successful cyberattacks, and how to limit the resulting impact on patients and systems.

Sen. Warner has been a leader in the cybersecurity realm throughout his time in the Senate, crafting numerous pieces of legislation aimed at addressing these threats facing our nation. Recognizing that cybersecurity is an increasingly complex issue that affects the health, economic prosperity, national security, and democratic institutions of the United States, Sen. Warner cofounded the bipartisan Senate Cybersecurity Caucus with former Sen. Cory Gardner (R-CO) in 2016.  A year later, in 2017, he authored the Internet of Things (IoT) Cybersecurity Improvement Act with Sen. Gardner. This legislation, signed into law by President Donald Trump in December 2020, requires that any IoT device purchased with federal funds meet minimum security standards. As Chairman of the Senate Select Committee on Intelligence, Sen. Warner co-authored legislation that requires companies responsible for U.S. critical infrastructure report cybersecurity incidents to the government. This legislation was signed into law by President Joe Biden as part of the Consolidated Appropriations Act in March 2022.

Sen. Warner has also examined cybersecurity in the health care sector specifically. In 2019, Sen. Warner sent a letter to several health care providers and industry trade associations – from large hospital networks to trade associations representing rural providers and medical technology vendors – asking a series of questions related to the steps their organizations and/or members had taken to improve their cybersecurity posture. Sen. Warner received a number of thoughtful responses to those questions that revealed a wide-range of cybersecurity capabilities and depth of understanding of the problems health care providers are facing.

Sen. Warner is releasing this policy options document with the intent of soliciting feedback from stake-holders on the potential options described within. Any individuals, researchers, businesses, organizations, or advocacy groups that are interested in submitting comments – specific to the content and questions outlined in this document or additional ideas or language for inclusion in eventual legislation – should send a letter or an email to cyber@warner.senate.gov.

A copy of full policy options paper can be found here.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA) and Tina Smith (D-MN), joined by Sens. Amy Klobuchar (D-MN), Tammy Baldwin (D-WI), Michael Bennet (D-CO), Chris Murphy (D-CT), Bernie Sanders (I-VT), and Cory Booker (D-NJ), sent a letter to Department of Health and Human Services and Centers for Medicare & Medicaid Services (HHS/CMS) leadership urging them to review and formally report on the adequacy of the Affordable Care Act’s Essential Health Benefits (EHBs). The letter expressed the need for a review of telehealth flexibilities and the impact that scaling back these service options will have on those who rely on telehealth capabilities for treatment.

“As we begin to envision health care policies post-pandemic, we remain concerned telehealth services will be significantly pared back, hindering access to care for millions of Americans—especially those with complicated health conditions,” the Senators wrote.

When the Affordable Care Act was enacted, it required the Secretary of HHS to review EHBs and provide a report to Congress, and the public, that contains:

• An assessment of whether enrollees are facing any difficulty accessing needed services for reasons of coverage or cost;
• An assessment of whether the EHBs list needs to be modified or updated to account for changes in medical evidence or scientific advancement;
• Information on how EHBs will be modified to address any such gaps in access or changes in the evidence base;
• An assessment of the potential of additional or expanded benefits to increase costs and the interactions between the addition or expansion of benefits and reductions in existing benefits to meet actuarial limitations;

Despite this requirement, this formal review and report have never been undertaken or completed. The Senators stressed the need for this process in light of changes being made to care as the health care system shifts to a post-pandemic structure.

“We have heard from constituents who have concerns that coverage will start to vary based upon visit modality. For some specialized, complicated care—eating disorders, for example—it has always been challenging getting the most appropriate treatment covered, whether that’s because of parity or network issues,” the Senators continued. “We are concerned that modality will become one additional way barriers to treatment will be enacted, if arbitrary in-person requirements become one more way care is denied or delayed.”

The full text of the letter is available here and below:

Dear Secretary Becerra, Administrator Brooks-LaSure and Deputy Administrator Montz:

We thank you for your continued partnership in establishing and extending telehealth flexibilities to ensure Americans have access to vital health care services and supports over the course of the COVID-19 pandemic. As we begin to envision health care policies post-pandemic, we remain concerned telehealth services will be significantly pared back, hindering access to care for millions of Americans—especially those with complicated health conditions.

