Can telehealth hitch a spending bill ride?

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Jan 05, 2024 View in browser   By Ben Leonard and Chelsea Cirruzzo Driving The Day Telehealth lobbyists are pressuring Congress to pass legislation that would allow standalone insurance plans that cover virtual doctor visits. | J Pat Carter/AP TELEHEALTH TANGO — Telehealth advocates are pushing to get one of their top priorities into an upcoming government funding package, several lobbyists told Pulse. They hope for a revival of now-expired pandemic provisions that allow employers to offer telehealth services as a separate benefit. Lobbyists are targeting the Agriculture-FDA spending package, which has a Jan. 19 deadline to avoid a partial shutdown, as a vehicle. Persuading Congress: Rachel Stauffer, executive director of the Partnership to Advance Virtual Care, told Pulse that her group has been working with bill leaders, the Senate, relevant committees and House leadership. Stauffer and Kyle Zebley, the executive director of the American Telemedicine Association’s lobbying arm, ATA Action, told Pulse they’re pushing for a three-year extension that would allow time for a permanent fix to come together. “Part of it is: Will there be extras on the … package?” Stauffer said. “That’s one big hurdle. But we are lining ourselves up as best as we can.” Act fast: Zebley acknowledged that timing is tight but said acting now could be a “wonderfully appreciated approach” instead of waiting, given the litany of Medicare and commercial plan telehealth rules expiring at the end of 2024 that Congress is set to address. Another industry lobbyist told Pulse that some on the Hill are looking at a one-year extension aligned with those expiring rules. “A year might not be enough runway to do it effectively,” Zebley countered. “It’s not easy to get this up and running.” It’s unclear how a funding deal might come together, with topline spending numbers yet to be agreed on. Other advocates are eyeing the package for health transparency measures. The backstory: Now-expired 2020 regulations aimed to incentivize employers to offer health coverage to workers not otherwise eligible for their companies’ insurance plans. A broader measure to permanently allow employers to offer standalone telehealth plans advanced through the House Committee on Education and the Workforce largely on party lines in June. Backers have likened the telehealth plans to vision and dental coverage. The opposition: Many committee Democrats objected to the bill, saying it would incentivize employers to offer less than comprehensive health insurance. Telehealth advocates have pushed back, saying the measure doesn’t change existing Affordable Care Act requirements. “There’s more education that needs to be done,” Stauffer said. “Leading up to some of those markups, time was crunched, and there wasn't a lot of time for us to dig deep into why folks think that.” WELCOME TO FRIDAY PULSE. There’s some unfortunate news for a Northern Virginia TikTok star: she’s been ordered to stop digging a tunnel under her home that she’s been working on since 2022. Our own tunnel-digging dreams are now in serious jeopardy. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo. Listen to today’s Pulse Check podcast INVESTMENTS HEALTH TRANSACTIONS TUMBLE — The number of deals, such as mergers and acquisitions, in health care and life sciences has fallen to below pre-pandemic levels, according to a report released today by consulting firm KPMG. KPMG said the Federal Trade Commission’s aggressive posture on mergers in several health care sectors has hurt dealmaking, including in biopharmaceuticals, hospitals and health systems. The firm also pointed to a number of other factors impacting dealmaking, including the Inflation Reduction Act’s drug pricing provisions, rising interest rates and “widespread uncertainty.” “That said, for companies with a sound legal preparation to combat FTC objections, there were several large acquisitions near the end of the year that demonstrated a continuing appetite for innovative cell-and-gene therapies and treatments for cancer and rare diseases,” the firm wrote. Among dealmakers surveyed, the top headwinds cited for 2024 were inflation concerns, competition for a small number of high-value targets and other negative economic impacts. Still, the firm found optimism for a turnaround in 2024. More than 3 in 5 surveyed said they expect mergers and acquisitions to rise this year, while just 9 percent said they expect them to fall. Thirty percent said they expect the number of deals to remain stable.   POLITICO AT CES® 2024: We are going ALL On at CES 2024 with a special edition of the POLITICO Digital Future Daily newsletter. The CES-focused newsletter will take you inside the most powerful tech event in the world, featuring revolutionary products that cut across verticals, and insights from industry leaders that are shaping the future of innovation. The newsletter runs from Jan. 9-12 and will focus on the public policy-related aspects of the gathering. Sign up today to receive exclusive coverage of the show.     