POLITICO's Morning eHealth: Telehealth-laden bill receives positive CBO news — FDA news: On UDIs, user fees and funding — The latest developments in cyber-land

By David Pittman | 05/17/2017 10:00 AM EDT

With help from Darius Tahir (@DariusTahir)

LANDMARK DAY FOR TELEHEALTH: Expanding Medicare reimbursement of telemedicine under a key Senate bill would cost $150 million over a decade, according to a preliminary estimate from the Congressional Budget Office. One policy - allowing Medicare Advantage plans to more easily cover the technology - would actually save Medicare $80 million over 10 years. Overall, the Senate Finance Committee's CHRONIC Care Act (S. 870) would be offset be cutting the Medicare Improvement Fund, according to the CBO. That's good news for backers of the bill, which the Senate Finance Committee plans to mark up Thursday.

-Paying for remote treatment and diagnosis of stroke would increase federal spending by $180 million over 10 years, the most expensive policy change in the bill. Allowing Medicare's accountable care organizations to offer telemedicine would cost $50 million over a decade.

As a reminder, the last public CBO score of telemedicine was back in 2001, when Congress created 1834(m) to allow Medicare to pay for live telemedicine interactions for rural patients in health care settings. CBO said at the time the changes would cost $150 million over five years, but Medicare spent a mere $57 million over the next 14 years, according to the Center for Telehealth and e-Health Law.

-Read our past coverage of the tension between CBO and telemedicine supporters.

Blessing from Hatch: While acknowledging ongoing "contentious debates" around health care during a hearing on Tuesday, the well-respected Finance Committee chair, Orrin Hatch, twice committed to passing the bipartisan CHRONIC Care bill. "We intend to get this bill through," he said in his closing remarks.

Bipartisanship at work: Hatch and Sens. Brian Schatz and Roger Wicker - both champions of telemedicine in the Senate - all wore purple ties to the hearing. Ranking Democrat Ron Wyden said the bill stands as "a model for bipartisanship...In this instance, the doors were open, not closed. There has been bipartisan cooperation, not partisan reconciliation. And the public was asked to help improve the bill, rather than being taken for granted."

eHealth tweet of the day: Stephanie Zaremba @s_zaremba: Hey @DataInnovation you missed a huge opp! Open gov data needs to extend to healthcare (when permitted, of course). http://www2.datainnovation.org/2017-data-innovation-agenda.pdf ...

Welcome to Morning eHealth where we're ready to grab Wednesday by the horns, perhaps aided by caffeine. Don't hesitate to reach out with tips, suggestions or thinly veiled criticisms to dpittman@politico.com and connect with us on Twitter @David_Pittman, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.

UDI FANS PRESS TRUMP'S HHS TO KEEP UP PROGRESS: Advocates for putting unique device identifiers on medical claims, including Pew Charitable Trusts, Aetna and the American College of Cardiology, urged the Trump administration to follow policy commitments made by the Obama administration. In a letter obtained by Darius, the groups cite a familiar refrain - UDIs will allow the FDA and others to better track devices and pinpoint safety issues. Under the Obama administration, the FDA and CMS endorsed that concept. Read the letter here and more from Darius.

THE LATEST IN HEALTH-CYBER NEWS: HHS sent another email blast dedicated to cybersecurity on Tuesday. This one led off by encouraging victims of ransomware attacks to contact the FBI. But cyber incidents should also be reported to the Department of Homeland Security's National Cyber Awareness System and the soon-to-be activated Healthcare Cybersecurity and Communications Integration Center within HHS.

-Lost in all the WannaCry news, HHS's cybersecurity center is expected to be operational by the end of next month, department officials said last week. The goal of the Healthcare Cybersecurity Communications and Integration Center is to share health-specific threat information with other agencies and the private sector. HHS officials broke the news last week during a CyberSecureGov conference in town - just before the WannaCry attacks.

Elsewhere from our Pro Cybersecurity colleagues: The Homeland Security Department is aware of fewer than 10 U.S. victims of the recent ransomware attack ... Democrats on the House Homeland Security Committee are asking for a hearing on the attacks.

HOUSE PANEL TO MOVE ON FDA USER FEES: The House Energy and Commerce Committee will markup a bill that reauthorizes the FDA's ability to collect user fees for faster product reviews on Thursday, the panel announced. The draft of the bill posted on the committee's website doesn't include language that requires the FDA to create a new category for over-the-counter hearing aids. The Senate moved its version of the bill last week.

FORMER FDA CHIEF TO VERILY?: CNBC is reporting Rob Califf, fresh off of his role leading the FDA, is in discussions to join the leadership ranks of Verily Life Sciences - the biotech arm of Alphabet, best known as the owners of Google.

