POLITICO's Morning eHealth: Congressional developments — What’s on tap for today: FDA — CMMI’s CPC+ rolls on

By Darius Tahir | 05/18/2017 10:00 AM EDT

With help from David Pittman (@David_Pittman)

CONGRESSIONAL DEVELOPMENTS: The legislature's gears are turning, with some notable progress:

- House VA Committee passes scads of bills: The House Veterans Affairs Committee advanced 11 bills on Wednesday. There are three worth Morning eHealth readers' attention: the VA Scheduling Accountability Act (H.R. 467), which will require VA facilities to certify each year that they are meeting scheduling commitments; the VA Prescription Data Accountability Act 2017 (H.R. 1545), which requires the department to share prescription data for all its patients with PDMPs; and the Veterans Affairs Medical Scribe Pilot Act of 2017 ( H.R. 1848), which requires Veterans Affairs to establish a pilot program for medical scribes.

- FDA user fee markup developments: A bill requiring the FDA to create a category for over-the-counter hearing aids is expected to be offered as an amendment in this morning's Energy and Commerce markup of FDA user fee reauthorization. The measure, supported by Rep. Joe Kennedy, was included in the Senate's user fee bill, but hasn't yet been added to the House bill, despite bipartisan support during a hearing earlier this month.

- Senate Finance updates: As the Senate Finance Committee marches on with its work to expand Medicare telemedicine reimbursement, committee members are offering few eHealth-related amendments for this morning's markup.

One from New Jersey Sen. Bob Menendez would strike Medicare's geographic restrictions on telehealth altogether - but that won't happen because it's too expensive.

Another would have CMS share Part A and B claims with Part D plans to better coordinate care.

Catch the markup, which starts at 10:30 a.m., here.

- Appropriations and budgetary drama continues: One top appropriator is signaling that a continuing resolution for the full fiscal year of 2018 is likely. Our Budget colleague Sarah Ferris notes that Rep. Mike Simpson - the chair of the House Appropriations Subcommittee on Energy and Water - says that "The rest of the appropriators and chairmen will probably kill me, but, I think we're into a CR for 2018."

The Trump administration budgetary requests are unlikely to be followed. "This is [OMB Director Mick] Mulvaney's budget," Simpson said. "Like I want to go home after having [voted] against Meals on Wheels and say 'Oh it's a bad program, keeping seniors alive.'"

That's probably good for advocates of the National Institutes of Health. Ed Yong, of the Atlantic, reported that the fleshed-out version of the Trump budget request for fiscal year 2018 is likely to include robust cuts to the NIH by targeting the agency's support for "indirect costs" - infrastructure, such as software and lab equipment, that underlies any specific medical research project.

Meanwhile, NIH director Francis Collins - who we'll reiterate still hasn't been officially retained or ejected from his job leading the agency - warned appropriators Wednesday against a "roller coaster" approach to budgeting, with rises in funding being followed by deep cuts.

"We will have to figure out how to allocate across all of the many priorities that we are currently responsible for, but no area would be untouched," Collins told reporters, including our Health Care colleague Brianna Ehley. "We would try to do some judicious prioritizing about how deep the cuts are going to be. But they're going to be deep in all places."

House appropriators at the Wednesday subcommittee hearing seemed divided on the idea of cuts, particularly regarding those "indirect costs." As STAT noted, Rep. Andy Harris - who had been rumored for the NIH top spot - "grilled" Collins on those costs.

But Rep. Tom Cole, the leader of the subcommittee with jurisdiction over the NIH, doesn't seem well-disposed to cutting medical research funding, calling the idea "penny wise and pound foolish." So the safe money at this point is still on substantial NIH funding.

eHealth tweet of the day: Saurabh Jha @RogueRad When I look at the EHR screen I see the patient's medication, when I squint I see the patient's age

THURSDAY: Your correspondent loves a good pun (you may have noticed). So he wanted to offer appreciation for this particularly fine pun from an Economist headline: "Old McDonnell has a plan. He eyes IOUs." Don't know what the headline's talking about? Your correspondent submits it doesn't much matter. Send us your favorite puns at dtahir@politico.com. Pun socially at @David_Pittman, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.

