Will a divided Congress give hospitals what they want?

Will a divided Congress give hospitals what they want?

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With David Lim, Megan R. Wilson and Ben Leonard

Driving the Day

India Wells, RN and Emergency Department OPNUM moves a patient in St Vincent's Hospital Emergency Department.

The American Hospital Association’s agenda this year includes boosting the healthcare workforce. | Lisa Maree Williams/Getty Images

HOSPITALS LOOK AHEAD — The American Hospital Association, one of the biggest health advocacy groups in the country, released its policy agenda for the coming year — focusing on solving workforce shortages and securing more federal money for hospitals.

Lisa Kidder Hrobsky, AHA’s senior vice president for federal relations, told Pulse the group has several targets this year, including strategies to train more health care workers and tailor payments for hospitals in different geographic and economic settings.

Kidder Hrobsky added that the group has some draft legislation that hasn’t been released yet. And though the outlook isn’t great for a big health bill, AHA’s lobbyists are interested in passing smaller items separately, hoping to get more approved.

AHA’s agenda not only points to coming discussions on health policy but also represents the difficulties facing health organizations of all kinds: trying to move key post-pandemic legislation amid a deeply divided Congress.

But the group also anticipates challenges in Washington, D.C.: Congressional staffers have warned the AHA that hearings looking into hospitals’ compliance with price transparency and merger rules might be on the horizon.

Workforce shortages, which are of interest to lawmakers and a pressing issue for providers, are a key focus for the AHA’s 2023 agenda. Kidder Hrobsky said they’ve seen bipartisan interest in boosting the workforce. The AHA lists four goals for the year: improving workplace safety for providers, increasing the number of residency slots eligible for Medicare funding, boosting the number of workers in nursing facilities and diversifying the workforce.

Payment increases is another focus, including starting payments for hospitals that can’t discharge patients, addressing inflation through increased Medicare payments, protecting drug discounts through the 340B program, altering the Rural Emergency Hospital designation and creating a payment designation for Metropolitan Anchor Hospitals.

Some challenges are also being watched by the group, particularly the possibility of hospital policy oversight.

Kidder Hrobsky said staffers on the Hill told the AHA that committees might look into hospitals’ compliance with price transparency rules — and mergers and acquisitions that could threaten a competitive marketplace.

But she said she was confident in the public’s view of hospitals.

“I think, reputationally, hospitals can really stand on their own,” she said.

WELCOME TO FRIDAY PULSE. Do you have a copy of draft legislation for the upcoming session? We want to take a look. Send us a note at [email protected] and [email protected].

TODAY ON OUR PULSE CHECK PODCAST, Megan Messerly talks with Ruth Reader about the Federal Trade Commission’s action against drug discount platform GoodRx for sharing customers’ health data with Google, Facebook and other third parties.

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.

In Congress

Sen. Bill Cassidy is pictured.

Sen. Bill Cassidy, now the ranking member of the Senate HELP Committee, wants to address HIPAA reform and gene therapy expenses. | Leigh Vogel/Getty Images

CASSIDY BECOMES TOP HELP GOP LAWMAKER — Sen. Bill Cassidy (R-La.) officially became the ranking member of the Senate Health, Education, Labor and Pensions Committee on Thursday following a final parliamentary step. Although Sen. Bernie Sanders (I-Vt.), a fierce progressive, controls the panel’s agenda as chair, Cassidy is still poised to have an impact, Ben, David and Megan report.

In an interview with POLITICO, Cassidy discussed HIPAA and paying for gene therapy — as well as the prospects of the Pandemic and All Hazards Preparedness ACT.

“There’s going to be some things upon which we disagree, but I think it’s fair to say that there’s bipartisan concern regarding it,” he said of PAHPA. “And there’s also a general awareness that we need to be prepared if another ‘all hazards’’ occurs. Inevitably, there are going to be philosophical differences — does the government do it, or does the private sector — but we actually saw during the best part of the Covid response, that interaction that worked pretty well, by the way, using tools that Congress had given. So, I don’t start off with an, ‘Oh my gosh, we can’t get it done.'”