According to federal statute, it is incumbent upon the Secretary to periodically review insurance plan Essential Health Benefits (EHBs) and provide a public report to Congress that contains 1) an assessment of whether enrollees are facing difficulty accessing needed services for reasons of coverage or costs; 2) an assessment of whether plan benefits need to be modified or updated to account for changes in medical evidence or scientific advancement; 3) information on how plan benefits will be modified to address any such gaps or changes in the evidence base; and 4) an assessment of potential of additional or expanded benefits to increase costs and the interactions between the addition of benefits and reductions in existing benefits.

We believe after 12 years of the ACA it is important that EHBs be formally reviewed and the mandated report be issued to the public and Congress, especially as your Administration is committed to maintaining and further strengthening the law’s protections. We urge you to undertake such a review and report, and in addition we urge you to ensure that visit modality is not one of the “reasons of coverage” for which “enrollees are facing difficulty accessing needed services.”

We have heard from constituents who have concerns that coverage will start to vary based upon visit modality. For some specialized, complicated care—eating disorders, for example—it has always been challenging getting the most appropriate treatment covered, whether that’s because of parity or network issues. We are concerned that modality will become one additional way barriers to treatment will be enacted, if arbitrary in-person requirements become one more way care is denied or delayed.

The Department addressed a delay in completing such a report to Congress in its 2019 Notice of Benefit and Payment Parameter Final Rule, citing the need for further insurance market stabilization that the final rule would provide. Although we understand the difficulty of reviewing the markets as they continue to evolve, it is for that reason critical that the Administration review and report on EHBs so that we have an understanding of whether they continue to be adequate in an ever-evolving health care ecosystem. The health care system will not be the same after the COVID-19 pandemic, and this is an opportunity to renew our commitment to comprehensive, affordable and accessible health care coverage. We respectfully request this report be conducted and issued to Congress to inform future health policy to better serve Americans.

Thank you for your consideration, and we look forward to continuing to work with you on this very important issue.

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) sponsored the Build, Utilize, Invest, Learn, and Deliver (BUILD) for Veterans Act of 2022 – legislation to strengthen the Department of Veterans Affairs’ (VA) ability to carry out key infrastructure projects, including medical facilities, in order to better care for veterans across the country. Virginia has one of the country’s largest and fastest-growing concentrations of veterans, resulting in increased demand for the services and benefits provided by the VA.

“I have been working for years to ensure that our nation’s veterans receive the high-quality medical care they deserve,” said Sen. Warner, who successfully spearheaded congressional efforts to approve new VA healthcare projects across the country, including outpatient clinics in Hampton Roads and Fredericksburg. “Unfortunately, as a country, we’ve struggled to keep up with the needs of veterans seeking care and support through the VA, due in part to processes that are just too slow and too bureaucratic, leading to years of unnecessary delays in opening and remodeling needed hospitals, clinics, and benefits offices. This legislation will push the VA to modernize and improve its capacity to manage current and future infrastructure projects.”  

Specifically, the BUILD for Veterans Act would bolster and invest in VA infrastructure by requiring the Department to:

• Develop relevant plans, metrics, infrastructure workforce hiring strategies, year-by-year budgets and oversight mechanisms to overhaul its capacity to accomplish new facility projects and provide Congress with its plans and performance data for enhanced accountability.
• Implement a more concrete schedule to eliminate or repurpose unused and vacant buildings such as old maintenance sheds or warehouses to safeguard taxpayer dollars, and focus funding on new and productive infrastructure.
• Examine infrastructure budgeting strategies, identify if reforms are required, and implement industry best practices.
• Provide annual budget requirements over a 10-year period so that Congress and VA can set about on the task of fully modernizing VA’s infrastructure in a strategic, comprehensive approach.

The legislation has been endorsed by The American Legion, Disabled American Veterans, Iraq and Afghanistan Veterans of America, Veterans of Foreign Wars (VFW), and Paralyzed Veterans of America.

