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Biden officials fed up with nursing homes’ booster rates

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Jan 12, 2023 View in browser
 
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By Krista Mahr and Daniel Payne

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With Ben Leonard

Driving the Day

A resident at the Hebrew Home receives a COVID-19 booster shot.

The Biden administration is pressing hospitals and nursing homes to more proactively offer Covid-19 booster shots. | Seth Wenig/AP Photo

BIDEN ADMINISTRATION FRUSTRATED BY OLDER AMERICANS' COVID RATES — State and federal health officials are frustrated that thousands of older adults have landed in the hospital with Covid-19 since the holidays, POLITICO's Megan Messerly and Adam Cancryn report.

Fewer than 40 percent of people over 65 have taken the updated booster shot available since the fall, according to the CDC, leaving millions with little protection against the latest strain sweeping the U.S.

The Biden administration — which is growing frustrated with the low vaccination rates in nursing homes — is forwarding lists of senior facilities with zero people vaccinated to state regulators for review and possible penalties, which could include fines. The administration is also contacting governors to push them to boost their immunization rates.

While 86 percent of nursing home residents have received their initial shots, fewer than half are up to date on their vaccinations, according to CMS data.

While nursing homes' vaccination rate is three times that of the general public, the industry has acknowledged that it still has more work to do, sharing an "all-hands-on-deck" strategy to do so with the Biden administration in November.

WELCOME TO THURSDAY PULSE — As Californians endure another brutal storm cycle, one restaurant owner-manager kept his staff and customers safe from the flood by using six 50-pound bags of rice. As he battled the elements, the diners kept eating. Send your news and tips to kmahr@politico.com and dpayne@politico.com.

TODAY ON OUR PULSE CHECK PODCAST, Ben Leonard talks with Krista about her report out of the Maine State Prison, where federal officials are taking note of a promising program on the front lines of fighting opioid overdose deaths.

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In 2021, Insurers and their pharmacy benefit managers (PBMs) subjected patients to six times the out-of-pocket costs for brand medicines through the use of deductibles or coinsurance compared to patients with only copays — even when these middlemen received a discounted price. That's not fair. Learn more.

 
In Congress

Fog envelopes the U.S. Capitol dome.

House Republicans have chosen subcommittee chiefs and taken an early stand on abortion. | Samuel Corum/Getty Images

HOUSE GOP CIRCULATES 'CARDINALS' LIST — Newly installed House Appropriations Chair Kay Granger (R-Texas) has selected her dozen subcommittee chiefs, known colloquially as "cardinals," for the next two years, POLITICO's Olivia Beavers and Sarah Ferris report.

Rep. Robert Aderholt (R-Ala.) is slated to head the Labor, Health and Human Services subcommittee. 

The caveat: The list will still need to be ratified by the GOP steering committee, which plans to meet next week. Granger's office cautioned that the list could change before it's presented to the full conference.

HOUSE GOP STICKS TO ABORTION PLAYBOOK — The House Republican majority highlighted abortion in two of its first policy votes of the new Congress on Wednesday, passing a resolution and bill on mostly party lines, Ben writes.

The resolution, which passed 222-209, condemned violence against anti-abortion organizations. The bill, which passed 220-210, reaffirms the rights of infants born after rare botched abortions.

It's highly unlikely the Democratic-controlled Senate will consider either measure, but the votes indicate that the GOP, at least for now, plans to handle the abortion issue as it has during past stints in the majority.

Fentanyl pills are pictured.

House Energy and Commerce Republicans plan to focus on clamping down on fentanyl. | Courtesy of the Department of the Interior

E&C'S OPENING SALVO ON FENTANYL — House Energy and Commerce Republicans held a roundtable Wednesday on the fentanyl crisis in a potential preview of the committee's focus on curbing the epidemic, Ben reports.

The roundtable with a former DEA official and an emergency medicine doctor included emotional testimony from Ray and Deb Cullen, who lost their 22-year-old son, Zachary, to fentanyl poisoning last year. Deb Cullen called for the crisis to be handled like Covid-19. Paul Knierim, former assistant administrator at DEA, warned of the fake pills' danger. Lawmakers also pointed to issues at the southern border as a contributing factor.

"We should be working together to punish those who produce, import and distribute these poisons to our children and help those with substance use disorders find the necessary treatment and necessary recovery," said Rep. John Joyce (R-Pa.) at the roundtable.

The committee's Republicans are expected to focus on addressing fentanyl's role in the opioid crisis in the new Congress. That includes pushing tech companies like Snapchat and TikTok to crack down on fentanyl sales on their platform.

