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By: HME NEWS

WASHINGTON – A bill to create a separate benefit for complex rehab within the Medicare program has been introduced in the House of Representatives.

H.R. 2408 was introduced by Reps. Jim Sensenbrenner, R-Wis., and Brian Higgins, D-N.Y., on May 1.

This follows the introduction on Monday of S. 1223, a bill that would exempt complex rehab manual and power wheelchairs and any wheelchair accessory, cushion or back when furnished in connection with a wheelchair from Medicare competitive bidding pricing.

Earlier in April, Reps. John Larson, D-Conn., and Lee Zeldin, R-N.Y., introduced H.R. 2293, a bill to suspend bid pricing for accessories for complex rehab manual wheelchairs for 18 months and to permanently exempt complex rehab manual wheelchairs from the program. 

Complex rehab stakeholders are in Washington, D.C., today and tomorrow to meet with members of Congress and ask for support of all three bills.

By: Susan Ferrechio & Naomi Lim of the Washington Examiner

The House Judiciary Committee voted Wednesday to push forward with the Democrats' plan to grill Attorney General William Barr for an additional hour via staff lawyers, setting up a political and legal fight with the country's top law enforcement officer.

Barr had been scheduled to appear in the House on Thursday about special counsel Robert Mueller’s report on Russian interference in the 2016 election. The House voted 21-14 to permit an extra 60 minutes of questioning by staff as opposed to lawmakers as the attorney general answered queries across the Capitol in the Senate Judiciary Committee, run by Republicans.

The Democrat-majority House panel voted along party lines regarding parameters for Barr's testimony a day after a news story revealed Mueller had complained last month to the attorney general that his memo about the report on Russian collusion “did not fully capture the context” of his findings.

Democrats have been eager to question Barr about his four-page memo, which they allege was purposely misleading and written to protect President Trump. Republicans, in turn, have sided with the Justice Department, which withdrew Barr’s agreement to testify when officials learned he would have to answer questions from staff, which is not the typical format.

"I don't believe it's proper that this committee even talk about doing something so unprecedented," Rep. Jim Sensenbrenner, R-Wis., said.

House Judiciary Chairman Jerrold Nadler, D-N.Y., however, argued that Congress does not need to justify to any part of the executive branch "the manner in which it chooses to conduct its own proceedings."

"Any attempt by the executive to dictate this is an obstruction of Congress. No witness can simply dictate to this committee the manner in which he or she is questioned when it is fully in accordance with House rules," Nadler said.

Nadler's counterpart, ranking member Doug Collins, R-Ga., said Democrats simply wanted to conduct an impeachment-like probe.

"The precedent for staff questioning is impeachment, but the problem is they can't bring themselves to bring impeachment," Collins said. "[They] want the appearance of impeachment to satisfy the base, to talk to others, to impugn integrity, to do whatever to smear the president ahead of the 2020 election."

But Rep. Sheila Jackson-Lee, D-Texas, shot back: "Democrats have no fear of the word impeachment and this is not an impeachment-like proceeding. What we are doing is investigating for the truth and investigating to edify the American people."

A Justice Department spokeswoman did not immediately respond to the Washington Examiner's inquiries about whether the attorney general will appear before the House on Thursday. The department also objects to the House Judiciary Committee’s intention to hold a closed-door session with Barr on the redacted portions of the report, which have not been disclosed.

Washington, D.C.—During today’s markup, the House Judiciary Committee passed two bills sponsored by Congressman Jim Sensenbrenner [WI-05] aimed at lowering drug costs. The CREATES Act and Stop STALLING Act both passed out of the committee unanimously.

Rep. Sensenbrenner: “I’m proud to be a leader in this bipartisan push to lower drug prices and bring relief to the American people. By holding accountable those who game the system, we can find market-based solutions that make prescription medicines more affordable. I thank Chairman Cicilline and Congressman Jeffries for joining me in this effort.”

Background on the legislation courtesy of the House Judiciary Committee:

H.R. 965, the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act
(Sponsored by Congressmen Jim Sensenbrenner and David Cicilline [RI-01])

In order for a generic or biosimilar prescription to have FDA approval, the generic manufacturer must be able to compare its product to the brand-name product. Simply put, if the product is as safe and effective as the label, then the FDA can approve the generic.

