Press Releases

Washington, D.C. – U.S. Sen. Mark R. Warner joines Sens. Catherine Cortez Masto (D-Nev.), Senate Minority Leader Chuck Schumer (D-N.Y.),  Finance Committee Ranking Member Ron Wyden (D-Ore.) and 24 Senate colleagues in calling on the Centers for Medicare & Medicaid Services (CMS) to withdraw the proposed Medicaid Fiscal Accountability Rule (MFAR), a dangerous proposal to disrupt state Medicaid financing. The rule’s complex technical changes would limit the types of financing mechanisms states can use to pay for their non-federal share of Medicaid costs. Moreover, the discretion reserved by CMS to approve or deny state proposals provides far too little clarity and certainty to states who must plan far ahead for program expenditures. Nevada hospitals have warned that it could cost the state’s hospitals between $21 million and $205 million depending on how its implemented.

In a time when state budgets are strained and Medicaid programs are set to take on new populations of unemployed Americans, this change would be devastating to providers across the country and the vulnerable low-income patients who rely on them. 

The senators said in part, “We are writing to express our serious concern regarding the Centers for Medicare & Medicaid Services’ (CMS) recently proposed rule entitled, Medicaid Program; Medicaid Fiscal Accountability Regulation, 84 Fed. Reg. 63722 (Nov. 18, 2019). This proposed rule would have disastrous consequences for the Medicaid program and the millions of individuals it serves, and we request that CMS withdraw the proposed rule.”

The senators continued, “According to the National Governors Association, the proposed rule would ‘significantly curtail the longstanding flexibility states have to fund and pay for services in their Medicaid programs’ having ‘significant and broad impacts’ that will ‘result in decreased access to care for many vulnerable Americans.’”

In addition to Sens. Warner, Cortez Masto, Schumer, and Wyden, the letter was signed by Senators Sherrod Brown (D-Ohio), Robert P. Casey, Jr. (D-Pa.), Edward J. Markey (D-Mass.), Sheldon Whitehouse (D-R.I.), Angus King (I-Maine), Elizabeth Warren (D-Mass.), Maggie Hassan (D-N.H.), Tina Smith (D-Minn.), Jeanne Shaheen (D-N.H.), Dianne Feinstein (D-Calif.), Dick Durbin (D-Ill.), Debbie Stabenow (D-Mich.), Tammy Baldwin (D-Wis.), Patrick Leahy (D-Vt.), Jacky Rosen (D-Nev.), Gary Peters (D-Mich.), Richard Blumenthal (D-Conn.), Kamala Harris (D-Calif.), Ed Merkley (D-Ore.), Brian Schatz (D-Hawaii), Kirsten Gillibrand (D-N.Y.), Amy Klobuchar (D-Minn.), and Tim Kaine (D-Va.).

Full text of the letter can be found below.

 

Dear Administrator Verma:

We are writing to express our serious concern regarding the Centers for Medicare & Medicaid Services’ (CMS) recently proposed rule entitled, Medicaid Program; Medicaid Fiscal Accountability Regulation, 84 Fed. Reg. 63722 (Nov. 18, 2019). This proposed rule would have disastrous consequences for the Medicaid program and the millions of individuals it serves, and we request that CMS withdraw the proposed rule. 

Medicaid provides comprehensive, affordable coverage for over 71 million Americans, including children, individuals living with disabilities, pregnant women, seniors, and low-income parents and adults. Ensuring the fiscal integrity of the program is vital to assuring the program can efficiently and effectively serve the millions of Americans who depend on it. Yet, this Administration continues to take actions to undermine this essential program. In addition to attempts to block grant and cap Medicaid, rescind important access protections, and promote policies that make it harder for individuals to get the health care they need, this proposed rule is yet another step in the Administration’s ongoing agenda to dismantle the financing structure of Medicaid and cut benefits, coverage, and access.

Numerous stakeholders including: the bipartisan National Governors Association; the independent Medicaid and CHIP Payment and Access Commission (MACPAC); states; providers including safety net hospitals, nursing homes, and academic medical institutions; managed care plans; children’s groups including the American Academy of Pediatrics and March of Dimes; disability advocates; groups representing millions of patients such as those with cancer and rare diseases; and the bipartisan National Association of Medicaid Directors have all expressed significant concern with the proposed rule.

According to the National Governors Association, the proposed rule would “significantly curtail the longstanding flexibility states have to fund and pay for services in their Medicaid programs” having “significant and broad impacts” that will “result in decreased access to care for many vulnerable Americans.” Organizations such as the American Hospital Association representing hospitals and providers across the country and the American Health Care Association representing nursing facilities nationwide have stated that under the rule, “[e]ntire communities could lose access to care . . . especially in rural areas where 15 percent of hospital revenue and nearly two-thirds of nursing facility revenue nationwide depend on Medicaid funding.” Groups representing patients with chronic health conditions and individuals with disabilities have said that CMS's proposed rule “will severely undermine the ability of Medicaid as a health insurer to effectively address the needs of patients,” and “make substantive changes to long-standing Medicaid policy that would jeopardize access to care for Medicaid beneficiaries with disabilities and chronic conditions.” Even the independent MACPAC, which provides policy and data analysis to Congress on a non-partisan basis, publicly expressed concern that the proposed rule “could reduce payments to providers in ways that could jeopardize access to care for Medicaid enrollees.” The Commission went further saying that  “CMS should collect and rigorously examine data on the potential effects of such changes on beneficiary access,” an analysis “especially important given CMS’ previous proposal to rescind the requirement that states evaluate access before reducing or restricting provider payments.” 

Such responses are representative of feedback from thousands of stakeholders who have weighed in warning of the calamitous impact CMS’s proposed Medicaid Fiscal Accountability Regulation would have on the Medicaid program, states, providers, and the millions of Americans Medicaid serves. To make matters worse, in issuing its proposed rule, the Administration failed to conduct a full fiscal impact analysis stating that the “fiscal impact on the Medicaid program from the implementation of the policies in the proposed is unknown.” This is one of the many reasons that independent organizations like MACPAC urged CMS “not to implement new limits for supplemental payments and financing arrangements at this time.” Such blatant administrative malpractice is completely unacceptable and one more item on a long list of reasons why the proposed rule must not move forward.

It is for these reasons that we request CMS withdraw the proposed Medicaid Fiscal Accountability Regulation and instead work with Congress to identify areas where additional transparency may improve efficiency, economy, and quality of care under the program to ensure the millions of American’s who rely on Medicaid for comprehensive coverage and care have access to the care and services to which they are entitled.

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WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine joined their Democratic colleagues in a letter to President Donald J. Trump and Vice President Mike Pence demanding answers about supplies and equipment in the Strategic National Stockpile (SNS) critical to addressing the Coronavirus Disease 2019 (COVID-19) pandemic. The Senators asked the President and Vice President to confirm any relevant supply and equipment shortages in the SNS, to outline their strategy to close any such shortages, and to clarify how they plan to use Defense Production Act powers to increase production of supplies and equipment needed for the pandemic response. Senator Kaine also cosponsored legislation to expedite the procurement of medical equipment under the Defense Production Act to quickly produce and ensure access to supplies like Personal Protective Equipment (PPE) for health care workers on the frontlines of this pandemic.

“State, local, territorial, and tribal public health agencies are leading the response to the pandemic. These departments know their communities well and are making the best decisions they can to keep their citizens safe. However, our constituents working as health care providers and front line responders in hospitals, public health departments, and throughout their communities report the health care system is woefully under-resourced, especially in our rural, underserved areas and minority communities that are often overlooked. This problem is most acute with shortages of supplies and equipment that are desperately needed to test for and treat COVID-19 patients,” wrote the Senators in the letter.

The Senators continued, “Given the scale of the threat that COVID-19 poses to public health, responding to the outbreak is placing substantial strain on state, local, territorial, and tribal public health agencies’ already- limited resources. Furthermore, states and health care facilities who are trying to do as the President says and ‘get it yourself,’ find that the supply simply is not available. We urge you to be proactive and utilize the powers that you invoked on March 18, 2020, under the Defense Production Act (DPA) to mobilize private industry to manufacture the supplies and equipment needed to address this crisis.”

The Senators call on the President and Vice President to answer the following questions no later than March 24:

  1. What is the current status of supplies in the Strategic National Stockpile (SNS) that may be used in the COVID-19 response? Please include data on which, and the number of, pharmaceuticals, personal protective equipment, and any other medical supplies currently in the SNS that may be utilized in the response. 
  1. What is the current nationwide status of supplies and equipment available to test for and treat COVID-19 and what is the quantity of supplies and equipment the administration has determined is necessary to fully provide states, local, and tribal organizations with what they need throughout the length of the pandemic? Please include the quantity of personal protective equipment (including N95 Respirators and Surgical Masks, gloves, gowns, face shields, eye protection), testing supplies (including reagents and swabs), and ventilators that is currently available and the quantity needed throughout the length of the pandemic.
  1. What is the current total nationwide COVID-19 diagnostic testing capacity for public health, commercial, and academic laboratories per day? What is your plan to increase testing capacity? When will testing capacity be sufficient to be fully responsive to the current outbreak? 
  1. What is your plan to mobilize the private industry to manufacture supplies and equipment under the DPA and what is your timeline on invoking that power? 
  1. What is your plan for using the MEP network to identify manufacturers with excess or idle production capacity? What are your plans for organizing MEP (Hollings Manufacturing Extension Partnership) and National Institute of Standards and Technology expertise and resources to optimize production?

The letter is available HERE and below.

 

March 21, 2020

Dear President Trump and Vice President Pence:

We appreciate the work that has been done so far to ensure that the states, local governments, and tribal organizations we represent in the United State Senate get the supplies and equipment they need to respond to and prepare for the Coronavirus Disease 2019 (COVID-19). On February 28, 2020, the first patient in the United States died due to COVID-19, and since then many more have died and thousands have tested positive for the virus. More widespread testing will hopefully provide a clearer picture of the true prevalence.

State, local, territorial, and tribal public health agencies are leading the response to the pandemic. These departments know their communities well and are making the best decisions they can to keep their citizens safe. However, our constituents working as health care providers and front line responders in hospitals, public health departments, and throughout their communities report the health care system is woefully under-resourced, especially in our rural, underserved areas and minority communities that are often overlooked. This problem is most acute with shortages of supplies and equipment that are desperately needed to test for and treat COVID-19 patients.

On the morning of March 16, 2020, President Trump told the nation’s governors on a phone call to get supplies themselves. Specifically, the President said, “respirators, ventilators, all of the equipment — try getting it yourselves. We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Given the scale of the threat that COVID-19 poses to public health, responding to the outbreak is placing substantial strain on state, local, territorial, and tribal public health agencies’ already-limited resources. Furthermore, states and health care facilities who are trying to do as the President says and “get it yourself,” find that the supply simply is not available. We urge you to be proactive and utilize the powers that you invoked on March 18, 2020, under the Defense Production Act (DPA) to mobilize private industry to manufacture the supplies and equipment needed to address this crisis.

