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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 Chelsea Cirruzzo and Ben Leonard | | | With Robert King
| | |  Most Americans don't want to live in a nursing home based on their poor opinion of the residencies' quality of care. | Scott Olson/Getty Images | NURSING HOME APPEAL IS LOW — Americans have a dim view of the quality of care in nursing homes, an assessment that could bolster the Biden administration’s case for tougher regulations, POLITICO’s Daniel Payne reports. According to new polling from Gallup: — Nearly 7 in 10 people are uncomfortable with the idea of living in a nursing home, with concern about the quality of care the main reason for their reluctance. — Thirty-three percent of Americans graded care a C, or “satisfactory,” and 36 percent graded care a D, or “poor.” Six percent gave care a failing grade. — Cost, mental health and independence are also significant concerns Americans have about nursing homes, Gallup found. The results were largely consistent across demographic and political groups. Why it matters: The Biden administration proposed new rules for nursing homes earlier this month that would require nearly 3 in 4 to hire additional staff, with the goal of improving the quality of care. “I think [the polling results] buttress the arguments that are being made by Biden officials right now,” said Dan Witters, a Gallup researcher, who noted the public’s general belief that the industry isn’t meeting care standards. Lawmakers have weighed in for and against the staffing proposal, as have patient advocates and industry leaders. The pandemic exposed safety problems in the homes. More than 200,000 nursing home residents and staff died due to Covid as of last year, according to KFF, the health research group. What’s next? The administration’s proposed staffing rules are open for public comment till the end of October, after which the Centers for Medicare and Medicaid Services will decide whether to make or finalize changes. WELCOME TO TUESDAY PULSE. This show returned yesterday for its 40th season, but it’s recycling old questions because of the SAG-AFTRA strike. What is Chelsea’s favorite show, “Jeopardy!”? Send your tips, scoops and feedback (in the form of a question) to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo. TODAY ON OUR PULSE CHECK PODCAST, host Kelly Hooper talks with Ben, who breaks down what's in House GOP leaders' newly unveiled health care package that's focused on boosting transparency and addressing high drug costs.
| | | | | | | A message from PhRMA: Middlemen can profit from where patients fill their prescriptions. Because insurance companies and PBMs own pharmacies, too. | | | | | | | 
CMS won't allow Utah to extend postpartum Medicaid because of the state's eligibility restrictions. | LM Otero/AP Photo | NO UTAH POSTPARTUM WAIVER — A proposed Utah waiver to extend postpartum Medicaid for 12 months was denied by CMS because the waiver would have limited coverage eligibility if the pregnancy ended in abortion, Robert reports. The decision could impact how other states weigh similar moves on a program meant to improve maternal health outcomes. Background: The American Rescue Plan Act enabled Medicaid to pay for postpartum coverage for one year as opposed to 60 days. However, it was up to the state to agree to the expansion. To qualify, the state had to submit a Medicaid plan amendment that lasts for five years. Utah instead wanted to change who would be eligible for such coverage. A woman whose pregnancy ends via an abortion not approved by the state — which clears the procedure for up to 18 weeks of pregnancy — wouldn’t be eligible, per the amendment. Thirty-seven states and Washington, D.C., have received approval for an extension as of Sept. 7, according to data from KFF. Nine additional states plan to implement an extension, and three — Idaho, Iowa and Arkansas — don’t. Wisconsin has sought to implement the coverage extension for only 90 days instead of a year. CMS said the evidence for supporting care to “all individuals during their postpartum period is very robust,” according to the letter to the state. Utah law says if CMS denies its request, the state will submit a new plan amendment consistent with the law’s requirements.
| | | | A message from PhRMA:   | | | | | VA NOMINATION ADVANCES — The Senate advanced the nomination of Tanya Bradsher to serve in the No. 2 position at the Department of Veterans Affairs in a 49-44 vote Monday over the objections of Republicans, Ben reports. Sen. Chuck Grassley (R-Iowa) put a hold on Bradsher in July. Such a maneuver forces a roll call vote instead of a speedier unanimous consent vote. Senate Majority Leader Chuck Schumer opted to move ahead with the vote, using precious floor time. Schumer hasn’t done the same for a blockade on hundreds of military promotions being blocked by Sen. Tommy Tuberville (R-Ala.) over the Pentagon’s abortion policies. In the new role, Bradsher would oversee the VA’s troubled EHR program, which is on pause and tens of billions over budget and has been tied to at least four veterans’ deaths. The accusations: Grassley opposes Bradsher, he has said, because of whistleblower testimony accusing her of failing to properly oversee a correspondence system that he believes mishandled veterans’ personal health information. Bradsher has shown “repeated indifference to congressional oversight,” he said previously. The defense: In a response to Grassley, Bradsher said that 0.05 percent of employees have access to the system and it follows “strict security and privacy guidelines.” She said the VA has enhanced security, bolstered training and limited access to better protect veterans’ information. The Senate is set to vote on her nomination today at 11:30 a.m.
