Press Releases

WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) joined Sens. Elizabeth Warren (D-MA), Chris Murphy (D-CT) and 13 of their Senate colleagues in requesting that the Department of Health and Human Services (HHS) and Department of the Treasury conduct an analysis of how the Affordable Care Act (ACA)’s repeal in California v. Texas would affect health care coverage in the United States, particularly during the COVID-19 pandemic.

“Passed in 2010, the ACA drastically expanded the number of Americans with health insurance. Before the ACA, over 45 million Americans were uninsured and the 133 million Americans with pre-existing conditions could be denied coverage,” the Senators wrote. “After the ACA’s passage, over 20 million people gained health care coverage—including roughly 12 million people who were newly enrolled due to the ACA’s expansion of the Medicaid program. People with pre-existing conditions could no longer be denied coverage health insurers were required to expand coverage for mental health and substance use treatment; and young adults could stay on their parents’ health coverage until age 26—making it easier for millions of Americans to access care.”

“In the midst of a global pandemic that has killed roughly 220,000 people in the U.S. and infected over 8 million others, the President of the United States is actively asking the Supreme Court to eliminate the ACA’s critical health protections,” they continued. “Republicans in the U.S. Senate had the opportunity to pass legislation barring the President from advocating against the ACA in court, but they refused—choosing instead to ram through Amy Coney Barrett’s nomination and place the health care law at even greater risk.”

Despite the ACA’s success in expanding access to health care and reducing the number of uninsured Americans, Republican lawmakers have spent years working to overturn and undermine our nation’s health care law. These efforts have culminated in California v. Texas, a case led by 18 attorneys general and President Trump’s Department of Justice that calls for the courts to declare the entire ACA unconstitutional. The President is also currently working to fill the late Justice Ruth Bader Ginsburg’s Supreme Court seat with his nominee, Judge Amy Coney Barrett, in time to hear arguments in the case on November 10, 2020. Barrett’s nomination is a key component of the President’s self-stated goal to “terminate health care under Obamacare [the ACA].” If the ACA is repealed, experts estimate that over 20 million Americans and 740,000 Virginians will lose health coverage – a number that is likely higher now as a result of the COVID-19 pandemic.

In order to better understand how a Supreme Court decision to overturn ACA would affect health care coverage in the U.S. the Senators requested answers to the following questions:

  1. How many individuals would lose health coverage? Of those individuals:
    1. How many people would lose coverage that are currently enrolled in Medicaid in states that expanded Medicaid under the ACA?
    2. How many people would lose coverage that are currently enrolled in health insurance through the ACA marketplaces?
    3. How many adult children under the age of 26 who are currently covered through their parents’ plans would lose coverage?
    4. How many individuals would lose coverage that acquired coverage through the ACA during the COVID-19 pandemic?
    5. How many individuals would lose coverage that have pre-existing conditions?
    6. To the extent practicable, please provide the number of individuals, by state, that would lose health coverage disaggregated by race, ethnicity, gender, age, disability status, and income level.
    7. By how much would consumers’ health care costs, including out-of-pocket costs and premiums, increase? To the extent practicable, please provide this information disaggregated by race, ethnicity, gender, age, disability status, and income level.
    8. How many individuals currently covered through marketplace plans would lose ACA subsidies for their plans, and what would be the average amount lost per person in subsidies?
    9. How many individuals currently enrolled in Medicare Part D would likely hit the program’s prescription drug coverage gap, or the “doughnut hole,” in the first year following the ACA’s repeal? Assuming a complete reopening of the coverage gap (i.e.,100% beneficiary coinsurance, with 0% plan contribution and no manufacturer coverage gap discount program), what would be the average increase in out-of-pocket drug costs for enrollees who reach the coverage gap phase? What would be the estimated 10-yearsavings that would accumulate to drug manufacturers under a scenario where there is no coverage gap discount program?
    10. How many Medicare beneficiaries would be affected if preventive services were no longer exempt from cost-sharing requirements, what would be the effect on out-of-pocket spending if preventive services were not “free”, and how would the drop in preventive service use affect Medicare spending?
    11. What impact would the repeal have on the solvency of the hospital insurance trust fund?
    12. What is the average tax cut that households earning over $200,000 a year, over $1 million a year, and over $3 million a year, respectively, would receive?
    13. Please provide copies of any internal analyses conducted at HHS or Treasury that assess the impact of a California v. Texas decision that overturns the ACA on health care coverage. What analysis, if any, have your agencies conducted? What plans, if any, have your agencies developed to address the predicted loss of health care coverage that would accompany such a decision?

A copy of the letter is available here and below.

Dear Dr. Secretary Azar and Secretary Mnuchin: 

We write to request that the Department of Health and Human Services (HHS) and the Department of the Treasury (Treasury) provide Congress with its analysis of the impact a Supreme Court decision striking down the Affordable Care Act (ACA) in California v. Texas would have on health insurance coverage in the United States. We ask that particular attention be paid to the impact such coverage losses would have on Americans in the midst of the coronavirus disease 2019 (COVID-19) pandemic.

Passed in 2010, the ACA drastically expanded the number of Americans with health insurance. Before the ACA, over 45 million Americans were uninsured and the 133 million Americans with pre-existing conditions could be denied coverage. After the ACA’s passage, over 20 million people gained health care coverage—including roughly 12 million people who were newly enrolled due to the ACA’s expansion of the Medicaid program. People with pre-existing

conditions could no longer be denied coverage health insurers were required to expand coverage for mental health and substance use treatment; and young adults could stay on their  parents’ health coverage until age 26—making it easier for millions of Americans to access care.

Despite the ACA’s unequivocal success in reducing the number of uninsured Americans, Republican lawmakers have spent years working to overturn the law. These years of sabotage have culminated in California v. Texas, a case—led by 18 attorneys general and President Trump’s Department of Justice—that calls for the courts to declare the entire ACA unconstitutional. The Supreme Court will hear arguments in the case on November 10, 2020. The President is currently working to fill the late Justice Ruth Bader’s Supreme Court seat with his nominee, Amy Coney Barrett, in time for the November 10th arguments. Barrett’s nomination is a key component of the President’s self-stated goal to “terminate health care under Obamacare [the ACA].”

Prior to the start of the COVID-19 pandemic, analysts predicted that over 20 million Americans would lose health coverage if the ACA was overturned. That number is now likely far higher. In the first three months of the pandemic, unemployment rates rapidly outstripped those of the Great Recession, leaving roughly 30 million people unemployed by July. Today, around 28 million workers are receiving or seeking unemployment benefits, and estimates suggest that 5.4 million workers lost their health insurance as a result of the pandemic—swelling the ranks of Americans purchasing health insurance on the ACA marketplaces or getting coverage through Medicaid. Meanwhile, wealthy Americans would likely get a tax cut should the ACA be repealed: if the revenue measures included in the law, including taxes on the wealthiest households in the country, were to disappear, “the highest-income 0.1 percent…households would receive tax cuts averaging about $198,000 per year.”

In the midst of a global pandemic that has killed roughly 220,000 people in the U.S. and infected over 8 million others, the President of the United States is actively asking the Supreme Court to eliminate the ACA’s critical health protections. Republicans in the U.S. Senate had the opportunity to pass legislation barring the President from advocating against the ACA in court, but they refused—choosing instead to ram through Amy Coney Barrett’s nomination and place the health care law at even greater risk.

It is essential that policymakers understand the implications of a California v. Texas decision overturning the ACA. We therefore ask that HHS and Treasury provide us with information on how such a decision would impact health care coverage in the U.S. including any pre-existing internal analyses of such a decision. Specifically, should the Supreme Court overturn the ACA in its entirety:

1.      How many individuals would lose health coverage? Of those individuals:a.      How many people would lose coverage that are currently enrolled in Medicaid in states that expanded Medicaid under the ACA?
b.      How many people would lose coverage that are currently enrolled in health insurance through the ACA marketplaces?
c.       How many adult children under the age of 26 who are currently covered through their parents’ plans would lose coverage?
d.      How many individuals would lose coverage that acquired coverage through the ACA during the COVID-19 pandemic?
e.      How many individuals would lose coverage that have pre-existing conditions?
2.      To the extent practicable, please provide the number of individuals, by state, that would lose health coverage disaggregated by race, ethnicity, gender, age, disability status, and income level.
3.      By how much would consumers’ health care costs, including out-of-pocket costs and premiums, increase? To the extent practicable, please provide this information disaggregated by race, ethnicity, gender, age, disability status, and income level.
4.      How many individuals currently covered through marketplace plans would lose ACA subsidies for their plans, and what would be the average amount lost per person in subsidies?
5.      How many individuals currently enrolled in Medicare Part D would likely hit the program’s prescription drug coverage gap, or the “doughnut hole,” in the first year following the ACA’s repeal? Assuming a complete reopening of the coverage gap (i.e.,100% beneficiary coinsurance, with 0% plan contribution and no manufacturer coverage gap discount program), what would be the average increase in out-of-pocket drug costs for enrollees who reach the coverage gap phase? What would be the estimated 10-yearsavings that would accumulate to drug manufacturers under a scenario where there is no coverage gap discount program?
6.      How many Medicare beneficiaries would be affected if preventive services were no longer exempt from cost-sharing requirements, what would be the effect on out-of-pocket pending if preventive services were not “free”, and how would the drop in preventive service use affect Medicare spending?
7.      What impact would the repeal have on the solvency of the hospital insurance trust fund?
8.      What is the average tax cut that households earning over $200,000 a year, over $1 million a year, and over $3 million a year, respectively, would receive?
9.      Please provide copies of any internal analyses conducted at HHS or Treasury that assess the impact of a California v. Texas decision that overturns the ACA on health care coverage. What analysis, if any, have your agencies conducted? What plans, if any, have your agencies developed to address the predicted loss of health care coverage that would accompany such a decision?

Given the grave implications of this lawsuit and the pending nature of a Supreme Court decision, we ask for your attention to this urgent matter.

Sincerely,

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) applauded the signing of his legislation to expand veterans’ access to mental health services and reduce the alarming rate of veteran suicide. The bipartisan Commander John Scott Hannon Veterans Mental Health Care Improvement Act includes a number of provisions authored by Sen. Warner to empower the Department of Veterans Affairs (VA) to provide resources to and share information with veteran-serving non-profits, as well as to require it to develop a measurement tool to assess the effectiveness of mental health programs. The legislation passed through the Senate in August and was approved by the U.S. House of Representatives late last month. 

“This bill – now a law – is for every veteran throughout our nation’s history who has struggled to cope with the invisible wounds of war. The signing of this legislation today reaffirms our nation’s commitment to veterans and sends the message that every person who serves our country is deserving of the basic tools and resources needed to heal those wounds,” said Sen. Warner. “I was proud to help write this legislation and see its passage through the Senate, and today I’m proud to know that, thanks to these efforts, we’ll be providing, for the first time, this kind of direct support to veteran-serving non-profits and community networks in order to reach more veterans.”

Provisions from Sen. Warner’s IMPROVE Well-Being for Veterans Act will create a VA grant program that leverages and supports veteran-serving non-profits and other community networks in order to reduce and prevent veteran suicides. Additionally, the bipartisan bill will enhance coordination and planning of veteran mental health and suicide prevention services, and better measure the effectiveness of those programs in order to reduce the alarming number of veteran suicides and best concentrate the program’s resources on successful organizations and services.

The VA estimates that around 20 veterans die by suicide each day. Unfortunately that number has remained unchanged despite Congress more than tripling the VA’s funding for suicide prevention efforts over the last ten years to nearly $222 million in FY20. Only six of the 20 veterans who die by suicide each day receive health care services from the VA before their death. 

Sen. Warner’s IMPROVE Well-Being for Veterans Act was introduced in June 2019. Days later, at a committee hearing, VA Secretary Robert Wilkie called the bill “key” to unlocking the veteran suicide crisis. In January 2020, provisions of the Warner-Boozman legislation were included in the Commander John Scott Hannon Veterans Mental Health Care Improvement Act. The bill was unanimously approved by the Senate Veterans Affairs Committee and was then passed unanimously by both the full Senate and House. 

Sen. Warner has been a strong advocate of improving care for Virginia’s veterans. In January, he sent a letter to the four VA medical facilities providing care for Virginia’s veterans requesting an update on their suicide prevention efforts. He’s also met with senior leadership at the Hunter Holmes McGuire VA Medical Center and Hampton VA Medical Center (VAMC) to discuss wait time reduction at their facilities and suicide prevention efforts. 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) applauded an announcement from the U.S. General Services Administration (GSA) on proposed site locations for the new Southside outpatient clinic for veterans in Hampton Roads, a region hosting one of the fastest-growing veteran populations in the country. This facility is much needed in the Hampton Roads area, where enrollees are expected to increase by 44 percent over the next 20 years, and outpatient workload is expected to increase by more than 70 percent. Additionally, while the veteran population in Virginia is predicted to grow more than two percent over the next eight years, enrollees at the Hampton VA are expected to rise approximately 16 percent within the same timeframe.

“After years of advocacy and pressure, we’re finally gaining momentum on this much-needed facility that will serve thousands of Virginia veterans. For too long, excessive wait times and overburdened facilities in the region have prevented our veterans from receiving the quality health care they deserve. With today’s announcement, we’re one step closer to ensuring that the fastest growing veteran population will receive the top-notch care they have earned,” said Sen. Warner. “While I’m pleased with the progress we’ve made today, make no mistake that I’ll keep up the pressure to make sure the GSA and the VA stay on track to get this facility up and running.”

The news follows Sen. Warner’s four-year advocacy to get the new Hampton VA clinic up and running. The 215,000 square foot outpatient facility – meant to alleviate demand in the region – is the result of a successful bipartisan effort originally spearheaded by Sen. Warner in 2016to approve 28 overdue Department of Veterans Affairs (VA) medical facility leases, including another outpatient clinic Fredericksburg, Virginia. Since then, Sen. Warner has been continuing his pressure to get these facilities up and running, including by pressuring the GSA and the VA to move these projects forward, personally calling and pushing the Office of Management and Budget (OMB) Director to sign off on these clinics’ lease prospectuses, and successfully urging the Senate Committee on Environment and Public Works (EPW) to bring up the prospectuses for approval.