Additionally, the Hollings Manufacturing Extension Partnership (MEP) centers in every state and Puerto Rico represent an existing, high-quality network connecting small and medium manufacturers with technical experts to develop strategies for innovation, optimizing supply chains, and improving efficiency and productivity. Given that efficiency, productivity, and supply chain management are critical for rapidly manufacturing much-needed medical equipment, we urge that you utilize the capabilities and connections of the MEP network to expedite the search for excess manufacturing capacity.

We urge you to within 3 days, provide the members of the United States Senate and House of Representatives the answers to the following questions in a manner that does not compromise national security: 

  1. What is the current status of supplies in the Strategic National Stockpile (SNS) that may be used in the COVID-19 response? Please include data on which, and the number of, pharmaceuticals, personal protective equipment, and any other medical supplies currently in the SNS that may be utilized in the response.
  2. What is the current nationwide status of supplies and equipment available to test for and treat COVID-19 and what is the quantity of supplies and equipment the administration has determined is necessary to fully provide states, local, and tribal organizations with what they need throughout the length of the pandemic? Please include the quantity of personal protective equipment (including N95 Respirators and Surgical Masks, gloves, gowns, face shields, eye protection), testing supplies (including reagents and swabs), and ventilators that is currently available and the quantity needed throughout the length of the pandemic.
  3. What is the current total nationwide COVID-19 diagnostic testing capacity for public health, commercial, and academic laboratories per day? What is your plan to increase testing capacity? When will testing capacity be sufficient to be fully responsive to the current outbreak?
  4. What is your plan to mobilize the private industry to manufacture supplies and equipment under the DPA and what is your timeline on invoking that power?
  5. What is your plan for using the MEP network to identify manufacturers with excess or idle production capacity? What are your plans for organizing MEP and National Institute of Standards and Technology expertise and resources to optimize production?

While Congress has provided supplemental funding for state, local, territorial, and tribal public health agencies, the need for additional support across the nation remains high. The large magnitude of this crisis requires an even larger response from our national leaders. Americans depend on this. We look forward to your prompt response.

Sincerely,  

###

WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine joined their Democratic colleagues in a letter to President Donald J. Trump and Vice President Mike Pence demanding answers about supplies and equipment in the Strategic National Stockpile (SNS) critical to addressing the Coronavirus Disease 2019 (COVID-19) pandemic. The Senators asked the President and Vice President to confirm any relevant supply and equipment shortages in the SNS, to outline their strategy to close any such shortages, and to clarify how they plan to use Defense Production Act powers to increase production of supplies and equipment needed for the pandemic response. Senator Kaine also cosponsored legislation to expedite the procurement of medical equipment under the Defense Production Act to quickly produce and ensure access to supplies like Personal Protective Equipment (PPE) for health care workers on the frontlines of this pandemic.

“State, local, territorial, and tribal public health agencies are leading the response to the pandemic. These departments know their communities well and are making the best decisions they can to keep their citizens safe. However, our constituents working as health care providers and front line responders in hospitals, public health departments, and throughout their communities report the health care system is woefully under-resourced, especially in our rural, underserved areas and minority communities that are often overlooked. This problem is most acute with shortages of supplies and equipment that are desperately needed to test for and treat COVID-19 patients,” wrote the Senators in the letter.

The Senators continued, “Given the scale of the threat that COVID-19 poses to public health, responding to the outbreak is placing substantial strain on state, local, territorial, and tribal public health agencies’ already- limited resources. Furthermore, states and health care facilities who are trying to do as the President says and ‘get it yourself,’ find that the supply simply is not available. We urge you to be proactive and utilize the powers that you invoked on March 18, 2020, under the Defense Production Act (DPA) to mobilize private industry to manufacture the supplies and equipment needed to address this crisis.”

The Senators call on the President and Vice President to answer the following questions no later than March 24:

  1. What is the current status of supplies in the Strategic National Stockpile (SNS) that may be used in the COVID-19 response? Please include data on which, and the number of, pharmaceuticals, personal protective equipment, and any other medical supplies currently in the SNS that may be utilized in the response.
  2. What is the current nationwide status of supplies and equipment available to test for and treat COVID-19 and what is the quantity of supplies and equipment the administration has determined is necessary to fully provide states, local, and tribal organizations with what they need throughout the length of the pandemic? Please include the quantity of personal protective equipment (including N95 Respirators and Surgical Masks, gloves, gowns, face shields, eye protection), testing supplies (including reagents and swabs), and ventilators that is currently available and the quantity needed throughout the length of the pandemic.
  3. What is the current total nationwide COVID-19 diagnostic testing capacity for public health, commercial, and academic laboratories per day? What is your plan to increase testing capacity? When will testing capacity be sufficient to be fully responsive to the current outbreak?
  4. What is your plan to mobilize the private industry to manufacture supplies and equipment under the DPA and what is your timeline on invoking that power?
  5. What is your plan for using the MEP network to identify manufacturers with excess or idle production capacity? What are your plans for organizing MEP (Hollings Manufacturing Extension Partnership) and National Institute of Standards and Technology expertise and resources to optimize production?

The letter is available HERE and below.

 

March 21, 2020

Dear President Trump and Vice President Pence:

We appreciate the work that has been done so far to ensure that the states, local governments, and tribal organizations we represent in the United State Senate get the supplies and equipment they need to respond to and prepare for the Coronavirus Disease 2019 (COVID-19). On February 28, 2020, the first patient in the United States died due to COVID-19, and since then many more have died and thousands have tested positive for the virus. More widespread testing will hopefully provide a clearer picture of the true prevalence.

State, local, territorial, and tribal public health agencies are leading the response to the pandemic. These departments know their communities well and are making the best decisions they can to keep their citizens safe. However, our constituents working as health care providers and front line responders in hospitals, public health departments, and throughout their communities report the health care system is woefully under-resourced, especially in our rural, underserved areas and minority communities that are often overlooked. This problem is most acute with shortages of supplies and equipment that are desperately needed to test for and treat COVID-19 patients.

On the morning of March 16, 2020, President Trump told the nation’s governors on a phone call to get supplies themselves. Specifically, the President said, “respirators, ventilators, all of the equipment — try getting it yourselves. We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Given the scale of the threat that COVID-19 poses to public health, responding to the outbreak is placing substantial strain on state, local, territorial, and tribal public health agencies’ already-limited resources. Furthermore, states and health care facilities who are trying to do as the President says and “get it yourself,” find that the supply simply is not available. We urge you to be proactive and utilize the powers that you invoked on March 18, 2020, under the Defense Production Act (DPA) to mobilize private industry to manufacture the supplies and equipment needed to address this crisis.

Additionally, the Hollings Manufacturing Extension Partnership (MEP) centers in every state and Puerto Rico represent an existing, high-quality network connecting small and medium manufacturers with technical experts to develop strategies for innovation, optimizing supply chains, and improving efficiency and productivity. Given that efficiency, productivity, and supply chain management are critical for rapidly manufacturing much-needed medical equipment, we urge that you utilize the capabilities and connections of the MEP network to expedite the search for excess manufacturing capacity.

We urge you to within 3 days, provide the members of the United States Senate and House of Representatives the answers to the following questions in a manner that does not compromise national security:

  1. What is the current status of supplies in the Strategic National Stockpile (SNS) that may be used in the COVID-19 response? Please include data on which, and the number of, pharmaceuticals, personal protective equipment, and any other medical supplies currently in the SNS that may be utilized in the response.
  2. What is the current nationwide status of supplies and equipment available to test for and treat COVID-19 and what is the quantity of supplies and equipment the administration has determined is necessary to fully provide states, local, and tribal organizations with what they need throughout the length of the pandemic? Please include the quantity of personal protective equipment (including N95 Respirators and Surgical Masks, gloves, gowns, face shields, eye protection), testing supplies (including reagents and swabs), and ventilators that is currently available and the quantity needed throughout the length of the pandemic.
  3. What is the current total nationwide COVID-19 diagnostic testing capacity for public health, commercial, and academic laboratories per day? What is your plan to increase testing capacity? When will testing capacity be sufficient to be fully responsive to the current outbreak?
  4. What is your plan to mobilize the private industry to manufacture supplies and equipment under the DPA and what is your timeline on invoking that power?
  5. What is your plan for using the MEP network to identify manufacturers with excess or idle production capacity? What are your plans for organizing MEP and National Institute of Standards and Technology expertise and resources to optimize production?

While Congress has provided supplemental funding for state, local, territorial, and tribal public health agencies, the need for additional support across the nation remains high. The large magnitude of this crisis requires an even larger response from our national leaders. Americans depend on this. We look forward to your prompt response.

 

Sincerely, 

 

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) urged four Department of Veterans Affairs (VA) medical centers to expend every effort to ensure that veterans and the health providers who care for them are safe amid the novel coronavirus (COVID-19) outbreak. In letters to the Hunter Holmes McGuire VA Medical Center, the Salem VA Medical Center, the Hampton VA Medical Center, and the Washington DC VA Medical Center, the Senators asked for more information on each facility’s efforts to address the spread of COVID-19 while ensuring the health of VA employees.  

“Many of Virginia’s veterans are particularly susceptible to COVID-19 due to age and underlying health conditions,” wrote the Senators, who have heard from veterans and VA employees concerned about the effect of the COVID-19 outbreak on VA medical centers. “As the Commonwealth of Virginia and the federal government respond to the spread of COVID-19 in the United States and around the world, we urge the VA to expend every effort to ensure that veterans will be appropriately cared for during the outbreak of this deadly disease, and to seek further assistance when required.”

They continued, “As the VA works to care for our nation’s veterans with COVID-19 and to reduce the spread of this disease, the VA must also prioritize the protection of its employees – the health care providers, administrators, support staff, and others – who are on the frontlines in the battle against COVID-19, and who risk daily exposure to the virus.”

In their letters, the Senators urged each medical center to allow individuals to telework whenever possible, as in the case of hospital administrators who may be able to perform their duties remotely. They also urged the facilities to make every effort to provide employees with appropriate personal protective equipment in order to safely support patients and help prevent healthcare workers from getting sick. 

They also requested that the hospitals provide more information on their efforts to reduce the transmission of COVID-19. Specifically, they asked for details on each facility’s ability to test patients and staff for COVID-19; whether any steps were being taken to train and protect medical staff from the virus; whether each medical center is allowing employees to telework when possible; whether facilities believe they can meet the growing demands during this crisis; and whether any steps have been taken to ensure that each facility can handle a surge of patients with possible or confirmed COVID-19 patients.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) released the following statement after the Center for Medicare and Medicaid Services (CMS) announced plans to pay clinicians across the country for telehealth services to Medicare beneficiaries during the coronavirus outbreak. This decision was enabled by passage earlier this month of provisions from Sen. Warner's bipartisan CONNECT for Health Act of 2019, as part of the initial $8.3 billion coronavirus response package.