This effort comes on the heels of the bipartisan Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act of 2022, legislation supported by Sen. Warner and signed into law by President Biden to expand health care and resources for toxic-exposed veterans. The law also provided $5.5 billion in funding for 31 new facilities across the country – including another outpatient clinic in Hampton Roads – and streamlines the process for the VA to execute on new leases, removing bureaucratic hurdles and cutting down on some of the frustrating delays to these facilities’ completion.

Sen. Warner has long fought to improve care for Virginia’s veterans.  In 2015, confronted with wait times in Hampton Roads that were three times the national average, Sen. Warner successfully urged the VA to send down a team of experts to address the problem. He also succeeded in getting the Northern Virginia Technology Council to issue a free report detailing how to reduce wait times. Sen. Warner also spearheaded a bipartisan effort to approve long-overdue leases for more than two dozen VA medical facilities across the country, including two in Virginia. In October 2020, Sen. Warner successfully saw through the signing of his legislation to expand veterans’ access to mental health services and reduce the alarming rate of veteran suicide. 

Full text of the BUILD for Veterans Act is available here. 

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WASHINGTON— Today, U.S. Sens. Mark R. Warner and Tim Kaine—who serves on the Senate Health, Education, Labor & Pensions Committee—teamed up with 28 of their colleagues to call on the Department of Health and Human Services (HHS) to take immediate action to safeguard women’s privacy and their ability to safely and confidentially get the health care they need. Specifically, the Senators urged the Biden Administration to strengthen federal privacy protections under the Health Information Portability and Accountability Act (HIPAA) to broadly restrict providers from sharing patients’ reproductive health information without their explicit consent—particularly with law enforcement or in legal proceedings over accessing abortion care.

Since the Dobbs decision, the new patchwork of state abortion bans has caused widespread confusion among health care providers over whether they are required to turn over patients’ health information to state and local law enforcement. As a result, patients may delay or avoid seeking the care they need out of fear their sensitive health information could be weaponized against them.

In recent weeks, states have investigated and sought to punish patients and providers for seeking and providing abortion care. While abortion is not currently criminalized in Virginia, Governor Youngkin has said he would “happily and gleefully” sign “any bill” limiting reproductive freedom, and has tapped Virginia state legislators to introduce legislation to that effect in 2023. Should that legislation be signed into law, the Senators’ push could help prevent personal health data from being used against Virginia women in legal proceedings. This letter makes clear that additional privacy protections are needed to protect this data so it cannot be used by prosecutors or law enforcement seeking to enforce an abortion ban.

“Our nation faces a crisis in access to reproductive health services, and some states have already begun to investigate and punish women seeking abortion care. It is critical that HHS take all available action to fully protect women’s privacy and their ability to safely and confidentially seek medical care,” wrote the Senators.

In their letter to Secretary Xavier Becerra, the Senators urge HHS to take immediate action to strengthen federal privacy protections under HIPAA, bolster enforcement of the protections, educate providers about their obligations, and ensure patients understand their rights. Shortly after the Dobbs decision, Becerra pledged to work to protect patient and provider privacy.

“To safeguard the privacy of women’s personal health care decisions and ensure patients feel safe seeking medical care, including reproductive health care, we urge you to quickly initiate the rulemaking process to strengthen privacy protections for reproductive health information,” urged the Senators. “In particular, HHS should update the HIPAA Privacy Rule to broadly restrict regulated entities from sharing individuals’ reproductive health information without explicit consent, particularly for law enforcement, civil, or criminal proceedings premised on the provision of abortion care.”

Joining Sens. Warner and Kaine in sending the letter were Senators Murray (D-WA), Baldwin (D-WI), Blumenthal (D-CT), Booker (D-NJ), Brown (D-OH), Cantwell (D-WA), Casey (D-PA), Duckworth (D-IL), Durbin (D-IL), Gillibrand (D-NY), Heinrich (D-NM), Hickenlooper (D-CO), Hirono (D-HI), Klobuchar (D-MN), Luján (D-NM), Markey (D-MA), Menendez (D-NJ), Merkley (D-OR), Padilla (D-CA), Reed (D-RI), Rosen (D-NV), Sanders (I-VT), Shaheen (D-NH), Smith (D-MN), Stabenow (D-MI), Van Hollen (D-MD), Warren (D-MA), and Wyden (D-OR).

