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Republicans plan health-related probes if they win the House


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Today’s edition: The Biden administration extended the public health emergency for monkeypox. A key Senate Democrat seeks changes to Medicare Advantage’s marketing practices. But first …

Expect investigations into covid origins, prescription drug middlemen and pandemic relief dollars if GOP takes the House

House Republicans are plotting a flurry of probes into the Biden administration’s pandemic response and the health industry if the party retakes control of the chamber next week.

Key party leaders have already drummed up lists of their oversight priorities amid growing confidence they’ll win control of the House in the midterm elections. This includes investigating the origins of covid-19, cracking down on prescription drug middlemen, examining how pandemic relief dollars have been spent and scrutinizing key federal agencies.  

Both Democrats and Republicans have already launched their own probes into the coronavirus over the last few years, seeking to shape the public narrative over the federal response. But the majority party can issue subpoenas to compel testimony and obtain documents — a power House Republicans deeply skeptical of some of the nation’s scientists and Biden’s covid response haven’t had for the duration of the pandemic. 

The effort would likely spark a round of political showdowns, leading to fraught congressional hearings and partisan bickering. The Biden administration has already been staffing up in preparation for more oversight, picking lawyer Richard Sauber — previously the general counsel of the Department of Veterans Affairs — to lead a White House response team. (The White House declined to comment for this piece.)

“Some of it will be about just scoring some political points, but others will likely be about really trying to understand some of the decisions that were made, why they were made, and what were the influences,” said Jen Kates, a senior vice president at the Kaiser Family Foundation. 

We’re taking a look at two main panels this morning. 

The first: The House Oversight and Reform Committee, which is the chamber’s chief investigative committee. In statements to The Health 202, the Republican who could soon run the panel, Rep. James Comer (Ky.), laid out his covid and health-care agenda. Here’s what the committee plans to prioritize:

  • The origins of the coronavirus and federal funds supporting research done at Wuhan Institute of Virology.
  • Waste, fraud and abuse in the trillions of dollars Congress approved for coronavirus relief aid.
  • The Centers for Disease Control and Prevention, such as data gaps and pandemic-era guidance Comer called “confusing.”
  • Prescription drug middlemen known as pharmacy benefit managers, which some Republicans accuse of contributing to the high cost of medicines.
  • Allegations that the pandemic policies of former governor Andrew Cuomo (N.Y.) and other Democratic governors made nursing homes take in patients infected with covid-19 (a spokesperson for Cuomo called this a “Trump retread” in which nothing came of a DOJ review into the matter).

The second panel to watch: The House Energy and Commerce Committee, which has sweeping jurisdiction over health-related issues and could be led next year by Rep. Cathy McMorris Rodgers (R-Wash.). The panel’s GOP lawmakers will also continue probing the origins of the coronavirus, and have opened inquiries into biosafety practices overseen by federal agencies. Here’s what else the panel is planning to focus on, per a committee GOP aide:

  • Biden administration covid policies, such as the impact of school-related policies on children.
  • The increasing rate of deaths from fentanyl, a powerful synthetic opioid.
  • Hearings regarding federal health agencies potentially related to the pandemic response and the Centers for Medicare and Medicaid Services.
  • Oversight into how the federal health department decides to implement Democrats’ new drug pricing policies.
  • Transparency into how much hospitals are charging, an effort which has been bipartisan.

Much of Republicans’ oversight agenda will meet fierce resistance from Democrats, as well as slices of the health-care industry. 

Already, Democrats are firing back at the plans. “Committee Democrats remain focused on repairing the damage Republicans inflicted on our nation’s public health institutions so that we can be in a better position to address the next public health crisis,” a Democratic spokesperson for the House Oversight and Reform Committee wrote in an email. 

At least one industry that could soon be caught in Republicans’ crosshairs said it’d comply with congressional probes. Yet, the lobby for prescription drug middlemen, Pharmaceutical Care Management Association, also contested the notion that pharmacy benefit managers were a reason for the rising price of medicines.

  • “We have a history of engaging with Congress — and would continue to do so whether they’re seeking information, whether they’re having a roundtable, a hearing, whatever it may be,” said JC Scott, PCMA’s president and CEO.