During his time in the Senate, Sen. Warner has long fought to reduce wait times for veterans in Hampton Roads. In 2015, confronted with wait times that were three times the national average, Sen. Warner successfully urged the VA to send down a team of experts to try 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.

Today’s GSA announcement also states that GSA is preparing an Environmental Assessment in compliance with National Environmental Policy Act (NEPA) regulations. GSA is also opening up a public comment period regarding its proposed site locations until mid-November.  

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) announced $3,910,184 in Appalachian Regional Commission (ARC) funding for communities in Southwest and Southside Virginia. The funding, awarded through ARC’s POWER (Partnerships for Opportunity and Workforce and Economic Revitalization) Initiative, will go towards addressing substance-use disorders, improving broadband connectivity, strengthening rural economies and improving local infrastructure. 

“We are thrilled that these federal dollars will go help fund some of the top priorities for communities in Southwest and Southside Virginia,” said the Senators. “As the COVID-19 crisis continues, it’s essential that we keep bolstering rural economies, ensuring internet reliability, and supporting some of the most vulnerable Virginians.”

“POWER grants are playing a critical role in supporting coal-impacted communities in the Appalachian Region as they recover from COVID-19 by building and expanding critical infrastructure and creating new economic opportunities through innovative and transformative approaches,” said ARC Federal Co-Chairman Tim Thomas. “Projects like this are getting Appalachia back to work.”

The funding will be awarded as below:

  • $1,494,000 for the New River/Mount Rogers Workforce Development Area Consortium Board in Radford, Va. to tackle the substance-use disorder problem by coordinating the healthcare sector and the economic development and workforce sector to build a recovery ecosystem.
  • $793,500 for St. Mary’s Health Wagon in Wise County, Va. to establish a substance-use disorder treatment program using medication-assisted treatment.
  • $50,000 for LENOWISCO to develop a strategic plan to establish a fiber network in a 13-county region throughout Virginia, Kentucky, and Tennessee.
  • $39,744 for the Center for Rural Development to create a Rural Leaders Institute for Southwest Virginia.
  • $32,940 for the New River Valley Regional Commission to develop a plan to boost tourism and job growth by cultivating the natural assets around the New River.
  • $1,500,000 for Henry County, Va. to make utility improvements to provide a natural gas pipeline to the Commonwealth Crossing Business Center.

ARC is an economic development agency of the federal government and 13 state governments focusing on 420 counties across the Appalachian region. Its mission is to innovate, partner, and invest to build community capacity and strengthen economic growth in Appalachia and help the region achieve socioeconomic parity with the nation. ARC’s POWER Initiative targets federal resources to help communities and regions that have been affected by job losses in coal mining, coal power plant operations, and coal-related supply chain industries due to the changing economics of America’s energy production.

 

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA), former technology entrepreneur and Vice Chairman of the Senate Intelligence Committee, today expressed grave concerns regarding the cybersecurity measures in place at one of the nation’s largest medical facility operators, which recently fell victim to an apparent ransomware attack. In a letter to United Health Services (UHS), Sen. Warner posed a series of questions for Chairman and Chief Executive Officer Alan B. Miller regarding the ransomware attack and stressed the need for UHS and other clinical providers to ensure that all information, medical, and critical systems are sufficiently protected.

“As UHS has expanded over four decades to encompass 250 medical facilities across the U.S., including twelve facilities in Virginia, effective clinical environment cybersecurity cannot be a casualty to value-based care cost savings and economies of scale. Indeed, hospital systems have frequently suggested to competition authorities that greater consolidation will allow for greater operational efficiencies; yet this does not appear to be the case when it pertains to something as vital as information security,” wrote Sen. Warner. “An increasing number of medical facilities sharing connected information systems and computer networks requires adequate protection for a significantly larger attack surface. Any failure to protect this considerable attack surface with appropriately segmented networks and data provides opportunities for lateral movement across disparate systems. An unmitigated breach in one facility can cripple systems at hundreds of medical facilities, risking patient care throughout a large provider network while healthcare delivery remains strained by a pandemic.”

“With the full resources of a Fortune 500 company receiving over $11 billion in annual revenue, UHS’s patients expect and deserve that their provider’s cybersecurity posture to be sufficiently mature and robust to prevent major interruptions to health care operations,” he continued. “While UHS’s latest annual report acknowledges that a cyber-attack that causes a security breach or loss of HIPAA protected health information could have a material impact on business, there is more than just business at stake when clinical operations are disrupted.”

In the letter, Sen. Warner noted that authorities in both countries where UHS operates – including the Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA) and the United Kingdom’s National Cyber Security Centre (NCSC) – have continued to raise alarm regarding the danger posed by advanced persistent threat groups who exploit the COVID-19 pandemic, waging attacks against healthcare providers that include password “spraying” campaigns, scanning for vulnerabilities in unpatched software, and targeting supply chains. 

Sen. Warner also posed the following series of questions in order to gain a better understanding of the situation facing UHS:

  1. Please describe the UHS vulnerability management process, including your current practices relating to patch management across your health infrastructure.
  2. How are various UHS facilities’ networks and IT systems isolated from each other to prevent a cybersecurity breach at one facility from affecting multiple facilities?
  3. Does UHS have effective segmentation measures in place within its healthcare facilities to prevent any type of malware from spreading?
  4. What policies does UHS maintain relating to third-party risk management?
  5. What are your cybersecurity and risk assessment requirements?
  6. How are clinical medical devices isolated from administrative systems and networks to ensure a breach of the administrative network does not interrupt medical devices?
  7. Who is the senior-most executive responsible for day-to-day oversight of information security and who does that executive report to?
  8. Has UHS paid any ransom or does UHS plan to any ransom?
  9. Have any patient medical records, HIPAA protected data, or healthcare information been affected or suffered a denial of access?
  10. Have any patient medical records, HIPAA protected data, or healthcare information been exfiltrated from UHS owned or operated systems without authorization? 

Sen. Warner, a former technology executive, is the co-founder and co-chair of the bipartisan Senate Cybersecurity Caucus. Throughout the COVID-19 crisis, he has fought for increased cybersecurity measures as Americans have increasingly relied on internet connectivity for remote work, health, and education purposes. Among other measures, Sen. Warner has recently advocated for increased funding to modernize federal information technology, urged internet networking device vendors to ensure the security of their products, and pressed cybersecurity officials to bolster defenses against cybersecurity attacks.  He has also introduced legislation to set strong and enforceable privacy and data security rights for health information as tech companies and public health agencies deploy contact tracing apps and digital monitoring tools to fight the spread of COVID-19. 

The letter is available here and text can be found below.

 

Mr. Alan B. Miller

Chairman and Chief Executive Officer

Universal Health Services, Inc.

367 S. Gulph Road

King of Prussia, PA  19406

Dear Mr. Miller: 

I write you with grave concerns about United Health Services’ digital medical records and clinical healthcare operations succumbing to an apparent ransomware attack. As one of the nation’s largest medical facility operators with 3.5 million patient visits a year, it is imperative that medical care is provided to all patients without any interruption or disturbance created by inadequate cybersecurity. While initial reports suggest that the attackers did not access patient or employee data, an incident such as this sharply highlights the need to ensure adequate cybersecurity hygiene in a healthcare setting. The national health crisis during the COVID-19 pandemic only exacerbates the consequences of insufficient cybersecurity. 

The need for health care providers to address cybersecurity threats has been obvious for several years now. Clinical providers including UHS must ensure all information, medical, and critical systems are sufficiently protected. Ransomware continues to impact organizations that have not demonstrated sufficient risk management maturity. The threat of ransomware to hospital systems – and the impact it has on clinical healthcare operations, patient care, and life safety – has been clear since 2016, when a series of major incidents occurred.[1] 

Although the threats are not new, authorities have continued to sound the alarm about the cyber threats to healthcare – including the heightened impact during our current public health emergency. For example, in both countries where UHS operates, the Department of Homeland Security (DHS) Cybersecurity and Infrastructure Security Agency (CISA) and the United Kingdom’s National Cyber Security Centre (NCSC) issued a joint alert on May 5, 2020[2]. This alert announced that advanced persistent threat (APT) groups are exploiting the COVID-19 pandemic as part of cyber operations against healthcare and essential services. Attacks observed against healthcare providers include password “spraying” attacks that automate attempts to use commonly used passwords, scanning for vulnerabilities in unpatched software, such as virtual private networks, and targeting supply chains. 

As UHS has expanded over four decades to encompass 250 medical facilities across the U.S., including twelve facilities in Virginia, effective clinical environment cybersecurity cannot be a casualty to value-based care cost savings and economies of scale. Indeed, hospital systems have frequently suggested to competition authorities that greater consolidation will allow for greater operational efficiencies; yet this does not appear to be the case when it pertains to something as vital as information security. An increasing number of medical facilities sharing connected information systems and computer networks requires adequate protection for a significantly larger attack surface. Any failure to protect this considerable attack surface with appropriately segmented networks and data provides opportunities for lateral movement across disparate systems. An unmitigated breach in one facility can cripple systems at hundreds of medical facilities, risking patient care throughout a large provider network while healthcare delivery remains strained by a pandemic.

With the full resources of a Fortune 500 company receiving over $11 billion in annual revenue, UHS’s patients expect and deserve that their provider’s cybersecurity posture to be sufficiently mature and robust to prevent major interruptions to health care operations. While UHS’s latest annual report acknowledges that a cyber-attack that causes a security breach or loss of HIPAA protected health information could have a material impact on business, there is more than just business at stake when clinical operations are disrupted. 

To gain a better understanding of this situation, I would appreciate answers to the following questions:

1.         Please describe the UHS vulnerability management process, including your current practices relating to patch management across your health infrastructure.

2.         How are various UHS facilities’ networks and IT systems isolated from each other to prevent a cybersecurity breach at one facility from affecting multiple facilities?

3.         Does UHS have effective segmentation measures in place within its healthcare facilities to prevent any type of malware from spreading?

4.         What policies does UHS maintain relating to third-party risk management?

5.         What are your cybersecurity and risk assessment requirements?

6.         How are clinical medical devices isolated from administrative systems and networks to ensure a breach of the administrative network does not interrupt medical devices?

7.         Who is the senior-most executive responsible for day-to-day oversight of information security and who does that executive report to?

8.         Has UHS paid any ransom or does UHS plan to any ransom?

9.         Have any patient medical records, HIPAA protected data, or healthcare information been affected or suffered a denial of access?

10.       Have any patient medical records, HIPAA protected data, or healthcare information been exfiltrated from UHS owned or operated systems without authorization?

Patients deserve to know that healthcare systems are secure, particularly as the nation faces a pandemic straining resources nationwide. When a cybersecurity failure occurs, patients need reassurance that their healthcare provider is committed to learning from and responding to this truly concerning incident, and that it is taking all appropriate steps to help ensure it cannot happen again.

Your response will be critical to this process, and I look forward to receiving that within the next two weeks. If you should have any questions or concerns, please contact my office.

Thank you for your attention to this important issue. I look forward to your response in the next two weeks.

Sincerely,

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) announced $2,901,726 in rural development funding to further distance learning and telemedicine at Ballad Health, Carilion Medical Center, Retina and Vitreous Center, P.C., and the Lee County School District in Jonesville, VA. This funding was awarded through the Distance Learning and Telemedicine grant program at U.S. Department of Agriculture (USDA) Rural Development.

“Staying connected has never been as important as it is during the COVID-19 pandemic when Virginians are increasingly reliant on broadband internet to safely access medical care and keep up with their education,” said the Senators. “That is why we are thrilled to see these grants go to boosting distance learning and telehealth services at the Mountain States Health Alliance, Carilion Medical Center, Retina and Vitreous Center, P.C. in Norfolk, and the Lee County School District.” 

The funding will be awarded as below:

  • $313,361 for Ballad Health to support a "School-Based Telemedicine Virtual Health Clinic" program to improve healthcare availability to underserved children in Lee and Smyth counties. The program improves access to acute sick care for school children and faculty and removes transportation as an obstacle to care. This rural investment will benefit approximately 46,765 residents across both Virginia and Tennessee.  
  • $752,857 for Lee County School District to implement Science Technology Engineering and Math (STEM) courses and facilitate meetups with in-the-field STEM professionals. This will also give students in alternative education programs the opportunity to attend their classes in real-time, enable teachers to access quality professional development synchronously without incurring travel and time costs, and provide students and the community access to telecounseling services such as preventative substance-abuse education. This rural investment will benefit approximately 4,590 residents.
  • $947,983 for Carilion Medical Center located in Roanoke, VA, to enable patient access to high-quality primary and specialty care services in 14 counties and six independent cities located in Southwest Virginia, Southside, Roanoke, and the Shenandoah Valley, by expanding and optimizing an existing telemedicine network. Project equipment will include telemedicine carts (for the provision of teleneurology), peripherals to facilitate patients’ physical examinations by transmitting audiovisual information to remote physicians (for use in the proposed virtual care centers), and portable examination and vital sign devices. This rural investment will benefit approximately 200,000 residents.
  • $887,525 for Retina and Vitreous Center, P.C. in Norfolk, VA, to purchase telehealth equipment required to provide diagnostic and treatment services to patients with diabetic retinopathy, macular degeneration, eye tumors, and ocular oncology, among other specialties. The system in each clinic will include live interactive videoconferencing hardware and software, a digital stethoscope, a specialized hand-held exam and diagnostics camera, and a variety of lens options. This rural investment will benefit approximately 3,762 residents. 

The USDA’s Distance Learning and Telemedicine program helps rural communities use the unique capabilities of telecommunications to connect to each other and to the world, overcoming the effects of remoteness and low population density. 

