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| Presented By PhRMA |
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| Axios Vitals |
| By Tina Reed · Mar 03, 2023 |
| Happy Friday, Vitals readers. Today's newsletter is 1,019 words or a 4-minute read. 😬 😜 🤦♀️ 1 fun thing: Axios readers know we're not strangers to the emoji. - A Japanese study published in Frontiers in Psychology found people use emojis to hide, as well as show, their feelings.
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| 1 big thing: New DEA rules on prescribing meds roil behavioral health |
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| Illustration: Annelise Capossela/Axios |
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| A federal crackdown on overprescribing controlled substances via telehealth is causing confusion and consternation in the behavioral health world over an in-person prescribing requirement for drugs to treat pain and opioid use disorder, Axios' Sabrina Moreno writes. Why it matters: The tighter standards come amid a proliferation of fentanyl-laced counterfeit pills made to look like prescription OxyContin, Xanax or Adderall. Experts fear patients could seek out alternatives on the street instead of making a doctor's appointment. Driving the news: Pandemic-inspired policies that allowed telehealth dispensing of pain pills and opioid use treatments like buprenorphine were hailed by addiction groups and the Biden administration as a temporary win against a worsening crisis. - But the Drug Enforcement Administration last Friday moved to require doctors to evaluate patients in person before writing prescriptions for controlled medications including Adderall and OxyContin — as well as buprenorphine — when the public health emergency ends in May.
- It's the agency's latest move to curb virtual overprescribing of controlled substances, which DEA administrator Anne Milgram said in a statement will widen access "while ensuring the safety of patients."
Yes, but: Experts say the policy isn't entirely straightforward and could hurt patients. - Pharmacists aren't clear on whether they're responsible for verifying whether a patient already had the in-person visit and qualifies for a refill, said Brigid Groves, vice president of pharmacy practice at the American Pharmacists Association
- People with disabilities who have relied on telehealth for pain management may now have to navigate health care facilities with inadequate parking or building access, said Chanda Hinton, disability advocate and executive director of Chanda Center for Health.
- And when it comes to buprenorphine: "There's really no empirical support for what they're trying to do," Leo Beletsky, a law professor at Northeastern University focused on substance use and addiction, told Axios. "The fallout is going to be measured in lives lost."
- The DEA didn't respond to a request for comment about criticisms of the policy in time for publication.
Go deeper. |
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| 2. North Carolina on track for Medicaid expansion |
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| Illustration: Brendan Lynch/Axios |
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| Republican leaders of North Carolina's state legislature on Thursday reached an agreement on how to expand the state's Medicaid program, after years of blocking the policy, Axios' Lucille Sherman writes. Why it matters: If the latest plan becomes law as expected, hundreds of thousands of the state's poorest residents would receive health care coverage. And it would bring to 40 the number of states, plus Washington, D.C., that have expanded the safety net program under the Affordable Care Act. Driving the news: North Carolina Senate President Pro Tempore Phil Berger and House Speaker Tim Moore announced the deal Thursday morning, saying the proposal will significantly reform the state's certificate-of-need laws, which restrict the growth of new health care facilities. What we're watching: Among the non-expansion states, Mississippi is weighing a plan that would extend postpartum coverage under Medicaid from two months to one year. - But Arkansas and South Dakota are considering plans to impose work requirements on some Medicaid recipients.
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| 3. Walmart Health eyes MA with expansion plan |
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| Photo: Dustin Chambers/Bloomberg via Getty Images |
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| Walmart Health is eyeing more Medicare Advantage business as it prepares to nearly double the footprint of its in-store clinics. Driving the news: The big retailer said Thursday it's planning to add 28 additional health clinics — which offer primary care, behavioral health services, vision checks and dental care within select Walmart stores — in 2024. - The new clinics are planned for Walmart Supercenters in Dallas, Houston, Phoenix and Kansas City, Missouri.
Between the lines: In September, Walmart and UnitedHealth Group announced a 10-year partnership to deliver care to seniors in Medicare Advantage plans. - The private Medicare plans are expected to serve more than half of eligible beneficiaries this year and have been highly lucrative for payers.
- Walmart looked to leverage its relationship with UnitedHealth and targeted expansion in places where it had a deep existing presence and projections for local population growth, said David Carmouche, senior vice president of omnichannel care at Walmart.
The big picture: Retailers are increasingly jostling for primary care dollars, most notably Amazon's recent $3.9 billion acquisition of concierge medical provider One Medical and CVS Health planned $10.6 billion purchase of Oak Street Health. Read the rest. |
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| A message from PhRMA |
| Patients are frustrated |
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| New data from IQVIA reveal patients with deductibles and coinsurance are more likely to abandon their medicines than patients with copays. The reason: Insurers and their PBMs shift the costs of covered medicines onto their patients. That's not fair. Learn more. |
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| 4. Community health centers push Congress for cash |
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| Illustration: Aïda Amer/Axios |
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| Community health centers need Congress to reauthorize at least $4 billion in funding this year, but representatives asked a Senate health committee hearing on Thursday for even more to avert a primary care cliff, Axios' Arielle Dreher writes. Why it matters: Congress has until Oct. 1 to renew mandatory funding for federally qualified health centers, and Senate HELP Chair Bernie Sanders (I-Vt.) has made the issue a priority for the committee this year. - The centers are feeling the pinch post-pandemic and asking Congress for more than $6 billion for fiscal 2024.
Driving the news: Lawmakers see the centers as key to fortifying preventive care as the nation comes out of the pandemic, though there are many unresolved details. - "When we invest in primary health care, we are going to save the system money," Sanders said.
- But funding for community health centers has increased in the past decade, HELP ranking member Sen. Bill Cassidy (R-La.) noted while supporting the reauthorization effort.
- Health centers' revenues more than doubled since 2010, from $12.7 billion to $26.3 billion, a 2019 Government Accountability Office report shows, and centers have become less dependent on federal grants.
- Cassidy has asked the GAO to provide updated information about the funding streams.
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| 5. Catch up quick |
| 🚫 An FTC order bars BetterHelp from sharing data with social media platforms. (Axios) 👀 Texas kids on the U.S.-Mexico border are more likely to die from a common type of leukemia, a new study has found. (Axios) 🌎 Where workers get paid leave to care for a sick parent. (Axios) |
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| 6. Dog of the week |
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| Bobbert. Photo: Anna Vivas |
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| Meet Bobbert, who is described as a mix of Ewok and gremlin. (A perfect description.) - He's an "extremely grumpy but sweet" pup who is typically forced to be based in New York City, but happy to be spending the winter in Miami, writes his human, Anna Vivas.
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| A message from PhRMA |
| Data shows insurers and their PBMs shift costs to patients |
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| Costly OOP expenses tied to deductible and coinsurance requirements are a leading concern for patients with commercial insurance. These harmful practices put in place by insurers and pharmacy benefit managers (PBMs) are even causing patients to abandon their medicines. Learn more. |
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| Have a news tip? Just reply to this email. Did someone forward this email? Subscribe here. Thanks for reading, and thanks to senior health care editor Adriel Bettelheim and senior copy editor Bryan McBournie for the edits. |
 | | Dive deeper into the future of health care | | |
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