The health policy Rand Paul and Elizabeth Warren agree on

By Daniel Payne and Krista Mahr

A group of senators is pushing back on upcoming Medicare payment cuts to health care providers. | Getty Images

A LAME-DUCK LIKELIHOOD — In a bipartisan letter sent Wednesday, 46 senators — from Sen. Rand Paul (R-Ky.) to Sen. Elizabeth Warren (D-Mass.) — asked leadership to address looming Medicare payment cuts to providers before the new year, when they would take effect.

“It is essential in the coming weeks that we make sure providers have the resources they need to keep their doors open for seniors and families,” the senators wrote.

The letter comes a day after the Centers for Medicare and Medicaid Services released its final rule confirming the cuts, which are required by law.

It took no time for providers to voice concerns about the final rule — in fact, they had been pushing for Congress to act before CMS published its final rule.

Floating reform: The group of senators is looking for sustainable changes — alongside a quick fix — to the current payment system.

“Going forward, we support bipartisan, long-term payment reforms to Medicare in a fiscally responsible manner,” the senators wrote.

The suggestion to change the system comes after a September request from House members for information on the same topic in the hopes of changing the current system.

Inflation and infections: Providers had already sounded the alarm over their financial futures going into next year.

Inflation and rising labor costs have been a major concern for clinics and hospitals — especially as there are few signs that reimbursements will keep pace with increasing expenses.

The government’s cash infusions from the pandemic are running dry, and another Covid-19 package from Congress seems less than likely, even as some hospitals face a concerning number of Covid, flu and RSV infections.

The worries aren’t all new, though — Congress has adjusted the payment rate before to mitigate cuts.

This year, a solution has already been proposed, with Reps. Larry Bucshon (R-Ind.) and Ami Bera (D-Calif.) introducing a bill that would stop the cuts.

Whether through that legislation or another vehicle, the persistent lobbying efforts from providers seem to be paying off as bipartisan consensus grows.

Those groups insist the decisions made in the coming weeks will affect patients in 2023.

“There are serious risks facing millions of seniors’ access to surgical care in less than two months — cuts to surgical care will affect how the surgical care team is able to care for patients across the country,” Michael Dalsing, president of the Society for Vascular Surgery, said in a statement following the letter.

WELCOME TO THURSDAY PULSE. Afraid of needles? Researchers at the University of Tsukuba developed a furry robot to put you at ease — and hopefully increase vaccination rates.

Have creative ideas to ease vaccine anxieties? What about tips about what’s happening in the health world? Drop us a line at dpayne@politico.com and kmahr@politico.com .

TODAY ON OUR PULSE CHECK PODCAST , Krista talks with Grace Scullion about Wednesday's news that, in a deal not yet finalized, CVS, Walgreens and Walmart agreed to pay $13.8 billion to settle thousands of lawsuits for their roles in the opioid crisis.

A message from PhRMA:

Fresh data show the 340B program may be driving up costs for some patients. How? A new analysis finds 340B hospitals prescribe patients more expensive medicines than non-340B hospitals on average. It’s time to fix the 340B program. Learn more.

REPS ASK LEADERSHIP TO BOOST ALTERNATIVE PAYMENT MODELS — In another lame-duck win for providers, more than 40 lawmakers in the House sent a letter to congressional leadership on Wednesday asking to extend a 5-percent payment increase to incentivize alternative payment models.

The congressional push isn’t far removed from the final rules from CMS on Tuesday, which effectively promote Accountable Care Organizations, or groups of providers who coordinate patient care for Medicare beneficiaries. It also comes after ACOs visited the Hill in September to lobby for a payment boost.

Sen. Mark Warner and his staff have released a report on cybersecurity in the health industry. | Anna Moneymaker/Getty Images

CYBERSECURITY TO HEALTH SECURITY — A new congressional report links cybersecurity in the health sector to patient safety, POLITICO’s Ben Leonard reports.

The new report, from Senate Cybersecurity Caucus co-founder Mark Warner’s (D-Va.) office, asks Congress to consider getting HHS to set minimum security standards for the health industry. The report also suggests HHS review patient privacy protections.

Warner’s report laid out several possible actions, including:

— Adding a senior leader in HHS charged with advancing cybersecurity

— Establishing a “regular process” to update HIPAA

— Setting minimum security standards for health organizations

— Considering cybersecurity expenses in Medicare reimbursements

The health care sector is under constant threat from hackers as it undergoes its digital transformation, Ben has previously reported , with hackers getting their hands on nearly 50 million Americans’ sensitive health data in 2021.