Sens. Warner and Kaine have been strong advocates for rural communities and health care access in the Commonwealth. In 2018, the Senators saw through the passage of the Opioid Crisis Response Act of 2018, which included a provision by Sen. Warner to expand telehealth services for substance abuse treatment. Earlier this year, the Senators introduced legislation to help ensure adequate home internet connectivity for K-12 students. In response to the onset of the COVID-19 crisis, Sen. Warner has also introduced comprehensive broadband infrastructure legislation to expand access to affordable high-speed internet for all Americans, as well as legislation to promote broadband in underserved areas. Last year, Sen. Warner  introduced legislation – cosponsored by Sen. Kaine – to expand telehealth services through Medicare, make it easier for patients to connect with their doctors, and help cut costs for patients and providers. Sen. Kaine also introduced legislation in 2019 to expand health care to rural areas through telehealth. The bill passed out of the Senate Health, Education, Labor, and Pensions (HELP) Committee as part of the Lower Health Care Costs Act of 2019.

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) released the following statement after President Trump announced his intent to nominate Judge Amy Coney Barrett to the Supreme Court: 

“There is so much on the line with this Supreme Court vacancy. The next justice has the opportunity to decide the future of the Affordable Care Act, and whether Americans with preexisting conditions will continue to be protected, or if millions of Americans covered by the ACA will have their health care ripped away in the middle of a pandemic. Everything from health care to reproductive rights to voting rights hangs in the balance. Given the stakes, the American people have a right to have their voices heard before the confirmation of a new justice.

“This is not a question of judicial qualifications or temperament – this is about following the standard established by Majority Leader Mitch McConnell in 2016, when he refused – over my own strong objections – to consider President Obama’s Supreme Court nominee 10 months prior to the election. That’s now the precedent. We can’t have one set of rules for Democratic presidents, and a different set of rules for Republican presidents. Our system of checks and balances, which has held strong and lasting for more than 200 years, was simply not meant to bear the brunt of such cynicism and hypocrisy. 

“Virginians are already casting their ballots. The Senate should not be considering a Supreme Court nomination before Inauguration Day.”

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WASHINGTON—Today, U.S. Sens. Mark R. Warner (D-VA), Tim Scott (R-SC), Kevin Cramer (R-ND), Kyrsten Sinema (D-AZ), Tom Cotton (R-AR), and Tina Smith (D-MN) introduced the PREVENT DIABETES Act. This legislation would increase access to the Medicare Diabetes Prevention Program (MDPP) Expanded Model by allowing CDC-recognized virtual suppliers to participate in the program.

"It’s no secret that diabetes is a disease that has disproportionately affected minority communities across the country. To ensure that all individuals have the tools needed to combat this preventable disease, the PREVENT DIABETES Act would help expand access to virtual classes under the existing Medicare Diabetes Prevention Program. This commonsense and cost-saving expansion will ensure that more Americans at-risk of developing diabetes who are living in either rural or medically underserved communities, can participate in this critical program that has been proven to delay the full onset of this preventable disease," said Sen. Warner.

"Diabetes remains the seventh leading cause of death in South Carolina and disproportionately impacts our most vulnerable communities,” said Senator Tim Scott. “The PREVENT DIABETES Act could deliver life-saving results for older Americans in the Palmetto State and across the country."

According to the Centers for Disease Control (CDC), there is a higher prevalence of diabetes within minority populations. Diabetes affects 16.4 percent of Black adults, 14.9 percent of Asian adults, and 14.7 percent of Latino adults, compared to 11.9 percent of White adults. To help combat these alarming trends, the PREVENT DIABETES Act would provide access to virtual programs under the Medicare Diabetes Prevention Program (MDPP) to help prevent or delay the onset of diabetes. The MDPP Expanded Model (EM) leverages evidence-based interventions to prevent the full onset of type 2 diabetes in at-risk Medicare beneficiaries. Unfortunately, the existing MDPP Expanded Model is only available through in-person sessions, making it more difficult for individuals in rural or medically underserved areas to participate in the program.

In October 2019, Senators Scott and Warner wrote to Department of Health and Human Services (HHS) Secretary Alex Azar urging him to expand the program by administrative action and more recently, to allow beneficiaries to access the program via a virtual platform during the COVID-19 pandemic. HHS has temporarily allowed individuals to access the program via a virtual platform during the COVID-19 pandemic, but this administrative change still excludes a number of providers and does not ensure long-term access to a virtual benefit. This legislation will improve access to the program by ensuring individuals can access the MDPP Expanded Model via virtual suppliers.

This legislation is supported by American Diabetes Association, American Medical Association, Association of Diabetes Care & Education Specialists, The Connected Health Initiative, Endocrine Society, Healthcare Leadership Council, Livongo, Noom, National Kidney Foundation, Novo Nordisk Inc., Omada Health, and YMCA of the USA.

To view the one-pager, click here.

Full text of the bill is available HERE.

WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) applauded House passage of his bipartisan bill with Sen. John Boozman (R-AR) to help address the alarming rate of veteran suicide. Provisions of the IMPROVE Well-Being for Veterans Acta bill to expand veterans’ access to mental health services, were included as part of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act to help the Department of Veterans Affairs (VA) reduce veteran suicides. In August, the Senate overwhelmingly passed the bipartisan legislation, and with today’s passage in the House of Representatives, the bill will now head to President Trump’s desk for his signature.

“Too many veterans suffering from the invisible wounds of war are left struggling when their tours of duty conclude. Though we can never repay the enormous physical and mental sacrifices that our servicemembers make for our freedom and national security, we can give them the resources and tools they need to begin the lengthy process of healing,” said Sen. Warner. “That’s why I was proud to help write this legislation to tackle the alarming rate of veteran suicide, including through providing greater support to veteran-serving non-profits and community networks in order to reach more veterans. I can think of no better way to conclude National Suicide Prevention Month than by seeing this legislation head to the President’s desk. I urge President Trump to swiftly sign this important legislation into law.”

“This new approach will allow us to reach more veterans and support organizations that have a track record of success in suicide prevention. Delivering additional resources to community-based groups providing support and services to at-risk veterans will allow them to expand their outreach, identify more veterans in need and provide great access to mental health care. I’ve been proud to join Senator Warner in leading Senate efforts to devise a strategy that empowers veteran community organizations to work with the VA in the fight against veteran suicide. I’m glad this will soon become law,” said Sen. Boozman.

The IMPROVE Well-Being for Veterans Act  would create a Department of Veterans Affairs (VA) grant program that leverages and supports veteran-serving non-profits and other community networks in order to reduce and prevent veteran suicides. Additionally, the bipartisan bill enhances coordination and planning of veteran mental health and suicide prevention services and better measures the effectiveness of those programs in order to reduce the alarming number of veteran suicides.

The VA estimates that around 20 veterans die by suicide each day. Unfortunately that number has remained unchanged despite Congress more than tripling the VA’s funding for suicide prevention efforts over the last ten years to nearly $222 million in FY20. Only six of the 20 veterans who die by suicide each day receive health care services from the VA before their death. That’s why Sens. Warner and Boozman are empowering the VA to share information with veteran-serving non-profits and requiring it to develop a tool to monitor progress so that resources can be concentrated on successful programs.

The IMPROVE Well-Being for Veterans Act was introduced in June 2019. Days later, at a committee hearing, VA Secretary Robert Wilkie called the bill “key” to unlocking the veteran suicide crisis. In January 2020, provisions of the Warner-Boozman legislation were included in the Commander John Scott Hannon Veterans Mental Health Care Improvement Act, and the bill was unanimously approved by the Senate Veterans Affairs Committee before being included as part of the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) Act. Then, in August, the Senate unanimously approved the legislation. Companion legislation was also introduced in the House of Representatives by Reps. Chrissy Houlahan (D-PA) and Jack Bergman (R-MI).

Sen. Warner has been a strong advocate of improving care for Virginia’s veterans. In January, he sent a letter to the four VA medical facilities providing care for Virginia’s veterans requesting an update on their suicide prevention efforts. He’s also met with senior leadership at the Hunter Holmes McGuire VA Medical Center and Hampton VA Medical Center (VAMC) to discuss wait time reduction at their facilities and suicide prevention efforts.

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WASHINGTON U.S. Sen. Mark R. Warner (D-VA) joined Sens. Dianne Feinstein (D-Calif.), Patrick Leahy (D-Vt.), Patty Murray (D-Wash.), Bob Casey (D-Pa.), Cory Booker (D-N.J.) and 29 senators today in calling on the Department of Homeland Security’s inspector general to expeditiously investigate a whistleblower complaint alleging forced hysterectomies at the Irwin County Detention Center (ICDC) in Ocilla, Ga.

“Forced sterilizations infringe on reproductive rights and autonomy,” the senators wrote. “To understand whether such violations may have been committed against immigrants in our federal government’s custody, the Inspector General’s Office should immediately investigate the reproductive health policies and practices at the ICDC and at other facilities, including but not limited to, all instances of forced, coerced, or medically unnecessary hysterectomies.”

 In addition to Senators Feinstein, Leahy, Murray, Casey and Booker, the letter was signed by Senators Richard Blumenthal (D-Conn.), Chris Van Hollen (D-Md.), Sheldon Whitehouse (D-R.I.), Tammy Baldwin (D-Wis.), Catherine Cortez Masto (D-Nev.), Mazie K. Hirono (D-Hawaii), Michael Bennet (D-Colo.), Maggie Hassan (D-N.H.), Amy Klobuchar (D-Minn.), Jeanne Shaheen (D-N.H.), Tom Udall (D-N.M.), Kirsten Gillibrand (D-N.Y.), Angus King (I-Maine), Tina Smith (D-Minn.), Tim Kaine (D-Va.), Tammy Duckworth (D-Ill.), Edward J. Markey (D-Mass.), Dick Durbin (D-Ill.), Sherrod Brown (D-Ohio), Bernie Sanders (D-Vt.), Elizabeth Warren (D-Mass.), Chris Coons (D-Del.), Jack Reed (D-R.I), Martin Heinrich (D-N.M.), Bob Menendez (D-N.J.), Tom Carper (D-Del.), Chris Murphy (D-Conn.) and Ron Wyden (D-Ore.).

Full text of the letter follows:

 

September 17, 2020

Hon. Joseph V. Cuffari

Inspector General

Department of Homeland Security

245 Murray Lane SW

Washington, DC 20528-0305

Dear Mr. Cuffari:

The Department of Homeland Security’s Office of the Inspector General should expeditiously conduct a thorough investigation into a whistleblower complaint alleging forced hysterectomies and other egregious abuses at the Irwin County Detention Center (ICDC) in Ocilla, Georgia. LaSalle Corrections operates that facility for the federal government, including for Immigration and Customs Enforcement (ICE). The alleged abuses detailed in the complaint and in related reports must be thoroughly and swiftly investigated to protect the rights and safety of women and patients in our nation’s care.

 The whistleblower expressed alarm about the “rate at which the hysterectomies have occurred” at the facility. Specifically, the complaint alleges that between October and December 2019 at least five women detained at the ICDC received hysterectomies. When asked about the procedures, however, the women “reacted confused when explaining why they had one done.” The complaint also describes how a gynecologist once removed the wrong ovary on a young woman, causing her “to go back to take out the left and she wound up with a total hysterectomy,” leaving her unable to bear children.

Another detained woman who received a hysterectomy recounted that medical personnel “did not properly explain to her what procedure she was going to have done.” Although she asked for more information about why she was receiving a hysterectomy, she was “given three different responses by three different individuals.” When the woman told a nurse that the procedure “isn’t for me,” the nurse “responded by getting angry and agitated.”

Forced sterilizations infringe on reproductive rights and autonomy. To understand whether such violations may have been committed against immigrants in our federal government’s custody, the Inspector General’s Office should immediately investigate the reproductive health policies and practices at the ICDC and at other ICE facilities, including but not limited to, all instances of forced, coerced, or medically unnecessary hysterectomies.

 In addition to thoroughly investigating the recent alleged abuses at the ICDC, we urge you to immediately conduct a national review of reproductive health policies and practices at ICE facilities to ensure that the human rights of women in federal immigration custody are assured.

Sincerely,

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WASHINGTON, D.C. – U.S. Sen. Mark R. Warner (D-VA) joined Sen. Tammy Baldwin (D-WI), a member of the Senate Committee on Health, Education, Labor and Pensions (HELP) and a bipartisan group of  colleagues in calling for enforcement action to address practices of pharmaceutical companies that threaten to undermine the 340B Drug Pricing Program during the COVID-19 public health emergency. 

The 340B program requires drug companies to sell discounted prescription drugs to safety net hospitals, rural health facilities, and other entities that provide care in underserved communities. Savings from the 340B program ensure that these “covered entities” are able to continue to serve their patients. However, drug manufacturers have recently announced new burdensome requirements on covered entities beyond the scope of the 340B program, or they have announced that they will no longer provide discounts for medications shipped to pharmacies that dispense drugs to patients on behalf of covered entities.

In their letter to Health and Human Services Secretary Alex Azar, the bipartisan group of Senators urge the administration to take immediate enforcement action to halt these tactics and ensure safety-net providers are able to continue providing life-saving medications to patients across the country.

The Senators write, “In the midst of the ongoing COVID-19 pandemic, where providers have seen drops in revenue and available resources, it is critically important that 340B covered entities, including federally qualified health centers (FQHCs), FQHC Look-Alikes, children’s hospitals, Ryan White HIV/AIDS clinics, and other safety-net hospitals and providers are able to continue to serve the individuals who seek out their care. As these threats to the Program progress, we fear the potential exacerbation of these shortfalls in resources for providers at a time when they are needed most.”

