| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | Presented by Humana | | | | | | 
The House has a heavy health care-related agenda this week as committees consider reauthorizations, new bills and other pressing issues. | J. Scott Applewhite/AP | THIS WEEK ON THE HILL — The Senate is focused on supplemental funding this week, but there’s still action on health care to watch in the lower chamber. The slew of hearings comes as Congress closes in on a March 1 deadline to avoid a partial government shutdown. The latest spending patch set deadlines for March 1 for FDA and VA programs and March 8 for HHS funds. The House Energy and Commerce Committee meets Wednesday for a grab-bag legislative hearing under the umbrella of legislation “to support patients and caregivers.” All the bills being considered are bipartisan and could hitch a ride on spending legislation. Many of the bills reauthorize programs, including legislation to tackle provider burnout, continue programs for traumatic brain injuries, boost rural emergency medical services and extend the National Alzheimer’s Project. Another bill from E&C Committee Chair Cathy McMorris Rodgers (R-Wash.) and Diana DeGette (D-Colo.) would boost funding for Down syndrome research. Rodgers, who said Thursday she’s not seeking reelection, has a personal tie to the issue — her son, Cole, has Down syndrome. The House Budget Committee meets Wednesday for a hearing on the CBO’s “budget and economic outlook.” CBO Director Phillip Swagel is set to testify. Last week, the committee unanimously advanced legislation to reform how the CBO estimates preventive health care. The House Select Subcommittee on the Coronavirus Pandemic is set to meet on Thursday to oversee the effectiveness of vaccine injury compensation and vaccine safety reporting. Biden administration officials, including the FDA’s Dr. Peter Marks, the CDC’s Dr. Daniel Jernigan and Dr. George Reed Grimes, who leads the Health Resources and Services Administration’s injury compensation programs, are set to testify. “Concerns arose that these systems were unable to properly inform the American public about vaccine injury reports and potentially contributed to the deterioration of public trust in vaccine safety,” Chair Brad Wenstrup (R-Ohio) said in a statement. A House Veterans’ Affairs subcommittee meets Thursday on the agency’s troubled electronic health record modernization effort, focusing on pharmacy oversight. Prescribing issues have plagued the rollout, which has ballooned in cost and been tied to several veterans’ deaths. Another Veterans’ Affairs subcommittee meets later that day to explore how AI is used at the VA and how it can be used in the future. WELCOME TO TUESDAY PULSE. Taylor Swift is now shaking up health care, too. The American Society of Tropical Medicine and Hygiene had to reschedule its conference in New Orleans because she was performing at the same time. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | A message from Humana: As detailed in Humana's value-based care report, developing relationships between healthcare providers and patients allows providers to focus on disease prevention and chronic disease management. Humana facilitates whole-person healthcare through care coordination. At CenterWell—a Humana Inc. Company—doctors, nurses, specialists, and other health professionals collaborate on primary care teams. These facilities also function as wellness centers where patients can socialize, exercise, and participate in activities that support their health. Read more. | | | | | ‘A SHOCK’: RESEARCH CHANGES SPUR FEAR — The Centers for Medicare and Medicaid Services said Monday it’s shaking up its research protocols, ruffling many feathers. CMS will stop shipping researchers physical copies of data extracts, citing a surge in data breaches and security concerns. Instead, researchers — save for those from excepted federal and state agencies — will be directed to a virtual center where they can access data. The agency has said the site boosts efficiency and is more cost-efficient than sending physical copies. But many academics raise concerns that this will mean increased costs for researchers and could impede high-quality and timely analysis. CMS data on millions of Medicare and Medicaid beneficiaries is often used in health care policy research. Adam Sacarny, an assistant professor of health policy at Columbia's Mailman School of Public Health, told Pulse that the move was a “shock.” The cost varies significantly by project for physical versus digital data extracts, he said. “For some projects, it’s great. For some projects, it's off the table because it's too expensive,” Sacarny told Pulse. “Imposing really high cost barriers to access to this data could really prevent researchers from doing the kind of work that can help us make the healthcare system better.” William Schpero, an assistant professor of health policy at the Weill Medical College of Cornell University, told Pulse that the move is like “throwing the baby out with the bathwater.” “While I understand the security concerns … there has to be a middle ground that will more efficiently balance security and access,” Schpero said. He said the move could disproportionately hurt students and less well-resourced institutions. CMS didn’t respond to a request for comment. What’s next: The policy changes ending the data’s physical dissemination for new studies will begin Aug. 19. Those with previously approved research will continue to receive physical data but can’t expand to get new types of data. The agency is taking feedback on next steps through March 29.