Some generic manufacturers, however, have difficulty obtaining samples of medication from the brand-name company. This is because brand-name companies have an incentive to make it difficult for generic producers to obtain their brand-name products.

The CREATES Act gives generic manufacturers the ability to bring actions in federal court against brand-name companies that refuse to provide samples of their products for purchase and use in the generic approval process. In so doing, the CREATES Act helps to increase the likelihood of a generic product coming to the market so consumers have more affordable options.

The CREATES Act also gives the FDA more discretion for approving alternative safety protocols that meet the statutory standards already in place. This helps the FDA more efficiently process generic applications. In the end, this helps consumers, who will have greater choice when selecting their medications.

According to a Congressional Budget Office estimate, the CREATES Act will save the federal government $3.9 billion on prescription spending.

More than 90 organizations representing consumers, physicians, pharmacists, hospitals, insurers, antitrust exports, and other support the CREATES Act. Supporters include AARP, Campaign for Sustainable Rx Pricing, Consumer Reports, Public Citizen, American Hospital Association, America’s Health Insurance Plans, Patients for Affordable Drugs, and the Coalition for Affordable Prescription Drugs.

H.R. 2374, the Stop Significant and Time-wasting Abuse Limiting Legitimate Innovation of New Generics (Stop STALLING) Act
(Sponsored by Congressmen Jim Sensenbrenner and Hakeem Jeffries [NY-08])

Individuals or companies can submit citizen petitions to voice concerns about a drug that could receive FDA approval. Because the FDA must respond to every petition it receives, bogus petitions often delay a generic drug from coming to market.

When used appropriately, citizen petitions allow all Americans to raise legitimate health and safety concerns, but prescription drug companies game the system by submitting numerous or baseless bogus citizen petitions to protect their market share unfairly. The Stop STALLING Act clarifies that such anticompetitive petitions are illegal under the Federal Trade Commission (FTC) Act.

The Stop STALLING Act also strengthens the FTC’s ability to challenge bogus petitions in court. This allows citizen petitions to continue serving their intended purpose while simultaneously deterring anticompetitive delays in the form of citizen petitions. 
Washington, D.C.—Today, Congressmen Jim Sensenbrenner (R-WI-05) and Brian Higgins (D-NY-26) introduced H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act. The bill creates a separate benefit category under Medicare to cover complex wheelchair and other adaptive equipment for people with severe medical needs.

Rep. Sensenbrenner“Individuals with significant medical conditions like cerebral palsy, muscular dystrophy, multiple sclerosis, and spinal cord injuries face unique physical and functional challenges. Many of these individuals rely on complex rehabilitation technology products to meet their medical needs and function on a daily basis. I’m proud to reintroduce this bipartisan legislation that would allow for targeted coverage and payment policies that address the unique situations of people with severe medical needs.” 

Rep. Higgins“The reimbursement criteria for many of the devices used today was developed a generation ago, before some of this technology was available. This bipartisan legislation is an effort to remove bureaucratic barriers that create unnecessary challenges for families and provide easier access to services and complex medically necessary equipment for those with severe disabilities.”   

Background:
Currently, Medicare includes complex rehabilitation equipment in the same category as standard durable medical equipment – i.e., traditional manual wheelchairs. However, individuals who use complex rehabilitation technology products tend to differ from the traditional Medicare population and have vastly different needs. Furthermore, these complex and often customizable products require a broader range of services and specialized personnel, as well as much more training and education for suppliers to ensure appropriate use.

Under H.R. 2408, Medicare would cover complex rehabilitation technology under a separate benefit category. This separate category would allow for targeted coverage and payment policies that address the unique situations of this specialized subset of durable medical equipment and the people with disabilities it serves. 

Additionally, to help prevent fraud and abuse, the legislation would establish clinical conditions for coverage that ensure these items are prescribed appropriately. Whenever prescribed, a licensed physical or occupational therapist with no financial relationship to the supplier would have to conduct an evaluation. This will ensure program safeguards by increasing quality standards for suppliers of these items.

