Telehealth’s future hangs in the balance

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Apr 11, 2024 View in browser   By Ben Leonard and Chelsea Cirruzzo Presented by the Healthcare Distribution Alliance With Lauren Gardner and Robert King Driving The Day Lawmakers in Congress have been meeting to consider whether to extend Medicare health rules. | Business Wire A MATTER OF DOLLARS AND CENTS — Congress appears poised to keep eased Medicare telehealth rules in place with at least another temporary extension, but members are concerned about costs and unintended consequences. Loosened virtual-care rules for Medicare and commercial markets expire at the end of 2024, and lawmakers are setting the stage for a possible temporary or permanent extension of the regulations to preserve expanded access. The House Ways and Means and Senate Finance committees have met recently to consider expanded telehealth rules. In a House Energy and Commerce Health Subcommittee hearing Wednesday, Democrats and Republicans indicated support for maintaining expanded telehealth payment for older adults but raised a number of issues: Cost: The cost to extend the eased rules is a major concern for lawmakers. A key question is whether virtual visits would be reimbursed at the same rate as in-person care. “Making these authorities permanent is likely to cost much more than a short-term extension, and we want to make sure that whatever we move out of committee is paid for,” Health Subcommittee Chair Brett Guthrie (R-Ky.) said. But, generally, lawmakers seemed willing to accept higher costs to expand access to virtual care. Full committee ranking member Cathy McMorris Rodgers (R-Wash.) acknowledged that extending the rules would be a “significant investment” but said that “we can’t afford to go backwards.” Harvard researcher Ateev Mehrotra told lawmakers that expanded telehealth is associated with a “modest” increase in spending but also improved outcomes, particularly in mental health. Trickle-down impact: Lawmakers want to ensure that changes to virtual care policy don’t hinder access to in-person care. Rodgers said she wants to ensure patients decide whether they get in-person or virtual care. Witnesses and lawmakers noted that some patients may prefer in-person care. Full committee ranking member Frank Pallone (D-N.J.) said he doesn’t want telehealth to be used to undermine consumer protections like network adequacy standards. “We also need to ensure that we are not further fragmenting care and that telehealth is being used in a way that facilitates coordination,” Pallone said. Industry ‘gaming’: Health Subcommittee ranking member Anna Eshoo (D-Calif.) raised concerns about the industry “gaming” virtual care to make it into a “cash cow.” What’s next: The Medicare Payment Advisory Commission meets today on telehealth in Medicare. WELCOME TO THURSDAY PULSE. We’re dismayed to hear the not-so-stellar reviews about the new restaurant in the Capitol. Still, we’ll have to try it ourselves and report back. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.   A message from the Healthcare Distribution Alliance: The healthcare distribution industry leverages its expertise and partnerships throughout the supply chain to solve some of the toughest healthcare challenges. Distributors deliver 10 million medicines across the country each day — from the biggest cities to the smallest towns – supporting providers and pharmacists and ensuring medicines are available to patients. Learn more.   In Congress Rep. James Comer intends to call out the FDA today for not being prepared for crises. | Alex Brandon/AP CALIFF’S HILL ADVENTURE — Rep. James Comer (R-Ky.) is expected to criticize the FDA for “failing to do the bare minimum to carry out its core mission” under the Biden administration at a hearing today featuring testimony from Commissioner Robert Califf, Lauren reports. According to excerpts from his prepared remarks, the House Oversight Committee chair will say the agency “appears consistently unprepared for crises,” naming the infant formula recall that spurred a nationwide shortage and persistent shortages of drugs to treat cancer and infections. He'll point to Republican points of contention — telework policies and the Inflation Reduction Act — as sources behind the issues. Comer also will take the FDA to task for not acting sooner to start the process of pulling from the market an over-the-counter decongestant shown to be ineffective when taken orally. Democrats’ response: Ranking member Jamie Raskin (D-Md.) is expected to say that it’s “crucial” for the agency to continue its mission “based on sound science and not conspiracy theories or ideological beliefs.” “Public attacks on FDA undermine its ability to effectively protect public health,” according to excerpts from Raskin’s prepared remarks. COLE ON HEALTH CARE — Rep. Tom Cole (R-Okla.) was voted chair of the House Appropriations Committee on Wednesday, moving squarely into the middle of GOP infighting over spending. Cole was most recently vice chair of the panel and previously chaired its Labor-HHS-Education Subcommittee. GOP Doctors’ Caucus Co-Chair Rep. Michael Burgess (R-Texas) will take over the House Rules Committee chair, which Cole is vacating to move to Appropriations. Rep. Kay Granger (R-Texas) isn’t seeking reelection and vacated the Appropriations chairship early. The health care angle: Cole’s move