| | | |   | Happy Thursday, D.C. Diagnosis readers! We hope to see some of you downtown tonight for our STAT in DC event. Today is also Congress’ self-imposed deadline to come to an agreement on legislation to fund the FDA, so stay tuned for updates — if lawmakers don’t blow past their own deadline, again. Send your best intel and updates to rachel.cohrs@statnews.com. | | | WTF is the MIF? 
MIF balance at the end of each calendar year (Rachel Cohrs/STAT) If you’ve never heard of the Medicare Improvement Fund, time to listen up — it’s a multibillion-dollar acronym you’ll want to know as the health care industry winds up for a contentious end-of-year funding fight.
The MIF, as it’s affectionately called by D.C. health policy veterans, was first created in 2008. It has been used over the years to capture savings from Medicare policies that save the government money and make sure they go back to Medicare, instead of just getting lost into the abyss of general deficit reduction. It fell out of favor after the Affordable Care Act passed, but now it’s coming back in a big way.
Congress’ gun safety bill earlier this year was paid for in part with a delay of a Trump-era rule that would have banned drug rebates, but there was quite a bit of extra savings that they didn’t actually need. So lawmakers plopped nearly $7.5 billion in the Medicare Improvement Fund — by far the largest chunk of change in the fund since 2010.
That’s a hefty sum that will be a perfectly ripe pay-for any health-care needs at the end of the year, according to two Senate aides and two health industry lobbyists.
There are two broad groups to watch that are going to be fighting over the funding this fall.
The first are physicians — the Trump administration in 2020 decided to boost primary care payments in Medicare at the expense of other specialties, including surgeons. Congress stepped in to give all specialties more money to soften the blow, but that gravy train ends in December. Physician groups are already gearing up their pushes to head off these “cuts” — Reps. Ami Bera (D-Calif.) and Larry Buschon (R-Ind.) introduced a bill on Tuesday that addresses the issue.
The second is telehealth folks. A bill that would have extended pandemic-era telehealth payment policy for another two years sailed through the House in July (notably, shortly before lead sponsor Rep. Liz Cheney’s (R-Wyo.) primary), and it dipped into about $2.4 billion of the MIF to pay for it. | SCOOPLET: HCA target of House investigation request A House Democrat with oversight responsibilities is taking aim at for-profit hospital giant HCA Healthcare over allegations about its emergency department hospital admissions policies, according to two letters exclusively obtained by your D.C. Diagnosis author.
Rep. Bill Pascrell (D-N.J.), who heads the Ways & Means Committee’s oversight subcommittee, asked HHS to investigate HCA’s admissions practices, including its joint venture with private equity-backed Envision Healthcare. He also requested information from HCA itself about staffing and physician incentives.
Read the full letters in my story out this morning. | Senators grill Biden officials on early monkeypox moves Lawmakers from both parties on Wednesday questioned top health officials about the government’s monkeypox response, arguing early mistakes have fueled an emergency with more than 20,000 cases and mixed vaccination success, my colleague Sarah Owermohle reports.
The CDC departed from the usual vaccine distribution system, resulting in shipments to the wrong states or spoiled shots stored in hot temperatures, said HELP Chair Patty Murray (D-Wash.), who chastised that “too many missteps were made early on.”
Republicans didn’t hold back either, but used the hearing to amplify big-picture questions about public health infrastructure, the Covid-19 response, and agencies’ budgets.
Per usual, Sen. Rand Paul (R-Ky.) sparred with Fauci over the need to vaccinate kids and the royalties that government scientists collect from pharmaceutical companies because of early patents, which officials aren’t required to detail right now. “When we take over, we're going to change the rules,” Paul said. | Healthcare distributors help increase patient access to 100 million+ medicines Healthcare distributors provide logistics expertise, administrative services and support to approximately 22,000 community pharmacies across the country. Research found that this has helped increase patient access to more than 100 million vital medicines, particularly in rural areas where fewer pharmacy options exist. Learn more about the ways distributors support pharmacists, so they can focus on what matters most — the patient. | The Senate GOP has gripes with Medicare's new drug negotiation program Half of the Senate Republican caucus wrote the Biden administration Wednesday morning to lay out their concerns about the upcoming drug price negotiation program that Democrats passed without any Republican votes this summer.
Specifically, they’re pressing HHS on the following issues: - How stakeholder feedback will be incorporated if the agency implements the program through guidance instead of formal rulemaking
- Which cost-effectiveness metrics will be used (or not used) in the negotiations
- How low prices could go since there’s a price ceiling, but no floor
- Whether it’s monitoring effects on launch prices, research investments, and other areas
The lawmakers likely don’t have much sway in the current climate, but they could create more headaches for the administration if the GOP takes control of the Senate in the upcoming midterm elections. | What we're reading - U.S. to spend more than $2 billion to launch Biden’s biomanufacturing initiative, STAT
- FDA leader Stephen Hahn was pressured to aid Texas firm Direct Biologics, The Niche
- ‘This is pharma’s dream’: How drugmakers are turning telehealth into a marketing gold mine, STAT
- Tackling cancer while battling the insurance system, Washington Post
- What if doctors are better at treating domestic abuse than cops?, Politico
| Thanks for reading! More next week,  | | | |
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