The Senators’ full letter is available below:

Dear Secretary Becerra:

Since the Supreme Court’s decision to strip away the constitutional right to abortion, patients across the country have lost access to reproductive health care, and providers have scrambled to adapt to the immense confusion, fear, and upheaval this ruling has caused. In some states, legislators and prosecutors have already sought to investigate and punish women seeking abortion care. To protect patients, and their providers, from having their health information weaponized against them, we urge you to take immediate action to strengthen education on and enforcement of federal health privacy protections, and to initiate the rulemaking process to augment privacy protections under Health Insurance Portability and Accountability Act (HIPAA) regulations.

Every day, health care personnel across this nation care for patients who are pregnant or may become pregnant. This care may include anything from an annual check-up to obstetrical visits to emergency care. In order for patients to feel comfortable seeking care, and for health care personnel to provide this care, patients and providers must know that their personal health information, including information about their medical decisions, will be protected. Recognizing this critical need, in 1996, Congress passed HIPAA, which directed the Department of Health and Human Services (HHS) to issue privacy regulations for personal health information. HHS issued corresponding privacy regulations (the “HIPAA Privacy Rule”) in 2000, with several subsequent updates over the years.

The Dobbs v. Jackson Women’s Health Organization decision has caused widespread confusion among health care providers on health privacy protections, and whether they are required to turn over health information to state and local law enforcement. Stakeholders have told us about providers who have felt uncertain about whether they must turn over personal health information to state and law enforcement officials, including cases where providers believed they had to turn over information when doing so is only permitted—but not required—under the HIPAA Privacy Rule. In other cases, providers did not know that certain disclosures are actually impermissible. Stakeholders have even described clashes between providers and health care system administrators on whether certain information must be shared. Many of these issues seem to arise from misunderstandings of what the HIPAA Privacy Rule requires of regulated entities and their employees.

This confusion is likely to grow as state lawmakers continue to implement a patchwork of laws restricting access to abortion and other reproductive health care services. Already, some states have laws in effect criminalizing abortion providers, and some states have enacted laws that penalize anyone who “aids or abets” an abortion, potentially exposing everyone from a referring provider to a receptionist to legal liability. Some state legislators have even proposed to bar women from traveling to another state for abortion care. And even before Dobbs, states had already prosecuted women following their abortions or miscarriages. In many cases, these laws have been used to disproportionately criminalize or surveil women of color for their pregnancy loss.

Actions to prohibit abortion access and undermine health privacy are likely to have devastating consequences for women’s health. Out of concern that their reproductive health information may be used against them, women may delay or avoid disclosing a pregnancy or obtaining prenatal care. They may fear initiating treatments for conditions like cancer or arthritis, where treatment could impact a pregnancy, even as health care providers may hesitate to provide them. And women who experience complications from a pregnancy or abortion may avoid seeking desperately needed emergency care, risking devastating health consequences and even death. These concerns are not without justification – in recent years, numerous medical providers have reported women to law enforcement for seeking care following an abortion, a miscarriage, or other pregnancy-related medical issue.

HHS has the tools to protect patients and health care providers, even in the wake of this devastating decision. For over twenty years, the HIPAA Privacy Rule has protected the privacy of individuals’ health information, laying out when health information may or may not be shared without a patient’s explicit consent. In addition, the HIPAA Privacy Rule has long recognized that stronger protections may be needed for particularly sensitive health information, such as psychotherapy notes. We commend you for the actions the Department has already taken to clarify privacy protections in the wake of the Dobbs decision, including the issuance of additional guidance on the HIPAA Privacy Rule. However, given the growing likelihood that women’s personal health information may be used against them, HHS must also take proactive steps to strengthen patient privacy protections.

