| | | | |  | | By Chelsea Cirruzzo and Ben Leonard | | Presented by |  | | | | | | | 
Epic says patient data from its electronic health records was improperly shared. | Pixabay | Pixabay | DATA DISPUTE ROILS HEALTH TECH — A conflict over whether patient data was shared properly involving electronic health records giant Epic is fueling angst about the security of medical information in the sector, Ben reports. Epic leads in market share for digital health records in hospitals, and it’s at the center of the dispute that’s playing out behind closed doors. The nitty-gritty: Epic claims that Integritort, which provides medical record analyses for legal cases, incorrectly accessed the EHR company’s patient data through Carequality, a nonprofit framework for sharing health data, using health IT firm Particle Health. Epic says Integritort retrieved the data by falsely claiming it was for treatment purposes, which made it easier to gain access without a doctor’s authorization in violation of Carequality’s rules. Integritort denies the allegations. It says it followed federal regulations and Carequality guidelines when it obtained the data, adding that it was for treatment purposes. The company says it used medical professionals to confirm a diagnosis, and that patients in mass tort litigation — like class-action lawsuits — often have a hard time getting their own medical records, which the company can help with. Alan Swenson, Carequality’s executive director, said that Carequality is confident in its process of allowing health data to flow appropriately. Particle Health suspended Integritort from its platform in March, later saying it had seen evidence that it was making data queries that weren’t for treatment. The bigger picture: The case highlights what legal and health tech industry experts say is a lack of clarity in data governance and oversight that threatens industry efforts to securely facilitate data flow. Some argue it also highlights tension between regulations mandating that health care organizations share patient data and those requiring that information be safeguarded as patient-data breaches surge. Many in the industry seek more clarity, and some make the case that a data-sharing framework being built by the federal government and a nonprofit coordinating entity is building out another framework known as the Trusted Exchange Framework and Common Agreement, or TEFCA, could offer more robust governance. “Until these networks establish standards for, and open up to, data-sharing permitted by HIPAA but that isn’t [for] treatment, we will see entities trying to morph themselves into a treatment use case in order to get the records they need,” said Deven McGraw, a former high-ranking HHS health privacy official in the Obama and Trump administrations and now chief regulatory and privacy officer at Citizen Health. WELCOME TO THURSDAY PULSE. Congress is apparently full of brats (yes, the offer to explain still stands). Rep. Buddy Carter (R-Ga.) used the Charli XCX meme format to slam pharmacy benefit managers. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
| | | | A message from AFP’s Personal Option: I scream, you scream, we all scream for…a Personal Option in healthcare! The Personal Option is the healthcare plan that funds families and individuals, not insurance companies. It offers as many healthcare options as there are ice cream flavors, so Americans get the coverage they want at a price they can afford. And the cherry on top? More personal control of healthcare means lower costs for everyone. Get the scoop at PersonalOption.com. | | | | | | | 
Vice President Kamala Harris' record during her time as California's attorney general could offer a glimpse into her approach toward health care policy if she were to be elected president. | Jamie Kelter Davis for POLITICO | HARRIS’ AG HEALTH CARE RECORD — Vice President Kamala Harris’ background as California’s attorney general could send a significant message during her presidential campaign: Big health care, beware, POLITICO’s Robert King and Rachel Bluth report. As attorney general from 2011 to 2016, she expanded the powers of the office to referee hospital consolidation, helped block a megamerger between insurers Cigna and Anthem and launched lawsuits to bring down inflated drug prices. Here are Harris’ key health care moves as attorney general: — Hospital deal oversight: One of the biggest fights during her tenure erupted over a hospital acquisition deal, which she initially approved but with heavy conditions. That case set a precedent for attorneys general that followed and pushed for more authority in reviewing health care acquisitions for anticompetitive practices. — Insurer mergers: Along with the U.S. Department of Justice and counterparts from 11 states and Washington, D.C., Harris joined a lawsuit in 2016, seeking to block the Cigna-Anthem deal over antitrust concerns. — Inflated drug prices: Harris sued several times to lower health prices while attorney general. She joined a lawsuit filed by 35 states and Washington, D.C., that challenged two pharmaceutical companies, Indivior and MonoSol Rx, for allegedly inflating the price of the opioid addiction treatment Suboxone, which resulted in a $300 million settlement. She also secured a portion of a $151 million settlement for California that drug distributor McKesson made with 29 states and Washington, D.C. — Medicaid lawsuits: Harris also pursued a case of Medicaid fraud. In 2012, she announced that her office had settled with the Los Angeles-based SCAN, a health plan and service provider that delivered services to older adults and people with disabilities in Californians. Harris’ office argued that the organization had overcharged Medicare and Medicaid for years, and the resulting $324 million settlement was the largest in the state’s history.
