Trumping pandemic preparedness

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May 09, 2024 View in browser   By Chelsea Cirruzzo and Ben Leonard With Daniel Payne Driving the Day Former President Donald Trump is threatening to close the Office of Pandemic Preparedness and Response Policy if he's reelected. | Morry Gash/AP HOW TO KILL AN OFFICE — Can former President Donald Trump eliminate a White House office tasked with preparing the nation for the next pandemic? In some ways, yes, but not entirely, Chelsea reports. The former president recently told TIME Magazine that if reelected, he would abolish the White House’s Office of Pandemic Preparedness and Response Policy. According to Trump, the office, created in 2022 via a bipartisan law, “sounds good politically, but I think it's a very expensive solution to something that won’t work.” The White House declined to comment on Trump’s remarks, and the Trump campaign didn’t respond to requests for comment. Here are some ways some lawmakers and health policy experts say Trump could undermine the pandemic office. 1. He could choose to not appoint anyone to run the office or staff it. According to the legislation, the president “shall” appoint a director of the office, but there’s no deadline for doing so. David Cleary, a senior policy adviser at the law firm DLA Piper, worked for then-Sen. Richard Burr when the North Carolina Republican co-sponsored the legislation to create the office with Sen. Patty Murray (D-Wash.). Cleary told POLITICO that Trump could use that lack of guidance to sideline the office by not appointing a director or staff. Cleary said the legislation that created the office doesn’t mandate that it be staffed. 2. He could ask Congress to overturn the law. Since Congress created the office, it would have to pass a law to shut it down. Cleary said Trump could make the case, but he might not gain traction because the law had bipartisan support. 3. He could keep the office but mold it in his image.  Cleary said Trump’s comments might have been reflexive and reflect his lack of trust in bureaucracy — and he could end up seeing value in the office. One motivation for Republican lawmakers to create the office was to shift pandemic response leadership away from the CDC, Cleary said. The current director of the White House office is retired Maj. Gen. Paul Friedrichs. “It overrides the bureaucracy [Trump] hates so much,” Cleary said. “That’s the benefit of having the office,” he added. “The alternative is all he’s doing is empowering the agencies by taking away a measure of control that we envisioned.”  WELCOME TO THURSDAY PULSE. The CDC has new rules on dogs entering the United States from abroad to prevent rabies. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.   THE GOLD STANDARD OF HEALTHCARE POLICY REPORTING & INTELLIGENCE: POLITICO has more than 500 journalists delivering unrivaled reporting and illuminating the policy and regulatory landscape for those who need to know what’s next. Throughout the election and the legislative and regulatory pushes that will follow, POLITICO Pro is indispensable to those who need to make informed decisions fast. The Pro platform dives deeper into critical and quickly evolving sectors and industries, like healthcare, equipping policymakers and those who shape legislation and regulation with essential news and intelligence from the world’s best politics and policy journalists. Our newsroom is deeper, more experienced and better sourced than any other. Our healthcare reporting team—including Alice Miranda Ollstein, Megan Messerly and Robert King—is embedded with the market-moving legislative committees and agencies in Washington and across states, delivering unparalleled coverage of health policy and the healthcare industry. We bring subscribers inside the conversations that determine policy outcomes and the future of industries, providing insight that cannot be found anywhere else. Get the premier news and policy intelligence service, SUBSCRIBE TO POLITICO PRO TODAY.     AROUND THE AGENCIES CMS seeks to increase access to kidney transplants with a mandatory payment model. | Sean Gallup/Getty Images KIDNEY TRANSPLANT MODEL — CMS proposed a mandatory payment model Wednesday that would incentivize most of the nation’s transplant hospitals to increase the number of kidney transplants they perform. It comes as federal officials overhaul the entire organ transplant system amid a swelling waitlist of patients waiting for organs and congressional scrutiny of the single organization, the United Network for Organ Sharing, that’s managed the entire system since the 1980s. Kidneys are the most commonly transplanted organ in the U.S. and the most effective treatment for people with end-stage kidney disease. According to HHS, 32 percent of the more than 100,000 people awaiting an organ transplant in 2021 were African American, but only 13.5 percent of recipients from a living donor were African American. White people make up a third of the waitlist but 61.8 percent of donor recipients. The six-year model proposed to begin next year — which CMS estimates would include 90 percent of hospitals that perform organ transplants — would evaluate hospitals on the number of transplants they perform, the number of organs they accept and their post-transplant outcomes. Hospitals would also be required to identify gaps among populations in their community and establish health-equity plans, such as creating programs to provide transportation assistance for patients on the waitlist.