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The state of SOTU, Sen. Burr’s next move, & the infinite drug reform timeline

February 7, 2023
Reporter, D.C. Diagnosis Writer

Happy Tuesday, D.C. Diagnosis readers! We hope you have a restful day before tonight's State of the Union address, but also feel inclined to send any speech rumors, news and tips to sarah.owermohle@gmail.com.

STATE OF THE UNION

What we're looking for in Biden's speech

GettyImages-1232006685JIM WATSON/AFP via Getty Images

The president will address the nation tonight from the Capitol, and on health care, he's going to mention some of his top priorities and victory-lap moments, per a press release yesterday. As expected, Medicare insulin caps, record ACA enrollment, and states opting-in to expanded Medicaid programs are teed up for mentions. 

The expected fixtures are there, even a reference to Medicare's new $35-a-month insulin price cap that ignores Democrats' failure to get a broader plan through last summer or former President Trump's earlier demo capping prices for the program. (More on why the drug pricing victory lap may be slow is right below).

Glaringly absent from the early outline is any mention of reproductive rights, which administration officials have scrambled to secure through bolstered access to the abortion pill and a clarified Plan B label. But officials have also admitted, as recently as a White House press briefing last week, that they don't see a public health emergency for abortion access being a viable path. 


MEDICARE NEGOTIATION

An informative mea culpa

An insightful note from my D.C. Diagnosis coauthor, Rachel: I wanted to pop in to correct an inaccuracy from last week's DCD. I always want to be up front when mistakes happen, and I think the further information I learned will be of interest, too.

Last Thursday, I wrote that "Medicare Part B drugmakers will be notified of the amount of penalties they owe the federal government in September." And it's true that CMS officials could, according to the text of the Inflation Reduction Act, start invoicing drugmakers that hike prices faster than inflation in September. 

But after we published, CMS pointed me to another provision that allows the agency to delay invoicing drugmakers for their price hikes until anytime before the end of September 2025. "The law provided CMS the authority to delay invoicing until 2025 for calendar quarters beginning in 2023 and 2024. This time is necessary to issue program instruction and build operations necessary for invoicing," a CMS spokesperson said. For Part D drugmakers, CMS has to send invoices no later than December 31, 2025.

Long story short, CMS appears to be delaying penalties for drugmakers for up to two years — a timeline that could potentially stretch implementation into a new presidential administration, depending on how the 2024 election works out.


ARound Washington

Richard Burr's next act

The North Carolina Republican who left the Senate and his top post in the health committee at the end of last year is also the latest lawmaker to join a prominent K Street firm. He'll join DLA Piper as a senior policy adviser and chair of a new health policy strategic consulting practice, my DCD co-writer Rachel Cohrs reports.

He won't be lobbying Congress right away, as former senators are banned from contacting either the Senate or House of Representatives for two years following their departure from office, according to ethics rules. The firm said Burr's group will provide strategic planning and consulting services. Burr said he would consider formally registering to lobby if it best served his clients once he joins the firm.

"I don't want to sit on the bench. I want to be in the game, even as a guy who technically should retire," Burr, a fierce advocate for biosecurity preparedness and defender of the tobacco industry, told Rachel. Read more about his priorities here.



Health Tech

Congress trains sights on mental health startups

Senators are plunging into oversight this session with a letter to telehealth startups that blasted them for failing to protect their patients' sensitive health information. The letter, led by Sen. Amy Klobuchar (D-Minn.) and a bipartisan handful of other senators, cited an investigation by STAT and The Markup which found dozens of telehealth companies sharing patient data with Facebook, Google and other major advertising platforms.

Reporters combed 50 telehealth websites, but found a few especially alarming examples. Patients who visited Workit's website, for example, answered questions about addiction treatment including opioid and alcohol use that were sent along with other personal details to Facebook. Presented with those findings, Workit said it adjusted how it was using the trackers. 

The letters come just days after  the Federal Trade Commission reached a $1.5 million settlement with the telehealth services market GoodRx for sharing users' health data with Facebook, Google and others for advertising. And it follows a lawsuit filed Jan. 5 against another telehealth company examined in the STAT and The Markup investigation, Hey Favor, as well as Fullstory, Meta, and ByteDance, the company behind Tiktok.


More around STAT
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What we're reading

  • Opinion: 'They were his best shot. And they failed to help': Why did EMS workers neglect Tyre Nichols? STAT
  • Biden's top covid adviser wishes he had tangled with Tucker Carlson, Politico
  • Eisai reports first U.S. sales of newly approved treatment for Alzheimer's disease, STAT
  • Bipartisan House pair hope to defy odds, forge a paid leave deal, The Washington Post

Thanks for reading! More on Thursday,


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