| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | Presented by |  | | | With Toni Odejimi
| | |  The Supreme Court's decision on the abortion pill could be used by anti-abortion groups to develop new legal strategies. | Stefani Reynolds/AFP via Getty Images | DIGGING INTO SCOTUS’ ABORTION RULING — The Supreme Court’s unanimous ruling Thursday shooting down a challenge to the FDA’s approval of abortion pill mifepristone was on its face a decisive loss for the anti-abortion movement — but there’s a catch, POLITICO’s Alice Miranda Ollstein reports. In its first abortion ruling since it turned abortion rights back to the states, the high court found that anti-abortion doctors and organizations don’t have standing to challenge the FDA’s decision to ease regulations around the drug, allowing the court to sidestep the issue. The ruling left in place federal regulations permitting patients to order abortion pills virtually and via mail delivery, which have spurred a surge in telehealth-prescribed abortions post-Dobbs. But the ruling contained potentially useful hints for abortion opponents mounting future challenges and restricting abortion access in other ways. Anti-abortion groups seized on those nuggets, saying their quest isn’t over. Here are four ways the decision could aid the anti-abortion movement: 1. It avoided the merits: Abortion opponents said the ruling was on “purely procedural grounds,” leaving the potential for future legal restrictions on mifepristone. The high court said the doctors bringing the case didn’t have standing because they weren’t directly impacted by the FDA’s policies easing access to the drug. But the justices’ decision didn’t weigh in on the merits of the group’s argument: that the agency didn’t sufficiently weigh mifepristone's risks when it approved the drug in 2000 and later eased restrictions. 2. Conscience can be a guide: Both anti-abortion and abortion-rights advocates honed in on the ruling’s discussion of the rights of doctors to refuse to perform abortions or other health services based on moral or religious beliefs. The doctors partly lacked standing, the Biden administration argued, because federal conscience protections would allow them to decline to offer follow-up care for patients taking abortion pills. Historically, said University of Texas law professor Liz Sepper, a federal law gave doctors the right to only refuse to participate in abortion or sterilization, but the new ruling expands the scope to “the full range of medical care.” 3. Conservatives can use it as a road map: The unanimous opinion and a separate concurrence from Justice Clarence Thomas had suggestions for how abortion opponents could bring legal challenges or seek restrictions via Congress or agencies. Anti-abortion groups already pursue those, but abortion-rights advocates said Thomas’ opinion outlined who he believes would have standing. 4. Standing goes both ways: Thomas’ concurrence also had a warning light for abortion-rights proponents who have used third-party standing — allowing doctors to bring suits on behalf of patients — to challenge abortion restrictions. Thomas wrote that the decision denying standing to the doctors should cut both ways. WELCOME TO FRIDAY PULSE. It was great to see many of you at our event last night. 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 HCA Healthcare: HCA Healthcare’s Care Transformation and Innovation (CT&I) team is creating a healthier future for its communities. CT&I works directly with clinicians to integrate their innovative ideas into technology solutions to create better experiences for care teams and patients. Learn more about how HCA Healthcare is working to improve healthcare delivery and solve longstanding challenges. | | | | | | | 
ARPA-H Deputy Director Susan Monarez told an audience at a POLITICO event Thursday that she wants technology to be developed for use by people with all levels of digital literacy. | Rod Lamkey Jr. for POLITICO | POLITICO EVENT TAKEAWAYS — Lawmakers, top agency officials and private sector leaders are bullish on the potential of new medical technology diagnostics to alter the health care system, but at a POLITICO event Thursday, they acknowledged that barriers remain. Here are three takeaways from POLITICO’s discussion: — Innovation can be a double-edged sword: Participants were optimistic that new technology and treatments can address longstanding health disparities but added that they could also exacerbate disparities. “What keeps me up at night is if a digital capability is being developed … [but] you are in a position where only well-financed health care systems are able to afford this,” said Susan Monarez, deputy director of the Advanced Research Projects Agency for Health. — AI questions remain: Rep. Ami Bera, who serves on the bipartisan House artificial intelligence task force and is a doctor, said liability will be a key consideration. — Trickle-down impacts from doctor payment issues? Alexander Ding, an American Medical Association board member, said the state of Medicare doctor pay is unsustainable and driving consolidation. Read more on our takeaways here.
| | | | THE GOLD STANDARD OF HEALTHCARE POLICY REPORTING & INTELLIGENCE: POLITICO has more than 500 journalists delivering unrivaled reporting and illuminating the policy and regulatory landscape for those who need to know what’s next. Throughout the election and the legislative and regulatory pushes that will follow, POLITICO Pro is indispensable to those who need to make informed decisions fast. The Pro platform dives deeper into critical and quickly evolving sectors and industries, like healthcare, equipping policymakers and those who shape legislation and regulation with essential news and intelligence from the world’s best politics and policy journalists.