Cassidy also noted that while HIPAA reform can be a “very difficult” thing to touch, the law could be better implemented to clear up confusion among practitioners about what information can be shared with caregivers.

“There’s a lot of misinformation about HIPAA, tremendous misinformation that adversely impacts family members of the mentally ill,” Cassidy said.

He also said he wants to examine how expensive gene therapies are paid for, especially in cases where a health benefit for a patient might not be realized for decades.

“We’ve got to have a point where no insurance company is disadvantaged as to whether or not they choose to cover a particular gene therapy for somebody,” Cassidy said. “If you find a way in which you truly socialize the cost of that gene therapy — yes, we want to reward innovation, but in which you don’t make it a crapshoot as to what insurance company or small business gets stuck with the bill — then you are going to be able to expand access.”

A message from PhRMA:

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E&C RELAUNCHES NIH INVESTIGATION — Republican leaders of the House Energy and Commerce Committee sent letters to the National Institutes of Health’s acting director, Lawrence Tabak, and EcoHealth’s president, Peter Daszak, asking for documents they believe could be related to Covid-19’s origins.

The requests build on similar queries from the last Congress.

EcoHealth, which oversaw funds to the Wuhan Institute of Virology, was recently at the center of a government audit, which found the NIH “did not effectively monitor or take timely action to address EcoHealth’s compliance with some requirements.”

Now, lawmakers want to further examine NIH’s oversight of the research and its possible role in the pandemic.

Global Health

EYE ON RSV — The European Union’s disease agency is looking to add respiratory syncytial virus to its list of notifiable diseases to better track its circulation — and stop it.

POLITICO’s Sarah-Taïssir Bencharif reports the agency hopes to add RSV to the list of more than 50 notifiable diseases — a list that dates to 2018 — which comes at a time when rising viral infections have put significant strain on health care systems across Europe.

ANOTHER BATTLE WITH BIG PHARMA — The EU wants to give European consumers access to more medicines at a faster pace and a cheaper price, picking a fight on the other side of the Atlantic with the pharmaceutical industry, POLITICO’s Carlo Martuscelli reports.

A draft plan to overhaul the EU’s pharmaceutical laws, a copy of which has been obtained by POLITICO, would see the European Commission rip up the perks that drugmakers enjoy to let unbranded rivals enter the market two years earlier.

Some of that time can be recovered by drug companies, though, should they make their medicines available in all EU markets — a proposal aimed at leveling out unequal access across the continent.

At the Agencies

STAFFING UP AT ARPA-H — The Biden administration is working to stand up its new research agency, ARPA-H, bringing over Barbara Menard from the OMB to lead its congressional relations team, Megan reports.

She’ll serve as the director of the ARPA-H’s legislative and government affairs office.

On K Street

TEVA LEAVES PhRMA — Generics manufacturer Teva Pharmaceuticals has left the Pharmaceutical Research and Manufacturers of America, the industry’s most powerful lobbying group, Megan reports.

The move comes as the pharmaceutical industry shifts its financial outlook and regroups overall. It follows a rare defeat in a yearslong battle against Democrats’ drug pricing measures that included allowing Medicare to negotiate drug prices.

Teva has seen declining revenues over the past several years and finalized a settlement agreement in November to pay up to $4.25 billion to resolve lawsuits over the marketing of opioid painkillers.

Teva is the second company to leave PhRMA in recent months. In December, POLITICO first reported that AbbVie did not renew its membership with the association.

Angela Wiles is now senior director on Pfizer’s federal government relations team. She previously was health policy director for Senate HELP ranking member Richard Burr (R-N.C.).

Nick Bath, previously health policy director for the HELP committee, is joining Manatt as a health partner.

Alexandria Phillips is now director of strategic comms at USAID. She most recently was comms director for Surgeon General Vivek Murthy and is an alum of Sen. Kirsten Gillibrand, Secretary Hillary Clinton and the State Department.

What We're Reading

STAT reports on the difficulty of keeping polio away, even after it’s eradicated.

Insider writes that shortages of a weight-loss drug are driving people to potentially risky knockoffs.

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.

( Information from politico.com was used in this report. Also if you have any problem of this article or if you need to remove this articles, please email here and we will delete this immediately. [email protected] )

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