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     In Congress MEDICARE REFORMS EN ROUTE — The first results of a Medicare payment reform effort in the Senate are expected next week, Daniel reports. According to a person familiar with the committee's plans, the Finance Committee plans to release a white paper outlining its plans to update the way Medicare pays health providers. That effort, closely watched by hospitals, doctors and insurers alike, could have significant implications for the cost and process of providing care in the U.S. What do you know about the reform efforts? Let us know at dpayne@politico.com. EASING TELEHEALTH RULES AIN’T EASY — The House Ways and Means Committee wants to ease Medicare telehealth rules, but how to do it is still in flux, Ben reports. How we got here: Expanded coverage for virtual care in Medicare and commercial plans under pandemic rules expires at the end of the year, as does the acute hospital care at-home program. On Wednesday, the committee considered legislation from Reps. David Schweikert (R-Ariz.) and Mike Thompson (D-Calif.) that would extend the virtual care rules in Medicare through 2026 and hospital at home through 2029. It advanced out of the committee in a 41-0 vote despite some division over several provisions. Lawmakers support — with caution — making expanded virtual care access permanent. Thompson, co-chair of the Congressional Telehealth Caucus, said telehealth should be permanent in Medicare partly because it can save money for the program, but he supports further studying virtual care use. Many offsets to pay for the bill are still up in the air, which has several pay-fors. But lawmakers can’t agree on which offsets should be included in the final language. Lawmakers on both sides of the aisle often zeroed in on curbing fraud related to virtual care. The legislation would increase scrutiny of providers that bill for pricey durable medical equipment to curb fraud and require a watchdog report on lab tests at high risk for fraud. Those can be a target for fraudsters in federal health care programs. So far, watchdog reports haven’t uncovered widespread telehealth billing issues. Insurers’ response: AHIP, which represents insurers, pushed back on the offset proposals in the legislation, saying in a statement that they would “undermine plan sponsors’ flexibility to develop value-based programs and shared-savings arrangements that benefit patients and taxpayers.” COLE TAKES A SECOND LOOK — House Appropriations Chair Tom Cole (R-Okla.) has been clear about his interest in reviving House earmarks in the Labor-HHS-Education funding bill, even though GOP leaders decided to forgo them again for fiscal 2025, POLITICO’s Caitlin Emma and Jennifer Scholtes report. Cole’s predecessor, Rep. Kay Granger (R-Texas), banned earmarks in the bill — but that doesn’t impact the Senate earmarks process. Cole wants to keep that debate going in the coming months. “It hurt us not to be able to earmark Labor-H,” Cole told reporters this week. Names in the News Electronic health records company NextGen Healthcare has hired Diane Kaye as chief product officer. Kaye previously was chief product officer and senior vice president at Omnicell. Jake Sims is now chief technology officer, having previously been executive vice president and chief technology officer at Gainwell Technologies. Garo Doudian is now chief information and security officer, having previously been chief information security officer for Risk Management Solutions, part of Moody’s Analytics. WHAT WE'RE READING POLITICO’s Marcia Brown reports that federal officials are asking makers of animal drugs to report on the status of an avian flu vaccine. The New York Times reports on how human-imposed changes to the planet have made us more vulnerable to future pandemics, according to a new analysis. Bloomberg reports on a Pfizer settlement regarding the cancer risks of its heartburn drug Zantac.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Katherine Ellen Foley @katherineefoley 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 Megan R. Wilson @misswilson   Follow us

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