Eye on the FDA NEW WEIGHT-LOSS DRUG SUICIDE DATA — Semaglutide, a popular diabetes and obesity treatment, is associated with a lower risk of suicidal ideations than drugs using other mechanisms, according to NIH-funded research. The findings, published today in Nature Medicine, come after the FDA said it’s evaluating reports of suicidal ideation and hair loss related to semaglutide — sold under such brand names as Wegovy and Ozempic — and “the need for regulatory action.” The drugs’ popularity has skyrocketed recently amid promising weight-loss results. The details: Researchers examined the digital health records of hundreds of thousands of U.S. obese or overweight patients who were prescribed semaglutide or other weight-loss medications between June 2021 and December 2022. They also did so for nearly 1.6 million patients with type 2 diabetes using semaglutide and those prescribed other treatments. Overall, those prescribed semaglutide had a 49 to 73 percent lower risk of suicidal ideations versus those taking other types of treatments. “Our analyses do not support concerns of increased risk of suicidal ideation with semaglutide and instead show a lower risk association,” the researchers wrote. Novo Nordisk, which makes Wegovy and Ozempic, said in a statement to Pulse that the company works closely with the FDA to “continuously monitor” safety and that known risks are reflected in product labeling. A spokesperson for Eli Lilly, which makes Zepbound and Mounjaro, drugs that also fall under the FDA's notice, told Pulse that “patient safety” is its priority and it is working with the FDA. Public Health NEW LEADING VARIANT — A new Covid-19 subvariant of Omicron, JN.1, is now the dominant circulating strain in the U.S., Chelsea reports. The variant, first detected in September, made up 44.2 percent of cases as of Dec. 23, jumping from 21 percent of cases as of Dec. 9 and surpassing the previously dominant variant HV.1, which makes up 22.1 percent of cases. What to know: The fast growth of JN.1 suggests it could be more transmissible than other variants, the CDC said, but there’s no evidence of increased illness severity, and the most up-to-date vaccine is expected to provide some protection. It comes amid an uptick in serious respiratory illness infections following the holiday season, prompting some medical facilities to return to mask mandates. Medicare Advantage CMS NIXES ADS — The Biden administration shot down about a third of TV ads for Medicare Advantage insurance plans over the past seven months, arguing they could mislead consumers about their benefits and costs, POLITICO’s Robert King reports. This is the first time the Centers for Medicare and Medicaid Services reviewed TV spots before they air, and it comes amid growing scrutiny over how privately run insurers administer the plans. The agency reviewed about 3,000 ads and nixed more than 1,000. Third-party marketing organizations were responsible for more than 80 percent of the rejected ads, CMS said. Senate Finance Chair Ron Wyden (D-Ore.) has focused on those third-party organizations, calling them “middle-men” for engaging in aggressive marketing tactics. On the horizon: A November proposal aims to clamp down on volume-based bonuses paid to marketing organizations by MA plans, which can incentivize more aggressive marketing tactics. VETERANS' HEALTH FRAUD RISK? The Department of Veterans Affairs’ disability benefits questionnaires pose a “significant risk” of fraud to the agency, a watchdog report released Thursday found. Veterans download such forms and ask outside medical providers to complete them to substantiate benefit claims. The VA Inspector General found that the Veterans Benefits Administration lacks “effective controls” to prevent the risk of fraudulent forms. Based on a sample of 100 claims reviewed, the fraud risk could be about $390 million, the watchdog report said. The Inspector General recommended several measures to reduce fraud risk — all of which the agency agreed with and offered “acceptable action plans” to implement.   Tune in on Wednesday, Jan. 10, as POLITICO explores Taiwan's upcoming presidential election. Hear from our panel on the potential outcomes to the race and the profound implications for U.S.-China relations depending on who wins. REGISTER HERE.     Names in the News Tracy Johnson has joined Manatt, Phelps & Phillips’ health care group as managing director. She has advised the Center for Medicare and Medicaid Innovation and served as Colorado Medicaid director. Branden Cordeiro is joining KPM Group DC as a public affairs manager. He was previously a government affairs associate at Capitol Associates. WHAT WE'RE READING McDermottPlus has a roundup of regulatory issues to watch in 2024. Healthcare Dive reports on a new study finding patients are more likely to suffer falls or infections at private equity-owned hospitals. Researchers in Nature Mental Health explore the digital divide in mental health care access.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM 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 Megan R. Wilson @misswilson   Follow us

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