To safeguard the privacy of women’s personal health care decisions and ensure patients feel safe seeking medical care, including reproductive health care, we urge you to quickly initiate the rulemaking process to strengthen privacy protections for reproductive health information. In particular, HHS should update the HIPAA Privacy Rule to broadly restrict regulated entities from sharing individuals’ reproductive health information without explicit consent, particularly for law enforcement, civil, or criminal proceedings premised on the provision of abortion care.

In addition, while HHS moves forward with the rulemaking process, the Department should take the following steps to improve awareness and enforcement of current privacy protections in the HIPAA Privacy Rule:

1. HHS should increase its efforts to engage and educate the health care community about regulated entities’ obligations under the HIPAA Privacy Rule, including the difference between permissible and required disclosures, best practices for educating patients and health plan enrollees on their privacy rights, how HIPAA interacts with state laws (including those related to prescriptions), and potential legal consequences for violations of the HIPAA Privacy Rule, including civil and criminal penalties. As part of this effort, HHS should engage the full range of health care personnel, including providers, senior executives, and smaller health care organizations, as well as pharmacists, health plan administrators and sponsors, legal and compliance personnel, and entities that provide HIPAA training. These efforts should include listening sessions, additional guidance and FAQs with specific examples, webinars, and additional avenues for individuals at regulated entities to seek confidential advice.

2. HHS should expand its efforts to educate patients about their rights under the HIPAA Privacy Rule, including when information may be shared without patient consent, the ability to request additional restrictions or corrections, and how to file a complaint with HHS.

3. HHS should ensure cases involving reproductive health information receive timely, appropriate attention for compliance and enforcement activities.

Our nation faces a crisis in access to reproductive health services, and some states have already begun to investigate and punish women seeking abortion care. It is critical that HHS take all available action to fully protect women’s privacy and their ability to safely and confidentially seek medical care. Thank you for your attention to this urgent matter.

Sincerely,

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WASHINGTON – U.S. Sens. Mark R. Warner (D-VA) and Susan Collins (R-ME) introduced bipartisan and bicameral legislation to expand access to critical advance care planning (ACP) services in Medicare that allow people, especially those with serious illness, to plan for their care and have their choices honored when it matters most. The Improving Access to Advance Care Planning Act would help more Americans access critical ACP services by allowing social workers to provide ACP services, removing beneficiary cost-sharing, and promoting increased education for providers on current ACP codes, and improved reporting on barriers to providing ACP services and billing the corresponding codes. This legislation was introduced in the U.S. House of Representatives by Congressman Earl Blumenauer (D-OR).

“Decisions about care planning are some of the hardest for a family to make, but they’re also some of the most important. One of my biggest regrets was not having early conversations about care planning with my own mom, who suffered from Alzheimer’s for 11 years and was unable to speak for nine of those years,” said Sen. Warner. “I’m proud to introduce this bill because folks with a serious illness deserve to have a say over what their care should look like, and families deserve the certainty of knowing they are honoring their loved ones’ wishes.”

“Unfortunately, most patients do not routinely make advance plans for their care in the event that they are diagnosed with a serious or life-threatening illness.  This can be a difficult topic for many families to address, but advance care planning has been shown to increase satisfaction and improve health outcomes because people with advance directives are more likely to get the care that they want, in the setting they prefer, and avoid the care that they don’t want,” said Sen. Collins. “The bipartisan bill we are introducing today would help provide an opportunity for patients to have a structured discussion with their health care providers about their goals and treatment options so that they can make their choices known and develop a plan of care in consultation with their loved ones.”

“I have been working to improve end of life care for well over a decade,” said Rep. Blumenauer. “Despite what was rated as the PolitiFact lie of the year during the Affordable Care Act debate over so-called ‘death panels,’ we won. Medicare has finally started paying physicians to help families understand their choices. This legislation will make advance care planning more accessible, allowing more of these conversations to happen and ensuring people’s wishes are heard, respected, and enforced.”