Our newsroom is deeper, more experienced and better sourced than any other. Our healthcare reporting team—including Alice Miranda Ollstein, Megan Messerly and Robert King—is embedded with the market-moving legislative committees and agencies in Washington and across states, delivering unparalleled coverage of health policy and the healthcare industry. We bring subscribers inside the conversations that determine policy outcomes and the future of industries, providing insight that cannot be found anywhere else. Get the premier news and policy intelligence service, SUBSCRIBE TO POLITICO PRO TODAY. | | | | | | | | CMMI IN THE HOT SEAT — Elizabeth Fowler, deputy administrator and director of the Center for Medicare and Medicaid Innovation, played defense against House Energy and Commerce Committee Republicans on Thursday, who criticized the organization for its $5.4 billion increase in government spending and largely unsuccessful payment models, Toni reports. The hearing centered on CMS’ transition to value-based care, a payment model for Medicare that focuses on improved health benefits to guide costs — something CMMI has been trying to implement. Fowler pushed back against GOP accusations that CMMI's operations are too expensive, arguing that CMS heeds providers’ advice and reducing spending is CMMI’s “statutory mission.” Why it matters: Republican criticism about CMMI’s ineffectiveness and lack of oversight has been mounting. Fowler was questioned repeatedly about why its models were largely inapplicable for broader use. Only six models saw some success, and not all could be applied federally. Fowler said that every model allows CMMI to learn and adapt. Democrats joined in asking Fowler how models could be successfully implemented, though they focused less on CMMI’s shortcomings and more on providing plans for marginalized communities. Big picture: Republican skepticism of Fowler adds momentum to a larger Republican effort to rein in CMMI. In April, top House Republicans called for an investigation into CMMI, citing the Congressional Budget Office report on its $5.4 billion in spending.
| | | | A message from HCA Healthcare:   | | | | | MEDPAC SPEAKS — The nonpartisan Medicare Payment Advisory Commission has released its June report to Congress, addressing Medicare Advantage, artificial intelligence, hospital-at-home care and more. Here are some key conclusions from Congress’ Medicare advisers: Payment rate update: MedPAC raised concerns about whether payments for clinicians will be sufficient in the future, which could disincentivize treating Medicare patients. MedPAC suggested changing payment rates through the Medicare Economic Index, a measure of inflation providers face, minus a percentage point. It also suggested continuing incentives for participating in alternative payment models for “a few more years.” Medicare Advantage prior authorization: Ninety-five percent of prior authorization requests were approved in Medicare Advantage in 2021, the group said. The findings come amid scrutiny of the private-sector alternative’s care denials. It found denial rates between 3 and 12 percent among the largest MA plans. Still, MedPAC pointed to watchdog audits saying that many claims denied should have been greenlit. High hospital-at-home costs: Acute hospital care at home has taken off since pandemic waivers facilitated it. The program is set to expire at the end of the year, and many lawmakers hope to extend it for five years. The commission found low rates of death and patients having to be admitted to a brick-and-mortar hospital. Care in the home might be more expensive than in-hospital care because of “inefficiencies,” the report said, but outcomes and potentially reduced costs for follow-up care have “yet to be conclusively determined.” AI: The commission said it will weigh how Medicare should pay for software like AI, saying it will need to balance access and affordability.
| | TELEMEDICINE ARREST — The founder and a top executive of digital health firm Done were both arrested Thursday on charges related to overprescribing stimulants used to treat ADHD. The Justice Department alleges that founder Ruthia He and clinical president David Brody conspired to offer easy access to Adderall for a monthly fee. The Justice Department alleges He and Brody were aware of online posts about using Done to get easy access to stimulants and that some members had overdosed. The company had come under DEA scrutiny over its prescribing practices as pandemic rules allowed providers to prescribe controlled substances via telemedicine without an in-person visit. “These defendants exploited the COVID-19 pandemic to develop and carry out a $100 million scheme to defraud taxpayers and provide easy access to Adderall and other stimulants for no legitimate medical purpose,” Attorney General Merrick Garland said in a statement. He and Brody didn’t respond to requests for comment. In response to an inquiry about the charges via LinkedIn, Done said, “Hi, which charges?” and didn’t elaborate. Done has previously pushed back on critical coverage, saying it takes patient safety seriously and works to avoid drug abuse. Zooming out: The arrests come as the DEA weighs permanent post-public health emergency prescribing rules for controlled substances, set to expire at the end of the year. Early last year, the DEA proposed curtailing the pandemic-era regulations but received backlash and reversed course.
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| | POLITICO’s Connor O’Brien reports on the House voting to overturn the Pentagon's abortion policy. The Wall Street Journal reports on “what happens when your insurer is also your doctor and your pharmacist.”
| | A message from HCA Healthcare: Imagine the hospital of the future. What will it look like? How will we use technology to provide the best possible patient experience? HCA Healthcare visionary innovators and providers ask these very questions each day.
At HCA Healthcare, we are grateful for the responsibility we have as a leading healthcare system to show up and advance patient care. Our Care Transformation and Innovation (CT&I) team is revolutionizing the future of patient-centered care by solving longstanding industry challenges in healthcare through clinically led integration of technology into care. We leverage our clinicians, data, machine learning and more, always innovating to create better healthcare outcomes and experiences for our patients and care team members.
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