Rep. Morgan Griffith (R-Va.) said he's hoping to release the latest version of the HALT Fentanyl Act in the next few days, which would permanently schedule fentanyl-related substances in Schedule 1 of the Controlled Substances Act.

 

STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.

 
 
Global Health

THE END OF THE EBOLA OUTBREAK — The Ebola outbreak in Uganda is over, the country's government and the World Health Organization said Wednesday, POLITICO's Carmen Paun reports.

No new cases have been reported for 42 days. Fifty-five people are confirmed to have died in the outbreak, and 164 cases have been reported since it began in September.

The outbreak was the first caused by the Sudan strain of Ebola in a decade. There are no licensed vaccines and therapies against that strain, which made managing the outbreak challenging, health officials said.

A critical missed opportunity: Three experimental vaccines arrived in December in Uganda, days after the last patient with Ebola was dismissed from the hospital, meaning researchers missed a rare window of opportunity to test whether any of the shots are effective. The developers of the three vaccines didn't have enough doses in vials ready to send immediately, and the WHO and Uganda officials took months to work out regulatory and logistical matters.

HOW TO SAVE NHS — The U.K.'s National Health Service is in crisis, with flu, Covid-19 and other seasonal respiratory viruses straining a system already buckling under immense waiting lists for treatment and a chronically understaffed and burnt-out workforce.

This week, British Health Secretary Steve Barclay set out a series of plans to relieve pressure on the system, but health experts say much more is needed, POLITICO's Helen Collis reports from London.

To improve care quickly in the U.K.'s national health care system, they said, the government needs to increase staff pay, cut paperwork and reduce targets for primary care doctors, streamline communication between hospitals and primary care doctors and better plan for discharged patients who need community care.

 

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At the Agencies

A TIMELINE FOR DRUG PRICE NEGOTIATIONS — The first 10 Medicare Part D drugs selected for price negotiations will be made public by Sept. 1, POLITICO's David Lim reports.

Once the list of 10 drugs is published, Medicare will go through the negotiation process with drug manufacturers next year, CMS Administrator Chiquita Brooks-LaSure said Wednesday.

CMS expects to publish the established maximum fair price for the drugs in September 2024 to take effect in January 2026.

The backstory: The Inflation Reduction Act, enacted last year, empowered the federal government to negotiate prices for a subset of high-cost, name-brand drugs covered by Medicare that don't have generic or biosimilar competition.

What's next: In the coming years, CMS will select additional drugs for negotiation. An additional 15 Medicare Part D drugs will be negotiated for 2027, 15 more Part B or Part D drugs for 2028 and 20 more Part B or Part D drugs in 2029 and later years. Medicare Part D drugs are retail prescription drugs, while Medicare Part B drugs are administered by doctors.

 

JOIN TUESDAY TO HEAR FROM MAYORS AROUND AMERICA: 2022 brought in a new class of mayors leading "majority minority" cities, reshaping who is at the nation's power tables and what their priorities are. Join POLITICO to hear from local leaders on how they're responding to being tested by unequal Covid-19 outcomes, upticks in hate crimes, homelessness, lack of affordable housing, inflation and a potential recession. REGISTER HERE.

 
 
In the States

NEW JERSEY COULD SEE $500 BILLION IN OPIOID SETTLEMENTS — New Jersey has joined nationwide settlement agreements with multiple pharmacy chains and drugmakers to resolve claims related to the opioid crisis, POLITICO's Caroline Petrow-Cohen reports.

CVS, Walgreens and Walmart, as well as drugmakers Teva Pharmaceuticals and Allergan, have agreed to pay a collective $20.1 billion to states and local governments as redress for their roles in the opioid crisis. New Jersey could receive more than $500 million of that, according to Attorney General Matthew Platkin.

Names in the News

Karen Lancaster is the new associate vice president of communications and public affairs for the American Clinical Laboratory Association.

What We're Reading

The Washington Post's editorial board says FDA Commissioner Robert Califf should call for the breakup of the FDA into separate drug and food divisions after the national baby formula crisis last year.

The New York Times reports on the chaotic conditions in New York City hospitals as the nurses' strike stretches on.

Stat reports why wastewater isn't a more mainstream public health tool.

 

A message from PhRMA:

Every day, patients at the pharmacy counter discover their commercial insurance coverage does not provide the level of access and affordability they need. New data from a study by IQVIA reveal the harmful practices of insurers and their pharmacy benefit managers (PBMs) can lead to significantly higher out-of-pocket costs for medicines — causing some patients to abandon their medicines completely. Learn more.

 
 

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