The bipartisan letter was also signed by Senators Rob Portman (R-OH), Debbie Stabenow (D-MI), Shelley Moore Capito (R-WV), John Thune (R-SD), Ben Cardin (D-MD), Patty Murray (D-WA), Susan Collins (R-ME), Ron Wyden (D-OR), Jerry Moran (R-KS), Jon Tester (D-MT), Mike Rounds (R-SD), Doug Jones (D-AL), Joni Ernst (R-IA), Gary Peters (D-MI), John Boozman (R-AR), Bob Casey (D-PA), Cindy Hyde-Smith (R-MS), Roger Wicker (R-MS), Angus King (I-ME), Kevin Cramer (R-ND), Chuck Schumer (D-NY), Thom Tillis (R-NC), Chris Van Hollen (D-MD), Elizabeth Warren (D-MA), Sherrod Brown (D-OH), and Kirsten Gillibrand (D-NY). 

This bipartisan effort is supported by the American Hospital Association (AHA), America’s Essential Hospitals, American Association of Medical Colleges (AAMC), 340B Health, Ascension Wisconsin, Children’s Wisconsin, Marshfield Health System, Gunderson Health System, Advocate Aurora, Rural Wisconsin Health Cooperative, and Sixteenth Street Community Health Centers in Milwaukee.

“The AHA thanks this bipartisan group of senators for their important effort to protect the 340B program, and the vulnerable communities it benefits, from big drug companies’ efforts to harm the program,” said Tom Nickels, AHA Executive Vice President. “The AHA continues to call on the Department of Health and Human Services to take action against drug companies and to protect the patients and communities the 340B program helps serve.”

“Drug manufacturers are flouting their statutory obligations by restricting access to safe, affordable medications for low-income Americans who also are among those most affected by COVID-19,” said Bruce Siegel MD, MPH, President and CEO of America’s Essential Hospitals. “We applaud the bipartisan Senate signatories, led by Sens. Baldwin, Thune, Stabenow, Portman, Cardin, and Capito, for their swift action to urge the administration to stop big pharma’s ill-timed and illegal efforts to narrow the 340B program.”

“The AAMC appreciates Senators from both sides of the aisle working together to protect the 340B program and patients,” said Karen Fisher, JD, Chief Public Policy Officer of the Association of American Medical Colleges. “Particularly in the midst of the COVID-19 pandemic, it is unwarranted that several major drug companies are attempting to undermine this important program that allows safety net hospitals, including many teaching hospitals, to provide critical health care services to vulnerable patients in communities across the country.”

“340B has a long history of bipartisan support in Congress. Drug companies must stop denying discounts on expensive outpatient drugs in violation of the 340B statute. We appreciate the efforts of these Senate leaders in making that message crystal clear,” said Maureen Testoni, President and CEO of 340B Health. 

“Wisconsin rural hospitals and communities need a strong 340B Program, now more than ever. The current program saves Medicare money and achieves the Congressional purpose to reach more eligible patients and providing more comprehensive services,” Tim Size, Executive Director of Rural Wisconsin Health Cooperative. 

“Coordinated efforts by drug manufacturers to place arbitrary limits on the number of contract pharmacies they will serve or to eliminate discounted 340B pricing will significantly impact the health of our most vulnerable patients. Some medications will not be available for uninsured patients through the sliding fee scale. And without the savings accrued from 340B pricing, health centers will no longer be able to offer affordable pharmaceuticals to low-income patients --- thereby directly jeopardizing the health of the uninsured or underinsured. We need immediate support from Congress and HRSA to stop recent actions from drug manufacturers and prevent others from following suit,” said Dr. Julie Schuller, President and CEO of Sixteenth Street Community Health Centers.

“We appreciate the Senator's continued support of safety net providers. From our Medical Mission events, providing free care in our communities, to supporting new moms through Blanket of Love in Milwaukee - the 340B Program helps us care for our communities. Ascension continues to experience substantial increases in the costs to acquire needed medication, and we applaud the bipartisan effort to urge HRSA to take enforcement action to protect the 340B Program,” said Bernie Sherry, Ministry Market Executive at Ascension Wisconsin.

 The full letter is available here and below.

 

 

Dear Secretary Azar:

We write to express our concerns regarding recent actions from pharmaceutical manufacturers that threaten to undermine the role of contract pharmacies in the 340B Drug Pricing Program. In the midst of the ongoing COVID-19 pandemic, where providers have seen drops in revenue and available resources, it is critically important that 340B covered entities, including federally qualified health centers (FQHCs), FQHC Look-Alikes, children’s hospitals, Ryan White HIV/AIDS clinics, and other safety-net hospitals and providers are able to continue to serve the individuals who seek out their care. As these threats to the Program progress, we fear the potential exacerbation of these shortfalls in resources for providers at a time when they are needed most. While we understand that the Health Resources and Services Administration (HRSA) is further investigating these actions, we urge HRSA to take immediate and appropriate enforcement action to halt these tactics and ensure safety-net providers are able to continue providing life-saving medications to patients across the country.

As you are aware, on September 1, 2020, Eli Lilly announced that the company would no longer allow 340B covered entities to receive discounts for products that are shipped to a contract pharmacy, with an exception for insulin. This follows similar actions from AstraZeneca, which announced in August that it would refuse 340B pricing to hospitals with on-site pharmacies for any drugs dispensed through contract pharmacies. Similarly, other companies have imposed additional and burdensome reporting requirements on all contract pharmacy claims.  For covered entities, and in particular rural hospitals and other rural covered entities that rely disproportionately on contract pharmacies, these changes could have long-lasting repercussions that will challenge a covered entity’s ability to support its community now during this pandemic and in the future. 

The Public Health Service Act requires that manufacturers wishing to participate in Medicaid and Medicare Part B enter into agreements with the Department of Health and Human Services (HHS) that “require that the manufacturer offer each covered entity covered outpatient drugs for purchase at or below the applicable ceiling price if such drug is made available to any other purchaser at any price.” Further, HRSA has recognized the importance of contract pharmacies by acknowledging such arrangements in current guidance. We believe these recent actions by pharmaceutical manufacturers run counter to the statute and create a dangerous and negative precedent for the 340B Program and the providers and patients it serves. 

To ensure pharmaceutical manufacturers continue to comply with the 340B statute and provide discounts to safety-net providers, we call on HRSA to take appropriate, prompt enforcement action to address violations of the Public Health Service Act. We appreciate your attention to this important issue and look forward to partnering with you and stakeholders to ensure the 340B program continues to support access to quality health services with proper oversight and transparency.  

Sincerely,

 

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WASHINGTON – Today U.S. Sen. Mark R. Warner (D-VA) joined his Senate colleagues in a letter to United States Postmaster General Louis DeJoy calling on him to immediately reverse all operational and organizational changes that have resulted in delays of critical medications to Americans.  

“The Postal Service is an essential public institution that must uphold its duty to serve every community. Your recently implemented changes pose an unacceptable threat and continue to have a devastating effect on communities that rely on consistent access to medication through the mail. We have received numerous reports from seniors about delays in receiving their prescriptions through the mail, leaving some without life-sustaining medication for days. Others have been forced to obtain emergency prescriptions from their doctors and pay out-of-pocket for medication because their original prescriptions covered by insurance never arrived,” wrote the Senators to Postmaster General Louis DeJoy.

“We call on you to immediately reverse all operational and organizational changes that have resulted in life-threatening delays of critical medications to Americans. As you noted, ‘it is imperative for the Postal Service to operate efficiently and effectively, while continuing to provide service that meets the needs of [its] customers.’ Right now, the Postal Service is failing to meet the needs of many Americans and adhere to its mission of ‘prompt, reliable, and efficient services to patrons in all areas.’ As we continue to fight this pandemic, the Postal Service is integral to keeping millions of Americans safe, especially seniors, people with chronic conditions, and people with disabilities,” continued the Senators.

In addition to Sen. Warner, the letter was led by Sens. Jacky Rosen (D-NV), Gary Peters (D-MI), Patty Murray (D-WA), Bob Casey (D-PA), Ron Wyden (D-OR), and signed by Sens. Amy Klobuchar (D-MN), Tom Carper (D-DE), Chuck Schumer (D-NY), Sherrod Brown (D-OH), Richard Blumenthal (D-CT), Tom Udall (D-NM), Elizabeth Warren (D-MA), Kirsten Gillibrand (D-NY), Patrick Leahy (D-VT), Chris Van Hollen (D-MD), Bernie Sanders (D-VT), Tammy Duckworth (D-IL), Jeanne Shaheen (D-NH),  Debbie Stabenow (D-MI), Tammy Baldwin (D-WI), Tina Smith (D-MN), Maggie Hassan (D-NH), Chris Coons (D-DE), Sheldon Whitehouse (D-RI), Cory Booker (D-NJ), Ed Markey (D-MA), Ben Cardin (D-MD), Jack Reed (D-RI), Martin Heinrich (D-NM), Mazie Hirono (D-HI), Maria Cantwell (D-WA), Dick Durbin (D-IL), Jeff Merkley (D-OR), and Kamala Harris (D-CA).

Last month, Sen. Warner fired off a letter to Postmaster General sharing concerns he’s heard directly from Virginians regarding delayed mail service following those structural and operational changes at the Postal Service. Sen. Warner also recently called on DeJoy to testify before Congress regarding service delays in Virginia. Additionally, he joined a number of Senate Democrats in raising concerns over the heightened impact of these changes to servicemembers and their families, and in pushing DeJoy and VA Secretary Robert Wilkie to correct the changes that are needlessly delaying veterans’ access to life-saving prescriptions.

In June, Sen. Warner sounded the alarm about the Administration’s efforts to undermine state work to expand mail-in voting. Following the USPS policy changes, Sen. Warner joined other Senate Democrats in an effort to urge the Postmaster General to provide answers regarding reports of recent changes to long-standing practices at USPS that would result in increased delivery times and costs for election mail, and urged him not take any further action that makes it harder and more expensive for states and election jurisdictions to mail ballots. He has since called on DeJoy to answer for service delays and urged him not to take any further action that makes it harder for states to mail ballots. In addition, Sen. Warner asked Virginia’s election registrars to ensure that all Virginians can access their right to vote.

 

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

Dear Mr. DeJoy:

In your three months as U.S. Postmaster General, you have made detrimental operational and structural changes to the U.S. Postal Service. After facing criticism from members of Congress, states, and the public as well as lawsuits from multiple state attorneys general you announced the reversal of some—but not all—of these policies.  Damage from your decisions has already been done as Americans continue to experience potentially life-threatening delays in the delivery of prescription medications. These delays will continue to disproportionately harm the same individuals who are most at risk during the COVID-19 crisis, including seniors, people with chronic conditions, and people with disabilities. 

While we hope that your recent policy reversals will curtail some of the harmful effects and delays we have seen, we continue to have grave concerns regarding widespread delays in the delivery of critical medications that millions of Americans rely upon every day. In the midst of the COVID-19 pandemic, it is now more important than ever for Americans to have safe and timely access to their medications from their homes. For years, Americans have entrusted the Postal Service to deliver essential goods—yet during this public health crisis, a number of Americans continue to await needed medications that are lost or delayed in the mail. 

The Postal Service is an essential public institution that must uphold its duty to serve every community. Your recently implemented changes pose an unacceptable threat and continue to have a devastating effect on communities that rely on consistent access to medication through the mail. We have received numerous reports from seniors about delays in receiving their prescriptions through the mail, leaving some without life-sustaining medication for days. Others have been forced to obtain emergency prescriptions from their doctors and pay out-of-pocket for medication because their original prescriptions covered by insurance never arrived. 

The National Association of Letter Carriers reported that the Postal Service delivers 1.2 billion prescription drug shipments each year – amounting to four million shipments every day, six days a week.  The Department of Veterans Affairs (VA) Mail Order Pharmacy provides prescriptions to approximately 80 percent of all veterans via mail, processing 470,000 prescriptions daily.  Despite these figures, “prescription medication can only be as effective as a patient’s ability to access it.” 

The Postal Service’s role in delivering medications to Americans has only grown during the COVID-19 crisis. When COVID-19 stay-at-home orders began in March, mail-order prescriptions reportedly increased by 21 percent from the year prior.  What was previously a routine visit to the pharmacy now places millions of Americans at an increased risk of exposure to COVID-19. The Centers for Disease Control and Prevention advises Americans to “limit in-person visits to the pharmacy” and, if possible, to use drive-thru windows, mail-order, or other delivery services to pick up medications.   As Postal Service delays cause Americans to worry when, if at all, they will receive their next supply of medication in the mail, patients across the country may be forced to seek their prescriptions in person at a pharmacy—increasing their risk of exposure to COVID-19 at a time when staying home is vital to their health and well-being.

We call on you to immediately reverse all operational and organizational changes that have resulted in life-threatening delays of critical medications to Americans. As you noted, “it is imperative for the Postal Service to operate efficiently and effectively, while continuing to provide service that meets the needs of [its] customers.”  Right now, the Postal Service is failing to meet the needs of many Americans and adhere to its mission of “prompt, reliable, and efficient services to patrons in all areas.”  As we continue to fight this pandemic, the Postal Service is integral to keeping millions of Americans safe, especially seniors, people with chronic conditions, and people with disabilities.

To that end, please provide the following information by September 21, 2020:

  1. What considerations did you give to mail-order medications before implementing the recent operational and structural changes throughout the Postal Service?
  1. What, if any, actions did you take to prevent potential delays in the delivery of mail-order medications? If you made no specific adjustments or considerations, please explain why.
  1. What steps, if any, does the Postal Service intend to take to address existing delays in the delivery of mail-ordered prescriptions that have occurred as a result of the operational and structural changes you implemented? 
  1. Please identify the operational and structural changes implemented during your tenure that you plan to reverse.
    1. Please explain how you decided which changes to reverse, as well as your rationale for each reversal.
    2. Do you plan to re-implement any of these changes after the November 2020 election? If so, what safeguards will you put in place to avoid significant mail delays and keep Americans safe?
  1. Please identify the operational and structural changes implemented during your tenure that you chose not to reverse.
    1. Please explain your justification for each decision.
    2. Please explain the consequences these changes could have for the ability of Americans to receive their medications in a timely and consistent manner through the mail, and whether the Postal Service has adopted safeguards to address these issues.  