“I am relieved that Medicare is quickly moving to take advantage of the telehealth authorities Congress has given it through my legislation. There is no doubt that, if properly implemented, this technology will be a crucial tool for protecting American seniors during the coronavirus outbreak,” said Sen. Warner. ”The key now is for Medicare to take clear and decisive steps to swiftly put this technology in the hands of doctors and seniors at this critical moment in the COVID-19 outbreak. While it is unfortunate that it took a public health crisis to push these important telehealth provisions through, I am hopeful that, with proper implementation, this experience will eventually lead to a full expansion of telehealth for Medicare beneficiaries through passage of the bipartisan CONNECT for Health Act.”

The Warner-authored language in the first coronavirus response bill cuts restrictions on Medicare's use of telehealth for the COVID-19 public health emergency response. CMS Administrator Seema Verma announced Medicare's telehealth expansion yesterday at the White House during a Coronavirus Task Force press conference. 

“These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus,” Administrator Verma said at the press conference. “Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.”

The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 builds on the progress made in recent years to increase the use of telehealth through Medicare. Specifically, the legislation would:

  • Provide the Secretary of Health and Human Services (HHS) the authority to waive telehealth restrictions when necessary;
  • Remove geographic and originating site restrictions for services like mental health and emergency medical care;
  • Allow rural health clinics and other community-based health care centers to provide telehealth services; and
  • Require a study to explore more ways to expand telehealth services so that more people can access health care services in their own homes.

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

A list of Sen. Warner’s work to protect and support Virginians during the coronavirus outbreak is available here.

 

 

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WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine joined more than 30 of their Democratic colleagues to press the Coronavirus Task Force on their preparedness and response plans for seniors and individuals with disabilities. The Senators sent three letters to the Trump Administration regarding the safety of people living in nursing homes, the ability of seniors living in the community to maintain critical services including delivered meals and home care, and ensuring that up-to-date and accurate information is easily accessible to seniors and people with disabilities.

“As this pandemic continues to spread, the health of seniors and individuals with disabilities is increasingly at risk,” Warner and Kaine said. “It’s crucial that the Administration address the growing threat to our most vulnerable communities.”

In an effort to guard against the spread of the virus in nursing homes, the Centers for Medicare and Medicaid Services took the unprecedented step of directing states to suspend nearly all nursing home inspections and oversight unrelated to infection control or instances of abuse and neglect.

The Senators requested information on steps that are being taken to protect nursing home residents, staff, and their families. They also urged the Trump Administration to outline its plans for ensuring that older adults who receive services in their homes and communities through their local Area Agencies on Aging, senior centers, and other community organizations will remain safe from the virus, and to what extent the Administration is taking action to ensure that information about the virus is accessible to everyone, including people who are deaf or have limited English proficiency.

Read the letter on nursing homes here.

Read the letter on home and community-based services here.

Read the letter on accessible information for people with disabilities here.

 

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA) and Richard Blumenthal (D-CT) expressed deep concern that Google – despite claiming to ban ads that capitalize on novel coronavirus (COVID-19) fears – continues to run ads for products such as face masks and hand sanitizer, which not only exploit fear for profit but also serve to trigger shortages of essential health care products at a time of critical need. In their letter to the Federal Trade Commission (FTC), the Senators slammed Google’s inattention to the misuse of its advertising platform and urged the FTC to intervene in order to protect the public and the nation’s supply chains.

“Browsing in incognito mode across a range of different devices, our staffs were consistently served dozens of ads for protective masks and hand sanitizer – in each case while on a page related to COVID-19,” the Senators wrote. “Scrutinizing the targeting information that Google provides pursuant to the AdChoices program, it became clear that these ads were targeted to users specifically because they were browsing articles on COVID-19. In other words, using browsing data that Google collects through its third-party web trackers, unscrupulous and predatory advertisers were able to directly target consumers browsing content on the outbreak in order to exploit their fear for profit.”

 “Google has made repeated representations to consumers that its policies prohibit ads for products such as protective masks. Yet the company appears not to be taking even rudimentary steps to enforce that policy, such as easily automated and scalable actions like flagging ads with relevant terms in the outbound URL. These misrepresentations generate direct harm to consumers, exploiting their legitimate fears over the COVID-19 outbreak to over-charge them for products. They also create widespread social harms to our nation’s response to this crisis, such as by contributing to shortages of products essential to the health care workers on the front lines of the COVID-19 response,” they continued. “Consumers should be able to rely on representations regarding a company’s business practices – particularly in cases, such as this, where Google has acknowledged that offending ads pose harm to consumers. If consumers cannot rely on a company’s representations, then the FTC must intervene.”

Earlier this month, the Department of Health and Human Services (HHS) announced that in light of the COVID-19 outbreak, it would need roughly 300 million N95 respirator masks – 270 million more masks than it currently has stockpiled. Due to this shortage, the U.S. Surgeon General urged the public to stop buying protective masks in order to ensure that health care workers have access to the resources they need to stay safe. 

On March 10, after several outlets reported that Google was serving these ads despite a policy that prohibits content that capitalizes off sensitive events, Google stated that it would formally ban ads for protective facemasks. However Google’s advertising platform continues to be exploited for fraudulent activity with these ads continuing to run, notably even on news articles reporting Google’s new policies.

In their letter, the Senators also highlighted previous efforts to encourage the FTC to address Google’s inattention to abuse and expressed disappointment with the FTC’s inaction.

A copy of the letter is available here and below. A list of Sen. Warner’s work to protect Americans amid the coronavirus outbreak is available here.

 

The Honorable Joseph J. Simons

Chairman

Federal Trade Commission

600 Pennsylvania Avenue, NW

Washington, D.C. 20530

Dear Chairman Simons,

The COVID-19 pandemic has impaired the global supply chain in myriad ways, but perhaps most notably by creating a shortage of products like protective face masks, which are needed by health care workers responding to this crisis. Major manufacturers like 3M are ramping up production in the wake of consumer-led shortages that are impacting supplies for the health care sector. In early March, the Department of Health and Human Services stated that while the U.S. has a stockpile of roughly 30 million N95 respirator masks, it needs roughly 300 million as the COVID-19 outbreak worsens.  In light of this, the U.S. Surgeon General has urged the public to stop buying protective masks.

Despite these pleas, a range of bad actors have continued to exploit fears surrounding the COVID-19 crisis for monetary gain. Earlier this month, CNBC and other outlets reported that Google was continually serving ads for products marketed as precautions for COVID-19 (including protective masks and hand sanitizer), despite a policy prohibiting content that capitalizes off of “sensitive events” such as natural disasters, conflicts, or death.  On March 10th, Google announced a formal ban on ads for protective face masks and claimed it would “take action as needed to protect users.”

Almost immediately, however, our staffs became aware that Google continued to serve ads for these masks – including, notably, on news articles reporting Google’s new policies. Browsing in incognito mode across a range of different devices, our staffs were consistently served dozens of ads for protective masks and hand sanitizer – in each case while on a page related to COVID-19. Scrutinizing the targeting information that Google provides pursuant to the AdChoices program, it became clear that these ads were targeted to users specifically because they were browsing articles on COVID-19. In other words, using browsing data that Google collects through its third-party web trackers, unscrupulous and predatory advertisers were able to directly target consumers browsing content on the outbreak in order to exploit their fear for profit.

These ads, from a range of different advertisers, were served by Google on websites for outlets such as The New York Times, The Boston Globe, The Washington Post, CNBC, The Irish Times, and myriad local broadcasting affiliates. In several hours of testing, our staffs were not served a single ad for such masks from other advertising platforms – yet generated several dozen from Google. Reporting by CNBC appears to confirm that other ad platforms seemed not to be serving such predatory ads.

Upon contacting the company, Google claimed it would need a full click string to detect these violations – a request that seemed odd in light of the sheer number of ads violating these policies and the ease with which our staffs were able to generate offending ads, across multiple devices and sites. Most disturbingly, the ad content included explicit references to “Protective Masks” and included a range of representations such as “Medical-Grade N95 filter mask.” The majority of these ads also suggested that consumers should take immediate action in light of “limited supplies.” Virtually every single outbound URL associated with these ads also contained clear indications that the ads violated the company’s policies – with “N95,” “mask,” “medical-grade,” and “3M-Mask” explicitly in the URL string. In addition to the social harm associated with contributing towards scarcity of these masks, the ads also appear to engage in price-gouging – with individual masks in many ads selling for $9.99 or $12.99.

For several years now, we have encouraged the FTC to address Google’s inattention to abuse, harmful activity, and fraud within the ad ecosystem that it largely dominates.  As one of us wrote your agency in 2018, “The FTC’s failure to act has had the effect of allowing Google to structure its own market; through a series of transactions, the company has accomplished a level of vertical integration that, in effect, allows it to act as the equivalent of market-maker, commodities broker, and commodities exchange for digital advertising… While the company controls each link in the supply chain and therefore maintains the power to monitor activity in the digital advertising market from start to finish, it has continued to be caught flat-footed in identifying and addressing digital ad fraud.”

Google’s inattention to the misuse of its advertising platform extends beyond digital ad fraud and predatory ads: in 2012, the Department of Justice announced one of the largest forfeitures in U.S. history, forcing Google to disgorge $500 million generated by unlawful ads marketing opioids to Americans.  Unfortunately, we have continued to see Google’s advertising platform exploited for abusive and fraudulent activity.

Google has made repeated representations to consumers that its policies prohibit ads for products such as protective masks. Yet the company appears not to be taking even rudimentary steps to enforce that policy, such as easily automated and scalable actions like flagging ads with relevant terms in the outbound URL. These misrepresentations generate direct harm to consumers, exploiting their legitimate fears over the COVID-19 outbreak to over-charge them for products. They also create widespread social harms to our nation’s response to this crisis, such as by contributing to shortages of products essential to the health care workers on the front lines of the COVID-19 response.

Consumers should be able to rely on representations regarding a company’s business practices – particularly in cases, such as this, where Google has acknowledged that offending ads pose harm to consumers. If consumers cannot rely on a company’s representations, then the FTC must intervene. The FTC routinely pursues enforcement actions against companies that don’t live up to the self-regulatory commitments they make, including in a 2012 case against Google for failing to follow the National Advertising Initiative code of conduct. 

Given the Department of Justice (DOJ)’s successful work in combatting similar misuse of the company’s advertising platform, we have provided a carbon copy of this letter to the DOJ to address this pattern of misbehavior in light of the FTC’s inaction.

Sincerely,

Cc:

Attorney General William Barr

Commissioner Rohit Chopra

Commissioner Rebecca Slaughter

Commissioner Noah Phillips

Commissioner Christine Wilson

 

###

WASHINGTON, D.C.—Today, U.S. Senators Mark R. Warner and Tim Kaine joined their colleagues in introducing the Free COVID-19 Testing Act, legislation that would expand free tests to confirm coronavirus (COVID-19) infections.

The Free COVID-19 Testing Act would waive cost-sharing for COVID-19 diagnostic testing and related health care services for individuals enrolled in private health plans, Medicare, Medicare Advantage, Medicaid, CHIP, TRICARE, VA as well as for federal civilians, American Indians and Alaska Natives. Private insurers would be barred from imposing limits like prior authorization for testing. For uninsured individuals, this legislation would cover the cost of lab fees, and states would have the option and new incentives to cover COVID-19 diagnostic testing and related health care services through their Medicaid programs.

