CONGRESS.
MRNA Before the Klieg Lights. MRNA’s Stephane Bancel appeared before the Senate HELP Committee to defend his planned commercial price of $110-130 for the Covid-19 vaccine. It went as expected with Sen. Bernie Sanders complaining about the price, Bancel’s salary and MRNA’s profits. Bancel justified the current government price as a discount due to volume purchasing.
Republicans were more sympathetic to the company with the exception of Sen. Rand Paul asking about incidence of myocarditis in the vaccinated. Bancel cited CDC reports that have been the subject of some controversy as independent researchers have raised issues about methods and data interpretation. But you know, Rand Paul.
No Surprise No Surprises Isn’t Working. HHS Secretary Xavier Becerra is asking for $500M to implement the Independent Dispute Resolution process for the No Surprises Act. We can forgive the SecHHS for having no memory of the Recovery Audit Contractors since he was not running the agency then, but the outcome – a system overloaded with appeals – is entirely predictable.
The SecHHS called many of the appeals frivolous and they very well may be, but everyone gets their day in court, including TeamHealth and Envision.
THE WHITE HOUSE.
See Jha. The White House Coronavirus Task Force is quietly disbanding. Its leader, Dr. Ashish Jha is expected to return to the private sector, presumably academia from where he came. One interpretation of this move is that the White House no longer sees a threat. The most likely explanation is that the money ran out.
The Forever Emergency. (MRNA, PFE, NVAX) Notwithstanding White House loss of interest, SecHHS Becerra is keeping the pandemic fires burning with a revision to what is known as the 564 declaration. This declaration exists separately from the Public Health Emergency and authorizes the issuance of Emergency Use Authorizations for in vitro diagnostics, Personal Protective Equipment, other medical devices and, of course, drugs and biological products.
The change made by Becerra is to permit use of the EUA’s in the presence of a public health emergency and in the presence of a potential public health emergency. The upshot here is that vaccines and antivirals can get approved through EUA almost indefinitely, with 90-day renewals, unless and until the SecHHS changes his mind or there is another president in the White House.
Assume such latitude to be used liberally.
Medicare Rule-A-Rama. (EHC, CHE, UHS, ENSG) Pending at the OMB are the group of spring rules for hospitals, hospice, skilled nursing, inpatient psychiatry and inpatient rehabilitation. The last of those for IRFs has gotten some preliminary attention as there has been some speculation that the IRF rule will include a change in the early discharge policy.
It is also worth considering that as the PHE recedes the policy making machinery will restart and the administration will get more aggressive on issues raised by the OIG and others.
For that reason it is very likely we will see the IRF include a new discharge policy – probably phased in as is typical or providing some other forbearance as providers grapple with the end of the PHE waivers.
Bold Goals. The White House in conjunction with the Department of Energy issued a report on bold goals for the bio-economy. The focus of these golds is on climate, fuels and agriculture instead of medicines which is, at least, different.
Recall that the Department of Energy was the recipient of a lot of the pandemic era cash to fund their laboratories. This report suggest the DOE’s direction will not only be mostly focused on things other than medicines but that it will be conducted under the top secret environment of the national laboratories.
Other Stuff.
Recent Events.
CNC: Overcoming Medicaid Redetermination
Venture View w/Marcus Whitney: SVB and More.
Upcoming Events
MOH: Overcoming Medicaid Redeterminations, Part II March 29 @10am ET (Add to Outlook Calendar)
Have a great weekend.
Emily Evans
Managing Director – Health Policy
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