It'd be an interesting move for Califf. The company recently announced plans to build a 10,000-strong research study - dubbed Baseline - to extensively monitor participants over a long period of time, with an eye to understanding the early warning signs of disease. At Duke, Califf ran the university's Clinical Research Institute, which has done a ton of clinical trials. (More than 970, per its website.) So you'd imagine his skills would be well-suited to running Baseline.

GOTTLIEB ADDRESSES HIS NEW FDA BRETHREN: The newly-sworn- in FDA commissioner delivered his first remarks to his agency this week, and he gave some hints about positions he'll take on new technology. "We need to make sure we're taking steps to foster innovation and regulating areas of promising new technology in ways that don't raise the cost of development or reduce innovation," Scott Gottlieb said. "We need to do all of these things without compromising our primary mandate to protect the public health." Gottlieb said Congress gave a "clear mandate to be forward-leaning" in evaluating emerging technology and analytic tools. (Hat tip to the FDA for posting his remarks online.)

ICYMI: SENATE DEMS WANT FULLY FUNDED HHS: Democrats on the Senate HELP Committee want President Donald Trump to drop his efforts to slash HHS's budget, saying it would hurt implementation of 21st Century Cures. ONC has voiced concern that it won't be able to carry out Cures' provisions without more money, let alone less. Read the letter here.

HOUSE CONNECT ACT COMING THIS WEEK: The House companion to the Senate's CONNECT for Health Act (S. 1016) should be introduced by Rep. Diane Black this week, the health aide to the bill's chief sponsor, Schatz, said Tuesday. The remark came during an American Telemedicine Association event on the technology's use in pediatrics. Black's office, who carried the bill in the House last year, didn't respond to our request for confirmation.

NOT HAPPENING TODAY: While the Senate Veterans Affairs Committee will hold a hearing this afternoon to discuss 15 health-related bills, Iowa Sen. Joni Ernst's VETS Act (S. 925) won't be one. The bill would make it possible for a veteran to receive care through telemedicine anywhere from any qualified doctor. But it was killed last Congress because of opposition from the American Medical Association and other doctor groups, many of whom still oppose it. Could the same thing kill it this year? A committee spokeswoman tells us it's "definitely too early" to make such a statement about this year. "We are happy to consider it during a future legislative hearing," she added.

BLOCKCHAIN PROPHECIES: We've tried to keep an eye out regarding the blockchain - a much-hyped data-storage technology - in health care here at Morning eHealth. Toward that end, we attended a Hill session held by the Chamber of Digital Commerce, featuring Micah Winkelspecht, CEO of blockchain startup Gem.

Winkelspecht noted that the health care data system is a bit bifurcated: either you have a jungle of different data-holders on one hand, or an "oligopoly" of data holders. (Such as, for example, claims data - where an unidentified company holds 70 percent of all claims data.)

In either case, sharing data is expensive: someone either has to contact and connect with lots and lots of individuals; or negotiate with a single gatekeeper, who has both the incentive and the power to clamp down on innovation.

Blockchain, he suggested - where changes to the database are updated in shared fashion - might be the remedy. "You can think of blockchain as more of a public utility," he said. "It's an infrastructure all of us can share but no one outright owns."

As such, it could reduce some of the massive costs of data-sharing - for example, the error-ridden databases that describe whether a doctor is in or out of network - and improve the health care system.

MORE MONEY UNDER MACRA: CMS is giving up to $30 million to health care groups to develop quality measures under MACRA, the agency announced . Specialty societies, professional organizations, patient advocates, schools, research organizations, health systems, and others are eligible to apply. All of them "with specific knowledge of clinician and patient perspectives and needs" may know better than government bureaucrats, CMS says. Applications are due by Sept. 30 with awards to be announced in late November. HHS Secretary Tom Price was a fan of specialty societies helping craft quality measurement while a member of Congress and helped insert a section in MACRA to enable the grant work CMS announced this week.

Related: A Harvard Medical School researcher argues in the Annals of Internal Medicine that MACRA may exacerbate health disparities.

WHAT WE'RE CLICKING:

Pennsylvania officials are bullish on their state's PDMP.

Study says telemedicine-provided abortions is safe, effective.

The importance of the soon-to-be telemedicine law in Texas is broken down by lawyers and journalists.

A West Virginia reporter writes a first-hand account of his being arrested last week for questioning Price in the state capitol.

Lessons health care can learn from other "disrupted" industries.

Tips, comments, suggestions? Send them along via email to our team: Arthur Allen (aallen@politico.com, @ArthurAllen202), David Pittman (dpittman@politico.com, @David_Pittman) and Darius Tahir (dtahir@politico.com, (@DariusTahir).

To view online:
http://www.politico.com/tipsheets/morning-ehealth/2017/05/telehealth-laden-bill-receives-positive-cbo-news-220357

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