“Costs should never be a barrier to accessing potentially life-saving testing,” Warner and Kaine said. “This legislation ensures any Virginian can get tested without the fear of a medical bill they can’t afford. The Senate must immediately pass this critical legislationto help mitigate the spread of the coronavirus and protect public health.” 

This legislation was led by Senators Tina Smith (D-Minn.), Gary Peters (D-Mich.), Democratic Minority Leader Chuck Schumer (D-N.Y.), Patty Murray (D-Wash.), and Ron Wyden (D-Ore.). In addition to  Warner and Kaine, this legislation is also cosponsored bySens. Amy Klobuchar (D-Minn.), Bob Casey (D-Pa.), Doug Jones (D-Ala.), Sherrod Brown (D-Ohio), Tammy Duckworth (D-Ill.), Jon Tester (D-Mont.), Sheldon Whitehouse (D-R.I.), Bernie Sanders (I-Vt.), Tammy Baldwin (D-Wis.), Jack Reed (D-R.I.), Chris Murphy (D-Conn.), Mazie Hirono (D-Hawaii), Brian Schatz (D-Hawaii), Debbie Stabenow (D-Mich.), Angus King (I-Maine), Chris Coons (D-Del.), Cory Booker (D-N.J.), Dianne Feinstein (D-Calif.), Kamala Harris (D-Calif.), Tom Udall (D-N.M.), Maggie Hassan (D-N.H.), Kirsten Gillibrand (D-N.Y.), Martin Heinrich (D-N.M.), Jeanne Shaheen (D-N.H.), Jacky Rosen (D-Nev.), Elizabeth Warren (D-Mass.), Tom Carper (D-Del.), Dick Durbin (D-Ill.), Chris Van Hollen (D-Md.), Ed Markey (D-Mass.), Richard Blumenthal (D-Conn.), Michael Bennet (D-Colo.), and Bob Menendez (D-N.J.).

You can access text of the bill here.


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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) sounded the alarm regarding America’s overreliance on Chinese- and foreign-made pharmaceutical products and supplies, and highlighted the dangerous consequences of this dependence on the wellbeing of Americans and on U.S. national security. In a letter to the U.S. Department of Health and Human Services, Sen. Warner requested that HHS develop a short-term strategy to ensure Americans have access to necessary medical products, and a long-term plan to reduce reliance on foreign supply chains.

“For millions of Americans, access to their drug supply can mean life or death. Yet increasingly, the United States produces very few of these products domestically,” wrote Sen. Warner. “For example, the active ingredients for medicines treating breast and lung cancers and the antibiotic Vancomycin are made almost exclusively in China.  China is also the largest supplier of medical devices, such as MRI equipment, surgical gowns and other equipment that measures oxygen levels in the blood.”

“As the outbreak for COVID-19 has occurred, the risks of our dependence are growing.  Our reliance on Chinese and other foreign API manufacturing facilities during this crisis is already beginning to compromise the U.S. drug supply, creating drug shortages and manufacturing quality problems. Some countries have increased restrictions on the export of their pharmaceuticals to the United States and other countries as they work to protect their own populations. For example, India recently decided to place restrictions on exporting Tylenol and the common antibiotic metronidazole to ensure Indian citizens have the pharmaceuticals they need,” he continued. “The nation’s dependence on foreign countries for medical products points to a much larger challenge that the United States must be prepared to address: China’s growing dominance in the health sector, including the biotechnology and pharmaceutical industries, and its collection of vast amounts of biomedical and other data, with potential long-term privacy risks for Americans.”

In the letter, Sen. Warner cited the testimony of Janet Woodcock, the Director of the Center for Drug Evaluation and Research who testified before the House Committee on Energy and Commerce about the growing U.S. reliance on foreign sources of active pharmaceutical ingredients (APIs). According to Director Woodcock, only 28 percent of manufacturing facilities making APIs for the U.S. market are in the United States, and three of the “essential medicines” identified by the World Health Organizations have API manufacturers that are based only in China.  

Additionally, Sen. Warner requested a briefing and a written response to the following questions:

  1. What actions has HHS taken to address the dependence on Chinese or other foreign manufacturers of drugs, APIs, or other pharmaceutical products and medical supplies and equipment since the outbreak of the COVID-19?
  2. What is your strategy to ensure that Americans get the pharmaceuticals they need if significant shortages occur? 
  3. As the coronavirus continues to spread, what actions has HHS taken to ensure that patients can still access the drugs they need without access to drug components manufactured overseas?
  4. What is your analysis of what drugs or ingredients cannot be made without supplies from China and other foreign countries?
  5. What is your plan to ensure that medical facilities, medical personnel and first responders have a reserve of necessary medical supplies and equipment as they continue to be on the front lines of efforts to prevent the spread of COVID-19?
  6. Congress recently passed the Coronavirus Preparedness and Response Supplemental Appropriations Act, which includes more than $2 billion for the Biomedical Advanced Research and Development Authority (BARDA) to invest in platform-based technologies with U.S-based manufacturing for vaccines and therapeutics. How will HHS ensure these funds effectively reduce our short and long-term reliance on foreign manufacturers of drugs, APIs, or other pharmaceutical products and medical supplies and equipment?

A copy of the letter is available here and below. A list of Sen. Warner’s work on coronavirus is available here.

 

Secretary Alex Azar

U.S. Department of Health and Human Services

200 Independence Avenue, S.W.

Washington, D.C. 20201

Dear Secretary Azar:

As the novel coronavirus (COVID-19) continues to spread globally, I write to convey my significant alarm over American overreliance on Chinese – and foreign-manufactured pharmaceutical products and medical supplies and the consequent dangerous impacts – both for the health and well-being of Americans and for U.S. national security.  I ask the Department of Health and Human Services to monitor the potential impact of this overreliance, and develop a strategy to ensure Americans have access to these medical products in the short-term while determining a longer-term plan to reduce U.S. reliance on foreign supply chains for these products.

As you are well aware, the COVID-19 was first detected in Wuhan, China and has now spread to more than 104 countries. There have been more than 109,000 cases confirmed and more than 3,800 deaths. For some time, experts both in and outside of the government have expressed serious concerns about the United States outsourcing medical products to foreign companies and the vulnerabilities resulting from this dependence. The outbreak of COVID-19 has put in stark relief the health, economic, and strategic risks of the current approach. 

For millions of Americans, access to their drug supply can mean life or death. Yet increasingly, the United States produces very few of these products domestically.  For example, the active ingredients for medicines treating breast and lung cancers and the antibiotic Vancomycin are made almost exclusively in China.  China is also the largest supplier of medical devices, such as MRI equipment, surgical gowns and other equipment that measures oxygen levels in the blood. 

During her October 30, 2019 testimony before the House Committee on Energy and Commerce, the Director of the Center for Drug Evaluation and Research, Janet Woodcock, asserted that the U.S. reliance on Chinese and other foreign sources of active pharmaceutical ingredients (APIs) was only growing. She described a set of startling statistics— while the United States has become a world leader in drug discovery and development over the past decade, it is no longer in the forefront of drug manufacturing.  In particular, manufacturers of APIs, including statins and penicillin are increasingly foreign-made– with only 28 percent of the manufacturing facilities making APIs for the U.S. market in the United States; thirteen percent of these manufacturers are located in China.   The U.S. pharmaceutical sector relies on China for components, materials, and finished products.   In fact, three World Health Organization (WHO) “Essential Medicines” have API manufacturers that are based only in China.   For drugs used to combat biological threats, China has 37 API manufacturing facilities, while the U.S. has 19, compared to 117 facilities in the rest of the world.  

As the outbreak for COVID-19 has occurred, the risks of our dependence are growing.  Our reliance on Chinese and other foreign API manufacturing facilities during this crisis is already beginning to compromise the U.S. drug supply, creating drug shortages and manufacturing quality problems. Some countries have increased restrictions on the export of their pharmaceuticals to the United States and other countries as they work to protect their own populations. For example, India recently decided to place restrictions on exporting Tylenol and the common antibiotic metronidazole to ensure Indian citizens have the pharmaceuticals they need.

The nation’s dependence on foreign countries for medical products points to a much larger challenge that the United States must be prepared to address: China’s growing dominance in the health sector, including the biotechnology and pharmaceutical industries, and its collection of vast amounts of biomedical and other data, with potential long-term privacy risks for Americans.

It is essential that the United States develop strategies to reduce U.S. reliance on China and other countries for drugs critical to American patients. I appreciate your willingness to work with Congress to further strengthen our response capabilities and emergency preparedness.

I respectfully request a briefing [and a written response] with answers to the following questions no later than March 23, 2020.

  1. What actions has HHS taken to address the dependence on Chinese or other foreign manufacturers of drugs, APIs, or other pharmaceutical products and medical supplies and equipment since the outbreak of the COVID-19?
  2. What is your strategy to ensure that Americans get the pharmaceuticals they need if significant shortages occur? 
  3. As the coronavirus continues to spread, what actions has HHS taken to ensure that patients can still access the drugs they need without access to drug components manufactured overseas?
  4. What is your analysis of what drugs or ingredients cannot be made without supplies from China and other foreign countries?
  5. What is your plan to ensure that medical facilities, medical personnel and first responders have a reserve of necessary medical supplies and equipment as they continue to be on the front lines of efforts to prevent the spread of COVID-19?
  6. Congress recently passed the Coronavirus Preparedness and Response Supplemental Appropriations Act, which includes more than $2 billion for the Biomedical Advanced Research and Development Authority (BARDA) to invest in platform-based technologies with U.S.-based manufacturing for vaccines and therapeutics. How will HHS ensure these funds effectively reduce our short- and long-term reliance on foreign manufacturers of drugs, APIs, or other pharmaceutical products and medical supplies and equipment?

I appreciate your immediate attention to this matter.  I look forward to working together on this critical issue moving forward.

Sincerely,

###

WASHINGTON, D.C. – U.S. Senators Mark R. Warner and Tim Kaine released the following statement on today’s announcement that a Marine at Fort Belvoir in Virginia has tested positive for the coronavirus:

“We are carefully monitoring the case of the coronavirus announced in Virginia today and are committed to doing everything we can to ensure the Commonwealth is getting the federal support it needs to respond. This week, we voted to pass a bipartisan emergency funding bill that directs needed resources to Virginia and other states – including funding for diagnostic testing, vaccine development, and additional resources for responders who are combating this outbreak. We will be staying in close touch with state officials on the frontlines, and we are prepared to act if it is determined that additional federal resources are needed to respond to the spread of this virus. We encourage all Virginians to check the Virginia Department of Health website for valuable updates and information on COVID-19 and heed the calls of public health professionals to protect against its spread.”