Specifically, this legislation would codify Medicare coverage of ACP services – a longtime priority for Sen. Warner, who first introduced legislation to improve planning options for patients in 2015. Today’s bill would also expand eligible providers that can bill for such services to include clinical social workers with experience in care planning. It would also remove beneficiary coinsurance and deductibles for ACP visits – including those that happen outside of an annual Medicare Annual Wellness Visit – to ensure that beneficiaries are not deterred from seeking these services, and providers are not deterred from offering them. The bill would also require two reports: one that directs CMS to educate providers on the ACP codes and report to Congress on such activities, and one that directs MedPAC to study and report to Congress on (A) barriers to providing and receiving ACP services despite the ability to bill for them, and (B) barriers to billing the code itself.

Sens. Warner and Collins were joined in introducing this legislation in the Senate by Sens. Tammy Baldwin (D-WI) and Amy Klobuchar (D-MN). 

Bill text is available here. 

This legislation has the support of a number of patient and family advocacy organizations, including the Coalition to Transform Advanced Care (C-TAC), LeadingAge, National Association for Home Care & Hospice, National Partnership for Healthcare and Hospice Innovation, Center for Medicare Advocacy, Respecting Choices, USAging, Social Work Hospice & Palliative Care Network, Smarter Health Care Coalition, Consumer Coalition for Quality Health Care.

“Those of us working to improve care for those impacted by serious illness have known that high copays for Advance Care Planning were a barrier to equitable, patient-centered care. Thanks to the tenacity of our C-TAC team and members of congress passionate about our issue, we’ve been able to help remedy this technicality in the law that now increases access to critical conversations between patients and their clinicians by eliminating copays and including social workers who are now eligible to be reimbursed for these services as part of the care team. A sincere thank you to Sen. Warner (D-VA) and Sen. Collins (R-ME) and Rep. Blumenauer (D-OR-3) for continuing to be the voice of the patient and family,” said Jon Broyles, CEO, The Coalition to Transform Advanced Care (C-TAC).

“The Social Work Hospice and Palliative Care Network (SWHPN) strongly supports the inclusion of clinical social workers in the definition of eligible practitioners who can bill for Medicare Advance Care Planning counseling services. As key members of the interdisciplinary team, clinical social workers are already well-trained to have meaningful conversations around Advance Care Planning with patients and families. This bill would have a direct and immediate impact on the ability for clinical social workers to bill for these services, reducing an important barrier to care and greatly enhancing the provision of these conversations,” said Jessica Strong, Executive Director, Social Work Hospice and Palliative Care Network.

“We applaud Senators Warner (D-VA) and Susan Collins (R-ME) and Representative Blumenauer (D-OR-3) for introducing the Improving Access to Advanced Care Planning Act. Advance Care Planning (ACP) is essential to ensuring that an individual’s care preferences are understood and honored during serious illness and at the end of life. The pandemic reinforced again how critical these conversations are for patients, families, and those that care for them. If enacted, this bill would bolster the health system’s ACP capacity by allowing properly trained clinical social workers to get reimbursed for these services, while also requiring a comprehensive provider education outreach campaign on the value of using Medicare’s ACP billing codes. Importantly, the legislation would also remove any beneficiary cost-sharing associated with these codes, a key equity-focused change that will address an oft-cited barrier to patient and provider willingness to engage in these discussions. NAHC is proud to support this thoughtful framework for improving our nation’s approach to advance care planning,” said William Dombi, President, The National Association for Home Care & Hospice (NAHC). 

“NPHI is proud to stand with C-TAC and others in support of the Improving Access to Advance Care Planning (ACP) Act.” Said Carole Fisher, President of NPHI. “As a national collective of community-based advanced illness care providers, NPHI and its members understand the importance of ensuring all Medicare beneficiaries have genuine access to counseling regarding their choices and preferences at the end-of-life. As we know, hospice services are often dramatically underutilized due to late referrals and a lack of prior planning. Engaging in ACP conversations earlier in the disease progression can improve quality of life for beneficiaries and lessen the burden on caregivers. We look forward to working with C-TAC, Congress, and others to pass this important legislation,” said Carole Fisher President, National Partnership for Healthcare and Hospice Innovation (NPHI). 

