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What lies beyond the Covid health emergency

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

Presented by

PhRMA

With David Lim and Alice Miranda Ollstein

Driving the Day

A home Covid-19 test kit is held.

Post-PHE, Medicare beneficiaries will no longer be able to get over-the-counter at-home Covid tests for free. | Ted S. Warren/AP Photo

HHS LAYS OUT THE END OF THE PHE — On Thursday, HHS officials spelled out some of what the end of the PHE would — and wouldn’t — mean for health care.

The agency was clear in its stance that the government is entering a new phase of the pandemic and “broad flexibilities for health care providers are no longer necessary and will end,” according to a fact sheet shared by the agency Thursday.

More information is on the way, the agency said, including a fact sheet from CMS early next week detailing the impacts on providers. And HHS officials said they gave more notice than promised — 90 days instead of 60 before the PHE’s end — to allow more time to work out details with stakeholders.

One notable change is the potential for less Covid surveillance as the government’s power to require some data-sharing will end. HHS said it was working to ensure voluntary sharing beyond the PHE to maintain intel on the virus in the country.

Though no longer linked to the end of the PHE, HHS officials also noted Medicaid redetermination as a focus for the coming months, saying they expect about 15 million people to no longer be eligible for the program — and noting it’s likely most of them are eligible for other coverage.

“This nation is in a better place in our response than we have been,” an HHS official said on a call with reporters Thursday. “Addressing Covid-19 remains a significant public health priority for the administration.”

But some groups want a few more tweaks before the PHE’s end. The American Hospital Association, for example, sent a letter to HHS Sec. Xavier Becerra this week asking him to make permanent some temporary changes established during the PHE, part of a larger push across the health industry to maintain pandemic policies as the U.S. government looks to move on.

The AHA specifically asked the department to continue policies that expand telehealth use, allow workforce flexibilities and reduce “unnecessary regulatory and data reporting requirements.”

The group also asked the agency to help ensure that Medicaid redetermination doesn’t leave people without access to care and consider how policies should change in light of emergency preparedness lessons learned.

WELCOME TO FRIDAY PULSE. Fossils found in New Zealand suggest that, after the dinosaurs, there was an era when giant flightless birds ruled some regions.

Which animal group is set to dominate next? Let us know — and send health news — at dpayne@politico.com and kmahr@politico.com.

TODAY ON OUR PULSE CHECK PODCAST, host Alice Miranda Ollstein talks with Josh Gerstein about a federal judge’s recent suggestion that a constitutional right to abortion could be conferred by the 13th Amendment.

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A message from PhRMA:

Costly out-of-pocket expenses tied to deductible and coinsurance requirements are a leading concern for patients with commercial insurance. These harmful practices put in place by insurers and pharmacy benefit managers (PBMs) are even causing patients to abandon their medicines. New IQVIA data break down how insurers and their PBMs are impacting how patients access and afford their medicines.

 
Abortion

Illinois Gov. JB Pritzker speaks at a news conference.

Illinois Gov. JB Pritzker has called on the federal government to enact a federal law legalizing abortion nationwide. | Charles Rex Arbogast/AP Photo

A PLEDGE TO PROTECT ABORTION — Democratic governors in two states promise to shield abortion rights, warning against further restrictions, POLITICO’s Kelly Hooper and Mia McCarthy report.

“We’re not an island; we’re an oasis,” Illinois Gov. JB Pritzker said in an interview with POLITICO on Thursday. “People come to Illinois to exercise what are their fundamental rights, and they’re being denied in other states, every state around us, and then another ring of states around them. So think about how if you want to exercise your rights, how far you have to travel if you don’t live in Illinois in order to exercise those rights.”

And North Carolina Gov. Roy Cooper said Thursday at POLITICO’s event that he “wouldn’t back down” when it comes to reproductive freedom.

Illinois and North Carolina have become havens for abortion access in regions where restrictions have mounted since the overturn of Roe v. Wade.

“We have become a critical access point in the Southeast, and we need to hold the line to protect women’s health,” Cooper said. “Get politicians out of the exam room with women and their doctors.”

