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Presented by Humana: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | |  | | By Krista Mahr and Daniel Payne | | | With Megan R. Wilson and Ben Leonard
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If the NDAA is enacted, the military will no longer release troops who refuse a Covid vaccination. | United States Forces Korea via Getty Images | A WIN FOR THE GOP ON MILITARY VAX MANDATE — A compromise defense policy bill released Tuesday night would end the Pentagon’s policy requiring troops to receive the Covid-19 vaccine and releasing troops who refuse it, POLITICO’s Connor O’Brien reports . The final version of the National Defense Authorization Act goes against what both the Pentagon and the White House want. Both said in recent days they want to retain the rule that separates troops who don’t receive the vaccine. Roughly 98 percent of the force has been vaccinated, according to the Pentagon. Republican resistance: Though neither defense bill in the House and Senate included a rollback of the mandate, getting rid of the policy became a top priority for Republicans in NDAA talks over the past few weeks. They have argued the mandate, first put in place by Defense Secretary Lloyd Austin in August 2021, has worsened a recruiting crisis in the military by forcing out thousands of people who declined the shot. They also have said the military services’ rules for granting religious exemptions are too stringent and rarely result in an accommodation. A bloc of GOP senators, led by Sen. Rand Paul of Kentucky, threatened to try to stall the bill if they don’t receive a vote on ending the mandate and reinstating troops with back pay. What’s next: Congressional leaders aim to bring the $847 billion defense policy bill up for a vote in the House this week. The Senate will follow and send the measure to President Joe Biden for his signature. Though administration officials say Biden and Austin oppose ending the mandate as a matter of military readiness, the White House hasn’t indicated that Biden would veto the must-pass defense bill over vacating the policy. Also included in the bill: — $5 billion for global pandemic preparedness . While the act doesn’t technically allot the money, Congress’ appropriators usually do what the authorization bill says. The amendment authorizes the funding for use over five years and calls for a strategy, to be developed by the president, for U.S. global health security and diplomacy that advances the CDC’s Global Health Security Agenda. The bill also calls on the president to designate a senior official to be the coordinator of global health security and an ambassador-at-large to report to the secretary of State. — Guidance on implementing education on healthy relationships and intimate partner violence through Tricare, the U.S. military’s health care program, which the secretary of Defense must provide. — A raft of other improvements to Tricare, including requiring an audit of mental health providers in the Tricare network, conducting an independent analysis of quality and the patient safety review program and ordering GAO studies of Tricare contracts and oversight and Tricare’s mental health services. WELCOME TO WEDNESDAY PULSE — Another day, another food recall. This time, it’s ham and cheese loaf . Send your processed meat of choice, news and tips to kmahr@politico.com and dpayne@politico.com . TODAY ON OUR PULSE CHECK PODCAST , Ben Leonard, at the Milken Future of Health Care Summit, talks with Steve Posnack, HHS' deputy national coordinator for health information technology, about what he thinks the biggest barriers are to people getting their health data. Plus, Megan R. Wilson on a Q&A with Jack Resneck, the president of the American Medical Association, about the nearly 8.5 percent in Medicare payment cuts for doctors that will take effect in January unless Congress acts.
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Doctors are lobbying lawmakers to stop a nearly 4.5 percent cut in payments, in addition to a 4 percent pay-as-you-go, or PAYGO, across-the-board Medicare cuts for all providers. | Adam Berry/Getty Images | DOCS ON THE HILL — When it comes to averting looming Medicare reimbursement cuts in Congress’ year-end spending package, doctors aren’t holding back. Jack Resneck, the American Medical Association's president , traveled from California to meet with policymakers on Capitol Hill this week, Megan reports. At a roundtable with reporters on Tuesday, Resneck said he’s “showing up everywhere I can show up to urge lawmakers to fix this.” It’s part of a lobbying blitz to stop a nearly 4.5 percent cut in payments for doctors, in addition to a 4 percent pay-as-you-go, or PAYGO, across-the-board Medicare cuts for all providers. Although the AMA and others are pushing to avert the full cuts, lobbyists and congressional staffers have told Megan and Daniel in recent weeks it’s more likely that lawmakers will stop only part of the cut from taking effect, potentially keeping the conversion factor around 3 percent — the amount Congress settled on last year. The good news for the AMA and company: Historically, lawmakers have never let the PAYGO cuts take effect. HOUSE PASSES MATERNAL HEALTH BILL — On Tuesday, the House passed the Data Mapping to Save Moms’ Lives Act, which would mandate that the FCC create maps showing where poor maternal health outcomes coincide with broadband service gaps, Ben reports. The 380-46 vote sends the bill, along with other noncontroversial measures, back to the Senate, which passed a slightly different version in March by unanimous consent. ASTRAZENECA EXEC SAYS DRUG PRICING COULD GO FURTHER — An AstraZeneca executive praised the Inflation Reduction Act’s drug-pricing negotiation provisions and suggested they should go further, Ben reports from the Milken Future of Health Summit on Tuesday. Rachele Berria, vice president and head of medical U.S. biopharmaceuticals at AstraZeneca, said the negotiation is a step in the right direction but more needs to be done and there’s room to expand its scope. “If you look at the proposal for Part D negotiation, it will actually have less than 10 percent of the seniors in the program,” Berria said. “The increased affordability of medicines will improve … adherence to treatment and health outcomes.”
