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| By Daniel Payne |
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With Robert King Programming note: We’ll be off this Monday for Juneteenth, but we’ll be back in your inboxes on Tuesday.
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 Congressional Medicare advisers want CMS to lower its payment rates for telehealth. | Peter Macdiarmid/Getty Images |
MORE TELEHEALTH, BUT … Congress’ Medicare advisers want more telehealth — but for less money, POLITICO’s Ben Leonard reports. On Thursday, the Medicare Payment Advisory Commission called for the Centers for Medicare and Medicaid Services to lower its payment rates for telehealth services, saying they don’t usually cost practices as much as in-person services. The recommendation calls specifically for rescinding fee increases adopted during the Covid-19 public health emergency “as soon as practicable” — which means 2024, according to MedPAC’s director. The group also suggested that CMS work with Congress to standardize payments for telehealth, taking care to not disincentivize in-person care. And MedPAC pushed for cost-sharing with beneficiaries to discourage overuse of virtual services. But those recommendations also came with support for expanded telehealth use. The panel said the measures embraced through the pandemic didn’t significantly impact the quality of care and only marginally increased costs for Medicare. Public health leaders have hoped that more telehealth could mean more access for underserved populations, though that’s only true for some demographic groups, according to MedPAC’s analysis. The guidance comes as the post-pandemic future of telehealth is in the balance. Emergency policy changes during Covid offered huge growth for the technology, but how that change is sustained or lost is a multibillion-dollar question. While bipartisan support for telehealth is strong — the fiscal 2023 omnibus spending law extended the pandemic rules through next year — some lawmakers are concerned about how much it will cost Medicare. WELCOME TO FRIDAY PULSE, where we recently learned about the connection between toilet plungers and better CPR outcomes. One plunger being used to restart a man’s heart has, over decades, led to innovations to make CPR more effective. What innovations in health policy are you watching? Let me know — and send other health news — to dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Alice Miranda Ollstein interviews Megan Messerly about Arkansas' speedy approach to removing ineligible people from the state's Medicaid rolls —and the confusion among many eligible residents who lost their coverage because of procedural reasons like not properly submitting paperwork.
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| A message from PhRMA: Pharmacy benefit managers (PBMs) decide if medicines get covered and what you pay, regardless of what your doctor prescribes. They say they want lower prices, yet they often deny or limit coverage of lower-cost generics and biosimilars, instead covering medicines with higher prices so they make more money. What else are they hiding? |
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HHS is proposing updated regulations to help older adults remain in their homes. | Tony Dejak/AP Photo |
FIRST UPDATE IN 35 YEARS — The Administration for Community Living issued the first proposed update since 1988 to regulations aimed at helping older adults live in their homes, Robert reports. The agency released a proposed rule Thursday that updates regulations for programs created under the Older Americans Act, including home-delivered meals and family caregiver support. The goal is to align regulations to reflect changes in how older adults are cared for, HHS said. “With our population aging rapidly, and nearly three out of four people needing assistance to age in place, this is more important than ever,” said Alison Barkoff, acting assistant secretary for aging, in a statement. The proposed rule aims to incorporate lessons learned from the Covid-19 pandemic and specifies who is eligible for services. It also creates expectations for legal assistance to help curb elder abuse, according to a fact sheet on the proposal. “The proposed rule will help ensure that older people, particularly those in greatest need, have the support they need to live independently,” said HHS Secretary Xavier Becerra in a statement. HHS is seeking comments on the proposal through Aug. 15.
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NEW ‘FLU-LIKE’ STRATEGY — The FDA’s expert panel on vaccines looks to make Covid boosters more like flu shots, POLITICO’s Katherine Ellen Foley reports. That strategy focuses on preventing a single, globally prevalent strain of the virus for the fall and winter months. The agency’s Vaccine and Related Biological Products Committee voted 21-0 Thursday to recommend that the next iteration of Covid vaccines protect against one variant of the XBB strain — which is in line with the World Health Organization, the European Medicines Agency and the European Centre for Disease Prevention and Control. The recommendation follows a plan the FDA outlined in January, which suggested that most adults and children with previous vaccinations would get a single booster shot for Covid ahead of the colder weather season when cases of respiratory illness increase. Older adults, adults with weakened immune systems and children, including kids who have never been vaccinated, can get additional shots, similar to prior Covid vaccination strategies.
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| JUDICIAL NOMINEE ADVANCES — The Senate advanced federal judicial nominee Julie Rikelman today, despite a targeted campaign by GOP members and anti-abortion advocacy groups to tank her nomination, POLITICO’s Alice Miranda Ollstein reports. Rikelman — the former leader of the Center for Reproductive Rights, an abortion-rights group — garnered some GOP backing, with Maine Sen. Susan Collins and Alaska Sen. Lisa Murkowski crossing the aisle to support her in the 53-45 cloture vote. Murkowski told POLITICO before the vote that the nominee’s time clerking for the first female justice on Alaska’s Supreme Court had her considering voting in favor of Rikelman’s lifetime appointment to the 1st U.S. Circuit Court of Appeals. Murkowski said she met with Rikelman and came away “impressed with the experience that she brings coming out of Alaska, which is not something that all of these nominees have.” — GOP opposition: Sen. John Kennedy’s (R-La.) prediction of “almost universal Republican opposition” to Rikelman in today’s vote came true, with every GOP member other than Collins and Murkowski voting no.
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| A message from PhRMA:   |
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BUCKING THE TREND — One Republican governor is taking a different approach than his counterparts on gender-affirming care, POLITICO’s Liz Crampton reports. Nevada stands as the sole state with a Republican governor who recently signed legislation requiring health insurers to cover gender-affirming care like sex reassignment surgeries for minors and adults. That law also eliminates exclusions that have been used to deny care based on a “cosmetic” classification. Gov. Joe Lombardo, in signing the bill into law, went against the state Republican Party, which opposed the measure. This week, he told a local news outlet that people should read the bill and find that “it’s not as draconian or detrimental or immoral as people are portraying it to be.”
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NEARLY 1 IN 5 — That’s the number of U.S. adults who report having ever been diagnosed with depression, according to new data from the CDC. But the rate — though averaging across the country at 18.4 percent — varies significantly from state to state and county to county. Hawaii, for instance, has a rate well below the national average at 12.7 percent. And West Virginia reports diagnosis rates well above average at 27.5 percent. The CDC says the data may be useful for policymakers considering resource allocation — a debate particularly pertinent as Congress mulls health workforce legislation that could be key in treating mental illness.
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| James E. Mathews, the executive director of MedPAC, will leave the agency at the end of August. Paul Masi, unit chief of the Health Systems and Medicare Cost Estimates Unit at the Congressional Budget Office, has been named MedPAC’s next executive director. Leigh Feldman and Jeffrey Davis have joined McDermott+Consulting as health policy directors.
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The New York Times Magazine reports on the corporatization of medical practices — and its effects on doctors. Healthcare IT News reports that CISA and the FBI are warning health systems about a ransomware gang. The Wall Street Journal reports on the questions raised about which medical professionals should make a hard call in the age of artificial intelligence.
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| A message from PhRMA: Middlemen say they want lower prices, yet they often deny or limit coverage of lower-cost generics and biosimilars while giving preferential coverage to medicines with higher prices. This might be good for PBM’s bottom line, but it can lead to higher costs for patients. What else are they hiding? |
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