###

WASHINGTON – U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) issued a statement today after the Senate approved a bipartisan emergency funding bill to combat the coronavirus (COVID-19) on a 96-1 vote:

“We are pleased that Congress quickly passed this important coronavirus response package on a bipartisan basis, and with sufficient funding to meet the threat posed by the COVID-19 outbreak. While the Trump Administration's initial $1.25 billion request fell far short of what state and federal agencies need to combat the spread of coronavirus, this $8.3 billion package will immediately direct needed resources to Virginia and other states – including funding for diagnostic testing, vaccine development, and additional resources for state and local responders who are on the front lines of a potential pandemic,” said the Senators. “This legislation is about making sure costs don't get in the way of a strong response to the threat posed by the coronavirus. Once it is signed into law, the Commonwealth will immediately receive $13.3 million in federal funding to help cover the costs of preparations for this public health emergency.”

“With the President's signature, state and local agencies in Virginia will be able to apply for further federal funds to reimburse for the costs of detecting, tracking and controlling the spread of the virus. While Virginia is fortunate that we have not experienced an outbreak, this bill sets aside $350 million that will be available to local authorities if our region does get hit. It also provides $500 million for masks, medication, protective equipment, and other much-needed medical supplies that can be distributed directly to hospitals and local health care providers. We are committed to working with federal, state and local health officials to make sure the Commonwealth is getting the federal support it needs to prepare for coronavirus, and we encourage all Virginians to follow the guidance of public health professionals to protect against its spread,” concluded the Senators.

The legislation also includes language based on Sen. Warner’s CONNECT for Health Act of 2019, which reduces restrictions on the use of telehealth for public health emergency response, as well as $500 million to facilitate its implementation.

Earlier today, the Sens. Warner and Kaine wrote to the leadership of the Virginia Chamber of Commerce encouraging the organization's member businesses to commit that workers will not be penalized for following recommended health procedures to protect the public from further spread of the coronavirus. Sen. Warner also led a group of 14 Senators in urging major U.S. employers to make the same commitment. 

In a letter sent yesterday, the Senators urged health insurers and federal and state officials to eliminate cost burdens that could disincentivize people with coronavirus symptoms from seeking testing and treatment for the contagious illness. In a separate letter, the Senators called on the Trump Administration to end efforts to undermine the Affordable Care Act that could jeopardize America's coronavirus response.

These letters represent the latest in a series of efforts by the Senators to push for a robust response to the threat of coronavirus. In January, Sens. Warner and Kaine asked the Administration to redirect available public health funds to combat the virus and to inform Congress of any additional resources needed to respond to the coronavirus. Earlier this week, in a letter to Vice President Mike Pence – who has been tasked with coordinating the federal government’s coronavirus response – Sen. Warner expressed concern over how the U.S. government has mobilized to combat the outbreak of coronavirus and urged the Vice President to devote the resources, expertise, and manpower needed to prevent this virus from spreading while also improving the government’s communication with Congress and the American public. This week, Sen. Kaine joined letters calling on Secretary of Education Betsy DeVos and Secretary of Labor Eugene Scalia to provide details on their Departments’ plans for preparedness and response efforts to protect the safety and health of students, teachers, school staff, and workers in light of the emerging threat of the novel coronavirus.

The House of Representatives passed this coronavirus response package yesterday by a 415-2 vote. With Senate approval, the bill now heads to the President's desk, and President Trump has announced he intends to sign it into law.

###

WASHINGTON – U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) today urged health insurers and federal and state officials to eliminate cost burdens that could disincentivize people with coronavirus symptoms from seeking testing and treatment for the contagious illness.

“We are fortunate that to date there have been no confirmed cases of the coronavirus in Virginia. While public health officials have warned us to expect the virus to spread, we must work to contain the virus as much as possible. In order to limit the spread of this deadly disease, we must ensure that at-risk individuals seek medical care as soon as possible – and that potential cost burdens are not a deterrent to seeking diagnosis and treatment. In Virginia, about 10 percent of residents lack any form of medical insurance. Among the insured, many individuals still face high deductibles and additional out-of-pocket costs that could be a deterrent to seeking medical care in a timely fashion,” wrote the Senators in several letters today to Vice President Mike Pence, Gov. Ralph Northam, the Virginia Association of Health Plans and the State Corporation Commission, which regulate various health care plans in Virginia. 

The Senators continued, “It is uncertain what the entirety of patient costs associated with COVID-19 may be, but we have already seen disturbing reports of patients left with enormous bills after appropriately and responsibly seeking medical care. In Miami, a patient with healthcare insurance returned from China and sought medical treatment for flu-like symptoms, but still received a $3,270 dollar medical bill after his hospitalization. An American who was evacuated from Wuhan received a $3,918 in medical bills after he and his 3-year-old daughter were required to spend several days in an isolation unit at a local children’s hospital. If patients fear the financial consequences of seeking appropriate screening, treatment and quarantine, it will severely handicap the government’s ability to control the spread of this virus.”

A copy of the letter to Vice President Mike Pence can be found here.

A copy of the letter to Governor Ralph Northam can be found here.

A copy of the letter to the Virginia Association of Health Plans can be found here.

A copy of the letter to the State Corporation Commission can be found here.

###

WASHINGTON – U.S. Sen. Mark R. Warner (D-VA), a member of the Senate Finance Committee, released the following statement after the Supreme Court said on Monday that it will hear the Republican lawsuit challenging the Affordable Care Act (ACA), Texas v. U.S., later this year:

“The President continues to claim he supports protecting people with preexisting conditions, yet his Administration continues to pursue this lawsuit that will rip protections away from millions of Americans without any viable plan to fix it.

“The uncertainty created by the Trump Administration’s repeated attacks on the Affordable Care Act jeopardize essential health care coverage for Virginia families. I am committed to strengthening our health care law, and will do everything in my power to protect it.”

In the Senate, Sen. Warner has sponsored several bills to block the Administration’s efforts to undermine the ACA and protect people with preexisting conditions. Last year, Sen. Warner led the entire Senate Democratic Caucus in forcing an up-or-down vote on overturning a Trump Administration rule that explicitly undermines protections for preexisting conditions by flooding the health care market with junk health care plans, which are often advertised in low-income communities or communities of color. That vote was defeated as a result of Republican opposition, jeopardizing protections for millions of Americans with preexisting conditions.

###

WASHINGTON – Today, in a letter to Vice President Mike Pence, U.S. Sen. Mark R. Warner (D-VA) expressed concern over how the U.S. government has mobilized to combat the outbreak of coronavirus (COVID-19), including how the Administration is communicating with state, local and federal officials, and Americans impacted by the virus. In his letter, Sen. Warner urged the Vice President to devote the resources, expertise and manpower needed to prevent this virus from spreading while also improving the government’s communication with Congress and the American public.     

“I am concerned that the Administration’s response to date has not been aggressive enough to effectively combat the virus and fails to underscore the threat posed by this virus,” wrote Sen. Warner. “I have been deeply frustrated with the U.S. government’s communication with Congress, my constituents and their family members impacted by the virus, and the American people more broadly.  I understand that individuals at the State Department, including in embassies around the world, the CDC and other federal agencies, have been working around the clock.  Yet despite this flurry of efforts, the U.S. government has not established an effective communication plan that tracks specific cases and communicates out guidance to individuals, their family members and Congressional offices working to get them help.  Nor has it effectively pushed back on disinformation around the coronavirus or given adequate information to the American public.”

“Since the outbreak of the coronavirus, I have been in frequent communication with a number of Virginians, who were traveling in Asia and were unable to return home,” he continued. “The U.S. government’s task force was unable to provide these folks with basic information on a timely basis about what they could expect for the next 24 hours and how they could be medically cleared.  Questions such as where they would sleep the following night, whether they should book a hotel or flight, and how they could be reunited with their spouses in country, went unanswered for far too long.  In addition, my office, despite repeated outreach to numerous government entities, struggled to get the basic information these constituents needed.  This process was opaque, time-consuming and ultimately unsatisfactory for my constituents.  We must do better.  We need to put better systems in place, especially as the virus continues to spread.”

To date, coronavirus has sickened more than 90,000 people around the world, killing more than 3,000 individuals. In the U.S., 88 cases of the virus have been confirmed and there have been two fatalities.

In his letter, Sen. Warner also emphasized the need for a government response that includes, at a minimum, a request for emergency funds from Congress, and an established communications strategy to ensure that government officials and the American public have the latest information they need to remain prepared and safe.

In January, Sen. Warner asked the Administration to redirect available public health funds to combat the virus and to inform Congress of any additional resources that are needed. The Administration has since requested $2.5 billion in emergency funds – an amount far below what most public health experts believe is needed to adequately prepare and respond to the virus. Congressional appropriators from both parties are currently working to negotiate and draft an emergency funding package to combat the coronavirus, which the Senate is expected to take up in the coming days.

A copy of the letter is available here and below.

 

Vice President Mike Pence

The White House

Office of the Vice President

1600 Pennsylvania Avenue, N.W.

Washington, D.C. 20500

Dear Vice President Pence:

I am writing to convey my concerns over how the U.S. government has mobilized to combat the novel coronavirus (COVID-19), including how the Administration is communicating with state, local and federal officials responding to the virus and Americans at large impacted by the virus.  As you take over the leadership of the U.S. government’s response to the coronavirus, I ask that you devote the resources, expertise and manpower needed to prevent this virus from spreading and that you improve the U.S. government’s communication with Congress and the American public.  

As you well know, the novel coronavirus has sickened more than 90,000 people around the world, and killed more than 3,000 people to date.  While there have only been 88 confirmed cases in the U.S. and two fatalities, the Centers for Disease Control (CDC) has stated that the virus is expected to spread within the U.S.  I am concerned that the Administration’s response to date has not been aggressive enough to effectively combat the virus and fails to underscore the threat posed by this virus. 

Earlier this month, I wrote to the Administration asking them to redirect available public health funds to combat this virus and to inform my colleagues and me of any additional resources that are needed.  This week, the Trump Administration asked Congress for only $2.5 billion dollars in order to contain the coronavirus and to try to prevent it from spreading in the U.S.  A number of independent public health experts have expressed concern that this amount will not be enough to effectively prepare, and both Republican and Democratic Members of the House and Senate have publically agreed this request is likely insufficient.

In addition, I have been deeply frustrated with the U.S. government’s communication with Congress, my constituents and their family members impacted by the virus, and the American people more broadly.  I understand that individuals at the State Department, including in embassies around the world, the CDC and other federal agencies, have been working around the clock.  Yet despite this flurry of efforts, the U.S. government has not established an effective communication plan that tracks specific cases and communicates out guidance to individuals, their family members and Congressional offices working to get them help.  Nor has it effectively pushed back on disinformation around the coronavirus or given adequate information to the American public. 

For example, since the outbreak of the coronavirus, I have been in frequent communication with a number of Virginians, who were traveling in Asia and were unable to return home.  The U.S. government’s task force was unable to provide these folks with basic information on a timely basis about what they could expect for the next 24 hours and how they could be medically cleared.  Questions such as where they would sleep the following night, whether they should book a hotel or flight, and how they could be reunited with their spouses in country, went unanswered for far too long.  In addition, my office, despite repeated outreach to numerous government entities, struggled to get the basic information these constituents needed.  This process was opaque, time-consuming and ultimately unsatisfactory for my constituents.  We must do better.  We need to put better systems in place, especially as the virus continues to spread.