| | | | Live briefings, policy trackers, and procedural, industry, and people intelligence from POLITICO Pro Analysis gives you the insights you need to focus your policy strategy this election cycle. Secure your seat. | | | | | | | | SENATE INVESTIGATION VOTE — The Senate HELP Committee will vote today on authorizing an investigation into Steward Health Care’s bankruptcy and subpoenaing the company’s CEO. How we got here: The private equity-backed health care system, which operates 31 hospitals, filed for bankruptcy in May. At the time, Sen. Bernie Sanders (I-Vt.), chair of the Health, Education, Labor and Pensions Committee, and Sen. Ed Markey (D-Mass.) wrote to HHS Secretary Xavier Becerra, urging the agency to protect Steward’s patients from care disruptions. According to a notice sent by Senate health leadership Wednesday, the vote in favor of a subpoena would compel Steward’s CEO, Ralph de la Torre, to testify before the committee in September. He previously declined to testify. Steward did not respond to a request for comment. THE HEALTH COSTS OF IMMIGRATION — The sharp surge in immigration to the U.S. in recent years has increased spending on federal health programs, including Medicare and Medicaid, according to a report out Wednesday. The Congressional Budget Office writes that Medicaid and Children’s Health Insurance Program spending is expected to increase by $40 billion over the next decade. An additional 300,000 people are expected to be enrolled in both programs in 2024 — and over the next decade, 65 percent of enrollees are projected to be children. The cost of premium tax credits, which helps lower the cost of health insurance purchased through the marketplace, is expected to increase by $59 billion while revenues will decline by $7 billion. The CBO estimates that in 2024, the immigration surge will increase the number of people receiving premium tax credits by 600,000. In 2034, an additional 800,000 people are projected to receive premium tax credits than they would if the surge didn’t occur. The CBO report notes that the estimates are uncertain and could change. Earlier this year, the Biden administration made it easier for some people who were brought to the country illegally as children to enroll in federal health care programs.
| | | | A message from AFP’s Personal Option:   | | | | | PRIMARY CARE RETURNS TO WALMART — Humana is opening almost two dozen primary care centers at Walmart retail stores in four states, the company said. The older adults-focused primary care centers at 23 Walmarts in Florida, Georgia, Missouri and Texas will be operated by CenterWell, Humana’s health care services business. Why it matters: The move comes after Walmart said earlier this year that it would shutter all 51 of its own health care centers along with its telehealth operations. CenterWell will operate its services in the same spaces Walmart Health did. The 30,000-foot view: Retail giants like Walmart, CVS and Walgreens have dipped their toes into offering primary care services in recent years with mixed success. Walgreens has shuttered nearly half of its VillageMD clinics. Amazon, however, acquired One Medical in 2022, and Aetna CVS acquired an eldercare and home health company.
| | | | SUBSCRIBE TO GLOBAL PLAYBOOK: Don’t miss out on POLITICO’s Global Playbook, our newsletter taking you inside pivotal discussions at the most influential gatherings in the world. Suzanne Lynch delivers the world's elite and influential moments directly to you. Stay in the global loop. SUBSCRI | | | | | | | | | Gretchen Hammer is now a senior fellow in Mathematica’s health unit. She most recently founded and led the Public Leadership Consulting Group and is a former Medicaid director of Colorado.
| | POLITICO’s Caitlin Emma reports on the limbo the HHS fiscal 2025 budget is in after the House agreed to leave early for its August recess. The New York Times reports on the progress toward finding a cure for an ultra-rare disease that speeds up aging. The Hollywood Reporter reports on New York’s largest hospital system getting into the entertainment business to boost its bottom line.
| | | | A message from AFP’s Personal Option: No one goes to an ice cream shop advertising “One flavor!” Yet that’s how healthcare is for too many Americans. But Americans want healthcare like they want their ice cream – countless flavors and endless toppings at an affordable price.
A Personal Option gives Americans that kind of personal control over their healthcare. How? By expanding access to health savings accounts and direct primary care plans that cut out insurance company middlemen. Price transparency to end surprise billing. And better access to the doctors Americans trust.
Polls show the Personal Option is more popular than ice cream in July – okay, maybe that’s an exaggeration. But a majority of voters do support it over competing plans. Affordable healthcare shouldn’t be a rocky road. A Personal Option is like a “build your own sundae” bar – you get to do it your way. Get the scoop at PersonalOption.com. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
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