 

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At the Agencies

COVID VACCINE ADDED TO SCHEDULE — The CDC has added Covid shots for children, adolescents and adults to its immunization schedule, POLITICO’s Katherine Ellen Foley reports.

The updates reflect current federal recommendations and formalize the guidance for health providers and schools.

The schedule isn’t a mandate — states and localities determine which vaccines schools require for students, and all states have medical exemptions for vaccines. Some states also have nonmedical vaccination exemptions for religious or philosophical reasons.

CMS FLOATS RULES OF THE ROAD FOR INFLATION REBATES — CMS has released technical draft recommendations outlining its process for drugmakers paying mandatory rebates should they raise the price of certain drugs more rapidly than the rate of inflation, David reports.

The government won’t invoice companies for the inflation rebates until late 2025, according to the Part B and Part D draft guidance documents released by CMS on Thursday afternoon. However, the first 12-month period for certain Part D drug inflation rebates started Oct. 1, and the first quarterly period for certain Part B drug inflation rebates began Jan. 1.

CMS officials told reporters they seek feedback on a variety of topics, including the process for determining whether a rebate should be reduced or waived due to shortages and the process for imposing civil monetary penalties on drugmakers that fail to pay rebates.

In Congress

DRUG PATENT REFORM BILLS ADVANCE — The Senate Judiciary Committee on Thursday advanced five bipartisan bills aiming to boost generic and biosimilar competition in the pharmaceutical marketplace, David reports.

Through a voice vote, the group demonstrated the popularity of efforts to cut down drug prices.

The package aims to boost coordination between the FDA and the U.S. Patent and Trademark Office, directs the Federal Trade Commission to study the role of pharmacy benefit managers in the supply chain, limits pay-for-delay agreements and deters use of citizen petitions that look to delay competition.

One bill, the Affordable Prescriptions for Patients Act, aims to facilitate competition by addressing product hopping and placing limits on the number of patents biologic manufacturers can assert during what’s known as the patent dance. That piece of legislation has drawn complaints from the brand-drug industry, which argues the product-hopping provision would “upend the biopharmaceutical innovation ecosystem” and create an “FTC enforcement cloud over almost any post-approval innovation.”

Providers

CHA PUSHING FOR RESIDENCY PROGRAM RENEWAL — Children’s Hospital Association leaders have been meeting with lawmakers this week to push for the renewal of the Children's Hospitals Graduate Medical Education program, which trains pediatric doctors.

The group is asking for $738 million in the 2024 budget — well above the sub-$400 million appropriations from the last decade.

But CHA’s board chair, Jeff Sperring, and president, Amy Knight, told Pulse they believe the program and its funding need to grow, especially amid workforce shortages and increased demand for pediatric mental health care.

“The pandemic has only accelerated this,” Sperring said. “The mental health crisis has even added to that burden for all of our providers.”

The program, focusing on pediatrician and pediatric specialist education, is being touted as a solution to the health workforce crisis that’s been front of mind for many health policymakers.

“Between the workforce issues and the child mental health issues, you know, we see there’s a long tail to the pandemic for kids,” Knight said. “We’re just now, I think most [children’s] hospitals will say, plateauing, not necessarily coming down from really high demand.”

 

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Abortion

ABORTION PILL CASE DELAYED — The deadline for a looming court ruling that could ban abortion pills nationwide has been pushed back from Feb. 10 to Feb. 24, Alice reports.

District Court Judge Matthew Kacsmaryk in Amarillo, Texas, said Thursday night that the extension would give Danco, the maker of the drug mifepristone, time to intervene in the case and submit its arguments to the court on why the FDA’s two-decade-old approval should be allowed to stand.

The ruling could ultimately decide the fate of the most-used abortion method in the U.S.

 

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.

 
 
Names in the News

Reservoir Communications Group has three new additions: Chrystine Zacherau as an SVP following her time at APCO Worldwide, Lauren Kotwicki as a VP following more than a decade of public affairs experience in the federal government and Grace Montgomery as a VP following her time at RF Binder.

What We're Reading

The New York Times reports on the odds being stacked against a promising new Covid drug.

CBS News reports that the U.S. is set to test shots against bird flu and is weighing poultry vaccinations.

 

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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Alice Miranda Ollstein @aliceollstein

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