H.R. 2408 is supported by the American Association for Homecare, American Physical Therapy Association, Brain Injury Association of America, Christopher and Dana Reeve Foundation, Easter Seals, National Association for Home Care & Hospice, National Coalition for Assistive and Rehab Technology, National Council on Independent Living, National Multiple Sclerosis Society, National Registry of Rehabilitation Technology Suppliers, Paralyzed Veterans of America, United Spinal Association.

By: Jackson Truesdale of the Brown Daily Herald

On April 3, U.S. Congressman David Cicilline ’83, D-R.I. proposed the Journalism Competition and Preservation Act for the second year in a row, which would allow online publishers and small newspapers to collectively negotiate with companies like Facebook and Google over the terms that regulate how these dominant online platforms distribute the publishers’ content.

“Right now, these two large platforms basically dictate the terms,” Cicilline told The Herald. To grant ‘News Content Creators’ more power in negotiations with ‘Online Content Distributors,’  the bill presents “a market-based solution. It’s not breaking up the platforms.” Instead, the act exempts publishers from antitrust laws that would otherwise prevent them from banding together during negotiations.

Cicilline introduced the bill last year in a GOP-majority House and found no Republican support, preventing the bill’s progress, The Hill reported. With the highest ranking Judiciary Republican Rep. Doug Collins, R-GA, now onboard, the bill stands a greater chance of moving forward.

President and CEO of News Media Alliance and the American Press Institute David Chavern emphasized the significance of the act. “The current antitrust laws protect Google and Facebook from news publishers. … We’re asking for the government to leave us alone” by limiting the liability of news content creators under the antitrust laws. Currently, newspapers have little to no collective negotiating power with large online platforms, which can prevent publishers from profiting when their own content is distributed. “More money has to flow back to publishers,” Chavern said

Four months before introducing this bill, Cicilline became chairman of the House Judiciary Committee’s Subcommittee on Antitrust, Commercial and Administrative Law. He told The Herald that the subcommittee would focus on big technology companies and healthcare sector issues, like hospital consolidations and prescription drug prices.

“It is well past time that we update and modernize our antitrust standards,” Cicilline told Bloomberg Opinion in January.

On March 19, Cicilline wrote a letter to the Federal Trade Commission urging the agency to investigate Facebook for using its position as a monopoly to unlawfully undermine competition. The FTC has not issued a public response. But on March 26, the Commission initiated an investigation into the practices and policies of internet service providers under a law that allows them to “enforce against unfair and deceptive practices,” according to an FTC press release.

Outside of large technology companies and internet privacy, the subcommittee’s efforts have also targeted the healthcare industry. In February 2019, the subcommittee introduced the bipartisan CREATES Act “to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products,” according to the legislation. According to the subcommittee’s ranking member, Rep. F. James Sensenbrenner, R-WI, Cicilline “has been a key ally on efforts to combat the rising costs of prescription drugs,” Sensenbrenner wrote in an email to The Herald. The CREATES Act “would expand access to markets for generics, making prescription drugs more affordable and saving taxpayers billions of dollars,” Sensenbrenner wrote.

“We need to promote policies that promote competition and choice. It should be bipartisan because Republicans have always been good on this issue,” Cicilline said.

Cicilline believes that further change is on its way. “We just haven’t had good enforcement of competition policy at the federal regulatory level,” Cicilline said, adding, “We didn’t have a Congress that made it a priority. We’re going to make it one now.”

Facebook did not respond to request for comment.

By: Simon Carswell of the Irish Times

US Democrat politician Nancy Pelosi has said she will renew efforts to pass a Bill extending working E3 visas to the Irish and raise the issue with the Republican leader in the Senate.

In her meeting with Taoiseach Leo Varadkar on Tuesday, Ms Pelosi, the speaker of the US House of Representatives, pledged to speak to Republican Senate leader Mitch McConnell as part of a fresh push to secure the passage of legislation in the US congress extending the existing visa scheme to Irish citizens.

The California Democrat, the third highest ranking elected official in US politics, expressed confidence that the Bill would pass through the House.

Sources said she told the Taoiseach she would raise the issue with Mr McConnell in an attempt to push the Bill through the Senate this time.