| | | | POLITICO AT CES 2023 : We are bringing a special edition of our Digital Future Daily newsletter to Las Vegas to cover CES 2023. The newsletter will take you inside the largest and most influential technology event on the planet, featuring every major and emerging industry in the technology ecosystem gathered in one place. The newsletter runs from Jan. 5-7 and will focus on the public policy related aspects of the event. Sign up today to receive exclusive coverage of CES 2023. | | | | | | | | CMS PROPOSES PRIOR AUTHORIZATION RULE — The Centers for Medicare and Medicaid Services proposed a rule Tuesday to require Medicare Advantage plans and other public payers to implement an electronic process for approving medical treatments, Ben reports. If finalized, the prior authorization rule would reduce delays in care by requiring insurers to respond to providers’ treatment requests more quickly. It also would bolster patient access to their medical data. MORE ADVICE FOR THE CDC — Plenty of opinions have been circulating on how the Centers for Disease Control and Prevention should approach its reset , incorporating the lessons and mistakes made during the pandemic. Today, the Robert Wood Johnson Foundation, the health philanthropy headed by former CDC acting director Rich Besser, weighed in with its suggestions in a new white paper , focusing on how the agency should prioritize equity across its operations. Its five recommendations: take a holistic approach to equity across the organization, earn the trust of communities impacted by health inequities, measure progress and adjust based on the health outcomes of people impacted by discrimination, communicate accessibly and prioritize equity when recruiting, training and evaluating staff. ‘CONSTANT TURMOIL’ AT THE FDA — A new report has found that the FDA’s Human Foods Program lacks leadership and mission clarity, leading to slow decision-making and weak regulation of foodborne illness, POLITICO’s Marcia Brown writes . The highly anticipated independent report on the FDA’s Human Foods Program comes after the agency commissioned an independent expert panel to review the program, prompted in part by the ongoing infant formula crisis. The report was led by Jane Henney , a former FDA commissioner, and conducted by the Reagan-Udall Foundation, which receives funding from the FDA, industry and private donations. A separate commissioner-mandated review will recommend changes to the FDA’s tobacco program by Dec. 19.
| | | U.S. WON’T BACK MORE COVID IP WAIVERS — The Biden administration said Tuesday it wasn’t ready to support a waiver of intellectual property protections for Covid-19 test materials and treatments despite backing an agreement in June that waived the protection for vaccines, POLITICO’s Doug Palmer reports. As part of that deal, the World Trade Organization set a Dec. 17 deadline to decide whether to also provide an intellectual property protection waiver for Covid-19 diagnostics and therapeutics, which would cover treatments such as Pfizer’s Paxlovid. That proposal ran into an aggressive lobbying campaign from pharmaceutical companies and business groups opposed to the original vaccine waiver. The main U.S. pharmaceutical industry group welcomed the Biden administration’s decision, saying it makes more sense for policymakers to focus on “the real barriers to global medicine access,” including the last-mile logistics, weak health care infrastructure and regulatory and trade barriers.
| | | | A message from Humana:   | | | | | | Sandhya K. Balaram has been named chief of cardiothoracic surgery at NewYork-Presbyterian Brooklyn Methodist Hospital. Balaram previously spent 19 years as a cardiac surgeon and associate professor at Mount Sinai Morningside in New York City. Jonathan Gold is now senior associate director of post-acute payment policy at the American Hospital Association. He was previously director of government relations at the American Medical Rehabilitation Providers Association.
| | | | 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 . | | | | | | | | In an op-ed in the Columbus Dispatch , Rep. Mike Turner (R-Ohio) urges the Senate to pass the Mainstreaming Addiction Treatment Act to expand access to buprenorphine and combat the overdose epidemic. Apple gets a win in its patent battle over heart-monitoring technologies found in the Apple Watch, Stat reports . The Washington Post investigates why the FBI’s database of fatal police shootings shows a decline in incidents when other sources, including the newspaper’s own count, show they’re on the rise.
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