CDC not masking disagreement

Presented by the Coalition to Protect America's Health Care: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

Jan 24, 2024 View in browser   By Ben Leonard and Chelsea Cirruzzo Presented by the Coalition to Protect America's Health Care With Megan R. Wilson  Driving the Day After pushback from providers, the CDC has asked its advisers to reconsider their recommendations on wearing N95 masks in health care settings. | Justin Sullivan/Getty Images CDC REJECTS TRANSMISSION GUIDANCE — The CDC disagrees with its advisers on the steps providers in health care facilities should take to prevent the spread of infectious diseases, Chelsea reports. Background: The advisers on infection control sent proposed updates to 16-year-old guidance on how providers can limit transmission of viral infections in health care facilities to the CDC for review in November. The new guidance redefined viral air transmission and recommended tiers for when providers should wear N95 masks. Why it matters: The initial proposal drew outcry from some health care providers who say masks should be worn as a minimum level of protection against suspected or confirmed respiratory infections. On Tuesday, the agency sent the draft guidance back, asking the panel to reconsider some of its proposals, offering experts to help with questions it posed. “We feel these questions, largely related to when masks and respirators (such as N-95) are recommended in healthcare settings, reflect concerns or areas of confusion that continue to be raised by stakeholders in response to the draft guideline,” Dr. Alexander Kallen, a top CDC official in the Division of Healthcare Quality Promotion, wrote in a letter to the group. In his letter, Kallen asked the advisers to consider in part adding language about the voluntary use of N95 masks for providers, deciding whether N95s are the only type of mask recommended for viruses that spread via the air and expanding recommendations on viral transmission prevention to all times in health care facilities. The agency explained in a blog post that its response partly stems from concerns that an aspect of the draft that recommended face masks only for “special air transmission,” or illnesses considered new and emerging, might not apply to Covid-19 because it’s a better-known virus. The agency added that it doesn’t want guidance to be misread to “suggest equivalency between facemasks and [National Institute for Occupational Safety and Health] Approved respirators, which is not scientifically correct nor the intent of the draft language.” National Nurses United, the nation’s largest union group for registered nurses, praised the CDC for returning the guidance. The group had previously called on the agency to reject the recommendations, arguing for a stricter stance on masking. WELCOME TO WEDNESDAY PULSE. During this cold spell, gators are learning how to survive in frozen ponds. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.   A message from the Coalition to Protect America's Health Care: If Congress Cuts Hospital Care, Patients Will Pay. https://actnow.protecthealthcare.org/a/no-cuts-to-care   In Congress Some lawmakers think that a new CMS rule limiting the amount of time Medicare Advantage and other plans have to respond to prior authorization requests doesn't go far enough. | Adam Berry/Getty Images WHAT’S NEXT ON PRIOR AUTH — Congressional leaders who want to reform prior authorization in Medicare Advantage and other programs are mulling their next steps after CMS finalized a rule last week that some thought could have gone further. The rule: The rule means that Medicare Advantage, Medicaid managed care and children's health insurance plans will soon have to respond within three days to an urgent request and one week to a standard request. It’s an effort to push back on a tool that critics argue is used too often to deny or delay care. What Congress wanted: A large group of bipartisan backers of the Improving Seniors’ Access to Timely Care Act had pushed for the final rule to include provisions from their bill. Those would require Medicare Advantage plans to adopt a “real-time” process for answering routinely approved items and respond in 24 hours for any “urgent” care. That would lower the legislation's overall cost because of the Congressional Budget Office's methodology, which would make it easier to pass. The path forward: A House Democratic aide granted anonymity to discuss internal deliberations told Pulse that lawmakers are waiting for an updated interim CBO score to determine what changes to the legislation, if any, are needed to get it done. “The rule was always an interim phase to get the policy on the books and help the bill along. We were never going to stop at the rule,” the aide said. BECERRA SUBPOENA — House Judiciary Chair Jim Jordan (R-Ohio) has subpoenaed HHS Secretary Xavier Becerra for documents about HHS policies regarding the placement of unaccompanied migrant children. Jordan also asked for information about agency policies on sponsor vetting and unaccompanied children with gang and criminal ties. Jordan wrote that he has sought voluntary cooperation for months, but HHS has “produced nothing of substance.” An HHS spokesperson said the agency continues to engage on the request. “To suggest that the Department hasn’t been responsive is a mischaracterization and yet another example of the