Organ transplant revamp needs a cash infusion

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

Nov 28, 2023 View in browser   By Chelsea Cirruzzo and Ben Leonard Presented by Driving the Day HRSA ORGAN OVERHAUL FUNDING WOES — The Health Resources and Services Administration wants to kick-start a revamp of the nation’s organ transplant system — but lacks the money to see it through. “We are going to do everything that we can with the resources we have available to advance as much as we possibly can,” HRSA Administrator Carole Johnson told POLITICO. “We’re optimistic that Congress is going to deliver here because they delivered on this bipartisan legislation in record time.” Congress has yet to approve any additional funding HHS has requested for implementing the modernization of what the Biden administration called a lifesaving, but outdated, system in any short-term funding bills passed this fall. While organ donation has risen since 2017 — reaching nearly 42,000 transplant recipients last year — the waitlist has also swelled to more than 100,000 people. According to HRSA, 6,000 patients awaiting transplants die each year.  Background: A law signed by President Joe Biden in September would replace the single-entity approach used for 40 years with a system that allows for multiple contractors to modernize different portions of the donor-transplant network. This summer, the Department of Health and Human Services asked Congress to double its investment in the system to $67 million and remove the cap on appropriations to contracts the department can award. Where things stand: Speaking outside the White House on the day Biden signed the law — Securing the U.S. Organ Procurement and Transplantation Network Act — HHS Secretary Xavier Becerra warned what might happen if the money, meant for reviewing and awarding grants to contractors, evaluating performance and supporting the program overall, didn’t come. “We won’t be able to, contractors won’t be able to [do what the law calls for],” Becerra said. According to a September presolicitation notice for contracts, HRSA could start asking for proposals by next month “subject to the availability of funds.” HRSA told POLITICO it plans to accept proposals from groups that want to tackle part of the system like IT and operations but declined to share a timeline. How we got here: Since it was established in 1984, the Organ Procurement and Transportation Network has been run by the United Network for Organ Sharing, which manages all organ procurement organizations and essentially all operations related to organ donation. WELCOME TO TUESDAY PULSE. Nearly 1 in 5 teens use melatonin to sleep, per new research in JAMA Pediatrics. The American Academy of Pediatrics says parents should talk to their child’s doctor before letting them try it. Send your sleep tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_. TODAY ON OUR PULSE CHECK PODCAST, your host Ben talks with POLITICO health care reporter Robert King about the growing bipartisan concern — and scrutiny — on Capitol Hill over reports that Medicare Advantage plans are too often using the tool known as prior authorization to deny care. Listen to today’s Pulse Check podcast   A message from PhRMA: Government price setting could put patients at a disadvantage. The Inflation Reduction Act (IRA) could have unintended consequences such as: Putting barriers between patients and their prescribed medications. Jeopardizing continued research into approved medicines. Shifting research and development away from pills and tablets. Learn more.   At the White House The Biden administration is investing in the domestic medical and food supply chains so the U.S. won't have to rely heavily on other countries to provide critical items. | Spencer Platt/Getty Images BIDEN WANTS STRONGER SUPPLY CHAIN — President Joe Biden said Monday he will sign a presidential determination to give HHS greater authority under parts of the Defense Production Act to invest in the domestic medical supply chain. That will include designating a new supply chain resilience and shortage coordinator under HHS responsible for strengthening the medical and food supply chains and addressing shortages. Why it matters: The pandemic exposed weaknesses in the nation’s ability to quickly manufacture medical supplies, with the U.S. forced to rely on countries like China to provide critical items. At its inaugural meeting Monday, the White House’s Council on Supply Chain Resilience announced that HHS can invest $35 million in domestic production of materials for sterile injectable medicine. The White House also said the Department of Defense will soon release a report on the resilience of the pharmaceutical supply chain, with hopes of reducing reliance on foreign suppliers.   GET A BACKSTAGE PASS TO COP28 WITH GLOBAL PLAYBOOK: Get insider access to the conference that sets the tone of the global climate agenda with POLITICO's Global Playbook newsletter. Authored by Suzanne Lynch, Global Playbook delivers exclusive, daily insights and comprehensive coverage that will keep you informed about the most crucial climate summit of the year. Dive deep into the critical discussions and developments at COP28 from Nov. 30 to Dec. 12. SUBSCRIBE NOW.     