I urge you to prioritize implementing an effective and reliable mobilization effort to support our nation’s response to the threat of coronavirus.  This response – at minimum – should include an emergency appropriations request to Congress with sufficient funding levels based upon recommendations from public health experts on the front lines of this outbreak.  In addition, I urge you to establish an organized and reliable communications strategy that ensures state, local and federal officials and the American public have the most up-to-date information they need to remain prepared and safe.  Thank you in advance for you attention to this letter, and I look forward to working together on this critical issue moving forward.

Sincerely,

MARK R. WARNER

 

cc:       

Secretary Alex Azar

Secretary Mike Pompeo

 

###

WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) welcomed news that the Drug Enforcement Administration (DEA) has announced long-awaited plans to improve patient access to substance use disorder treatment via telehealth. Yesterday, the DEA announced a proposed rule that will ensure health care providers can effectively use telehealth to diagnose and treat patients suffering from substance use disorders.

“The opioid and addiction epidemic has had a devastating impact on communities in Virginia and across the country,” said Sen. Warner. “We need to use every tool at our disposal to ensure that individuals struggling with addiction can access the treatment they need, and telehealth is an important part of that. I am pleased the DEA has finally issued proposed rulemaking that will improve telehealth access for these patients and I hope they will work quickly to finalize this rulemaking once stakeholders have had an opportunity to weigh in.”

In January, Sen. Warner sent a letter to the DEA urging the agency to finalize this long-delayed rule that will ensure providers can successfully use telehealth to treat individuals with substance use disorders. The proposed rulemaking released yesterday is an important step in the right direction that gives stakeholders an opportunity for review and comment before a final rule is issued.

Sen. Warner helped draft and pass the Senate’s comprehensive substance abuse treatment bill, which included a provision directing the Department of Justice, in consultation with the Department of Health and Human Services, to create a process for exempting certain health care providers for the purpose of providing telehealth services for substance use disorder. In addition – that legislation included four other provisions led by Sen. Warner that use telehealth to expand access to treatment for individuals suffering from substance use disorder. The bipartisan legislation was signed into law in 2018; however, the Attorney General failed to finalize a rule by the October 2019 deadline. For provisions of this legislation to be most effective, the DEA must complete its rulemaking process.

###

WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) addressed the coronavirus (COVID-19) outbreak and what it means for individuals in the Commonwealth of Virginia.

Specifically, Sen. Warner expressed concern with the Trump Administration’s response to the outbreak, and stressed the need for a more aggressive response in order to effectively combat the coronavirus. He also encouraged Virginians to heed instructions from the Centers for Disease Control (CDC) and directed Virginians to the CDC website for the most up-to-date information.

A transcript of his remarks is available below:  

“Hello, I’m Virginia Senator Mark Warner. Today, I’d like to talk to you about the coronavirus outbreak and what it means for the Commonwealth.

“As folks may know, coronavirus has sickened more than 82,000 people around the world. Almost three thousand people have died – now, mostly all in China. In the United States, there have been sixty confirmed cases – none of which are currently in the Commonwealth. However, the Center for Disease Control – CDC – has stated that the virus is expected spread within the U.S. on some level.

“My office has been in regular contact with officials on the ground in Virginia. Our priority is to make sure they have the resources they need and are fully prepared to respond to any potential cases of coronavirus in the Commonwealth. In addition, I’ve been closely tracking the actions of the Trump Administration and working with federal officials to make sure they’re taking this threat seriously.

“Earlier this month, I wrote to the Administration asking them to redirect available public health funds to combat this virus and to inform me and my fellow Senators of any additional resources they may need. This week the Trump Administration asked Congress for $2.5 billion dollars in order to contain the coronavirus and to try to prevent it from spreading in the U.S.

“I am reviewing this request, but frankly, based upon the initial feedback of public health experts, I am concerned that the Administration’s response to date may not be aggressive enough to effectively combat the virus. I’m also concerned that we will need a more robust response – particularly in funding – if we are going to be fully prepared.

“I plan to continue working with folks in the Commonwealth and at the federal level to ensure the health and safety of all our fellow Virginians. In the meantime, I urge all Virginians to heed CDC advice, including travel advisories and tips on how to keep your family safe. For more information, visit www.CDC.gov. We will get through this. Thanks so much.”

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) released the following statement on President Trump's State of the Union address:

"Rather than taking this evening as an opportunity to attempt to unify a deeply divided nation, President Trump instead delivered a State of the Union address that seemed focused solely on rallying his own political supporters behind him. 

"I'm especially stunned that the President walked into the House chamber tonight and declared that he wants to protect Americans with preexisting health conditions, despite the fact that he has spent three years undermining the Affordable Care Act, putting those protections at risk for the more than 3 million Virginians who have a preexisting condition. 

"If the President really means what he says about protecting people with preexisting conditions, he should immediately direct the Department of Justice to reverse its support for a lawsuit designed to take down the health care law in its entirety, and instead work with Democrats to lower health care and prescription drug costs and end surprise medical billing." 

Sen. Warner, a longtime champion of access to health care, has been outspoken about the Trump Administration’s effort to overturn the Affordable Care Act in court. Last year, he introduced legislation to allow Virginia, and any other states that expanded Medicaid after the 2014 deadline, to receive the same federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. According to the Virginia Hospital & Healthcare Association, this bill would save Virginia’s hospitals an estimated $300 million per year in the first three years of implementation. 

Additionally, in October, Sen. Warner forced a Senate vote on a Congressional Review Act (CRA) resolution that would have overturned a Trump Administration waiver rule that destabilizes the nation’s health insurance market and weakens protections for 3 million Virginians with preexisting conditions.  

In his speech tonight, President Trump called on Congress to pass legislation to lower prescription drug prices. The Senate Finance Committee, of which Sen. Warner is a member, in a bipartisan 19-9 vote last year approved legislation that would help address the rising cost of prescription drugs by taking on industry price hikes and protecting seniors with the highest out-of-pocket costs. However, despite support from Republican Committee Chairman Chuck Grassley (R-IA), whom the President named as a partner on the issue in tonight's address, the Senate Majority Leader has declined to bring the bill to the full Senate floor for a vote.

In Congress, Sen. Warner has long pushed for policy changes to help lower prescription drug costs for Virginia seniors and families. Last year, Sen. Warner re-introduced legislation to allow Medicare to negotiate prescription drug prices—a move that would cut costs for nearly 43 million seniors enrolled in Medicare Part D.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) requested information from four U.S. Department of Veterans Affairs (VA) medical centers in Virginia and Washington, D.C. regarding their strategies for preventing suicide among the veterans and families they serve. In letters to Salem VA Medical Center, Hunter Holmes McGuire VA Medical Center, Hampton VA Medical Center, and Washington DC VA Medical Center, the Senators pushed the medical centers to take a more integrated approach to suicide prevention and asked for more information regarding each facility’s outreach efforts.

“We are writing to request more information on your efforts to prevent suicide in the veterans population you serve in the Commonwealth of Virginia,” wrote the Senators. “It is clear that a new and more creative approach is necessary to combat this crisis, especially given that only six out of the nearly 20 veterans who take their own lives everyday received healthcare services at the VA.”

According to a 2019 veteran suicide prevention report by the VA, more than 6,000 veterans per year have died by suicide across the United States since 2008 – an average of nearly 20 current or former servicemembers each day. Additionally, an estimated 135 surviving individuals are affected by each suicide, including include family members, friends, and coworkers, among others. The number of veteran suicides per year has risen by 6 percent since 2005, despite hundreds of millions of dollars set aside for suicide prevention efforts by the VA during this period of time.

In their letters, the Senators asked for more information regarding each facility’s efforts to lower suicide rates among veterans. Specifically, they requested information on how each facility is employing social media and technology, as well as partnerships with various community stakeholders and veteran services organizations to reach more veterans. The Senators also asked about each facility’s use of community-specific public health data to tailor its approach to suicide prevention, and about the provision of additional suicide prevention training for community and clinical service providers.

Noting that a significant portion of the veteran population does not qualify for VA healthcare based on socioeconomic or disability prerequisites, the Senators also underscored their efforts to address this problem. In the letters, they highlighted a piece of bipartisan legislation introduced by Sen. Warner to establish a new grant program to expand the reach of veteran suicide prevention services, as well as bipartisan legislation introduced by Sen. Kaine to explore innovative mental health treatment options to help veterans combat Post Traumatic Stress Disorder (PTSD) and other mental health issues.

In December, Sen. Warner visited the Hampton VA Medical Center, where he urged Director David Collins to quickly resolve high wait times and staffing challenges at the medical center. In his visit, Sen. Warner also expressed support for a partnership between the medical center and Virginia Beach Police to help lower suicide rates. Last week, language from a bipartisan bill introduced by Sen. Warner to help address the alarming rate of veteran suicide was included in comprehensive legislation passed by the Senate Veterans Affairs Committee to expand veterans’ access to mental health services.

Through his work on the Senate Armed Services and Health, Education, Labor, and Pensions (HELP) Committees, Sen. Kaine has been an advocate for investments in mental health services and suicide prevention efforts. In July 2018, Sen. Kaine urged Defense Secretary Jim Mattis to release data on suicide rates among military families.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) announced that he will be inviting a Medicaid recipient and health care advocate from Chesapeake, Va. as his guest to the President’s State of the Union address on Tuesday evening. Terry “Bean” White, who lost his private insurance in 2008 when severe arthritis forced him to give up his job in the Newport News shipyards, is one of nearly 400,000 Virginians who gained coverage under Virginia’s Medicaid expansion and who are in danger of losing their health care coverage if the Trump Administration is successful in its effort to overturn the Affordable Care Act (ACA) in court.

Mr. White, who has congestive heart failure and has been previously treated for prostate cancer, became eligible for coverage after the Commonwealth expanded Medicaid at the beginning of last year – a move that was made possible under the ACA. Prior to that, Mr. White incurred an enormous amount of medical debt and had no choice but to move in with his sister, her daughter, and her two-year-old granddaughter.

“Despite the Trump Administration’s best efforts to dismantle our nation’s health care law, people like Mr. White are proof that Obamacare is working for Americans, and that Medicaid expansion is thriving in Virginia,” said Sen. Warner. “Bean was a hard worker who lost his health insurance through no fault of his own and soon found himself drowning in health care debt – all while struggling to manage his medical conditions. Thankfully, he was able to access coverage after Virginia voted to expand Medicaid under the ACA. But now, under the Republican-backed lawsuit that seeks to wipe out our nation’s health law, hundreds of thousands of Virginians like Bean are at risk of losing the coverage that in many cases keeps them alive and stands between them and bankruptcy. I hope that his presence will serve as a reminder of the potentially devastating consequences if the Trump Administration’s shameful lawsuit succeeds in overturning the health care law Congress passed back in 2010.”

