| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | | | | | | 
While the House spending package includes legislation that would require Medicaid plans to cover drug treatments for substance use disorders, it doesn't reauthorize the SUPPORT Act, which addresses the opioid epidemic. | AP Photo | WHAT’S IN THE FUNDING DEAL FOR HEALTH — Congress is poised to blunt payment cuts for doctors under Medicare and boost payment for community health centers under a spending deal released Sunday. Under the package, the FDA would get funding closely in line with previous levels at $6.7 billion. The VA's topline funding under the package sits at $307 billion, a $24 billion boost when accounting for funding under the debt-ceiling deal related to toxic exposures. A number of other health policy priorities caught a ride. Here’s some of what made the cut: — Doc pay: The legislation provides a 1.68 percent boost in Medicare pay for doctors. The amount, combined with the 1.25 percent increase Congress provided for them in the 2023 year-end package, results in a 2.93 percent payment bonus for 2024 but doesn’t mitigate the full 3.4 percent pay cut that the Biden administration finalized last fall through a mandated formula. — Community health centers: The legislation backdates funding to the beginning of the fiscal year, bringing community health center funding to an annualized rate of $4.27 billion a year, a $270 million increase over the previous year. — Substance use disorder: It includes legislation to permanently require state Medicaid plans to cover medication-assisted treatment. The bill also includes legislation to create a permanent state Medicaid option allowing treatment of substance use disorder at institutions. Here’s what didn’t: — PBMs: A bipartisan bid to rein in pharmacy benefit managers didn’t make the cut, as expected. Senate Finance Committee Chair Ron Wyden (D-Ore.) said he’s “extremely disappointed” that such provisions aren’t included and will be “unnecessarily delayed until December or longer.” — ‘Poison pill’ riders: The package is largely devoid of new controversial policy riders related to abortion that had bogged down talks. — SUPPORT Act: The legislation doesn’t reauthorize the sweeping package aimed at addressing the opioid epidemic that expired in September. What’s next: Congress has until Friday to get the bill onto President Joe Biden’s desk and signed into law. The rest of government funding, including for HHS, is set to expire on March 22 under a stopgap measure signed into law last week. WELCOME TO MONDAY PULSE. POLITICO’s health care summit on March 13 is quickly approaching. You can find out more and register here. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | A message from the Coalition to Protect America's Health Care: As Congress approaches a government funding deadline, special interests are pushing to enact harmful Medicare cuts that would put patients at risk. Congress: Don’t cut patient care. Learn more. | | | | | | | 
Even though Medicare drug plan premiums could rise this fall, strategists say the increase might fly under the radar — a potential break for President Joe Biden's reelection campaign. | Susan Walsh/AP | MEDICARE DRUG PLAN PREMIUMS’ TIMELY SPIKE — Older Americans could see an increase in the premiums they pay for a new Medicare drug plan just weeks before the presidential election. In a normal election year, that could be a political headache for incumbent President Joe Biden, but strategists in both parties say he could get a pass, POLITICO’s Robert King and Megan R. Wilson report. The reason is that other issues like immigration and abortion will continue to dominate headlines and other benefits for Medicare beneficiaries could mitigate any hike. “In this election cycle, the idea that this is consequential in any way feels crazy,” Rodney Whitlock, a health care adviser with McDermott Consulting, said. Republicans also aren’t likely to message heavily on the issue, much to the chagrin of some strategists. “Why you wouldn't pick this up and run with it is beyond me,” Joel White, president of the Council for Affordable Health Coverage and a Republican lobbyist, said. “This is an issue that resonates strongly with Americans, they want more affordable coverage. And I think Biden's got a huge pass on this.” One Democratic strategist said if Republicans try to make political hay out of any premium hike, it could backfire. “It will open the door to this discussion about Medicare negotiation and the fact that Republicans oppose that,” the strategist, who was granted anonymity to talk about the election, said. The potential premium hike stems from changes to Medicare Part D as part of the Inflation Reduction Act. Insurers must cover more of the drug costs for older Americans once a $2,000 annual cap on out-of-pocket costs goes into effect next year. Plans could boost premiums to cover the expected boost in costs, but the exact amount will likely vary from plan to plan, according to Wall Street and health policy analysts. This year, the average monthly premium for a standalone plan was $48, up from $40 the year before, according to KFF.