Immigration was one of the main topics of discussion between the Taoiseach and the Speaker in their meeting during a visit by a US congressional delegation led by Ms Pelosi to Dublin.

Democratic congressman Richie Neal plans to resubmit his Bill, co-sponsored by Wisconsin Republican congressman Jim Sensenbrenner, at the end of this month.

‘Good sense’

“My Bill is going to be refiled. It has already passed the House of Representatives unanimously. It makes good sense,” Mr Neal, who was part of the delegation, told The Irish Times.

Mr Neal said he was confident that it would pass the Senate this time around.

“My understanding is that not only does the House favour it, Trump favours it and the Senate overwhelmingly favours it; there are but one or two recalcitrants in the Senate who object,” he said.

Ms Pelosi indicated in her meeting with the Government that she was going to look at the possibility of attaching the E3 Irish visa Bill to a routine funding Bill being passed by Congress.

It will be the second attempt to extend the 10,500 visas a year scheme, currently only available to Australians, to Irish applicants after the House approved the Bill but it fell short of votes in the Senate.

Republican senator Tom Cotton of Arkansas blocked the passage of the Bill last December.

Australians take up only about half of the country’s annual allocation of E3 visas – introduced by the US in 2005 and seen as a thank you for Australia’s support of the US in the war in Iraq.

Lobbied

The Government lobbied to be included in the visa scheme, arguing that Irish citizens should be able to apply for any visas not taken by Australian citizens.

Fine Gael TD John Deasy, the Government’s special envoy to the US, said he was confident the Bill would pass given that it now had the backing of President Donald Trump, who expressed his support for when he met Mr Varadkar in the Oval Office during the Taoiseach’s St Patrick’s Day visit to the US.

Mr Trump said the White House had asked for the Bill to be reintroduced.

“The E3 has been brought too far to quit on it. We have agreement from every leadership office in the House and Senate and both sides [Republican and Democrat] that it needs to be pursued again,” he said.

Written by the Associated Press and ran in the Milwaukee Journal Sentinel

Madison — Wisconsin lawmakers have introduced a bill that seeks to elevate the status of two trails, therefore providing access to more funding to expand and maintain the routes.

The legislation seeks to designate the Ice Age and North Country national scenic trails as units of the National Park Service, Wisconsin Public Radio reported. Democratic U.S. Sen. Tammy Baldwin and Republican Rep. Jim Sensenbrenner are sponsoring the bill.

"The Ice Age Trail is a beautiful part of Wisconsin's natural wonders and also a significant contributor to our state's economy. According to a study by the University of Wisconsin-Whitewater, the trail has an annual economic impact of $113 million, drawing roughly 1.2 million visitors," Sensenbrenner said in a news release.

The trails are currently administered by the National Park Service in cooperation with other local, state and federal partners. But Baldwin said the trails don't have full trail status.

The bill would allow the trails to access funding that is available only to trails that are designated as a unit of the National Park Service, said Kevin Thusius, the director of land conservation with the Ice Age Trail Alliance.

"The Ice Age Trail Alliance and its partners at the National Park Service and other partners are working to close the gaps in the Ice Age National Scenic Trail by acquiring additional properties or additional trail rights between segments that are currently on the ground," he said.

There are 670 miles of the trail open for use. The trail is expected to stretch more than 1,200 miles once the project is complete, Thusius said.

The North Country National Scenic Trail runs across seven states: New York, Pennsylvania, Ohio, Michigan, Wisconsin, Minnesota and North Dakota. It's expected to stretch across 4,600 miles once finished, an effort that could be aided if the bill passes, said Peter Nordgren, a volunteer with the Brule-St. Croix Chapter of the North Country Trail Association.

"It is the longest scenic trail in the United States, and there's still plenty of work to be done on it," Nordgren said.

Gripes pepper meeting

April 16, 2019

By: Steve Sharp of the Watertown Daily Times

JOHNSON CREEK -- Although the fireworks were nowhere near what they have been in past years, a visit by U.S. Rep. F. James Sensenbrenner, R-Menomonee Falls, to several Jefferson County town and village halls Monday offered moments of confrontation.

The fiery veteran congressman has never been known to back down during these town hall meetings he uses to make contact with his constituents. Likewise, certain members of the citizenry are usually armed with a few strategic political jabs and questions of their own.