| | | | DOWNLOAD THE POLITICO APP: Stay in the know with the POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need. DOWNLOAD FOR iOS – DOWNLOAD FOR ANDROID. | | | | | | | | MILLION DOLLAR HIPAA SETTLEMENT — One of the country’s largest publicly operated health plans has settled a $1.3 million suit over potential HIPAA violations with HHS. HHS’ civil rights office says L.A. Care, which provides coverage, including Medicare, Medicaid and marketplace plans, to Los Angeles County residents, failed to comply with HIPAA rules to protect the personal health data of beneficiaries after some were affected by breaches in 2014 and 2019. As part of the settlement, L.A. Care will implement a plan to improve security measures. HHS has settled a number of HIPAA-related complaints this year, including an $80,000 settlement with United Healthcare. Earlier this month, Melanie Fontes Rainer, director of the HHS Office for Civil Rights, told reporters that the office has received 51,000 overall complaints this year, its highest number to date.
| | ACIP MULLS UPDATED COVID SHOTS — The CDC’s vaccine advisory group meets today to review updated Covid-19 vaccines and discuss who might be the best candidates to receive a shot, POLITICO’s Katherine Ellen Foley reports. Background: On Monday, the FDA greenlit updated Covid vaccines by Moderna and Pfizer that generate immunity against the XBB.1.5 subvariant of Omicron, paving the way for individuals to receive shots later this month. Novavax’s candidate, the only non-mRNA vaccine, is still pending authorization from the agency. The Advisory Committee on Immunization Practices will convene today to hear from all three manufacturers as well as get updates on the latest data around Covid’s spread and current vaccine effectiveness. They’ll discuss who should get an updated shot, such as adults with compromised immune systems, and vote on whether to recommend the vaccines. What’s next: The shots will become available once CDC Director Mandy Cohen endorses a vaccine recommendation by the advisers. Pfizer and Moderna have said their vaccines will cost between $110 and $130. But private insurance, Medicare and Medicaid will cover the costs for those eligible to receive them.
| | A TARGET FOR MEDICARE ADS — An older adult with low income is more likely to be exposed to deceptive advertising for private Medicare plans than someone who has a higher income, Robert reports. That’s according to a new study from the think tank Commonwealth Fund, which examined marketing during the Medicare open-enrollment period that runs from Oct. 15 through Dec. 7. The survey comes amid higher scrutiny from CMS and lawmakers into how Medicare Advantage plans are marketed to older adults amid concerns they’re not getting the full picture of the plans they sign up for. Researchers interviewed 2,001 adults 65 or older from Nov. 30 through Dec. 8 last year. The study found that 22 percent of older adults with low income received fraudulent marketing calls compared with 10 percent overall. Twenty-two percent said they didn’t know how to file a complaint about the marketing outreach. The findings also detail issues with private drug and Medigap plans that cover benefits traditional Medicare doesn’t offer. CMS has adopted new requirements that take effect in 2024 for Medicare Advantage plans to tighten oversight of third-party brokers that reach out to customers.
| | Michelle Baker is joining Forbes Tate Partners as a public affairs partner. She previously was chief of staff of health and EVP of corporate strategic initiatives at Ketchum.
| | | | A message from PhRMA: Insurance companies and pharmacy benefit managers (PBMs) are putting their profits before your health. That’s because the largest PBMs own or are owned by the largest insurance companies, and they own pharmacies, too. First the PBM can deny coverage for your medicine in favor of one that makes them more money. Then, they steer you to the pharmacy they own. Without you ever knowing why it all happens this way. See what else they do. | | | | | The Wall Street Journal reports on insurers charging thousands of dollars for cheap generic drugs. Scientific American reports on research into why humans crave sugar and highly processed foods. The New York Times reports on new challenges faced by an aging population with HIV.
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