“It is an honor to be invited to the State of the Union and I would like to thank Senator Warner,” said Mr. White. “The senator understands that without the ACA some of us, like myself, wouldn't be here. I am diabetic and recently survived prostate cancer. If it weren’t for Medicaid expansion, I would pay about $7,000 a month in medication costs.”

In December, the Fifth Circuit Court of Appeals struck down the individual mandate as unconstitutional and remanded the Texas vs. United States lawsuit to the lower court, instructing it to rule on which parts of the ACA should be eliminated. If the President’s lawsuit is successful, more than 20 million Americans and nearly 400,000 Virginians could lose their health coverage, with costs going up for millions.

In Virginia, Medicaid expansion made more than 400,000 Virginians like Mr. White eligible for low- or no-cost health care coverage. As of January 2020, more than 375,000 people have actually enrolled in the program. Prior to this expansion, these individuals fell into a “coverage gap” due to incomes that were too high to be eligible for Medicaid, but too low to receive tax credits to purchase affordable coverage in the health care marketplace.

Sen. Warner has been a champion of health care access for all Virginians amid this Administration’s relentless efforts to dismantle our nation’s health care law in Congress and now in court. Last week, Sen. Warner denounced a new plan by the Trump Administration to allow and incentivize states to cut Medicaid funding, thereby undermining Medicaid’s critical financing structure and putting care for vulnerable Americans on the chopping block. Last year, Sen. Warner introduced legislation to allow Virginia, and any other states that expanded Medicaid after the 2014 deadline, to receive the same federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. According to the Virginia Hospital & Healthcare Association, this bill would save Virginia’s hospitals an estimated $300 million per year in the first three years of implementation. Additionally, in October, Sen. Warner forced a Senate vote on a Congressional Review Act (CRA) resolution that would have overturned a Trump Administration waiver rule that destabilizes the nation’s health insurance market and weakens protections for three million Virginians with preexisting conditions.  

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) issued the following statement after the Trump Administration announced a new plan to allow and incentivize states to cut Medicaid funding, thereby undermining Medicaid’s critical financing structure and putting care for vulnerable Americans on the chopping block:

“I am very troubled by the Medicaid demonstration program announced today by the Trump Administration. Instead of focusing its efforts on improving and expanding access to health care coverage, this Administration continues down the road of undermining our nation’s health care system – this time by unveiling a proposal that will disrupt access to affordable health care for millions of Americans.

“It is clear the Administration is going to keep ignoring the repeated warnings of our physicians, hospitals and leading health experts across the country who have emphatically stated that such a proposal will lead to increased health care costs and reduced health care coverage. Plain and simple – this new demonstration program will allow states to cut essential and legally mandated health care benefits including coverage for behavioral health and substance use disorder, while increasing costs for other services across the board. Additionally, this rule will harm our ongoing efforts to combat the opioid and addiction epidemic and will increase the number of Americans without access to affordable health care coverage.”

In addition to allowing states to cut key Medicaid benefits and increasing costs for Medicaid expansion enrollees, the new Trump Administration rule allows states to deny retroactive health care coverage and payments to newly enrolled beneficiaries.

Sen. Warner, a longtime champion of access to health care, has been outspoken about the Trump Administration’s most recent effort to overturn the Affordable Care Act in court. Last year, he introduced legislation to allow Virginia, and any other states that expanded Medicaid after the 2014 deadline, to receive the same federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. According to the Virginia Hospital & Healthcare Association, this bill would save Virginia’s hospitals an estimated $300 million per year in the first three years of implementation. Additionally, in October, Sen. Warner forced a Senate vote on a Congressional Review Act (CRA) resolution that would have overturned a Trump Administration waiver rule that destabilizes the nation’s health insurance market and weakens protections for three million Virginians with preexisting conditions.  

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WASHINGTON – 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 is one step closer to becoming law. Today, the Senate Veterans Affairs Committee included language from the Senators’ IMPROVE Well-Being for Veterans Act as a provision in a comprehensive bill that expands veterans’ access to mental health services. The legislation unanimously passed the committee and now awaits consideration by the full Senate.

“Our nation’s veterans have faithfully served our country, and they deserve to know that, as they face the invisible wounds of war, we will do everything we can to make sure they receive the help they need. Currently, we are facing an alarming rate of suicide deaths among our veteran population and we’ve got to make tackling this issue a priority. With today’s markup of our bill, we are one step closer to making sure veterans get the services and resources they need,” said Sen. Warner.

“This is a great step in the right direction to getting our veterans the resources, services and care they need. 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 Department of Veterans Affairs (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 would better measure the effectiveness of these programs in order to reduce the alarming number of veteran suicides.

The VA estimates that around 20 veterans die by suicide each day. That number has unfortunately remained roughly unchanged despite drastic increases in funding. Over the last ten years, Congress has more than tripled the VA’s funding for suicide prevention efforts to $222 million.

Only six of those 20 veterans were receiving 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, VA Secretary Robert Wilkie called the bill “key” to unlocking the veteran suicide crisis at a committee hearing.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) joined Sen. Patty Murray (D-WA) and 28 of their Democratic Senate colleagues in requesting updates on the Administration’s response to the outbreak of Novel Coronavirus (2019-nCoV) and information on the steps being taken to keep families safe.

This letter comes on the heels of an announcement by the Virginia Department of Health (VDH), which earlier today ruled out Novel Coronavirus in two of three Patients Under Investigation, who met both clinical and epidemiologic criteria for the coronavirus. Test results for a third individual from Northern Virginia are expected to be received later this week.

“We write to express concern about the rapidly evolving 2019 Novel Coronavirus (2019-nCoV), to urge your continued robust and scientifically driven response to the situation, and to assess whether any additional resources or action by Congress are needed at this time. A quick and effective response to the 2019-nCoV requires public health officials around the world work together to share reliable information about the disease and insight into steps taken to prevent, diagnose, and treat it appropriately,” wrote the Senators.

They continued, “Unfortunately, the 2019-nCoV outbreak follows troubling proposals from the Trump Administration to cut the budgets of core public health programs at home and abroad. Yet, outbreaks like this serve as a solemn reminder of the need for an unwavering commitment to global health security and the need for strong public health programs worldwide.”

Despite repeated calls by the Trump Administration for cuts to public health programs, the December budget deal backed by Sens. Warner and Kaine increased funding for the Centers for Disease Control and Prevention (CDC) and its Infectious Disease Rapid Response Reserve Fund, which provides the agency with an immediate source of funding to prevent, prepare for, or respond to an infectious disease emergency either at home or abroad.

Sen. Kaine has introduced the Saving Lives Through Better Data Act, bipartisan legislation to modernize public health data infrastructure so clinicians, state health departments, and the CDC can work together more quickly and seamlessly to identify and respond to health threats like the coronavirus.

In their letter to the Department of Health and Human Services (HHS), the Senators also requested that the Department provide information regarding the severity of the disease, the country’s capacity to diagnose cases, the steps being taken to prepare U.S. health care workers, the screening systems in place at U.S. airports, the status of a novel coronavirus vaccine, and more.

In addition to Sens. Warner, Kaine and Murray, the letter was signed by Sens. Maria Cantwell (D-WA), Sherrod Brown (D-OH), Dick Durbin (D-IL), Tammy Duckworth (D-IL), Tammy Baldwin (D-WI), Chris Murphy (D-CT), Jacky Rosen (D-NV), Jack Reed (D-RI), Kirsten Gillibrand (D-NY), Amy Klobuchar (D-MN), Michael Bennet (D-CO), Bob Casey (D-PA), Chris Van Hollen (D-MD), Richard Blumenthal (D-CT), Ed Markey (D-MA), Tina Smith (D-MN), Elizabeth Warren (D-MA), Maggie Hassan (D-NH), Kamala Harris (D-CA), Tom Carper (D-DE), Debbie Stabenow (D-MI), Chuck Schumer (D-NY), Jeff Merkley (D-OR), Robert Menendez (D-NJ), Ron Wyden (D-OR), Angus King (I-ME), Dianne Feinstein (D-CA), and Cory Booker (D-NJ).

A copy of the letter is available here and below.

 

Dear Secretary Azar,

We write to express concern about the rapidly evolving 2019 Novel Coronavirus (2019-nCoV), to urge your continued robust and scientifically driven response to the situation, and to assess whether any additional resources or action by Congress are needed at this time. A quick and effective response to the 2019-nCoV requires public health officials around the world work together to share reliable information about the disease and insight into steps taken to prevent, diagnose, and treat it appropriately.

Chinese health officials confirmed the first case of 2019-nCoV in Wuhan, Hubei Province, China in December 2019. Since then, the case count has exploded in China, with nearly 3,000 confirmed cases as of the writing of this letter. At least 80 people have died. Cases have now been confirmed on four continents. On January 21, the first U.S. case was confirmed in Washington state, where state and local public health officials quickly responded with support from the Centers for Disease Control and Prevention (CDC). A second U.S. case was confirmed in Chicago on January 24. Subsequently, CDC confirmed two cases in California and one in Arizona, bringing the total U.S. case count to five. Airport screening procedures have been put in place to screen all passengers arriving in the U.S. from Wuhan. In Wuhan, and across China, officials have enacted travel restrictions and canceled planned festivals to celebrate the Lunar New Year. Even with these steps, the case count in China is expected to continue to rise, along with additional cases in the U.S. and around the globe. The World Health Organization is monitoring the situation closely, but has determined it is too early to formally designate this as a Public Health Emergency of International Concern. A quick, robust, and comprehensive approach to this outbreak is critical, while also remaining aware that, according to CDC, “the immediate health risk from 2019-nCoV to the general American public is considered low at this time.”

Unfortunately, the 2019-nCoV outbreak follows troubling proposals from the Trump Administration to cut the budgets of core public health programs at home and abroad. Yet, outbreaks like this serve as a solemn reminder of the need for an unwavering commitment to global health security and the need for strong public health programs worldwide.

We recognize the situation is evolving quickly and appreciate the information you have already provided. We ask you keep us apprised of developments as they occur, including any information related to the following questions:

1)      What can Congress do to fully support the U.S. Government response to this outbreak?

2)      How many HHS officials are currently engaged in the 2019-nCoV response domestically and abroad and in what capacities?

3)      What is HHS's best current judgment about the clinical severity of this disease? 

4)      What is the current domestic diagnostic capacity? How many facilities across the country are able to diagnose 2019-nCoV?

5)      What is currently known about the risk 2019-nCoV poses to health care workers? How is CDC communicating with U.S. health care facilities to ensure providers remain healthy and safe? What additional guidance is being supplied to health care providers?

6)      How many passengers have been screened by the airport screening procedures that are in place at American airports? How many potential cases have been identified as a result of this screening? Are there any planned changes to airport screening procedures?

7)      What progress has been made on the development of a 2019-nCoV vaccine?

Thank you for your attention to this urgent issue.

Sincerely,

 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) expressed concern with repeated delays by the Drug Enforcement Administration (DEA) that are preventing providers from being able to properly treat their patients via telehealth. In a letter, Sen. Warner urged the DEA Acting Administrator to finalize a long-delayed rule that will ensure providers can successfully use telehealth to treat individuals with substance use disorders.