Thank you for your attention to this important matter. 

Sincerely,

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WASHINGTON – Today, U.S. Sens. Mark Warner and Tim Kaine (both D-VA) announced $5,115,615 in federal funding through the U.S. Department of Justice’s (DOJ) Office on Violence Against Women (OVW) to reduce domestic violence, dating violence, and sexual assault in Charlottesville, Norfolk, Marion, and Richmond.  

“Community-based intervention programs are an invaluable tool in the fight against violence against women,” said the Senators. "We are pleased to announce these critical funds to support communities across the Commonwealth in their effort to end domestic violence.”

The funding was awarded as follows:

·       $340,313 for the Sexual Assault Resource Agency’s Engaging Men Program in Charlottesville, VA.

·       $369,340 for the Rural Sexual Assault, Domestic Violence, Dating Violence, and Stalking Program to YWCA South Hampton Roads in Norfolk, VA.

·       $744,326 for the Rural Sexual Assault, Domestic Violence, Dating Violence, and Stalking Program to Southwest Virginia Legal Aid Society in Marion, VA.

·       $3,661,636 for the Virginia Department of Criminal Justice Services STOP (Services, Training, Officers, Prosecutors) Violence Against Women Formula Grant Program in Richmond, VA. 

Sens. Warner and Kaine have worked to secure funding that better supports victims and survivors of domestic violence and sexual assault. In April, the senators wrote a letter to Congressional leadership requesting that any future legislation to address the ongoing coronavirus pandemic (COVID-19) provides funding to support victims and survivors, including programs authorized by the Violence Against Women Act (VAWA). In December, the Senators also joined their colleagues in introducing companion legislation to the House-passed Violence Against Women Reauthorization Act that would reauthorize VAWA through 2024.

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WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine released the following statement today before voting against moving forward on Senator McConnell’s latest attempt to pass a “skinny” COVID-19 relief bill:

“We’re not going to vote for a half-baked relief bill, pat ourselves on the back, and call it a day while families are left out in the lurch. The two of us are ready to vote for meaningful relief for small businesses and struggling families but not for something that deprives Americans of much-needed relief while nullifying Virginia protections to keep workers safe from COVID-19. It’s time for the Senate to take up a bill that offers what this one does not: paid sick leave, emergency rental assistance, adequate public school and child care support, funding for states and localities to continue critical services while so many are out of work, and other measures to help our troubled nation.”

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WASHINGTON, DC – As communities across the country grapple with how to reopen as safely as possible, U.S. Sen. Mark R. Warner joined Sens. Tom Carper (D-Del.), Bill Cassidy, M.D. (R-La.) and a bipartisan group of senators in calling on the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) to improve, automate and modernize COVID-19 data collection and management. In a letter sent to Secretary Azar and Dr. Redfield, the lawmakers specifically called on the agencies to harness technologically advanced systems and build on existing data sources in order to provide public health officials and community leaders with more accurate, real-time information as they make critical decisions about reopening.

Unfortunately, recent reports have shown that case reporting and contact tracing across the country are being hampered by a fragmented health system and antiquated technology, including manual entry of patients’ data and results and sharing of such results through paper and pencil or fax. In Texas, some patients were having to wait l0 days to find out if they had been infected with coronavirus because their results were being faxed to public health officials and then entered into a database by hand. 

In their letter, the lawmakers wrote, “During an emergency such as the current pandemic, scaling up and using existing systems to the greatest extent possible can improve data collection and contact tracing efforts. We therefore ask that you and your colleagues utilize and build on existing data sources, such as electronic health record (EHR) and laboratory information management systems (LIMS), claims databases, and other automated systems to provide government leaders, public health officials, community leaders, and others with actionable, easy-to-interpret data from a wide-ranging set of sources. Data generated by contact tracing, syndromic surveillance, and large-scale testing can help inform decisions on how to safely reopen communities and bring economies back online. Modernizing and automating data collection should augment detection, testing, and contact tracing plans, while also helping to prevent and improve the management of new outbreaks.”

The bipartisan group highlighted the fact that some of these tools are already being successfully utilized in communities across the country. They noted, “Fortunately, software-based systems providing data management for state public health entities and major testing laboratories already exist, and they are more efficient and accurate while reducing the burden of excess paperwork. For example, North Carolina and Florida have taken steps to modernize and improve patients’ Covid-19 test results and other infectious disease symptoms. In Florida, nurses can register patients for Covid testing in the field using tablet computers that are connected to a HIPAA compliant cloud. By managing the patient and order requisition information electronically, lab processing time is reduced and transcription errors are eliminated.”

Joining Sens. Warner, Carper and Cassidy in sending this letter are Sens. Michael Bennet (D-Colo.), Richard Blumenthal (D-Conn.), Bob Casey (D-Penn.), Susan Collins (R-Maine), Chris Coons (D-Del.), Tina Smith (D-Minn.), and Thom Tillis (R-N.C.).

The letter is available here

 

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WASHINGTON – Today U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) announced $4,138,947 in federal funding through the U.S. Department of Health and Human Services (HHS) to help support health centers across the Commonwealth as they continue battling the COVID-19 crisis. 

“We’re thrilled to announce that these federal dollars will go towards supporting Virginia’s health centers as they continue to provide essential care during this pandemic,” said the Senators. 

The funding for health centers was awarded as follows:

  • $280,654 for Eastern Shore Rural Health System in Accomack County, Va.
  • $353,441 for Neighborhood Health in Alexandria, Va.
  • $222,750 for Johnson Health Center in Amherst County, Va.
  • $75,905 for Bland County Medical Clinic in Bland County, Va.
  • $335,491 for Central Virginia Health Services in Buckingham County, Va.
  • $215,250 for Tri-Area Community Health in Carroll County, Va.
  • $222,750 for Portsmouth Community Health Center in Portsmouth, Va. 
  • $224,446 for St. Charles Health Council in Lee County, Va.
  • $282,459 for Rockbridge Area Free Clinic in Lexington, Va.
  • $126,094 for Loudoun Community Health Center in Loudoun County, Va.
  • $40,000 for Southern Dominion Health Systems in Lunenburg County, Va.
  • $240,953 for Martinsville Henry County Coalition for Health and Wellness in Martinsville, Va.
  • $207,750 for Free Clinic Of The New River Valley in Montgomery County, Va.
  • $220,818 for Blue Ridge Medical Center in Nelson County, Va.
  • $317,485 for Greater Prince William Community Health Center in Prince William County, Va.
  • $227,936 for Daily Planet Health Services in Richmond, Va.
  • $217,856 for Kuumba Community Health and Wellness Center in Roanoke, Va.
  • $222,750 for Southwest Virginia Community Health Systems in Smyth County, Va.
  • $104,159 for Horizon Health Services in Southampton County, Va. 

This funding was awarded through the Health Resources and Services Administration’s Health Center Program, which provides funds to community-based health care providers that provide primary care services in underserved areas. These health centers must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients.

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U.S. Sen. Mark R. Warner joined Sens. Jon Tester (D-MT), Ranking Member of the Senate Veterans’ Affairs Committee, and Gary Peters (D-MI), Ranking Member of the Senate Homeland Security and Governmental Affairs Committee, in demanding immediate action following reports of significant delays in veterans’ prescription medications through the U.S. Postal Service (USPS).

In a letter to Postmaster General Louis DeJoy and VA Secretary Robert Wilkie, Sens. Warner, Tester, and Peters and 28 Senate colleagues urged USPS to correct operational changes that are needlessly delaying veterans’ access to life-saving prescriptions.

“Veterans and the VA should be able to count on USPS for the timely delivery of essential prescription drugs,” the Senators wrote. “No veteran should have to wonder when their antidepressant or blood pressure medication may arrive – and the effects can be devastating if doses are missed.”

The Senators continued, “USPS needs to immediately cease operational changes that are causing mail delays so that veterans do not needlessly suffer from illnesses exacerbated by delayed medication deliveries. Those who gave so much to serve this country should be able to count on the nation’s Postal Service to deliver their medications in a timely manner.”

The VA fills about 80 percent of its prescriptions through their Consolidated Mail Outpatient Pharmacy (CMOP), which primarily uses the U.S. Postal Service to deliver to veterans’ homes. The VA CMOP fills almost 120 million prescriptions a year, with deliveries arriving daily to about 330,000 veterans across the country. According to the VA website, “prescriptions usually arrive within 3 to 5 days.” Reports from veterans and VA staff have said that recently these medications are sometimes taking weeks to be delivered and causing veterans to miss doses of vital medications.

Read the Senators’ full letter HERE.

 

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) introduced the Health Care Improvement Act, legislation that builds on the progress of the Affordable Care Act (ACA) to expand health care coverage, reduce costs, and protect Americans with preexisting conditions.

“Ten years ago, I was proud to vote for the Affordable Care Act. Since that time, despite relentless attacks by the Trump Administration and Republicans trying to dismantle the law, our country has made enormous strides in making health care coverage affordable, accessible, and available to more Americans,” said Sen. Warner. “But in spite of our progress, too many families are still struggling to deal with spiraling health care costs and a shortage of affordable options in their area. I’m proud to introduce this legislation to reduce health care costs for working families and increase access to care for uninsured Virginians while continuing to protect all Americans with preexisting conditions.”

The Health Care Improvement Act will reduce costs for working families by:

  • Eliminating the existing premium subsidy cliff on the ACA exchanges: The Health Care Improvement Act will ensure no individual or families pays more than 8.5 percent of their total household income for their health insurance. Currently, no family making more than 400 percent of the federal poverty line ($51,040 for an individual in 2020) is eligible for premium assistance on the ACA exchanges. This provision expands premium assistance to individuals making more than 400 percent of the federal poverty line and places a cap on insurance costs for all individuals and families on the ACA exchanges.
  • Establishing a low-cost public health care option: The Health Care Improvement Act will also require the Secretary of Health and Human Services to create a low-cost, public health care option for individuals who are eligible to enroll for health care coverage via the ACA exchanges. Establishing a public health care option will increase competition and ensure an added lower cost health care option for more American families.
  • Enacting a federal ban on surprise medical bills: Nearly 60 percent of Americans have received a surprise medical bill for services they thought would be covered by their insurance. The Health Care Improvement Act will create additional federal protections to ensure Americans no longer receive surprise medical bills.
  • Authorizing the federal government to negotiate prescription drug prices: Under existing federal law, the government is explicitly banned from negotiating with pharmaceutical companies for lower drug prices. The Health Care Improvement Act will allow the federal government to leverage its purchasing power to negotiate prices and reduce drug costs for more than 37 million seniors on Medicare.
  • Allowing insurers to offer health care coverage across state boundaries: The Health Care Improvement Act will allow insurers to offer health care coverage across state boundaries, increasing choice and competition among plans and driving down costs while maintaining quality, value and strong consumer protections.
  • Supporting state-run reinsurance programs: The Health Care Improvement Act will will create a new “State Health Insurance Affordability and Innovation Fund” to support state run reinsurance programs and additional state efforts to reduce premium costs and expand health care coverage. The non-partisan Congressional Budget Office has previously estimated such programs could reduce health care premiums by 8 percent within one year.

The Health Care Improvement Act will increase access to affordable health care coverage by:

  • Incentivizing states to expand Medicaid: If all states were to expand their Medicaid programs, the number of uninsured Americans would decrease by more than 2 million. The Health Care Improvement Act will provide additional incentive to states to expand their Medicaid program by temporarily increasing federal matching funds to states that expand their programs and reducing existing administrative payments to states that do not expand their programs. It would also provide retroactive payments to states like Virginia that were late to expand Medicaid and have not received their fair share of federal matching payments.
  • Expanding Medicaid eligibility for new moms: The Health Care Improvement Act will allow states to provide new mothers up to 12 months of postpartum Medicaid eligibility. This provision would significantly improve maternal health outcomes by ensuring mothers have access to vital health care services during the immediate months after giving birth.
  • Simplifying enrollment: There are over 7 million Americans currently eligible for cost-free Medicaid coverage, but who are not enrolled due a variety of factors including unnecessary paperwork and a confusing enrollment process. The Health Care Improvement Act will simplify Medicaid and CHIP enrollment by permanently authorizing the successful Medicaid Express Lane Eligibility program and expanding it to include adults. The Department of Health and Human Services will also be required to conduct a study and develop recommendation to allow states to further implement Medicaid and CHIP auto-enrollment for individuals eligible for cost-free coverage.
  • Increasing Medicaid funding for states with high levels of unemployment: The Health Care Improvement Act will implement a counter-cyclical Medicaid matching payment from the federal government to ensure that states with high levels of unemployment receive a higher federal matching payment to appropriately account for an increase in Medicaid enrollment. This will ensure states can maintain affordable health care coverage during economic downturns and temporary periods of high unemployment.
  • Funding rural health care providers: Under current law, rural providers are unfairly compensated at a much lower rate than urban providers, making it more difficult for Virginia providers to keep their doors open in underserved communities. The Health Care Improvement Act will create a rural floor for the Area Wage Index formula the Centers for Medicare and Medicaid use to reimburse rural providers. Fixing the Area Wage Index will boost access to affordable health care coverage in Virginia’s rural and medically underserved communities.
  • Reducing burdens on small businesses: The Health Care Improvement Act will modernize ACA employer reporting requirements to ensure that businesses can provide comprehensive health care benefits to their employees without additional administrative costs or unnecessary paperwork.

 

“The Virginia Poverty Law Center applauds Senator Warner’s introduction of comprehensive legislation on health care.  His bill addresses a wide range of critical issues for consumers in Virginia and across the country.  We strongly support his proposed improvements in ACA health plan affordability, enhanced application assistance, incentives for more states to adopt Medicaid expansion, continuity of health care for new mothers, reduction in Medicare drug prices, and consumer protections from surprise billing.  We encourage Congress to move quickly on this omnibus legislation that will help so many consumers during and after the COVID pandemic,” said Jill Hanken, Health Attorney, the Virginia Poverty Law Center.

