| | | | |  | | By Daniel Payne and Krista Mahr | | | | | | | 
Under the public health emergency, telehealth has transformed into an essential tool for many rural doctors and patients. | Mark Lennihan/AP Photo | A REVOLUTION IN RURAL CARE — The pandemic-era push for more telehealth didn't just bring a boost to health tech companies: It changed the way rural providers did business. But as some policies that eased restrictions on telehealth are set to end a few months after the public health emergency comes to a close, doctors in large swaths of the country are worried about the future of the newfound avenues for care. Creative solutions: Virtual care changed rural care across practices and specialties, doctors in several states told your host. From obstetrics check-ins or surgery follow-ups to oncologist visits or primary care needs, virtual care meant residents in places with few providers had new access — not just to nearby doctors but also to specialists that may have been hours away. Waits for some particular providers, like child psychiatrists, dropped dramatically in several states. And long travel times were nonexistent for those who could talk with their doctors from home. Some visits require only a conversation about how a patient is feeling or a photo to show how an incision is healing, doctors said. Eyes on the Hill: Though a recent bill that would extend policies promoting telehealth easily passed in the House, some providers are concerned that it's not yet passed in the Senate — even as the number of days left in the lame-duck Congress ticks down. Worries that increased virtual care would cost the government more money or promote fraud have been hang-ups for a few members of Congress. Beyond pushing for individual policies, though, many doctors are looking for broader government signals that expanded telehealth is here to stay — and new investments to integrate tech and health care should continue. "Some of those changes in legislation, if maintained, could absolutely change the way we provide care," said Jeremy Cauwels, the chief physician of Sanford Health in South Dakota, the nation's largest rural health system. "What's at stake here is, unfortunately, moving backwards in time rather than forwards." WELCOME TO TUESDAY PULSE, where we're tracking the top judicial news of the day: how long it really takes to make microwaveable mac and cheese. Going to court: a multibillion-dollar company and a Florida woman. Is there another key court decision we should be tracking? What about an issue on the Hill? Let us know at dpayne@politico.com and kmahr@politico.com . TODAY ON OUR PULSE CHECK PODCAST , POLITICO's Emily Schultheis talks with Ruth Reader about the doctors, researchers and women's activists who convened in Riga, Latvia, to explore ways to use pills to circumvent anti-abortion laws.
| | | | A message from PhRMA: 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. | | | | | | | 
The WHO has renamed the monkeypox virus, citing concerns about stigmatizing those with the virus. | Cynthia S. Goldsmith and Russell Regnery via the CDC | M - - - - - POX — Monkeypox officially has a new name: mpox. That's according to a new designation from the World Health Organization made Monday, POLITICO's Ashleigh Furlong reports . The change, first reported by POLITICO last week , comes after the White House pressured the international group to move quickly in renaming the disease to reduce stigma around it. After consulting with member countries and scientists, the WHO recommended mpox be used as a synonym for monkeypox for a year before being adopted as the preferred term. Biden officials urged the change, worried about the original name causing stigma, especially for people of color. That was on top of ongoing concerns about stigmatization of men who have sex with men, who were hit particularly hard by the global outbreak. Several public health officials and patient advocates applauded the move, saying it will help remove testing and treatment barriers. "Public health officials and authorities must remove every barrier to improving understanding about how viruses spread and who is most affected," Sarah Kate Ellis, president and CEO of LGBTQ advocacy group GLAAD, said in a statement. "Decades of public health research shows stigma slows down testing, treatment, access to care, and vaccine equity, particularly in communities of color, which are often disproportionately impacted by global outbreaks."
| | | | GO INSIDE THE MILKEN INSTITUTE FUTURE OF HEALTH SUMMIT: POLITICO is featuring a special edition of our "Future Pulse" newsletter at the 2022 Milken Institute Future of Health Summit from Dec. 6 to 8. The newsletter takes readers inside one of the most influential gatherings of health industry leaders and innovators solving the biggest global health issues to ensure a healthier, more resilient future for all. SUBSCRIBE TODAY TO RECEIVE EXCLUSIVE COVERAGE . | | | | | | | | CRUNCH TIME FOR PREGNANT WORKER PROTECTIONS — Time's running out for legislation that would give pregnant workers more job protections, POLITICO's Eleanor Mueller reports . Even though the Pregnant Workers Fairness Act — which would require employers to provide "reasonable accommodations" for pregnant workers — has bipartisan support and momentum in both chambers, the shrinking window to pass it has some advocates concerned. In next year's divided Congress, advocates say, a few House Republicans could derail the bill's passage. Sen. Bill Cassidy has been meeting with Senate leadership to pass the bill, acknowledging that "the clock is ticking."
