Biden Final Rule on Health Care Refusal Released
On January 9, 2024, the US Department of Health and Human Services (HHS) released its final rule (PDF) rescinding most of the Trump administration’s 2019 health care refusal rule.

The 2019 health care refusal rule never took effect, thanks to successful litigation challenging the rule brought by NFPRHA and its member Public Health Solutions, represented by the American Civil Liberties Union (ACLU), in coordination with cases brought by Planned Parenthood Federation of America (PPFA) and by the New York Attorney General on behalf of 20 states, two cities, and one county. The 2019 rule had been scheduled to go into effect on November 22, 2019, but on November 6, the district court struck it down, vacating (setting aside) the rule in its entirety.

The Biden final rule is substantially similar to the notice of proposed rulemaking (NPRM) published in January 2023 rescinding the most harmful aspects of the 2019 rule, though the final rule does add in several provisions concerning enforcement and compliance.

NFPRHA joined the ACLU in issuing a press statement commending the final Biden rule and the recission of the Trump rule, available here.

The final rule is scheduled to be officially published in the Federal Register on January 11, and will take effect 60 days after the official publication.

If you have questions, please contact Robin Summers, Vice President and Senior Counsel, at rsummers@nfprha.org.

FY 2024 Federal Funding Remains Uncertain 
There is still no final package to fund the federal government for the year. In November 2023, Congress passed a continuing resolution (CR) to fund part of the government through next Friday, January 19, and part of the government through Friday, February 2. Important programs for family planning providers are included in both sets: for example, mandatory funding for the community health center program and for the Personal Responsibility Education Program (PREP) and discretionary funding for WIC expires on January 19, while discretionary funding for HHS, including Title X, expires on February 2.  

Earlier this week Speaker Mike Johnson (R-LA) and Senate Majority Leader Chuck Schumer (D-NY) announced an agreement on a topline funding number for the year, but funding amounts for each of the twelve appropriations bills remain in discussion, not to mention funding for individual programs. There is also no formal agreement on new poison pill policy riders (for example, the House-proposed provision to bar Planned Parenthood from receiving federal dollars); Democrats insist they will not allow any new riders, while Republicans in the House continue to assert that such provisions are on the table for inclusion. Given the lack of specifics in the deal, several members of Congress have confirmed that another CR will be needed to at least extend the deadline for the parts of the government currently slated for a January 19 end date. However, it will be challenging for Speaker Johnson to get such a measure passed on the House floor, given widespread conservative opposition to the funding package. Congressional leaders are expected to release details of a CR in the coming days.  

FDA allows importation of syphilis medication to address Bicillian L-A shortages
To address ongoing shortages, the Food and Drug Administration (FDA) announced temporary approval for the importation of the syphilis medication Extencilline, the Laboratories Delbert (France) formulation of benzathine penicillin G (the same antibiotic as Bicillin). Widely available outside of the US, this antibiotic – exclusively manufactured and marketed by Pfizer as Bicillin L-A in the US but available from other manufacturers internationally – is the only drug that can be used to treat syphilis in pregnant people; it also is the preferred treatment for nearly all syphilis patients. Of note, the Centers for Disease Control and Prevention’s (CDC’s) most recent data shows a 203% increase in congenital syphilis in the five-year period between 2017 and 2021.

Direct Success will be the sole distributor of imported Extencilline, which is expected to be available for purchase beginning next week. Two products will be available, with a minimum purchase quantity of 5 vials:

• Extencilline: 81284-0521-01 = the 1.2 MIU-1 glass vial(s) of powder at 1.2 MIU - 1 glass ampoule(s) of solvent of 5 ml
• Extencilline: 81284-0522-01 = the 2.4 MIU-1 glass vial(s) 2.4 MIU - 1 glass ampoule(s) of 5 ml
  • Wholesale acquisition cost (WAC) for the 2.4 MIU is $500.00.

Of note, this product will NOT be eligible for 340B pricing. Health care organizations should reach out to distribution@dsuccess.com or call 1-877-404-3338 for more information. NFPRHA will share more information as it becomes available.

Federal Agencies Receive Reprieve on Mandatory Funding Cut 
In late December, the Office of Management of Budget (OMB) issued a memo (PDF) to clarify the Fiscal Responsibility Act of 2023’s requirement (PDF) that all discretionary programs be cut by 1% if FY 2024 funding was not finalized by either December 31, 2023, or April 30, 2024. OMB wrote that these cuts will not come into effect until April 30, and only then for any part of the government still funded under a short-term CR as of that date. A full-year CR would count as final funding and would not lead to the mandatory sequester.  

If you have any questions about the budget & appropriations process, please contact Lauren Weiss at lweiss@nfprha.org.  

January Membership Spotlight
NFPRHA's first Membership Spotlight of 2024 is Madi Weisberg of Montana Family Planning! Madi has a history of advocacy both at the local and national level, including participation in a panel conversation about threats to contraceptive access on Capitol Hill following the 2023 NFPRHA National Conference last year. Read why, in her own words, she's passionate about family planning and sexual health care work on NFPRHA's X/Twitter or Facebook.

OPA Seeks Spanish-Speaking Title X Program Reviewer
The Office of Population Affairs (OPA) is searching for Spanish-speaking providers to conduct program reviews. See the flyer here for details (PNG). If you or someone you know is interested, contact OPASupport@norc.org.

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Resource: NILC Health for All Resources
National Immigration Law Center (NILC) recently released a series of reports explaining different tools available to states to achieve health for all: access to quality, affordable health coverage for all state residents, regardless of immigration status. 

Medicaid Renewal Resource Hub
HHS launched a new, online, and user-friendly hub for partners to access Medicaid and CHIP renewal and transition resources as they work to protect people’s health coverage as states conduct renewals.

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TOMORROW: Travel Assistance Deadline for NFPRHA Winter Seasonal Meeting
NFPRHA’s 2024 Winter Seasonal Meeting will take place February 12-14 in Newport Beach, CA, and the deadline for travel assistance is tomorrow, January 12! Register today to join fellow NFPRHA members at a welcome reception on the evening of Monday, February 12, followed by plenaries and workshops February 13-14. A draft agenda of the sessions on timely topics for family planning providers and administrators can be found here, and includes plenaries on the Bicillin shortage and Medicaid unwinding, as well as sessions on leveraging perinatal quality collaboratives, health inequities with Black women and PrEP, and more.

NFPRHA seasonal meetings are open only to current NFPRHA members, with no cost to register. Travel assistance is available by request for one person per member organization. The deadline to apply for travel assistance and the hotel reservation cutoff is tomorow, Friday, January 12. Grantee members in good standing are encouraged to inform their subrecipients that they are eligible to apply for travel assistance for NFPRHA’s Winter Seasonal Meeting, which includes a two-night hotel stay and no cost to register. Member organizations may send additional staff to this meeting at their own expense. 

NFPRHA’s number one priority is the health and safety of our event participants, and our goal will always be to hold a safe event. You can find NFPRHA’s health and safety guidelines for this meeting here (PDF). 

To access the information for this virtual meeting, you must first log in using your NFPRHA user ID. Please contact Victoria Rosborough, Director, Events, at vrosborough@nfprha.org with any questions.

Webinar Opportunity: The State of State-level Public Health Advocacy
The Network for Public Health Law will host a webinar on January 18, 1:00 p.m. ET, on their newly-released report, The State of State-level Public Health Advocacy (PDF). The webinar will cover opportunities, bright spots, and potential models for engaging funders, allies, and public health partners in advocating for public health, as well as key findings identified in the research. You can register here.