WHAT'S ON TAP FOR TODAY - FDA: Your correspondent will be listening in on the morning session of FDA's public workshop on the cybersecurity of medical devices. (Main page here and agenda here). The agency is hoping to fill in some of its regulatory cybersecurity gaps. Some of the topics that may be addressed include:

- Potential metrics, evaluation tools to test and quantify the cybersecurity of medical devices and systems

- Best practices for cybersecurity of medical device deployment and application of updates throughout the medical device lifecycle

- Relationship between medical device cybersecurity and patient safety

- Differences in cybersecurity between home care, large health care providers and acute care settings (e.g., ambulance, emergency room, etc.)

Given last week's cybersecurity catastrophe at the National Health Service in the U.K., we're sure interest in the workshop will be high - and we'll keep you abreast of any developments.

TECH-CENTRIC CMMI INITATIVE ROLLS ON: Any talk of the CMS Innovation Center being gutted under the Trump administration took another hit Wednesday. The agency announced its Comprehensive Primary Care Plus (CPC+) model would expand to Louisiana, Nebraska, North Dakota and the Greater Buffalo region of New York.

If you recall, the CPC+ program, which launched in January, means Medicare, Medicaid and private insurers will pay primary care practices treating Medicare patients an estimated $15 or $28 per patient - in addition to their fee-for-service payments - as an incentive to help keep chronically ill patients out of the hospital. The more advanced track of the model requires medical practices to work with health IT vendors to improve their practices.

FAH HAS DEREGULATORY IDEAS: In a letter to HHS Secretary Tom Price, the Federation of American Hospitals submits many ideas to reduce health care providers' regulatory burden. (18 pages of them, in fact.)

As you might expect, many of these ideas are health IT-related: no mandatory CMMI demos; fewer reportable measures for MACRA and MIPS; delay of the requirements for clinical decision support for appropriate use of imaging; more flexibility to discount transport services; suspension of the hospital star rating system; delay of meaningful use stage 3 and much, much more.

For palace intrigue watchers, we found the addressees of the letter highly interesting: not merely Tom Price, not merely Seema Verma, but also cc'd are White House aides Gary Cohn and Jared Kushner.

HHS NOTES: We noticed Wednesday that John Fleming - HHS's deputy assistant secretary for health technology - will be speaking at a May 24 event co-hosted by the Council of Accountable Physician Practices and the American Cancer Society.

- Personnel notes: Sarah Lloyd Stevenson, a former staffer of Sen. Roger Wicker, has joined HHS as an advisor to the secretary. Stevenson served as Wicker's senior policy advisor on healthcare - and we note that Wicker has done a fair amount of recent work on telemedicine.

- Twitter: It appears the Precision Medicine Initiative's All of Us cohort just started tweeting here. Apparently, the project will include "casual, candid updates" (per its director, Eric Dishman) on its "Director's Corner" website. At the moment, updates include Mr. Dishman writing on a whiteboard and/or butcher sheet. We would urge even more casualness - say, emojis.

FUNDING NOTES: The Robert Wood Johnson Foundation is giving out money to researchers interested in partnering with data owners. One of the partners for the project is athenahealth. Initial proposals are due May 24.

TECH UPDATES: House Energy and Commerce Committee Dems unveiled a $40 billion, five-year broadband infrastructure plan, our Tech colleague (and erstwhile eHealther) Ashley Gold notes. The net neutrality wars are heating up - note this tweetstorm from Sen. Al Franken - ahead of today's FCC vote on proposed rulemaking.

SILICON VALLEY UPDATE: Former FDA commissioner Robert Califf confirms Tuesday's rumors and announces he's joining Verily in a blog post. He's also going to be an adjunct professor at Stanford University (we wonder why he couldn't get a tenure-track position). ... Amazon is hiring an executive who will explore how the company can break into the pharmacy market. Venrock venture capitalist Bryan Roberts expressed preemptive pleasure on Twitter : "My appreciation in advance to @amazon for rationalizing the Pharmacy Benefit [Manager] industry as they have other sectors that needed disruption."... Google Brain is going to be using the much-hyped machine learning approach to build predictive tools for disease. Hospitals are contributing stripped-down versions of millions of patient records. ... Technically not Silicon Valley, but Partners and General Electric are developing artificial intelligence tools together.

WHAT WE'RE CLICKING ON:

Cancer researcher launches site to help patients navigate cancer trials.

New England Journal of Medicine article on APIs.

Is Verily going to be a real business?

To view online:
http://www.politico.com/tipsheets/morning-ehealth/2017/05/18/congressional-developments-220383

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