What Washington wants in Cures 2.0

Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

Aug 06, 2024 View in browser   By Chelsea Cirruzzo and Ben Leonard Driving The Day Rep. Diana DeGette, along with Rep. Larry Bucshon, has introduced major legislation to build on the 21st Century Cures Act. | Francis Chung/POLITICO CURES 2.0, 2.0 — A coalition of health care industry groups want the sequel to the sprawling 21st Century Cures Act to focus on health data, Ben reports. The 2016 law aimed to speed up the FDA approval process, improve health data-sharing and boost research. Now, Reps. Diana DeGette (D-Colo.) and Larry Bucshon (R-Ind.) are laying the groundwork for the latest iteration of the follow-up, dubbed “Cures 2.0” — a major legislative package that could see action in the next Congress. DeGette and former Rep. Fred Upton (R-Mich.) released the first version of Cures 2.0 in late 2021, and portions of its goals were signed into law, including establishing the Advanced Research Projects Agency for Health. DeGette — considered a favorite to replace Rep. Anna Eshoo (D-Calif.) as the top Democrat on the House Energy and Commerce Health Subcommittee — and Bucshon, who isn’t running for reelection, sought feedback from the public in June. Pulse obtained a slew of responses, including those from lobbyists like AHIP and the ERISA Industry Committee and other groups like the American Health Information Management Association, many of which suggested lawmakers focus on health data-sharing and pandemic prevention issues. Among the responses: — A coalition of dozens of influential organizations wrote: “Unlocking the power of health data holds the promise to improve health outcomes for patients and families, reduce burden for clinicians and other providers, lessen costs for businesses and taxpayers, and target cures.” — The College of Healthcare Information Management Executives wants support for providers not eligible for incentives to adopt electronic health records. The group is also concerned about a “lack of clarity in data governance,” pointing to organizations “taking advantage of … or misunderstanding” rules, referencing a recent dispute involving digital health records giant Epic. — The American Society for Microbiology called for a national testing and response strategy for pandemics and support for wastewater surveillance programs. — The National Health Council, which represents patient groups, their partners and firms across the industry, called for more pathways for CMS coverage of new medical devices. — PhRMA called for lawmakers to reauthorize the Pandemic and All-Hazards Preparedness Act, which expired last year. The American Telemedicine Association’s senior vice president, Kyle Zebley, told Pulse he’d like to see provisions that make telehealth access in Medicare permanent. He also advocated for a federal standard on artificial intelligence that balances patient protections, data accountability and promoting innovation and avoids a “patchwork” of state laws. WELCOME TO TUESDAY PULSE. Now that the second season of “House of the Dragon” has concluded, I’m tuning into “The Gilded Age.” Please tear me away from bad TV by sending your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.   During unprecedented times, POLITICO Pro Analysis gives you the insights you need to focus your policy strategy. Live briefings, policy trackers, and and people intelligence secures your seat at the table. Learn more.     Opioids Relaxing X-waiver requirements hasn't resulted in an increase of prescriptions for buprenorphine to help treat opioid use disorder. | Joe Raedle/Getty Images NO BUPE RX UPTICK — Relaxed training requirements to prescribe a drug used in medication-assisted treatment for opioid use disorder increased the number of clinicians who could prescribe the drug but not the number of providers who prescribed it or patients who received it, a study published in JAMA Network Open says. How we got here: The so-called X waiver required doctors who wanted to prescribe buprenorphine — a partial opioid and controlled substance — for opioid use disorder to undergo special training and seek additional permission from the federal government. The Biden administration relaxed X-waiver requirements in 2021. Advocates have hoped that doing away with the X waiver, which was eliminated in 2023, would make it easier for people with opioid use disorders to access the drug. Researchers from the University of Colorado School of Medicine, Denver Health and Hospital Authority, the Research Triangle Institute and other organizations analyzed 33 communities from four states — Kentucky, Massachusetts, New York and Ohio — with high opioid overdose rates from May 2020 to 2022. They found that relaxing X waiver requirements was associated with an increase in the number of clinicians able to prescribe buprenorphine. However, only communities in Kentucky saw an increase in the number of clinicians prescribing the drug after the policy. Similarly, only communities in Massachusetts saw an increase in patients receiving the drug. Other communities saw no changes or declines. The study was limited by a small sample of states and data that didn’t extend beyond 2022, a relatively short window of time from when the policy was relaxed. They also didn’t include data on methadone treatment. “Our findings suggest that the removal of X-waiver training requirements by itself may not lead to substantial increases in the number of clinicians prescribing buprenorphine or the number of patients receiving buprenorphine treatment in the short term,” the researchers wrote. AROUND THE AGENCIES RECORD HEALTH CENTER PATIENTS — More than 31 million patients nationwide received services at a community health center last year, the highest number of patients in the program’s history, according to HHS data out Monday. According to HHS, this was an increase of 2.7 million patients since 2020. Health centers serve patients regardless of their ability to pay. According to the data, more than 90 percent of patients had incomes less than 200 percent of the federal poverty line. According to HHS, health centers in 2023 served: — 1 in 8 children in the U.S. — More than 9.7 million rural patients — More than 6.4 million patients who live in or near public housing — More than 1.4 million people experiencing homelessness HHS also said Monday that, since 2020, health centers had administered more than 4 million HIV tests and treated more than 585,500 prenatal patients. PRIVATE EQUITY PRIVATE EQUITY DIGS ITS TEETH INTO DENTAL — The number of private equity-affiliated dental practices nearly doubled from 2015 to 2021, according to a new study published in Health Affairs. Why it matters: Congress and federal officials have grown critical of private equity acquisitions in health care. Earlier this year, HHS, the FTC and the DOJ launched a joint effort to probe how private equity impacts patient care, and HHS appointed its first chief competition officer. According to the Private Equity Stakeholder Project, a watchdog group, private equity owns 460 U.S. hospitals. Researchers in Health Affairs said that analysis into PE-acquired dentistry has been sparse in recent years, though an earlier study found a rise in PE deals in dentistry from 2011 to 2019. What they found: PE transactions within the dentistry industry increased nearly twofold from 2015 to 2021, with a brief dip in 2020 before a substantial rebound in 2021. In particular, researchers said, PE firms prefer larger practices as well as those with endodontists, oral surgeons and orthodontists. Researchers suggest this may be because of the high price of their services, such as root canals. The researchers also found that PE-affiliated practices had a higher rate of Medicaid participation than non-PE-affiliated practices did. Newly PE-affiliated offices were more likely to accept Medicaid patients, which might suggest that PE facilitates greater access to dental care in poorer communities. However, researchers said more research is needed on how such acquisitions impact quality of care and prices of services. Names in the News Stephanie Katz is now vice president of reimbursement, innovation and advocacy at the National Association of Chain Drug Stores. She previously was assistant vice president for policy and advocacy at the National Council for Mental Wellbeing.   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. SUBSCRIBE NOW.     WHAT WE'RE READING Reuters reports on a second patient implanted with a Neuralink and Elon Musk’s conversations with presidential candidate Donald Trump. The Associated Press reports on the unanswered health questions around microplastics.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Lauren Gardner @Gardner_LM Sophie Gardner @sophie_gardnerj 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   Follow us

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