Committee issuing a subpoena entirely without basis,” the spokesperson said. “These actions by the Committee fail to solve the important and urgent issue of ensuring a safe and humane immigration system.” Abortion PROTESTORS INTERRUPT BIDEN RALLY — President Joe Biden’s rally in the Washington suburbs Tuesday night to mark Roe v. Wade’s anniversary was knocked off course when protestors interrupted his speech pushing back against his handling of the Israel-Hamas war. Biden’s speech touted his administration’s efforts to safeguard reproductive freedom but was interrupted every few minutes by protestors calling for a cease-fire, POLITICO’s Myah Ward and Lauren Egan report. Biden supporters tried to drown them out with “four more years” chants. The protest underscores the discontent in some of the Democratic party about Biden’s stance on the war. He’s more frequently had to confront public opposition.   JOIN 1/31 FOR A TALK ON THE RACE TO SOLVE ALZHEIMER’S: Breakthrough drugs and treatments are giving new hope for slowing neurodegenerative diseases like Alzheimer’s disease and ALS. But if that progress slows, the societal and economic cost to the U.S. could be high. Join POLITICO, alongside lawmakers, official and experts, on Jan. 31 to discuss a path forward for better collaboration among health systems, industry and government. REGISTER HERE.     Lobby Watch LOBBYING LATEST — The top 10 health lobbying spenders remained roughly the same as last year — with trade groups for drugmakers, hospitals and doctors topping the list — but PBMs responding to scrutiny from lawmakers jolted them into the fray, Megan reports. The analysis comes from newly filed fourth-quarter lobbying disclosure reports. The Pharmaceutical Care Management Association, which represents PBMs, spent $5.3 million in the last three months of last year — double the amount it had spent during the same time in 2022. “In the face of [drugmakers’] disingenuous attacks on our industry and Congress’ singular focus on pharmacy benefit companies, it is imperative to educate lawmakers and the public on the value PBMs provide to the health care system by lowering prescription drug costs and helping improving health outcomes,” said a spokesperson for the group. Cigna, which also jumped onto the top 10 list, did not respond to a request for more information about its increase.   A message from the Coalition to Protect America's Health Care:   Medicaid AVOIDABLE HOSPITALIZATIONS IN MEDICAID — Black Medicaid patients are much more likely than white patients to be hospitalized for preventable conditions, including diabetes, lung disease and heart failure, according to a new analysis by the Urban Institute and funded by the Robert Wood Johnson Foundation. Preventable hospitalizations are even higher for Medicaid enrollees with a disability in the Supplemental Security Income program, Chelsea reports. For example, in 2019, nearly 13 percent of Black Medicaid enrollees with a disability had potentially preventable hospitalizations for heart failure compared with about 7 percent of their white counterparts. Why it matters: Researchers say the results highlight a need to improve outpatient care for chronic conditions among Black Medicaid enrollees, including for enrollees in Medicaid managed care plans. “It may also be beneficial to track and report measures for this group separately to ensure their outcomes improve over time and to identify particular plans that may fail to serve them adequately. Approximately 75 percent of the enrollees eligible for Medicaid because of SSI in our study states are served by comprehensive managed care plans,” the researchers wrote. Names in the News Shayne Woods is joining the Alpine Group as vice president. He was most recently a senior legislative assistant to Sen. Tim Scott (R-S.C.). Lisa David has been appointed chair of the board of directors of Medicines360. She’s CEO of Public Health Solutions and was chief operating officer at Planned Parenthood Federation of America.    Enter the “room where it happens”, where global power players shape policy and politics, with Power Play. POLITICO’s brand-new podcast will host conversations with the leaders and power players shaping the biggest ideas and driving the global conversations, moderated by award-winning journalist Anne McElvoy. Sign up today to be notified of new episodes – click here.     WHAT WE'RE READING POLITICO’s Rachel Bluth reports on a California lawmaker making another bid to get free condoms in high schools. Healthcare Dive reports on the FTC blocking another data firm from selling location data. CNN reports on states easing Covid isolation guidelines.   A message from the Coalition to Protect America's Health Care: Corporate insurance companies are banking record profits —often by delaying and denying Americans’ care. Now the same big insurers are pushing Congress to enact harmful cuts to hospital care. A majority of American hospitals already operate at a loss. They care for underserved communities, even when patients can’t afford to pay. More than 149 rural hospitals have shuttered or cut services. Hundreds more are at risk of closing. It’s time to act to protect American patients and the hospitals they count on. Learn more: https://actnow.protecthealthcare.org/a/no-cuts-to-care     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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