FRUITING BODIES, HEALING MINDS — A high dose of the psychoactive chemical in magic mushrooms was shown to help people with treatment-resistant depression, according to a new clinical trial.

Mental health care company COMPASS Pathways funded the Phase II clinical trial, POLITICO’s Helen Collis and Sarah-Taïssir Bencharif report, which demonstrated synthetic psilocybin — along with psychotherapy — led to a decline in symptoms over three weeks.

The therapy came with some side effects, including headache, nausea, dizziness and fatigue. Suicidal behavior was reported more often in the group of participants receiving the highest dose, but researchers said it was too early to tell if psilocybin was the cause.

The results, published in The New England Journal of Medicine , raise hopes that a new class of effective depression treatments could be on the horizon.

PUBLIC HEALTH EXPERTS SLAM BIDEN ON TITLE 42 — Dozens of public health experts nationwide are calling on President Joe Biden and top federal officials to stop the expanded use of Title 42 to keep a growing number of migrants from seeking asylum in the United States.

Title 42, a CDC order designed to stop the spread of communicable disease by preventing migrants from entering the country, was enacted under the Trump administration during the pandemic’s early days and has been in place at the U.S. southern border ever since. The CDC tried to end the order in April following a thorough reassessment , saying it was no longer needed given the other tools like vaccines and masks available to control Covid-19. But several states sued to keep the order in place, and the Biden administration has since been blocked from ending it.

Last month, the U.S. and Mexico agreed that Venezuelan migrants fleeing their country and arriving illegally at the U.S. southern border could also be expelled to Mexico under Title 42. International migration organizations, including the International Organization for Migration and the U.N. Refugee Agency, said after the announcement that the continued use of the CDC policy to prevent migrants from seeking asylum in the U.S. ran afoul of international law.

The group of public health experts, who have spoken out against the use of Title 42 to keep migrants out of the country throughout the pandemic, said it’s also a threat to long-term public health.

“The continuing and expanded use of the order, even when the Centers for Disease Control and Prevention (CDC) itself sought to end it in April of this year given its lack of public health need, is a travesty,” the signatories wrote in a letter on Wednesday to Biden, HHS Secretary Xavier Becerra, CDC Director Rochelle Walensky and DHS Secretary Alejandro Mayorkas.

FLORIDA REPUBLICANS ASK ABOUT IMPORTING CANADIAN DRUGS — Four members of Florida’s congressional delegation sent a letter to the FDA asking for an update on the state’s application to import cheaper prescription drugs from Canada, POLITICO’s Arek Sarkissian reports.

The letter raises concerns that the FDA is working faster with other states than it is with Florida.

Importing drugs from Canada has been a priority for Florida Gov. Ron DeSantis, who wants the state to be the first in the nation to bring in prescription drugs from the north to cut costs.

A message from PhRMA:

Ryan Walker is now VP of government relations at Heritage Action. He previously was senior director at PhRMA.

Ann DeFabio joins the Kaiser Family Foundation later this month as the group’s first senior vice president and chief communications officer. She comes from Pew Charitable Trusts, where she was senior vice president and chief communications officer.

Irving Washington will join KFF as a senior fellow to lead the development of a new health misinformation program area. He comes from Online News Association, where he was the CEO.

Osula Evadne Rushing joined KFF this week as senior vice president for strategic engagement, a new position. She comes from Grantmakers In Health, where she was vice president for program and strategy.

Jason Ginenthal is now associate director of media relations at pharmaceutical company Boehringer Ingelheim. He most recently was a freelance PR consultant.

The New York Times’ Emily Baumgaertner writes about the RSV surge that reminds some hospitals of March 2020.

ABC News’ Kevin Shalvey writes about the $10 billion settlement CVS and Walgreens paid over an opioid case.

STAT’s Olivia Goldhill reports on the excitement around psilocybin as an effective treatment for depression — as well as the concerns over the drug’s durability.

A message from PhRMA:

The 340B program grew, yet again, hitting a whopping $43.9 billion in sales at the discounted 340B price in 2021. But there has not been evidence of corresponding growth in care provided to vulnerable patients at 340B covered entities. And making matters worse, fresh data show that 340B may actually be driving up costs for some patients and our health care system as whole. The program of today is having the opposite effect of what Congress intended when they created 340B. That’s a problem. It’s time to fix the 340B program. Learn more.

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