| | | | 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. | | | | | | | | | A NEW WAY FOR HEALTH AI? The Coalition for Health AI is moving forward with new guidelines to ensure that artificial intelligence is safe and effective in health care, the group said today. “One of the ultimate goals and hopes is building transparency to help build trust and identify spots where AI is not working well,” CEO Dr. Brian Anderson, a co-founder of the group and chief digital health physician at MITRE, told POLITICO. The move by the public-private partnership — whose effort includes the help of the White House, HHS, the FDA and the VA — comes as regulators and lawmakers weigh how to regulate the emerging technology as it shakes up the sector with major gaps in regulation. Assurance labs in the cards? The FDA and ONC have previously backed the idea of AI assurance labs, which could validate and monitor AI in the sector. Anderson said CHAI aims to arrive at a consensus for testing and evaluation that allows the group to support a network of assurance labs by the third quarter of this year. Later this year, the group hopes to publish model report cards from the labs. Dr. John Halamka, who will chair CHAI’s board and is president of the Mayo Clinic Platform, is eyeing a nationwide network of such labs — not one entity. “The only way to do this is in a very federated and distributed way,” Halamka said, envisioning such labs at major universities. CHAI members include Google, Microsoft, Stanford Medicine and more than 1,300 additional organizations. What’s next: FDA Commissioner Robert Califf will deliver opening remarks at a launch event on Tuesday. TELEMED BACKERS PUSH DEA — Dozens of telemedicine advocates are calling on the Drug Enforcement Administration to issue guidance to clarify that the distance between prescribers’ and their patients’ locations shouldn’t raise a “red flag” for drugs prescribed during telehealth visits. Many pharmacies give prescriptions through telehealth more scrutiny, the groups — including Amazon, the American Telemedicine Association and the American Psychological Association Services — wrote to the DEA. The red flags aren’t codified in statute but stem from concerns about overprescribing contributing to the opioid epidemic, they said. “Pharmacists need clearer green lights from the DEA to appropriately dispense critical medications to patients, not continued ‘red flags,’” they wrote. The ask: The groups called on the agency to address the issue in upcoming rulemaking on the future of virtual prescribing. Eased rules on the prescribing of controlled substances via telemedicine expire at the end of 2024. A DEA spokesperson didn’t respond to a request for comment.
| | | | A message from the Coalition to Protect America's Health Care:   | | | | | BIDEN MULLS CASH FOR HACK IMPACT — The White House’s National Security Council is eyeing ways to offer financial relief to hospitals amid the fallout of a cyberattack on Change Healthcare, according to a senior administration official, POLITICO’s John Sakellariadis reports. Change, which connects hospitals and pharmacies with insurers, has had most of its systems offline since a Feb. 21 hack, impeding claims processing nationwide. The details: The official said the NSC has talked about ways to use funding from HHS and the VA to facilitate support for health care organizations in a way that wouldn’t require Congress to get involved. “The cash flow situation is really the biggest impact that we have right now. So this is what we're focusing all of our energies on,” the official, granted anonymity due to the ongoing nature of the discussions, said.
| | | | DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The stakes are high as America's health care community strives to meet the evolving needs of patients and practitioners, adopt new technologies and navigate skeptical public attitudes toward science. Join POLITICO’s annual Health Care Summit on March 13 where we will discuss the future of medicine, including the latest in health tech, new drugs and brain treatments, diagnostics, health equity, workforce strains and more. REGISTER HERE. | | | | | | | | | LAB TEST REG ADVANCES — A proposal to overhaul the regulation of laboratory-developed tests is chugging along, having reached the White House Office of Management and Budget for review Friday. The proposed rule would subject many medical tests to new oversight by regulating them as medical devices. The industry has opposed the Biden administration’s moves, arguing they’re a burdensome stretch of its authority. The FDA has said it wants to finalize the proposal by April.
| | The Wall Street Journal reports on Oregon’s reversal on hard drugs. The New York Times reports on elected officials in recovery driving policymaking.
| | | | A message from the Coalition to Protect America's Health Care: If Congress enacts proposed cuts to Medicare, patients’ access to 24/7 hospital care could suffer.
Hospitals provide critical care 24 hours a day, seven days a week. They treat sicker patients. They’re better equipped to handle complications. And they provide vital capacity during public health emergencies and disasters.
Yet the same corporate insurance companies that bank record profits while delaying and denying treatment are pushing Congress to slash patient care. If they do, the most vulnerable communities will pay the highest price.
Learn more about how proposed cuts will hurt patient care. Learn more. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
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