| | | | CONGRESS OVERDRIVE: Since day one, POLITICO has been laser-focused on Capitol Hill, serving up the juiciest Congress coverage. Now, we’re upping our game to ensure you’re up to speed and in the know on every tasty morsel and newsy nugget from inside the Capitol Dome, around the clock. Wake up, read Playbook AM, get up to speed at midday with our Playbook PM halftime report, and fuel your nightly conversations with Inside Congress in the evening. Plus, never miss a beat with buzzy, real-time updates throughout the day via our Inside Congress Live feature. Learn more and subscribe here. | | | | | | | | | FIRST IN PULSE: PRIVATE EQUITY RISING — Private equity fundraising is rising in health care, according to a new report from the American Investment Council. Through Aug. 30, 2023, $15.1 billion in private equity was raised in health care-focused funds, up more than $10 billion from a decade ago, according to the report, which used Pitchbook market data. Overall, health care funds have around $73 billion under management, according to AIC. In the report from the private equity lobbying firm first obtained by Pulse, the group argued that private equity makes the health care system more efficient. “All of that capital is being recycled into hospital systems, outpatient clinics, pharmaceutical manufacturers, medical device innovation, and dozens of other life-saving and cost-reducing initiatives that ultimately improve patients’ lives,” the group wrote.
|  | Zooming out: The report comes as lawmakers on Capitol Hill and government agencies increasingly target private equity firms’ involvement in the health care sector. CMS has taken measures to boost transparency about private equity ownership of nursing homes amid concerns about quality of care. House Ways and Means ranking member Richard Neal (D-Mass.) has pushed for private equity reporting requirements to be included in a sweeping transparency deal. AIC has previously pushed back on CMS, saying private equity has been unfairly targeted.
| | | | A message from Humana:   | | | | | TEFCA GETS A BOOST — HHS has added two more organizations to its data-sharing initiative known as Trusted Exchange Framework and Common Agreement — the CommonWell Health Alliance and Kno2. On Monday, the Office of the National Coordinator for Health IT announced that they’ve designated two firms as Qualified Health Information Networks, which allows them to immediately begin supporting data exchange under a common agreement. The initiative aims to better connect providers, public health agencies, researchers and others in medicine through a nationwide network to facilitate sharing of patient information. It’s a boon for the network-to-network exchange, as Oracle Cerner, one of the largest electronic health record vendors, is a founding member of the CommonWell Health Alliance. The firms join electronic health record giant Epic; health information network eHealth Exchange; interoperability platform Health Gorilla; KONZA, a nonprofit that supports health information exchanges; and health IT firm MedAllies in the effort that became operational in December. Congress set off the process in 2016. What’s next: QHINs are set to adopt a new version of the common agreement in the first quarter of this year.
| | | | DON’T MISS POLITICO’S GOVERNORS SUMMIT: Join POLITICO on Feb. 22 to dive into how Governors are wielding immense power. While Washington remains gridlocked, governors are at the center of landmark decisions in AI and tech, economic development, infrastructure, housing, reproductive health and energy. How are they setting the stage for the future of American politics, policies and priorities? How are they confronting major challenges? Explore these questions and more at the 2024 Governors Summit. REGISTER HERE. | | | | | | | | | MA RULES IMPACT — Medicare Advantage insurers will face “margin pressure” amid new regulations from the Centers for Medicare and Medicaid Services, according to a new report from policy analysis firm Capstone. Those changes require that Medicare Advantage plans cover any services covered by traditional Medicare with respect to national and local coverage determinations and tighten prior authorization requirements. The latter is a bid to crack down on a common tool that critics say is used to delay or deny patient care. “There will likely be continued strife between hospital groups attempting to utilize new coverage policies to get reimbursed at a higher rate and MA plans developing policies to remain in line with the new coverage mandates but retain some aspect of utilization management,” Capstone’s Grace Totman and David Mohler write. They said to expect the first substantial look at the “margin pressure” in April via first-quarter financials. Insurer advocacy group the Better Medicare Alliance in a statement applauded CMS’ “leadership in modernizing the prior authorization process” in response to the prior authorization rule.
| | Dr. Robyn Neblett Fanfair has been chosen to lead the CDC’s HIV prevention division. She’s been at the agency since 2010. Dr. Theresa M. Miskimen Rivera has been selected as president-elect of the American Psychiatric Association. She’s currently chair of the psychiatry department at Hunterdon Medical Center.
| | STAT reports on universities moving to protect themselves amid “a flurry” of research misconduct cases. The Wall Street Journal reports that Medicare Advantage plans might have fewer “freebies” next year.
| | | | A message from Humana: Many patients, especially those with chronic conditions, need cross-disciplinary care.1
Humana connects beneficiaries with access to primary care physicians, specialists, and pharmacists, assisting their health journey when and where they need it. Some patients can also access care within their homes, which may improve outcomes.2
1. The Journal for Nurse Practitioners, "Improving Care Coordination of Patients With Chronic Diseases," 2022.
2. AJMC, "Value-Based Care Through Postacute Home Health Under CMS PACT Regulations," 2022.
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