State Rep. Barbara Dittrich, R-Oconomowoc, of the 38th Assembly District, accompanied Sensenbrenner on his visit to the Johnson Creek Village Hall.

Sensenbrenner is recovering from hip replacement surgery he underwent early this year and told his audience of 18 with a laugh that he will be able "to kick some behinds again thoroughly in about a month."

The Johnson Creek meeting began with questions regarding immigration into the United States by people from Mexico and other parts of Central America.

Sensenbrenner said he favors the building of a wall to keep out illegal immigrants, along with the substantial funding of such a physical barrier.

Sensenbrenner said there also needs to be changes in asylum laws to make verification systems tighter. He said if people can make it into the country illegally and get amnesty, they can often bypass those who are trying to enter the United States legally.

"And most Americans are in favor of legal immigration," Sensenbrenner said.

He said if people want asylum, they should stay in Mexico, apply for it, get it and then come north legally.

Sensenbrenner said the Mexican government is to be congratulated for offering opportunities for those from other Central American countries to locate there for at least a year, but most do not accept the invitation and want to move straight up and into the U.S.

"I give the Mexican government credit for its efforts," he said.

One woman at the Johnson Creek meeting suggested putting chips in those people coming into the U.S. from Mexico illegally, so after they come in, if they disappear, they can be found and deported.

Sensenbrenner said he felt this was too "Big Brother-ish."

"Once we do that, then we will all have chips put in us," he said.

One member of the audience said he wanted to see taxes that are put on dealings made by FFA and 4-H students in Wisconsin related to county fair meat animal sales made simpler. He said the taxes are too complicated for the youths and for the committees that govern these events.

"The IRS has a knack for finding ways to tax good things," Sensenbrenner said.

The congressman said President Donald Trump's recent approaches toward "emergency declarations" as they relate to controlling the U.S. border with Mexico irritate him at times. He said if the Trump declarations would have been enacted in a full-blown manner, they would have taken money from the military that, in Sensenbrenner's estimation, deserves it more for construction projects and improving soldiers' living conditions.

"Congress directed this money to the military. Congress controls the purse strings and (Trump) wanted something different," Sensenbrenner said.

Medicare, Medicaid, gerrymandering and redistricting were also brought up in Johnson Creek Monday before Sensenbrenner headed to a meeting with 10 more constituents in Helenville.

There, one audience member asked why the U.S. does not do away with foreign aid and pay off the country's deficit.

Sensenbrenner said foreign aid comprises only a small portion of the U.S. budget and the goodwill it engenders worldwide is very much worth the expenditure.

"Doing away with foreign aid would have little effect on our debt," he said. "Foreign aid allows us to show the world what America is really like."

When asked if the American public should have better access to the tax returns of Donald Trump, Sensenbrenner said he did not believe such an option would shed much light on the current president's financial dealing beyond what the public already knows.

"I don't think these should be released for political reasons," Sensenbrenner said. "You can see if a president is lining his pockets as it is already. The information is there. A tax return will not allow you to do that ... The Mueller report came back and said there is 'nothing.' It was an independent counsel that found nothing."

Under further questioning from an audience member, Sensenbrenner said he would "never be able to convince" this visitor to the town hall session that Trump had not been aided in the election by Russia. He said he and his assistants watch some of the television networks that are considered by most to be left-leaning and suggested this person, a self-described Democrat, to watch Fox News.

"That way you can balance things out," he said.

Sensenbrenner said the U.S. economy is booming at present and there are more jobs available than people willing to fill them. In response to a question, he said the country's debt and deficit are due, in part, to Congress spending too much, but he would not take the blame for that, saying he has the strongest record on the congressional panel for voting against excessive spending.

The remainder of Sensenbrenner's day in Jefferson County, as scheduled, included visits to Sullivan and Palmyra.

By: York Dispatch Editorial Board

In 2014, there were no deaths in York County that involved fentanyl.

In 2018, there were 129.

York County has been hit hard by the opioid epidemic, and the introduction of the synthetic drug that is 50 to 100 times more potent than morphine has ratcheted up the stakes. 