“Providers across the country have been frustrated in their inability to provide adequate care as they wait for Congressionally-mandated guidance from your agency to clarify the process whereby health care professionals can legally use telehealth to better treat patients suffering from substance use disorder,” wrote Sen. Warner. “The DEA’s failure to promulgate the rule has meant that – despite Congress’ best efforts – many patients suffering from substance use disorders remain unable to access treatment via telehealth. These patients cannot afford to wait and we are concerned the DEA is standing in the way of treatment for individuals that cannot access a provider in person – particularly those in rural and underserved areas.”

“The opioid and addiction epidemic has devastated communities nationwide, with a particularly devastating impact on rural and medically underserved areas,” he continued. “Expanding telehealth services to individuals suffering from substance use disorder can bridge the distance between patients and care and ensure increased access to services they need.”

In order to crack down on the online proliferation of dangerous controlled substances online, the Ryan Haight Act of 2008 prohibited the delivery, distribution, or dispensing of a controlled substance by means of the internet without a prior in-person exam. However, this prevented providers from properly using telehealth to treat individuals – particularly those in rural communities who rely on this service to obtain timely access to health care.

Sen. Warner helped draft and pass the Senate’s comprehensive substance abuse treatment bill, which included a provision directing the Department of Justice, in consultation with the Department of Health and Human Services, to create a process for exempting certain health care providers for the purpose of providing telehealth services for substance use disorder. In addition – that legislation included four other provisions led by Sen. Warner that use telehealth to expand access to treatment for individuals suffering from substance use disorder. The bipartisan legislation was signed into law in 2018; however, the Attorney General failed to finalize a rule by the October 2019 deadline. For provisions of this legislation to be most effective, the DEA must complete its rulemaking process.

In the letter to Acting Administrator Uttam Dhillon, Sen. Warner emphasized the wide disparity in opioid deaths between urban communities and rural communities, which have a 45 percent higher rate of deaths by opioids. Sen. Warner also requested that the DEA provide an explanation if it does not intend to promulgate rulemaking on this issue in a timely manner.

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

 

Mr. Uttam Dhillon

Acting Administrator

Drug Enforcement Administration (DEA)

U.S. Department of Justice

800 K Street NW Suite 500

Washington, D.C. 20001

Acting Administrator Dhillon,

I am writing regarding the Drug Enforcement Agency’s (DEA) implementation of critical provisions in the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (Ryan Haight Act) (Public Law 91-513) and the recently passed SUPPORT for Patients and Communities Act (SUPPORT Act) (Public Law 115-271) that ensure individuals with substance use disorders can successfully access medical treatment via telehealth.

As you likely know – the Ryan Haight Act prohibits the delivery, distribution, or dispensing of a controlled substance online without first conducting an in-person exam. The intent of this law is to prevent illegitimate entities from selling dangerous controlled substances online while maintaining the ability for legitimate healthcare providers to treat patients in need.

The Ryan Haight Act also directed the DEA to promulgate rules exempting certain health care professionals from this requirement with the goal of ensuring patients have access to care via telehealth. However, in the 10 years since passage, the DEA has not promulgated rules to this effect. Congress further expressed its intent in passing the SUPPORT Act in 2018, which allows Medicare-eligible individuals suffering from substance use disorder to be diagnosed and treated via telehealth. The SUPPORT Act – similar to the Ryan Haight Act – mandated rulemaking by October 2019. Another deadline that has been missed.

Providers across the country have been frustrated in their inability to provide adequate care as they wait for Congressionally-mandated guidance from your agency to clarify the process whereby health care professionals can legally use telehealth to better treat patients suffering from substance use disorder. The DEA’s failure to promulgate the rule has meant that – despite Congress’ best efforts – many patients suffering from substance use disorders remain unable to access treatment via telehealth. These patients cannot afford to wait and we are concerned the DEA is standing in the way of treatment for individuals that cannot access a provider in person – particularly those in rural and underserved areas.

The opioid and addiction epidemic has devastated communities nationwide, with a particularly devastating impact on rural and medically underserved areas. According to the Centers for Disease Control and Prevention (CDC), there were more than 70,000 overdose deaths in 2017 – a 9.6 percent increase from 2016.   Furthermore, the CDC cites opioid deaths as 45% higher in rural areas, compared to urban communities. 

Expanding telehealth services to individuals suffering from substance use disorder can bridge the distance between patients and care and ensure increased access to services they need.

As detailed above, Congress passed the SUPPORT Act in 2018 and instructed the Attorney General – in consultation with the Department of Health and Human Services (HHS) – to promulgate rules on health care professional exemptions for prescribing controlled substances via telemedicine. This rule will ensure providers can successfully use telehealth to treat patients with substance use disorders. HHS has previously published suggestions on the potential uses of telehealth to diagnose and treat substance use disorder, but until the DEA takes action, providers will continue to face significant barriers in using telehealth to treat patients with substance use disorders. 

I strongly urge the DEA to promulgate rulemaking on this issue as soon as possible so that patients suffering from substance use disorders can receive the care they need. Furthermore, I ask that if you do not intend to promulgate this rule in a timely manner you respond in writing with an explanation of your decision. Thank you for your consideration of this request and I look forward to your response.

Sincerely,

 

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA), co-chair of the bipartisan Senate Cybersecurity Caucus, urged the Defense Health Agency to remove sensitive medical data belonging to servicemembers exposed online, where it remains vulnerable due to insecure data practices at Ft. Belvoir Medical Center, Ireland Army Health Clinic, and the Womack Army Medical Center.

“As a matter of national security, the sensitive medical information of our men and women of the armed services is particularly vulnerable and should be, at a minimum, protected by robust security controls and routine scans,” wrote Sen. Warner. “The exposure of this information is an outrageous violation of privacy and represents a grave national security vulnerability that could be exploited by state actors or others.”

He continued, “We owe an enormous debt to our armed forces, and at the very least, we ought to ensure that their private medical information is protected from being viewed by anyone without their express consent. Whenever data moves from one entity to another it should be protected by encryption, proper hashing, segmentation, identity and access controls, and vulnerability management capabilities that include diligent monitoring, auditing, and logging practices.”

In September 2019, Sen. Warner sought answers from TridentUSA Health Services regarding reports that many unsecured picture archiving and communication servers (PACS) left the names, dates of birth, medical images, and medical procedures of more than one million Americans accessible to anyone with basic computer expertise. Following that letter, the images were removed but millions of records were left online. Nearly two months later, Sen. Warner called out the U.S. Department of Health and Human Services (HHS) for its failure to act following the exposure.

Since the letter to HHS, 16 systems, 31 million images and 1.5 million exam records have been removed from the internet. However, a significant number of personally identifiable and sensitive medical information belonging to servicemembers remains online, due to unsecured Army PACS.

In his letter to the Assistant Secretary, Sen. Warner asked the agency to remediate the situation immediately and posed the following questions for Assistant Secretary Thomas McCaffery:

  1. Please describe the information security management practices at military medical hospitals. Do you require organizations to operate on a segmented network? To implement micro-segmentation? To implement access controls? If so, what kind? Do you require the hospitals to implement multifactor authentication, logging, and monitoring?
  2. Do you audit and monitor logs? 
  3. Do you require full-disk encryption and authentication for PACS?
  4. Do you require the hospitals to have a Chief Information Security Officer?
  5. Please describe what steps you took to address this issue, and when you were able to remove these systems from the internet.  

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

 

Mr. Thomas McCaffery

Assistant Secretary of Defense for Health Affairs

Defense Health Agency

7700 Arlington Boulevard

Falls Church, VA 22042

Dear Mr. McCaffery,

As the healthcare sector becomes increasingly reliant on technology to deliver essential services to patients, it also faces rising threats from malicious actors that seek to compromise the personally identifiable and other sensitive information of Americans. As a matter of national security, the sensitive medical information of our men and women of the armed services is particularly vulnerable and should be, at a minimum, protected by robust security controls and routine scans. It is with great alarm that I recently learned that unsecured Picture and Archiving Servers (PACS) at Ft. Belvoir Medical Center, Ireland Army Health Clinic, and the Womack Army Medical Center have left personally identifiable and sensitive medical information available online for anyone with a DICOM viewer to find.

Following a report  in September of 2019 highlighting the exposure of sensitive medical images belonging to millions of American through unsecured PACS, I wrote letters  to two healthcare entities that controlled the PACS, and those images were removed. However, millions of records remained online. The following month, I wrote  to the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) regarding the remaining exposure of the personally identifiable information belonging to 6 million American patients. Since that letter, 16 systems, 31 million images and 1.5 million exam records were removed from the internet. However, I recently learned that a significant number of medical records belonging to servicemembers remain online. This information was discovered by the German researchers at Greenbone Networks, who accessed the information using German IP addresses; this itself should have triggered alarms by the hospital information security systems.

The exposure of this information is an outrageous violation of privacy and represents a grave national security vulnerability that could be exploited by state actors or others. We owe an enormous debt to our armed forces, and at the very least, we ought to ensure that their private medical information is protected from being viewed by anyone without their express consent. Whenever data moves from one entity to another it should be protected by encryption, proper hashing, segmentation, identity and access controls, and vulnerability management capabilities that include diligent monitoring, auditing, and logging practices. To better understand how this happened, I would like information about your organization’s oversight of the information security practices at military hospitals, particularly at Ft. Belvoir Medical Center and Womack Army Medical Center.

I ask that you immediately remediate this situation, and remove the vulnerable PACS from open access to the internet. To understand how these records have been exposed and accessed repeatedly by a German IP address, please also answer the following questions:

  1. Please describe the information security management practices at military medical hospitals. Do you require organizations to operate on a segmented network? To implement micro-segmentation? To implement access controls? If so, what kind? Do you require the hospitals to implement multifactor authentication, logging, and monitoring?
  2. Do you audit and monitor logs? 
  3. Do you require full-disk encryption and authentication for PACS?
  4. Do you require the hospitals to have a Chief Information Security Officer?
  5. Please describe what steps you took to address this issue, and when you were able to remove these systems from the internet.

Given the gravity of this issue, I would appreciate a response within two weeks.

Sincerely,

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) released the following statement after the Fifth Circuit Court of Appeals ruled the individual mandate of the Affordable Care Act (ACA) unconstitutional, sending the case back to the lower courts:

“Despite the millions of Americans who have gained health care coverage thanks to the Affordable Care Act and the critical protections for individuals with pre-existing conditions, Republicans remain determined to throw out our existing health care system with no viable options to replace it.

“The uncertainty created by this court ruling and the repeated attacks on our nation’s health care laws place essential health care coverage for American families in serious jeopardy. As I have said before – the Trump Administration and Republicans in Congress should be working in a bipartisan fashion to strengthen existing law, not engaging in misguided attempts to take away people’s health care.

“Should Republicans succeed in their campaign of health care sabotage, millions of Americans would be without insurance, have higher costs, and have fewer protections. In light of this ruling – I remain committed to strengthening our health care law and will do everything I can to protect it.”

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