is likely a boon to backers of boosting NIH funding because he has long supported the agency’s mission, with close family members having had Alzheimer’s and multiple sclerosis. “It’s always good to have someone who understands health care in important positions,” Neil Trautwein, executive director of the Partnership for Employer-Sponsored Coverage and a former aide to Sen. Mitch McConnell, told Pulse. “[Cole’s] priorities on biomedical research and the NIH are important. Still, employer issues are less appropriations-driven.” He introduced a bill with Rodgers to boost NIH Down syndrome research that passed through E&C unanimously last month. He’s called for expanding access to health savings accounts and telehealth, though the Appropriations Committee has less say on those issues than other panels. Joel White, president of the Council for Affordable Health Coverage and a former GOP House Ways and Means staffer, also noted Cole’s support of the Indian Health Service and his efforts to address the fentanyl and opioid epidemic.   YOUR GUIDE TO EMPIRE STATE POLITICS: From the newsroom that doesn’t sleep, POLITICO's New York Playbook is the ultimate guide for power players navigating the intricate landscape of Empire State politics. Stay ahead of the curve with the latest and most important stories from Albany, New York City and around the state, with in-depth, original reporting to stay ahead of policy trends and political developments. Subscribe now to keep up with the daily hustle and bustle of NY politics.      Abortion DETAILS OF BIDEN’S ABORTION PLAN — President Joe Biden’s campaign plans to hit former President Donald Trump for his role in eroding abortion rights by elevating the voices of ordinary American women who have suffered from restrictions on the procedure, POLITICO’s Adam Cancryn, Elena Schneider and Jennifer Haberkorn report. The strategy was on display this week in a campaign video featuring the story of a Texas woman; Biden himself made no appearance in the ad. The plan represents a concession of sorts for Biden, who has a complicated history with abortion and has been reluctant to say the word. It was partly inspired by recent down-ballot successes in some states, including Kentucky and Ohio. “It's less important for Biden to be the messenger on this,” said Amanda Litman, co-founder of the Democratic political group Run for Something.   A message from the Healthcare Distribution Alliance:   Around the Agencies CMS FLOATS PAY BUMP FOR HOSPITALS — CMS has proposed a $3.2 billion pay bump for hospital inpatient payments for fiscal 2025 starting on Oct. 1, Robert reports. The increase is slightly below the amount that CMS finalized for the current federal budget year, which could draw the ire of hospital groups seeking a heftier bump. The agency also projects that payments to so-called safety net hospitals will increase by approximately $560 million. CMS has proposed separate payments to smaller hospitals to help them set up a stockpile of emergency drugs in case of shortages.   Easily connect with the right N.Y. State influencers and foster the right relationships to champion your policy priorities. POLITICO Pro. Inside New York. Learn more.     Climate NEXUS OF HEALTH CARE AND CLIMATE CHANGE — Extreme weather events tied to climate change are taking a physical, mental and financial toll on people worldwide. A Kaiser Permanente event presented by POLITICO today at 3:45 p.m. will examine the consequences and how the issues should be approached. The conversation, which will include a top HHS official, will explore ties between catastrophic weather events and medical issues and the potential for industry and government collaboration on disparities at the intersection of health care and climate change. The speakers at the event, moderated by POLITICO’s Carmen Paun, will be: — Dr. John Balbus, director of HHS’ Office of Climate Change and Health Equity —Dr. Victor Dzau, president of the National Academy of Medicine — Sarah Hunt, president of the Rainey Center — Matthew Tejada, senior vice president of environmental health at the Natural Resources Defense Council   A message from the Healthcare Distribution Alliance: Healthcare distributors work hard to ensure patients have the medicines they need. As the vital link in healthcare, distributors deliver medicines safely and reliably each day to nearly 330,000 frontline providers, pharmacies, hospitals and other sites of care across the country — from the biggest cities to the smallest towns. When a supply chain disruption occurs, healthcare distributors are there to help lessen the impact. We're problem solvers: focused on collaborative solutions to reduce negative outcomes on patients and ensure a more resilient pharmaceutical supply chain. Learn more.   Names in the News Erica Rogers has been appointed to the board of directors at Medicines360. She was previously CEO of Silk Road Medical. WHAT WE'RE READING POLITICO’s Carmen Paun reports on Samantha Power, head of the U.S. Agency for International Development, saying Ugandan law imposing criminal penalties for gay people has led to a “dramatic decrease in uptake of life-saving services.” The New York Times reports on European countries restricting hormone treatments for children.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Megan R. Wilson @misswilson   Follow us

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