“End of life issues are nuanced and complicated, which is why it’s so vital that older adults and families have good access to advance care planning. This bill is an important step toward greater, affordable access to planning that all Americans need. With members delivering care across all settings of aging services, LeadingAge recognizes the importance of acknowledging the preferences and beliefs of people and their families to deliver quality care. We hope greater access to these conversations will improve end-of-life and help providers meet unique patient needs,” said Katie Smith Sloan, President and CEO, LeadingAge. 

“Including licensed clinical social workers as eligible practitioners, allowing them to bill for Medicare ACP counseling services, will address one of the major barriers to access to ACP services faced today.  Social workers are an important part of the healthcare system and have the appropriate training and skills to facilitate high quality ACP conversations. Providing reimbursement for them to do so will expand the pool of resources available to provide ACP counseling services, thereby improving access,” said Carole Montgomery MD, FHM, MHSA, Executive Medical Director, Respecting Choices. 

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA), Tim Kaine (D-VA) and Rep. A. Donald McEachin (D-VA) celebrated $52.9 million in funding from the federal government for the Petersburg/Richmond region to support job creation and increase American independence from foreign drug manufacturers.

This funding was recently awarded through the Economic Development Administration and funded by the American Rescue Plan, which was supported by the three lawmakers and passed through the Senate by a vote of 50 – 49 and the House by a vote of 220 – 211.

“The American Rescue Plan is the gift that keeps on giving – this time with $52.9 million that will go towards establishing Central Virginia as a hub for pharmaceutical manufacturing. This unparalleled federal investment will help boost American production of essential drugs and active pharmaceutical ingredients while creating 21^st century jobs for Virginians and tackling our nation’s dangerous overreliance on foreign supply chains for medicines,” said the lawmakers. 

The Virginia Advanced Pharma Manufacturing (APM) and R&D Cluster  –  led by the Virginia Biotechnology Research Partnership Authority–  is one of 21 winners of the $1 billion Build Back Better Regional Challenge – the most impactful regional economic development competition in decades. The projects funded as part of this award include expanding a nascent pharmaceutical manufacturing corridor in Central Virginia through investment in new wet lab space, development of critical infrastructure to sustain industrial capacity in Petersburg, and engagement with local business to enhance the regional pharmaceutical supply chain. The project will also catalyze a new partnership between Virginia Commonwealth University and Virginia State University to create new pathways for underserved residents to high-quality training and jobs in the pharmaceutical industry.

The Build Back Better Regional Challenge (BBBRC) is an unprecedented competitive federal grant program that provides each regional coalition with significant investments to tackle a wide variety of projects – including entrepreneurial support, workforce development, infrastructure, and innovation – to drive inclusive economic growth. Each coalition’s collection of projects aims to develop and strengthen regional industry clusters – all while embracing economic equity, creating good-paying jobs, and enhancing U.S. competitiveness globally. Projects span 24 states and include $87 million to two primarily Tribal coalitions and over $150 million for projects serving communities impacted by the declining use of coal.

Sen. Warner helped negotiate portions of the American Rescue Plan and directly advocated for this project. In March, he sat down with the Virginia Biotechnology Research Partnership Authority and other pharmaceutical industry professionals for a roundtable discussion on the need to manufacture more prescription drugs in Virginia.

While on Richmond City Council, Sen. Kaine played a major role in the formation and growth of the Virginia Biotechnology Research Partnership Authority, served on its board when he was Mayor of Richmond, and appointed board members while he was Governor. In addition to advocating for the American Rescue Plan, which provided the funding for the EDA Build Back Better Regional Challenge, Sen. Kaine specifically advocated for this project to win this grant. He also visited the project’s facilities in Richmond and Petersburg in April of this year.

Rep. McEachin proudly supported the American Rescue Plan and engaged with the Biden administration throughout the BBBRC application and selection process in support of the Virginia Biotechnology Research Partnership Authority. He sent multiple letters to Secretary of Commerce Gina Raimondo advocating for this project and held briefings with relevant stakeholders to keep them apprised of developments and receive timely updates.

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