White House prescriptions

Monkeypox alert: The nation’s top health official, Xavier Becerra, renewed the public health emergency for monkeypox yesterday, meaning such a declaration will be in effect for at least another 90 days. 

Two major pharmacies agree to opioids settlement

CVS Health and Walgreens have agreed to pay about $10 billion total to states, cities and Native American tribes to settle all opioid lawsuits, The Post’s Rachel Lerman and Meryl Kornfield report. The two massive retail pharmacies have been accused of dispensing pain medication with little oversight; they in turn have blamed doctors for overprescribing the pills.

“The settlements announced Wednesday are not yet finalized, the companies said, and are not an admission of wrongdoing in the opioid epidemic that has killed hundreds of thousands of Americans,” our colleagues write. “A substantial number of the plaintiffs would need to sign on to receive the funds.”

  • If the CVS settlement goes through, the chain of pharmacies would distribute roughly $4.9 billion to states and local governments and about $130 million to Native American tribes over 10 years, beginning in 2023.
  • Walgreens has tentatively agreed to pay $4.79 billion to states and $154.5 million to tribes. It would also pay an extra $753.5 million in attorneys’ fees, where those charges are part of the total CVS figure.

Walgreens handled nearly 1 in 5 of the most addictive opioids at the height of the epidemic. It said in a statement that the settlement “is in the best interest of the company and our stakeholders at this time.”

DHS is broadening efforts to monitor online speech

The Department of Homeland Security is broadening its efforts to police online speech it considers dangerous — and that includes language around the origins of the coronavirus pandemic and vaccines, the Intercept reports.

Reporters Ken Klippenstein and Lee Fang detail ways the U.S. government is increasingly trying to shape online discourse and prevent misinformation, partly by pressuring online platforms like Facebook to take a more active role in removing content. According to a draft of a DHS report on future strategy, the agency plans to target “inaccurate information” on a range of topics including “the origins of the COVID-19 pandemic and the efficacy of COVID-19 vaccines, racial justice, U.S. withdrawal from Afghanistan, and the nature of U.S. support to Ukraine.”

DHS has said such intervention is necessary because misinformation online could exacerbate terrorist threats. But defining what constitutes misinformation isn’t clear cut.

“How disinformation is defined by the government has not been clearly articulated, and the inherently subjective nature of what constitutes disinformation provides a broad opening for DHS officials to make politically motivated determinations about what constitutes dangerous speech,” Ken and Lee write.

Physicians gear up to blitz the Hill to avert Medicare payment cuts

Get ready for intense lobbying from doctors in Congress’ lame-duck session. The federal government is officially reducing Medicare payments to physicians next year by 4.5 percent — a cut doctors want to avoid, Stat reports.

CMS finalized the change in a regulation this week, and some experts say the decrease could be closer to 8.5 percent — and potentially surpass 10 percent due to other potential cuts and inflation for buying medical supplies.

Technically, Medicare must cut doctors’ pay by 4.5 percent next year due to legislation Congress previously passed. But in recent years, physicians have been able to avoid most cuts by getting help from their allies in Congress and will try to do so again, Stat’s Bob Herman notes.

New this a.m.: A Senate Democratic committee report says it found evidence of widespread aggressive and deceptive marketing practices in Medicare Advantage and prescription drug plans.

The report from Senate Finance Committee majority staff was based on a panel inquiry launched in August 2022, which collected information on marketing complaints from 14 states. The panel found that nine of the 10 states tracking complaint data saw an uptick in complaints from 2020 to 2021. 

The source of the complaints included mail advertisements, robocalls, telemarketers and television advertisements. The report identified a number of policy recommendations for CMS, such as reviewing the models for agent/broker compensation and prohibiting educational and marketing events from occurring on the same day and at the same place.

The other side: The Better Medicare Alliance, which advocates for Medicare Advantage plans, has previously pushed back on Democrats’ probe, arguing marketing materials are “already subject to careful regulation.”

Democrats spend heavily on abortion ads in key gubernatorial races (By Kimberly Kindy and Greg Morton l The Washington Post)

What you need to know about covid boosters and the latest research (By Carolyn Y. Johnson l The Washington Post)

Paul Pelosi is still in the hospital. What we know about his injuries. (By Frances Stead Sellers and Sabrina Malhi l The Washington Post)

Thanks for reading! See y’all tomorrow.

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