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Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | |  | | By Daniel Payne and Krista Mahr | | | | | | | 
Sens. Richard Burr and Patty Murray, seen here with Sen. Rand Paul at left, are pushing for Congress to pass their PREVENT Pandemics Act. | Pool photo by Scott Applewhite | Members of Congress — along with special interest groups — are looking to get their priorities into the year-end package. Two policies to watch as we go into the weekend: PANDEMIC PREP IN JEOPARDY — The leading bill aimed at bolstering the nation’s defenses against future pandemics is in peril as Congress races to put together a year-end package, POLITICO’s Alice Miranda Ollstein reports. Members of both parties and lobbyists are skeptical that the legislation can get the support it needs — even as Sens. Patty Murray (D-Wash.) and Richard Burr (R-N.C.), the bill’s authors, argue it’s vital to protect the U.S. against future disease outbreaks. The two lawmakers are urging congressional leaders to include the bill in an end-of-year spending package that must pass in the coming weeks. Beyond that, into the next Congress, prospects for their PREVENT Pandemics Act appear even dimmer, with Republicans — already balking at spending any more on the pandemic — taking control of the House. At stake, the bill’s supporters say, is the opportunity to address shortfalls from the Covid-19 pandemic, such as abysmal data sharing across state lines and a severe shortage of nurses and other frontline health workers. “We’re back to the panic and neglect cycle,” said Tom Frieden, the former director of the Centers for Disease Control and Prevention who runs the public health advocacy group Resolve to Save Lives. “The problem is that, structurally, prevention usually loses. It’s never as urgent. You don’t know when the next pandemic is going to be. And there’s no constituency of people who know that their lives will be saved by the money that you’re going to spend.” DOCS LOOK FOR A MEDICARE DEAL — Members of the GOP Doctors Caucus pushed colleagues for a deal to stop Medicare cuts, telling House Republican committee leaders Thursday that they need to use the year-end spending package to help providers, according to two people in the room granted anonymity to discuss the private meeting. Your host reports that Reps. Cathy McMorris Rodgers (R-Wash.) and Kevin Brady (R-Texas), the ranking members of the Energy and Commerce and Ways and Means committees, respectively, were guests at the weekly caucus meeting to hear concerns about the looming Medicare cuts. “The message from docs is: Stop all of [the cuts], but I suppose there’s a sense of reality here that they may not get that,” said a GOP Doctors Caucus aide, granted anonymity to discuss the details of the meeting. “My boss walked away feeling good about it.” WELCOME TO FRIDAY PULSE, where we know that when your mom wants a picture, you let her take it — even if you’re the House minority leader . Does your mom have a photo of you at work — or a tip about which health provisions are going in the year-end spending package? Tell her to reach out at dpayne@politico.com and kmahr@politico.com . TODAY ON OUR PULSE CHECK PODCAST , Ben Leonard talks with Ruth Reader about the brain-implant technology developed by Elon Musk’s health tech company Neuralink.
| | | | | | | 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. | | | | | | | 
Two health care provider groups are behind separate court cases in Texas. | AP Photo | TWO TEXAS CASES — Provider groups are fighting the government on two fronts in Texas courts, with new developments emerging this week: The Texas Medical Association brought another surprise billing case this week, looking to change the rules of how payment disputes between providers and insurers are decided — and how a fair payment is calculated. The suit alleges providers would be unfairly paid under the new rules. In Braidwood Management v. Becerra, several large health groups — led by the American Medical Association and represented by Democracy Forward — asked the court Wednesday night to uphold the Affordable Care Act’s requirement that insurers cover recommended preventive care at no cost to patients. The request comes after a September ruling on the case in which a judge ruled the federal advisory board that recommends which preventive health care services should be covered doesn’t actually have that legal power.
| | | | 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 . | | | | | | | | RETIREES' SHRINKING HEALTH BENEFITS — Fewer employers are offering health benefits for retirees, according to a new analysis from KFF . Just over 10 percent of large employers offer retiree health benefits to Medicare-age retirees, the analysis found. Employers and unions have made changes to their offerings to try to prevent liability, worried about the costs associated with the benefits. Among those still providing coverage, an increasing number are using Medicare Advantage plans, which could affect beneficiaries and federal spending alike, KFF found.
| | | FDA WEIGHS NEW BLOOD DONATION POLICIES — The FDA is considering loosening restrictions on blood donations for gay and bisexual men, relying on individual screening questionnaires to reduce the risk of HIV transmission, POLITICO’s David Lim and Katherine Ellen Foley write. Currently, men who have sex with men are asked to abstain from sex for three months before donating blood, a policy implemented in 2020 amid significant blood shortages stemming from the Covid-19 pandemic. For decades, men who have sex with men were barred from donating blood following the AIDS epidemic — a policy lifted in 2015 when the FDA said those who abstained from sex for a year could give blood. The new considerations, first reported by The Wall Street Journal , come amid recent data on donated blood from sexually active gay and bisexual men. AGENCIES COULD DO MORE TO STOP TELEHEALTH ABUSE, OVERSIGHT PANEL SAYS — The independent Pandemic Response Accountability Committee said in a report released Thursday that federal programs could do more to prevent fraud, waste and abuse in telehealth, POLITICO’s Ben Leonard reports. The committee was created under the 2020 CARES Act and worked with inspectors general from six federal agencies to examine expanded telehealth in Medicare and in federal employee health benefits, veterans’ care, workers’ compensation programs and health care for federal prisoners. The report comes amid some on the Hill voicing concerns about fraud in negotiations to extend rules that made telehealth less burdensome during the pandemic.
| | | | A message from PhRMA:   | | | | | | DOCTORS AND INSURERS MUST ENSURE VENDORS FOLLOW PRIVACY LAWS — HHS said Thursday that health insurers, hospitals and doctors tracking user data online are responsible for their vendors’ compliance with the health privacy law HIPAA, Ben reports. “Providers, health plans, and HIPAA-regulated entities, including technology platforms, must follow the law. This means considering the risks to patients’ health information when using tracking technologies,” said Melanie Fontes Rainer, director of HHS’ Office of Civil Rights, in a release. NEURALINK TRIALS COMING SOON, MUSK SAYS — Elon Musk said Wednesday that his health tech venture, Neuralink, is asking the FDA to launch a human clinical trial, the next step for the company. Musk believes Neuralink holds the promise of using implantable technology to enhance the brain and cure a range of ailments from blindness to paralysis, POLITICO’s Ruth Reader reports. “We’ve submitted most of our paperwork,” Musk said. "We think, probably in about six months, we should be able to have our first neuralink in a human.” The tech could have big implications for those with spinal cord injuries or Lou Gehrig’s disease. The wireless device, which is about the size of a quarter and is implanted under the skin, works by translating brain signals into actions.
| | | FIRST IN PULSE — Rational 360, a strategic communications and digital advocacy agency, announced Ilyse Veron, health policy communications strategist and technology market analyst, as senior vice president working with the firm’s healthcare practice.
| | | | 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 . | | | | | | | | Widespread outages shut down the 988 mental health hotline , The Associated Press reported. The Washington Post’s Carolyn Y. Johnson, Cate Cadell and Joel Achenbach dive into the vaccine strategy that came before China’s zero-Covid crisis . Anand Parekh, chief medical adviser at the Bipartisan Policy Center, argues in Newsweek that pandemic preparedness is just as important as military preparedness .
| | | | 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 | | | | |  |