“The Virginia Community Healthcare Association represents more than 150 health center sites, serving over 350,000 individuals across the Commonwealth with the goal of ensuring access to primary care for all Virginians,” said Rick Shinn, Director of Government Affairs for the Virginia Community Healthcare Association. “We applaud Senator Mark Warner’s Health Care Improvement Act of 2020, which advances our shared goal of expanding affordable health care coverage to more individuals and families across the Commonwealth.”

“The Arc of Northern Virginia and the Autism Society of Northern Virginia are supportive of Senator Warner's Health Care Improvement Act of 2020,” said Lucy Beadnell, Director of Advocacy of the Arc of Northern Virginia and Sharon Cummings Advocacy Chair of the Autism Society of Northern Virginia & Arc of Northern Virginia. “The proposed legislation gets at the core of some healthcare challenges for people with disabilities, particularly issues with healthcare affordability, and ensures people with pre-existing conditions are able to receive affordable care.  Many individuals with disabilities are born with pre-existing conditions and battled mightily to find appropriate care for years before the passage of the ACA and we cannot risk returning to a system where people spend their lifetimes in a battle to get basic health care.”

“The Commonwealth Institute for Fiscal Analysis supports actions to bolster the Affordable Care Act and ensure more people in Virginia can access, maintain, and utilize affordable and comprehensive health coverage. Opportunities for states to receive federal funding to pursue proven policies to lower consumer costs, such as a state reinsurance program as is currently being considered in Virginia, are critically important to the health and economic well-being of families across the Commonwealth. And increased federal funding for Medicaid during an economic downturn has proven to be crucial in responding to the health and economic crises of COVID-19 and would ensure Virginia has the resources to prioritize health care coverage for families across the state during challenging times,” said Freddy Mejia, Health Policy Analyst, the Commonwealth Institute.

“We at the American Medical Student Association (AMSA) believe that access to quality health care is a right, not a privilege, and that access to comprehensive health services must be recognized and protected as a basic human right. To that end, we support this effort to expand health care coverage in the U.S. AMSA especially supports Medicaid eligibility expansion, the simplification of enrollment procedures for Medicaid and SCHIP programs, and the expansion of federal financing. AMSA applauds Senator Warner and the Health Care Improvement Act,” Dr. Ali Bokhari, President of American Medical Student Association, said.

“As President Trump and his Republican allies try to rip coverage away from millions of Americans in the middle of a public health crisis, Senator Warner is working to make health care more accessible and affordable for the American people,” said Brad Woodhouse, Executive Director of Protect Our Care. “Senator Warner’s bill would take bold steps to reduce costs, expand coverage, and strengthen protections for people with pre-existing conditions at a time when access to affordable health care has never been more critical. Mitch McConnell and Senate Republicans should prioritize the health and well-being of Americans by working with Senator Warner to build on the success of the Affordable Care Act and abandon their disastrous lawsuit to take health care away.”

“The Association of University Centers on Disabilities (AUCD) is aware of how access challenges and high costs in our health care system disproportionally affect people with disabilities. We appreciate Senator Warner’s commitment to work closely with the disability community as he leads efforts to address plastics pollution.  AUCD supports the Health Care Improvement Act of 2020 and its commitment to address the pressing needs of reducing health care costs and protecting the rights of people with disabilities,” said Rylin Rodgers, Policy Director, the Association of University Centers on Disabilities (AUCD).

“The pandemic has exacerbated the deep, structural problems in our health care system: namely, cost is far too big of a burden and not enough people have adequate protection. We must make real reforms to health care, and Third Way applauds Senator Mark Warner for the leadership he has shown in the Health Care Improvement Act of 2020,” said Gabe Horwitz, Senior Vice President for the Economic Program at Third Way. “Among its very important provisions, this legislation would expand coverage by making enrollment in Medicaid automatic whenever a low-income uninsured patient accesses health care. As Third Way has long called for, automatic enrollment makes health care easier for people to navigate and is an important step to achieve universal coverage. The Warner legislation also builds on the Affordable Care Act and makes coverage affordable for millions of middle-class families who currently fall through gaps in the program. And it provides financial relief to states during economic downturns like the one we’re experiencing now by increasing the federal share of Medicaid payments to the states. Americans need far more security and stability in their health care, and we are excited about the vision shown in Senator Warner’s bill.”

Bill text is available here. A section-by-section explainer on the bill is available here.

Sen. Warner has been a longtime champion of access to health care, and has been an outspoken opponent of the Trump Administration’s efforts to overturn the Affordable Care Act in court. Last year, Sen. Warner led the entire Senate Democratic Caucus in a legislative maneuver to protect health coverage  for Americans with preexisting conditions from the Trump Administration’s attempts to undermine those safeguards. Amid the coronavirus health crisis, Sen. Warner has been a fierce advocate in demanding that the Trump Administration stop its health care sabotage that has undermined our preparedness for and ability to respond to COVID-19. Recently, Sen. Warner penned an op-ed sounding the alarm of the devastating effects the health and economic crisis caused by COVID-19 has had on record high uninsured rates across the country. 

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WASHINGTON – U.S. Sens. Mark R. Warner (D-VA) and Tim Scott (R-SC) introduced legislation to encourage Americans to seek preventive care in order to avoid an increase in more serious health conditions down the line. The Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act would authorize a public awareness campaign to educate the public on the importance of resuming routine procedures and screenings – something Americans were discouraged from doing for a period of time during the COVID-19 outbreak.

“Preventive health care and screenings can significantly reduce serious medical emergencies and improve long-term health outcomes,” said Sen. Warner. “In the initial days of the COVID-19 pandemic, health providers rightly encouraged patients to avoid non-essential care, but now we have to make sure the American public is aware of the importance of getting their regular health check-ups.”

“The COVID-19 pandemic has triggered a troubling decline in vital screenings and immunizations, undermining efforts to ensure prevention, early diagnosis, and effective treatment for dangerous diseases,” said Sen. Scott. “Drops in immunization and screening rates are particularly problematic for some of our most vulnerable populations, including our seniors. This bipartisan legislation would encourage Americans to safely and responsibly seek out the preventive care they need.”

During the initial phase of the COVID-19 pandemic, Americans were discouraged from seeking non-emergency care in order to prevent the spread of the virus and free up needed capacity at overwhelmed hospitals that were struggling to administer life-saving care to individuals with COVID-19. During this time, many states put executive orders in place to suspend elective procedures, and health care providers all across the country worked to limit face-to-face interactions, restricting office appointments to emergency needs. As a result of these necessary measures, there has been a significant decrease in routine health visits that normally play a crucial role in detecting a number of conditions and diseases that can be effectively treated when caught early.

Reuters has reported that diagnostic panels and cancer screenings fell by 68 percent nationally, with even more dramatic drops in COVID-19 hot spots. Additionally, the Epic Health Research Network estimates that over the span of three months, between March 15 and June 16, Americans missed about 65 percent of breast, colon, and cervical exams, which are essential in detecting cancer. There has also been an alarming decrease in childhood vaccination rates, which experts worry could trigger an epidemic of other infectious but vaccine-preventable diseases. The Centers for Disease Control and Prevention (CDC) estimates that the health care system could save over 100,000 additional lives per year if every person received recommended preventative care.

According to the CDC, preventative care is also essential in reducing health care costs. In fact, estimates show that avoidable chronic diseases account for more than 75 percent of the nation’s health care spending.

With many Americans still reluctant to seek non-emergency care, the GET CARE Act would authorize a public awareness campaign in order to bring attention to the importance of resuming preventive. Specifically, this legislation would direct the CDC to make competitive grants available to public or private entities in order to carry out a national, evidence-based campaign.

This campaign would:

  • Increase awareness of the importance of recommended preventive care services for the prevention of and control of diseases, illness and other medical conditions during and after the COVID-19 pandemic;
  • Combat misinformation about seeking preventive care during the pandemic;
  • Disseminate scientific, evidence-based preventive care-related information to increase the utilization of preventive care services; and
  • Ensure the public awareness campaign is appropriately tailored to medically underserved communities, racial and ethnic minorities, and communities disproportionately impacted by the COVID-19 pandemic;

This legislation has the support of a number of organizations, including American College of Preventive Medicine, American Public Health Association, American Hospital Association, Virginia Hospital and Healthcare Association and Ballad Health System.

“We thank Senators Warner and Scott for introducing the GET CARE Act, which will help to educate the public about the importance of prevention and preventive care. This is especially important for individuals living with, or at risk of getting, preventable chronic diseases, which may place them at increased risk for serious health complications due to COVID-19,” said Georges C. Benjamin, MD, Executive Director, American Public Health Association.

“The American College of Preventive Medicine strongly advocates for this initiative to support prevention as the cornerstone of our health care system. Increased adoption of preventive services will reduce the burden of disease, especially in communities facing racial, demographic, and economic disparities in care and worsening health outcomes, and make our health system more sustainable and equitable. The power of prevention is to better prepare individuals, communities, and the nation for health crises of all types by building resilience through better health,” said Stephanie Zaza, MD, MPH, President, the American College of Preventive Medicine. 

“Prevention has the power to save lives, create healthier communities, and transform our healthcare system. Increased use of preventive services makes health care systems and communities more resilient and better prepared to fight disease. It is of critical importance that we balance efforts to control the COVID-19 pandemic with innovative and safe approaches to continuing essential preventive services, such as childhood vaccination and flu vaccination,” said Donna Grande, MGA, CEO, the American College of Preventive Medicine.

“During the initial months of the COVID-19 pandemic, health care facilities across the Commonwealth voluntarily postponed non-emergency scheduled procedures to free up additional treatment capacity to accommodate incoming patients and to preserve personal protective equipment as part of the strategy to fight this deadly virus,” said Sean T. Connaughton, President and CEO, Virginia Hospital & Healthcare Association. “Taking these necessary, proactive steps meant that many Virginians had to forgo care for conditions including cancer and cardiac care and preventive screenings and treatment services such as vaccinations, mammograms, and colonoscopies. While many hospitals and health care facilities resumed scheduled procedures in early May, data indicates that many patients are avoiding or delaying care, perhaps due to fears associated with COVID-19. The GET CARE Act of 2020 is important legislation that will help spread the word that health care facilities are open and ready to safely care for patients. It’s important that all Virginians who need care, whether for a routine check-up, a vaccination, or care for a serious medical condition, get the care they need without delay.”

“Our entire team applauds Sen. Mark Warner and Sen. Tim Scott for proposing bipartisan support for America’s health systems and hospitals as we strive to save lives and serve our communities,” said Alan Levine, Chairman and CEO, Ballad Health. “The Get Care Act would create a public awareness campaign underscoring the importance of preventative health screenings and seeking routine medical care.   Among other things, this bill provides important resources and templates to help hospitals and health systems initiate and sustain public service communications efforts.  This effort follows a similar initiative provided by Ballad Health, in which resources were provided by Ballad Health for free to any rural, not-for-profit health system for use in their communities. This effort by the Senators brings scale to something desperately needed. Right now, many Americans are forgoing not only preventative health screenings but even treatment of acute health conditions because of concern about the COVID-19 pandemic. Ballad Health has witnessed this trend firsthand, as our hospital and outpatient volumes have decreased by as much as 70% during the past several months. Like other healthcare providers, we are concerned about the long-term impacts for patients who are not seeking the routine care they need. Healthcare providers everywhere have established detailed and deliberate safeguards to protect their patients during the pandemic, and this bill would help reassure patients that it is safe to seek both routine and emergency care. I congratulate the Senators for this important bipartisan effort.”

“Inova has made significant investments in technology and procedures to ensure patients feel and are safe managing their health, whether they seek care in person or through telehealth,” said J. Stephen Jones, MD, FACS, President & CEO of Inova Health System. “I thank Senator Warner for championing this timely and proactive initiative encouraging all Americans to make their preventative health a priority.”     

A summary of this bill is available here. Bill text can be found here.  

 

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WASHINGTON – U.S. Sens. Mark R. Warner (D-VA) and Cory Booker (D-NJ) introduced legislation to reduce prescription drug costs for children, while bringing in savings for states. The Fair Drug Prices for Kids Act would give states the ability to purchase prescription drugs at the lowest price possible, lowering the cost of prescription drugs for children and saving state dollars.

“This commonsense legislation will improve health care for our nation’s children by allowing states that have standalone Children’s Health Insurance Programs get the same prescription drug discounts as traditional State Medicaid programs,” said Sen. Warner. “There’s no reason we should pay more for the drugs our kids depend on. This bill will fix that and improve care for the more than four million children nationally enrolled in a standalone CHIP program.”

“Health care – including access to affordable prescriptions drugs – is a fundamental right, but skyrocketing prescription drug prices drive up costs and threaten to limit access to coverage and care, including for our nation’s children,” said Sen. Booker. “Our bill will make important changes to bring down prescription drug costs for standalone CHIP programs, therefore strengthening these programs for the families who rely on them.”

The Children’s Health Insurance Program (CHIP) provides low-cost health coverage to low-income children who would otherwise be uninsured. Currently, states can either have a standalone CHIP that is separate from Medicaid, or they can expand Medicaid eligibility to achieve the same goal of providing health insurance to low-income children. States can also have a combination CHIP, where they receive federal funding to implement both, a Medicaid expansion program and a separate CHIP.

However, states that have a standalone CHIP are not allowed to participate in the Medicaid Drug Rebate program (MDRP), which allows state Medicaid programs to purchase products from drug manufacturers at “Medicaid best price” – the lowest price offered to any other commercial payer. This means that these states are forced to pay higher prices for the same prescription drugs, which can result in higher costs for families and reduced access to medicines and other forms of needed care.  

The CHIPS for Kids Act would give states the option of purchasing prescription drugs for their standalone CHIP through the Medicaid Drug Rebate Program. This would generate immediate savings for individual CHIP programs and the federal government, opening the door for states to use those excess dollars to ensure additional families and children have access to essential medical care and prescription drugs.