That's one reason Sen. Pat Toomey's new bill to ensure consequences for nations where fentanyl is illicitly produced needs to get on the books as quickly as possible.

The bill from the Pennsylvania Republican would let the government gather information about illicit fentanyl production in foreign countries and cut off foreign aid and Export-Import Bank loans for countries that illegally produce the drug.

The exceptions are for countries that have emergency scheduling procedures for new illicit drugs, prosecute criminals for the manufacturing or distribution of the drugs and require the registration of machines that make tablets and capsules.

Sen. Doug Jones, D-Ala., is co-sponsoring the bill. A partner bill is also in the House, sponsored by Rep. James Sensenbrenner, R-Wis., and co-sponsored by six others including Rep. Lloyd Smucker, R-Lancaster County.

Data from the U.S. Customs and Border Patrol shows that China is the main source of fentanyl, and in June 2018 the CBP seized 110 pounds of the drug — worth $1.7 million on the streets — from China at the Port of Philadelphia. 

In January, officers at the border crossing in Nogales, Arizona, found 254 pounds of fentanyl, more than $3 million in value, being smuggled across the border along with 395 pounds of methamphetamine in a produce truck, the largest seizure of the drug in this country.

This is a smart way to address the problem of illegal drugs coming into our country, by putting some of the impetus on countries where those drugs are manufactured.

It's certainly a better strategy than pouring billions of dollars into a border wall when the vast majority of illegal drugs that are seized are coming in through legal ports of entry.

There are the websites that allow people to order fentanyl through the mail, and President Donald Trump's decision to withdraw the U.S. from the International Postal Union has made it more difficult for Washington to push for better control of international mail, which in turn would make shipping fentanyl more risky, according to Foreign Affairs.

In December, Trump announced during the G-20 summit that China will tighten its controls over the manufacture of fentanyl, which is purely chemical and therefore easy to make.

But China has more than 400,000 chemical manufacturers, and its regulatory system just can't keep up. 

Toomey's bill would force China and Mexico, the second greatest source of fentanyl, to take more responsibility for the chemical manufacture of the highly potent and deadly drug.

The bipartisan support for the bill is just an added bonus.

While previous versions of this legislation haven't made it out of the Senate Foreign relations Committee, we hope that this is the one that will complete the process and become law.

With the number of overdoses continuing to rise, there's no time to waste.

By: NBC 26

MADISON, Wis. (AP) — Wisconsin lawmakers have introduced a bill that seeks to elevate the status of two trails, therefore providing access to more funding to expand and maintain the routes.

The legislation seeks to designate the Ice Age and North Country national scenic trails as units of the National Park Service, Wisconsin Public Radio reported. Democratic U.S. Sen. Tammy Baldwin and Republican Rep. Jim Sensenbrenner are sponsoring the bill.

"The Ice Age Trail is a beautiful part of Wisconsin's natural wonders and also a significant contributor to our state's economy. According to a study by the University of Wisconsin-Whitewater, the trail has an annual economic impact of $113 million, drawing roughly 1.2 million visitors," Sensenbrenner said in a news release.

The trails are currently administered by the National Park Service in cooperation with other local, state and federal partners. But Baldwin said the trails don't have full trail status.

The bill would allow the trails to access funding that is only available to trails that are designated as a unit of the National Park Service, said Kevin Thusius, the director of land conservation with the Ice Age Trail Alliance.

"The Ice Age Trail Alliance and its partners at the National Park Service and other partners are working to close the gaps in the Ice Age National Scenic Trail by acquiring additional properties or additional trail rights between segments that are currently on the ground," he said.

There are 670 miles (1,080 kilometers) of the trail open for use. The trail is expected to stretch more than 1,200 miles (1,930 kilometers) once the project is complete, Thusius said.

The North Country National Scenic Trail runs across seven states: New York, Pennsylvania, Ohio, Michigan Wisconsin, Minnesota and North Dakota. It's expected to stretch across 4,600 miles (7,400 kilometers) once finished, an effort that could be aided if the bill passes, said Peter Nordgren, a volunteer with the Brule-St. Croix Chapter of the North Country Trail Association.

"It is the longest scenic trail in the United States, and there's still plenty of work to be done on it," Nordgren said.