| | | BERLIN'S ADVICE FOR BEIJING — The German government has an idea for China's leaders to quell protests over Covid-19 restrictions: Use Western vaccines. POLITICO's Hans von der Burchard reports that the vaccines could be the key to China finding its way out of the pandemic — and out of its strict zero-Covid policies. Those policies, including continued large-scale lockdowns, have led to some of the most pronounced civil unrest in decades. A spokesperson for the German government said Monday that Chancellor Olaf Scholz made clear the success of mRNA vaccines in a visit with Chinese leaders in recent weeks. So far, China has been relying on its own vaccines and not allowing the use of vaccines from Western countries.
| | | LOSING ITS LAST LOBBYIST — Guarding Against Pandemics, an advocacy organization funded by embattled cryptocurrency mogul Sam Bankman-Fried, no longer has a lobbying firm on its payroll, POLITICO's Ben Leonard reports. Monument Advocacy, which has been working for the group since October, filed a termination report indicating its work stopped on Nov. 14. The firm was paid $40,000 for the month and a half of work, just part of the total $750,000 lobbying effort from Guarding Against Pandemics since last year. The group pushed for more funding to respond to Covid-19 and pandemic preparedness efforts. Bankman-Fried, whose cryptocurrency exchange FTX went bankrupt earlier this month, had tapped a new leader for the group — his brother, Gabriel, who has since left the firm.
| | | SHARING SUBSTANCE ABUSE RECORDS — HHS is considering making it easier to share the treatment records for substance abuse patients, Ben reports. According to a notice of proposed rulemaking released Monday, the agency is looking at lessening the privacy requirements for those records. Currently, records about substance abuse require a patient's consent every time they're shared — a higher standard than what's required for other medical treatments. But the new rule, if enacted, would require consent once for sharing multiple times in the future. Providers have said the change would help give them access to the information they need to best treat patients. HHS also proposes giving itself new authority to enforce the rules should providers violate them.
| | | | A message from PhRMA:   | | | | | | MURPHY'S COVID REVIEW — New Jersey Gov. Phil Murphy's office announced its independent review of the state's handling of the pandemic, POLITICO's Daniel Han reports. Murphy has long promised an assessment of how the state handled the public health crisis. The probe, which will be led by two outside firms, will look into everything ranging from the continuation of government functions and public health management to policy decisions around congregate care settings, according to Murphy's office. A report on the findings is expected to be released late next year. WEATHERING FUTURE STORMS — Hurricane Ian exposed a serious flaw in Florida's health system: an inability to evacuate, POLITICO's Arek Sarkissian reports . Despite being under evacuation orders and in Ian's path, hospitals remained open and removed only a handful of patients before the Category 4 hurricane made landfall, according to state records. Only after the hurricane had pounded the facilities for several hours did staff move at least 640 patients from five hospitals in Charlotte, Sarasota and Lee counties. In one instance, hospital staff had to delay transferring patients for hours because it was too dangerous to move anyone outside the hospital as the storm raged. Now, with some fearing future storms' effects on hospitals, some pressure could be placed on state leaders to rethink evacuation procedures for the health system.
| | | | POLITICO APP USERS: UPGRADE YOUR APP BY DECEMBER 19! We recently upgraded the POLITICO app with a fresh look and improved features for easier access to POLITICO's scoops and groundbreaking reporting. Starting December 19, users will no longer have access to the previous version of the app. Update your app today to stay on top of essential political news, insights, and analysis from the best journalists in the business. UPDATE iOS APP – UPDATE ANDROID APP . | | | | | | | | Jennifer Friedman is now vice president of government affairs at Outset Medical. She most recently advised HHS Secretary Xavier Becerra on issues related to Medicare and the Office of the National Coordinator for Health Information Technology.
| | | ProPublica's Ava Kofman writes about the profit motive's role in shaping hospice care. Sandeep Jauhar writes in The New York Times' Opinion section about the aging population of doctors in the U.S. The Washington Post's Ariana Eunjung Cha and Dan Keating report the number of Covid deaths among older Americans is reopening questions about what "acceptable loss" means several years into the pandemic.
| | | | 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. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
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