This legislation has the support of Patients for Affordable Drugs Now as well as Little Lobbyists.

“States and families across the country are suffering from the high prices of prescription drugs. Medicaid and CHIP make it possible for some families to get the medication they need to live,” said Sarah Kaminer Bourland, Legislative Director, Patients For Affordable Drugs Now. “The Fair Drug Prices for Kids Act will extend basic drug pricing provisions so all CHIP programs get the medication patients need at the lowest possible price. We are grateful to Senators Warner and Booker for introducing this important legislation.”

“All children have a right to the health care they need to survive and thrive. The Fair Drug Prices for Kids Act offers the 4.1 million children covered under separate CHIP programs more affordable access to the medications they need. Additionally, it frees up CHIP funds so that this critical program can be expanded to cover all families who are struggling to afford their children's health care. Little Lobbyists is proud to support the swift passage of the Fair Drug Prices for Kids Act,” said Erin Gabriel, Director of Advocacy, Little Lobbyists.

A one-page summary of the bill is available here, and bill text can be found here.

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WASHINGTON – Today, the Senate unanimously approved a bipartisan bill introduced by U.S. Sens. Mark R. Warner (D-VA) and John Boozman (R-AR) to help address the alarming rate of veteran suicide. Provisions of the IMPROVE Well-Being for Veterans Act, a bill to expand veterans’ access to mental health services, were included as part of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act to help the Department of Veterans Affairs (VA) reduce veteran suicides.

“Today, Congress came together in a bipartisan fashion to make sure our veterans receive the tools and resources they need to heal from the invisible wounds of war. Right now, too many veterans still die by suicide long after having completed their tours of duty. This important legislation will help tackle the alarming rate of veteran suicide by ensuring our military heroes have the support they need after faithfully serving our country. It’s my hope that the President quickly signs this critical life-saving bill into law,” said Sen. Warner.

“We can’t take our focus off the veteran suicide crisis even with all that is going on in the world right now. In recent years, Congress has increased funding to reach at-risk veterans, yet the number who commit suicide each day has remained largely unchanged. It’s clear a new strategy is necessary and the approach that Senator Warner and I have proposed in this bill is a key part of that. Coordinating and sharing information between the VA and veteran-serving organizations that have the common goal to save lives will have a positive impact,” said Sen. Boozman.

The IMPROVE Well-Being for Veterans Act creates a new grant program to enable the VA to conduct additional outreach through veteran-serving non-profits in addition to state and local organizations. Additionally, the bipartisan bill enhances coordination and planning of veteran mental health and suicide prevention services and better measures the effectiveness of those programs in order to reduce the alarming number of veteran suicides.

The VA estimates that around 20 veterans die by suicide each day. Unfortunately that number has remained unchanged despite Congress more than tripling the VA’s funding for suicide prevention efforts over the last ten years to nearly $222 million in FY20.

Only six of the 20 veterans who die by suicide each day receive healthcare services from the VA before their death. That’s why Sens. Warner and Boozman are empowering the VA to share information with veteran-serving non-profits and requiring it to develop a tool to monitor progress so that resources can be concentrated on successful programs.

The IMPROVE Well-Being for Veterans Act was introduced in June 2019. Days later, at a committee hearing, VA Secretary Robert Wilkie called the bill “key” to unlocking the veteran suicide crisis. In January, provisions of the Warner-Boozman legislation were included in the Commander John Scott Hannon Veterans Mental Health Care Improvement Act, and the bill was unanimously approved by the Senate Veterans Affairs Committee. Additionally, the IMPROVE Well-being for Veterans Act was included as part of the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) Act, which was unveiled last month.

Sen. Warner has been a strong advocate of improving care for Virginia’s veterans. In January, he  sent a letter to the four VA medical facilities providing care for Virginia’s veterans requesting an update on their suicide prevention efforts. He’s also recently met with senior leadership at the Hunter Holmes McGuire VA Medical Center and Hampton VA Medical Center (VAMC) to discuss wait time reduction at their facilities and suicide prevention efforts.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) took to the Senate floor to request immediate passage of the States Achieve Medicaid Expansion (SAME) Act to allow states – including Virginia – to further benefit from expanding Medicaid, and to further incentivize states who have not yet expanded to do so. Immediately after Sen. Warner requested to pass the SAME Act by unanimous consent, Senate Republican objected and thereby blocked the immediate passage of this crucial legislation, which would have brought in additional federal Medicaid dollars for states during the greatest public health crisis in generations.

Sen. Warner’s request comes as the nation surpasses four million COVID-19 cases and Americans find themselves increasingly without health care after having lost their jobs and their employment-connected benefits.

“I can think of no better time to pass this legislation than right now, when more than 5 million Americans find themselves having lost their health care coverage in the last three months alone. In fact, some reports actually estimate that nearly 27 million Americans have lost their employer-sponsored health insurance and are now in jeopardy of becoming uninsured,” Sen. Warner said on the Senate floor. “Estimates show that if every state were to expand its Medicaid program, about 3 million additional Americans would have health care coverage. This is not a political argument nor a philosophical exercise – this legislation has a real-world impact and it’s clear that Americans want and need this legislation to pass.”

He continued, “Across our nation, Americans are making clear they want expanded access to health coverage – and Congress needs to listen. With all due respect to my Republican colleagues, you can’t say you want to help Americans in this devastating time and simultaneously oppose this bill, which would do just that. As we stand here in this chamber, we have the privilege of knowing that we and our families have access to the health care coverage we need. That if anything were to go wrong, we would be covered. So why shouldn’t we ensure that same access for more Americans?” 

The SAME Act would allow states like Virginia that expanded Medicaid after 2014 to receive the same full federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. Under this legislation, the 14 states that have not expanded Medicaid would also be eligible for increased federal funds once they choose to expand the program. 

The Affordable Care Act provides financial support to states that have expanded their existing Medicaid programs to provide healthcare coverage to all individuals up to 138 percent of the federal poverty level. The federal government covers the full cost of expansion for three years, phasing down to a 90 percent match rate for the sixth year of the expansion and in subsequent years. Currently, states choosing to expand coverage after 2014 do not receive the same federal matching rates as those that expanded immediately. This is due to the Supreme Court’s holding in National Federation of Independent Business (NFIB) v. Sebelius, which made expansion optional for states, despite intentions to make Medicaid expansion national in 2014. The SAME Act would ensure that any states that expand Medicaid receive an equal level of federal funding for the expansion, regardless of when they chose to expand.

In his remarks, Sen. Warner noted the $14,000 median cost of a COVID-19-related hospitalization and stressed this cost could mean bankruptcy for the 30 million Americans without health insurance.  

“I know my colleagues on the other side of the aisle want to do right by their constituents and the millions of Americans that need help. So today, I ask you to come together to support the SAME Act,” stressed Sen. Warner. “No one should go bankrupt because they got sick and sought medical care. But more importantly, no one should go bankrupt when this legislative body has the opportunity to act. Let’s do the right thing here – put politics aside and pass this commonsense legislation.”

 

Sen. Warner’s floor remarks as originally prepared for delivery are available below:

Madam President, I rise today to talk about an issue that is weighing on too many American families right now, and that’s access to health care coverage. 

We’re in the midst of the greatest public health crisis in generations. And this unprecedented time calls for equally unprecedented action from this Congress.  

Today, I come to the floor to pass legislation I introduced along with Senator Doug Jones and several of our colleagues – legislation that could provide access to quality and affordable health care coverage for millions of Americans.

To be clear, the SAME Act is the bill I’ve been pushing for more than three years. This bill was a good idea before this pandemic, but the need for it has become even greater in light of the COVID-19 outbreak.

The SAME Act would ensure that states like Virginia – that have expanded their Medicaid programs to serve more Americans – can get their fair share of federal matching dollars. It would also incentivize additional states – who haven’t yet expanded Medicaid – to expand this critical program to millions more Americans. 

I can think of no better time to pass this legislation than right now, when more than 5 million Americans find themselves having lost their health care coverage in the last three months alone.

In fact, some reports actually estimate that nearly 27 million Americans have lost their employer-sponsored health insurance and are now in jeopardy of becoming uninsured.

My legislation would provide much-needed financial support to states that are seeing an increase in Medicaid enrollment, as folks face the fallout of this crisis. And for those millions of people, the SAME Act would provide a significant lifeline.

Estimates show that if every state were to expand its Medicaid program, about 3 million additional Americans would have health care coverage.

This is not a political argument nor a philosophical exercise – this legislation has a real-world impact and it’s clear that Americans want and need this legislation to pass. 

Take Oklahoma, for example. Just a few weeks ago, Oklahomans voted to expand their Medicaid program to provide broader access to coverage. We have seen similar actions from citizens in Utah, Maine, Idaho, and others. 

Across our nation – Americans are making clear they want expanded access to health coverage – and Congress needs to listen.

With all due respect to my Republican colleagues, you can’t say you want to help Americans in this devastating time and simultaneously oppose this bill, which would do just that.  

As we stand here in this chamber, we have the privilege of knowing that we and our families have access to the health care coverage we need. That if anything were to go wrong, we would be covered. So why shouldn’t we ensure that same access for more Americans? 

The median cost of a hospitalization due to COVID-19 is $14,000. For Americans without health insurance – the nearly 30 million and growing – that could mean losing their house or their car… It could mean bankruptcy. 

I know my colleagues on the other side of the aisle want to do right by their constituents and the millions of Americans that need help. So today, I ask you to come together to support the SAME Act.

No one should go bankrupt because they got sick and sought medical care. But more importantly, no one should go bankrupt when this legislative body has the opportunity to act.  

Let’s do the right thing here – put politics aside and pass this commonsense legislation. Thank you. 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) and Sen. Richard Blumenthal (D-CT), along with Sens. Michael Bennet (D-CO), Mazie Hirono (D-HI), Angus King (I-ME), Bob Menendez (D-NJ), Kamala Harris (D-CA), Ed Markey (D-MA), Cory Booker (D-NJ), Tammy Baldwin (D-WI), Elizabeth Warren (D-MA), Amy Klobuchar (D-MN), and Dick Durbin (D-IL), sent a letter to Senate leaders urging them to include the Public Health Emergency Privacy Act in the next coronavirus relief package as negotiations between Senate Republicans and Democrats are underway. Inclusion of the legislation will help strengthen the public’s trust to participate in critical screening and contact tracing efforts to aid in the fight against COVID-19.

“As you begin negotiations on another coronavirus stimulus package, we write to urge inclusion of commonsense privacy protections for COVID health data. Building public trust in COVID screening tools will be essential to ensuring meaningful participation in such efforts. With research consistently showing that Americans are reluctant to adopt COVID screening and tracing apps due to privacy concerns, the lack of health privacy protections could significantly undermine efforts to contain this virus and begin to safely re-open – particularly with many screening tools requiring a critical mass in order to provide meaningful benefits,” the Senators wrote in a letter to Senate Majority Leader Mitch McConnell, Senate Minority Leader Chuck Schumer, and the Chairman and Ranking Member of the Senate Committee on Health, Education, and Labor.

According to a recent survey, 84 percent of Americans feel uneasy about sharing their personal health information for COVID-19 related mitigation efforts. Public reluctance can be attributed to a myriad of investigative reports and congressional hearings that have exposed widespread secondary use of Americans data over the years. The Senators noted that with the inclusion of their bill, Congress can establish commonsense targeted rules to ensure the collection, retention, and use of data by COVID screening tools are focused on combatting COVID and not for extraneous, invasive, or discriminatory purposes.

“Our urgent and forceful response to COVID-19 can coexist with protecting and even bolstering our health privacy. If not appropriately addressed, these issues could lead to a breakdown in public trust that could ultimately thwart successful public health surveillance initiatives. Privacy experts, patient advocates, civil rights leaders, and public interest organizations have resoundingly called for strong privacy protections to govern technological measures offered in response to the COVID-19 crisis. In the absence of a federal privacy framework, experts and enforcers – including the Director of the Bureau of Consumer Protection of Federal Trade Commission – have encouraged targeted rules on this sensitive health data. The Public Health Emergency Privacy Act meets the needs raised by privacy and public health communities, and has been resoundingly endorsed by experts and civil society groups,” the Senators continued.

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

 

Dear Leader McConnell, Leader Schumer, Chairman Alexander, and Ranking Member Murray,

As you begin negotiations on another coronavirus stimulus package, we write to urge inclusion of commonsense privacy protections for COVID health data. Building public trust in COVID screening tools will be essential to ensuring meaningful participation in such efforts. With research consistently showing that Americans are reluctant to adopt COVID screening and tracing apps due to privacy concerns, the lack of health privacy protections could significantly undermine efforts to contain this virus and begin to safely re-open – particularly with many screening tools requiring a critical mass in order to provide meaningful benefits. According to one survey, 84% of Americans “fear that data collection efforts aimed at helping to contain the coronavirus cost too much in the way of privacy.”

Public health experts have consistently pointed to health screening and contact tracing as essential elements of a comprehensive strategy to contain and eradicate COVID. Since the onset of the pandemic, employers, public venue operators, and consumer service providers have introduced a range tools and resources to engage in symptom monitoring, contact tracing, exposure notification, temperature checks, and location tracking. Increasingly, we have seen higher education institutions mandate the use of these applications for incoming students and employers mandate participation in these programs among employees.

Health data is among the most sensitive data imaginable and even before this public health emergency, there has been increasing bipartisan concern with gaps in our nation’s health privacy laws. While a comprehensive update of health privacy protections is unrealistic at this time, targeted reforms to protect health data – particularly with clear evidence that a lack of privacy protections has inhibited public participation in screening activities – is both appropriate and necessary.

Our legislation does not prohibit or otherwise prevent employers, service providers, or any other entity from introducing COVID screening tools. Rather, it provides commonsense and widely understood rules related to the collection, retention, and usage of that information – most notably, stipulating that sensitive data collected under the auspices of efforts to contain COVID should not be used for unrelated purposes. As a litany of investigative reports, Congressional hearings, and studies have increasingly demonstrated, the widespread secondary use of Americans’ data – including sensitive health and geolocation data – has become a significant public concern. The legislation also ensures that Americans cannot be discriminated against on the basis of COVID health data – something particularly important given the disproportionate impact of this pandemic on communities of color.

Efforts by public health agencies to combat COVID-19, such as manual contract tracing, health screenings, interviews, and case investigations, are not restricted by our bill. And the legislation would allow for the collection, use, and sharing of data for public health research purposes and makes clear that it does not restrict use of health information for public health or other scientific research associated with a public health emergency.

Our urgent and forceful response to COVID-19 can coexist with protecting and even bolstering our health privacy. If not appropriately addressed, these issues could lead to a breakdown in public trust that could ultimately thwart successful public health surveillance initiatives. Privacy experts, patient advocates, civil rights leaders, and public interest organizations have resoundingly called for strong privacy protections to govern technological measures offered in response to the COVID-19 crisis. In the absence of a federal privacy framework, experts and enforcers – including the Director of the Bureau of Consumer Protection of Federal Trade Commission – have encouraged targeted rules on this sensitive health data. The Public Health Emergency Privacy Act meets the needs raised by privacy and public health communities, and has been resoundingly endorsed by experts and civil society groups.

Providing Americans with assurance that their sensitive health data will not be misused will give Americans more confidence to participate in COVID screening efforts, strengthening our common mission in containing and eradicating COVID-19. For this reason, we urge you to include the privacy protections contained in the Public Health Emergency Privacy Act in any forthcoming stimulus package.

Thank you for your attention to this important matter.                                                                       

Sincerely,

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WASHINGTON – U.S. Senators Mark Warner (D–Va.) and Tim Scott (R–S.C.) introduced the Long-Term Care (LTC) Pharmacy Definition Act of 2020. This bipartisan legislation, if passed, will ensure seniors requiring long-term care have access to the medication and treatments they need. This bill would also codify an adaptable definition for “long-term care pharmacy” to enhance clarity and consistency across diverse programs and agencies. Without adding new costs to the healthcare system, a clear federal definition for LTC pharmacy would provide policymakers and regulators with the tools needed to facilitate the unique supports that these pharmacies offer, within both current models and the innovative models of the future.  

 "Long-term care pharmacies are essential to providing quality care to millions of our nation’s seniors. Unfortunately, under existing rules, they are regulated in the same way as more traditional retail pharmacies, which has created unnecessary bureaucracy around providing life-saving medication and services for a vulnerable population," said Sen. Warner. “That’s why we’re introducing legislation that will create a distinct definition for long-term care pharmacies to better reflect the specialized care they provide for the senior population they serve."

"This commonsense legislation would ensure clarity and consistency for our long-term care pharmacies without adding costs to our healthcare system," said Sen. Scott. “I urge my colleagues to support this bipartisan bill, which will make it easier for this important sector to navigate regulatory confusion and allow them to care and provide for our nation’s seniors."

Congressmen Markwayne Mullin (R-OK) and Kurt Schrader (R-OR) introduced companion legislation in the House of Representatives.

"Long Term Care Pharmacies provide critical services for seniors, who often require multiple prescriptions to maintain their health. Because there is no statuary definition for LTC Pharmacies, they must negotiate a patchwork of vague, inconsistent provisions, which could disrupt services and impact care for seniors. This commonsense legislation will help agencies give more consistent regulatory direction as well as streamline services to residents,” said Rep. Mullin.

"The personal services that long term care pharmacies provide seniors, many who take upwards of 10 medications per day, are critical for the health and wellness of millions of Americans,” said Rep. Schrader. "COVID-19 has had a disproportionate effect on this vulnerable population and now more than ever a consistent regulatory framework that defines long term care pharmacies is crucial. This bipartisan legislation will offer greater governmental oversight and create regulatory consistency across multiple federal agencies."

"Now more than ever, as the nation’s LTC community copes with the unprecedented impact of COVID-19, establishing a clear and consistent regulatory framework for LTC pharmacies is essential,” said Alan G. Rosenbloom, President and CEO of the Senior Care Pharmacy Coalition. “We commend Senators Scott and Warner as well as Congressmen Schrader and Mullin for recognizing the unique value proposition LTC pharmacies offer seniors in nursing homes and other LTC facilities by introducing this much-needed legislation. The patient care services LTC pharmacies provide, including the 12 prescriptions per day per person on average, are crucial to the health and safety of our most vulnerable citizens."

Full text of the bill is available here.

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WASHINGTON, D.C. – U.S. Sen. Mark R. Warner (D-Va.) joined Sens. Bob Menendez (D-N.J.), Ben Cardin (D-Md.) and group of Senate colleagues in introducing the COVID-19 Health Disparities Action Act to address the disproportionate impact of COVID-19 on communities of color. The bill would require  targeted testing, contract tracing, public awareness campaigns and outreach efforts specifically directed at racial and ethnic minority communities and other populations that have been made vulnerable to the COVID-19 pandemic.

“COVID-19 has had a particularly devastating impact on racial minorities across America,” said Sen. Menendez. “The fact is black and brown Americans suffer higher rates of chronic disease, inequitable access to health care, fewer economic opportunities, and in some cases real language barriers. Add to that the lack of testing, tracing and education efforts by the Trump Administration targeting communities of color during this pandemic and the impact is deadly. The COVID-19 Health Disparities Action Act would create a much needed plan of action specifically designed to address this issue at the federal, state and local levels.”

“COVID-19 has disproportionately impacted communities of color and the Trump administration’s response has failed to address the needs of these vulnerable populations,” said Sen. Cardin. “Health disparities for people of color is rooted in systemic racism, racial discrimination, and record-high levels of income inequality. The COVID-19 Health Disparities Action Act will ensure that future public health response efforts, including testing, contact tracing, and potential vaccine distributions are tailored for diverse communities. Our bill will help racial and ethnic minorities in the ongoing fight against this pandemic, and will help inform future reform efforts to reverse long-standing systemic racism in medical research, testing and delivery of care.”

According to the COVID Racial Data Tracker, the pandemic has a disproportionate impact on communities of color. Nationwide, African Americans are dying from COVID-19 at approximately 2.5 times the rate of white people. American Indian, Alaska Native, Hispanic, and Asian American communities are also facing disproportionate rates of COVID-19.

In New Jersey, 21.3 percent of COVID-19 deaths involve African Americans, although they make up just 14 percent of the state’s population. Hispanics account for 25.7 percent of COVID-19 cases despite making up 20.6 percent of the state’s population.

In Maryland, 40.6 percent of COVID-19 deaths involve African Americans, although they make up 30 percent of the state’s population. Hispanics account 25.9 percent of COVID-19 cases despite making up just 10 percent of the state’s population.

The bill is supported by Families USA, the National Hispanic Medical Association (NHMA), the National Alliance against Disparities in Patient Health (NADPH) the Friends of the National Institute on Minority Health and Health Disparities (NIMHD), the National Council of Urban Indian Health (NCUIH) and UnidosUS.

“Families USA thanks Senator Menendez and Senator Cardin for their leadership at such a critical time in our country and for championing health equity. The COVID-19 Health Disparities Action Act of 2020 centers the needs of historically marginalized communities who have been disproportionately impacted by COVID-19,” said Amber A. Hewitt, Ph.D., Director of Health Equity, Families USA. “This bill addresses the need for complete and accurate data collection on COVID-19 health outcomes, to better inform and tailor testing and contact tracing efforts, and eventually equitable distribution of a COVID-19 vaccine, which will be dependent upon culturally and linguistically appropriate messaging. This pandemic has not only exacerbated disparities in health and health care outcomes, but also health inequities, which are unjust and avoidable.”

“Latino communities continue to have high rates of infections, hospitalizations, and deaths from COVID-19. NHMA strongly supports the COVID-19 Health Disparities Action Act because it will support targeted strategies to reduce health disparities for COVID-19 and future public health emergencies,” said Elena Rios, MD, MSPH, FACP, President & CEO of the National Hispanic Medical Association.

“As the impact of COVID-19 health disparities has shown all too well, whether from a public health or an economic perspective, the effect of health disparities is a National crisis,” said Alex J. Carlisle, Ph.D.; Founder, Chair, & CEO, National Alliance against Disparities in Patient Health (NADPH). “By allocating resources to the communities most severely impacted by COVID-19, and the agencies and stakeholders with recognized and demonstrated commitments to serving these communities, the COVID-19 Health Disparities Action Act of 2020 provides the National leadership and response needed to help our Nation overcome this crisis.” 

The COVID-19 Health Disparities Action Act would:

  • Require the Trump Administration to develop an action plan to address the disproportionate impact of COVID-19 among racial and ethnic minority, rural, and other vulnerable populations.
  • Require states to revise testing and contact tracing plans to address racial and ethnic minority, rural, and other vulnerable populations experiencing health disparities related to COVID-19.
  • Authorize the development of targeted public awareness campaigns about COVID-19 symptoms, testing, and treatment directed at racial and ethnic minority, rural, and other socially vulnerable populations disproportionately impacted by COVID-19.
  • Ensure that federally funded contact-tracing efforts are tailored to the racial and ethnic diversity of local communities.  

Joining Sens. Warner, Menendez and Cardin as co-sponsors of the legislation are Sens. Elizabeth Warren (D-Mass.), Chris Van Hollen (D-Md.), Ed Markey (D-Ore.), Tina Smith (D-Minn.), Cory Booker (D-N.J.), Catherine Cortez Masto (D-Nev.), Jeff Merkley (D-Ore.), Mazie K. Hirono (D-Hawaii), Bernie Sanders (I-Vt.), Jeanne Shaheen (D-N.H.), Richard Blumenthal (D-Conn.), Jacky Rosen (D-Nev.), Kamala Harris (D-Calif.), Maggie Hassan (D-N.H.), and Amy Klobuchar (D-Minn.).

“We’ve seen that communities of color all over the country have been disproportionately affected by this pandemic. In many cases, these disparities have been exacerbated by factors like overrepresentation in front-line jobs, higher rates of chronic health conditions, inequitable access to health care, and bias within the health care system itself. That’s why we need to be doing everything possible to make sure the hardest hit communities have access to the targeted tools they need to respond to the COVID-19 crisis,” said Sen. Mark R. Warner.  

“Structural racism continues to plague our country, and its impact can be seen in the pandemic’s disproportionate toll on Black and Latino neighborhoods and in Indian Country,” said Sen. Warren. “Addressing the public health impacts of systemic racism must be at the very heart of the federal government's response to this pandemic, and that starts with quickly passing the COVID-19 Health Disparities Action Act.”

“COVID-19 has ravaged communities of color in Maryland and throughout our country. This pandemic has laid bare the deep-seated health and socioeconomic inequities that many Black and Latino Americans face and their deadly impacts. As they experience higher rates of COVID-19 and are disproportionately working on the front lines of the COVID response, it is unacceptable that the Trump Administration has no plan to tackle this crisis. Our bill will concentrate resources where they’re needed most and ensure that our response to COVID-19 is tailored to best reach these communities,” said Sen. Van Hollen.

“The coronavirus pandemic is a public health and economic crisis without precedent in our lifetimes, and it is abundantly clear that this virus has not only exposed, but also exacerbated, the deep, structural racial inequalities that have been taking the lives and livelihoods of people of color and Black Americans in particular for centuries,” said Sen. Booker. “Our bill seeks to create a much-needed national strategy for addressing the deadly disparities exacerbated by COVID-19 and any future public health crises by directing resources that are accessible and responsive to the communities that need them the most.”    

“Growing data on COVID-19 is making one thing clear: communities of color are being disproportionately affected by this pandemic,” said Sen. Cortez Masto. “Many are frontline workers who don’t have the luxury of working from home and for those who live in multigenerational homes, social distancing is nearly impossible. We cannot hope to get ahead of the curve without addressing the racial inequities that exist in how COVID-19 spreads and how we respond. This bill does exactly that by developing a different approach to COVID-19 to address the health disparities that exist in our communities.”

“The COVID-19 pandemic has laid bare the grim reality of persistent disparities in our health care system. Nationwide, racial and ethnic minorities have experienced higher rates of infection and worse health outcomes, and in Hawaii, our Pacific Islander community has been disproportionately impacted by the virus,” said Sen. Hirono. “This legislation takes important steps to address COVID-19 health disparities with a clear strategy to tailor testing, contact tracing, and outreach to communities of color.”

“COVID-19 has taken a particularly devastating toll on communities of color while the administration has failed at remedying this tragedy,” said Sen. Blumenthal. “I’m proud to co-sponsor this legislation to help address existing health disparities which have acutely exacerbated this crisis. This bill will ensure a robust investment in a public health approach tailored to communities of color and help combat deeply-rooted racism in medical research and the health care delivery system, strengthening our public health system for generations to come.”

“Longstanding inequities have caused communities of color to be disproportionately affected by the coronavirus,” said Sen. Rosen. “In Nevada, our state’s Latino population is being devastatingly impacted at a higher rate from COVID-19 than any other group. This legislation will help address racial and ethnic health disparities by increasing testing, contact tracing, and outreach to our most affected communities. We must take concrete steps to overcome these health inequalities now and for the future. I will continue working to protect the well-being of all Nevadans.”

“People of color represent 10 percent of New Hampshire’s population, but 25 percent of our COVID-19 cases – and similar health care disparities have existed for far too long,” Sen. Hassan said. “I recently spoke with public health leaders in New Hampshire about the racial disparities in health care outcomes and this legislation is a good first step to help address these unacceptable inequities in our health care system.” 

Earlier this year, Sen. Menendez called on the Trump Administration to do more to help minority communities that are seeing a disproportionately higher impact from the COVID-19 pandemic, and also urged pharmaceutical companies to include patients from diverse backgrounds in clinical trials for a COVID-19 vaccine.

The text of the bill can be downloaded here and a one pager is available here.

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