Public Health NURSING HOMES GET THE JAB — Roughly 25 percent of nursing home residents have gotten the updated Covid-19 shot, new data shows, but the percentage still remains lower than this time last year despite CDC efforts to increase vaccination numbers among vulnerable populations, Chelsea reports. Why it matters: CDC Director Mandy Cohen told POLITICO in October that vaccinating nursing home residents is a priority given the way Covid ran rampant in long-term care facilities throughout the pandemic. However, this same time last year — as of Nov. 27, 2022 — 46 percent of nursing home residents were up to date on their Covid vaccination, meaning they’d received the bivalent booster. Among states, Iowa, New Hampshire, North Dakota, South Dakota and Vermont have reported the highest vaccination rates within nursing homes this year — at least 40 percent. States with the lowest percentages of nursing home vaccination rates — 20 percent and under — include Arkansas, California, Maine, Nevada and West Virginia. And, among nursing home staff, vaccination rates have lingered at 5 percent for most of November, getting a recent bump to 6 percent as of Sunday. The total percentage of adults who’ve reported receiving the updated shot is about 15 percent, according to a recent CDC survey. PROTECTING KIDS FROM WINTER VIRUSES — The wave of respiratory diseases hitting China is more likely the return of seasonal illness the country suppressed with prolonged Covid lockdowns than another pandemic threat — and the risk of global spread is low — public health experts tell POLITICO’s Kelly Hooper and Carmen Paun. Still, some say the U.S. can prepare for a similar situation by increasing hospitals’ surge capacity, especially for children. Most children’s hospitals in the U.S. run at capacity even in good times to survive economically, said Dr. Peter Hotez, the co-director of the Texas Children’s Hospital Center for Vaccine Development. Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said he’s seen cuts in health care capacity overall and even harsher downsizing of pediatric units. That makes him wonder about the actual number of sick children in China compared with the capacity of the country’s health system. “Nobody’s reporting out rates of disease,” he said. “They just say: ‘Clinics are overrun.’ But what does that mean? Is it 3 percent of people infected? Is it 10 percent?”   A message from PhRMA:   Telehealth AETNA CHANGES TELEHEALTH COVERAGE — Insurer Aetna has reversed course on a previous decision to stop covering some types of virtual mental health and substance use disorder treatment, Ben reports. The major insurer had planned to end coverage for virtual intensive outpatient and partial hospitalization program care on Dec. 1. But in an update effective Nov. 15 obtained by POLITICO, the insurer said it would continue to cover such care. Aetna spokesperson Alex Kepnes said its post-Dec. 1 coverage will be more extensive for telehealth than it was pre-pandemic. The change came after REDC, previously known as the Consortium Representing Eating Disorders Care; the American Society of Addiction Medicine; and other groups raised concerns about Aetna’s policy shift. They argued it would hurt access to care and contradict many policies CMS and other federal agencies have adopted to promote telehealth access. “This policy will force patients to forgo treatment, increase acuity, and result in a higher and costlier level of care because of Aetna’s coverage decision,” the groups wrote in a letter last month. “No clinical rationale has been given for this upcoming termination in coverage, particularly at a crucial moment when the United States continues to experience a rise in the number of people needing treatment.” Still, Allison Ivie, a government relations representative for the REDC, said it’s a partial victory, given it only applies to self-insured plans. Zooming out: Many providers are grappling with the future of telehealth coverage as eased telehealth rules in the Medicare program and some commercial plans are set to expire at the end of 2024.   JOIN WOMEN RULE ON 12/12: For centuries, women were left out of the rooms that shaped policy, built companies and led countries. Now, society needs the creativity and entrepreneurship of women more than ever. How can we make sure that women are given the space and opportunity to shape the world’s future for the better? Join POLITICO's Women Rule on Dec. 12 for Leading with Purpose: How Women Are Reinventing the World to explore this and more. REGISTER HERE.     Names in the News Lauryn Fanguen is now a regional press secretary at the DCCC. She previously was a communications manager at Planned Parenthood. Brian D. Pieninck, president and CEO of CareFirst BlueCross BlueShield, has been elected chair of the Blue Cross Blue Shield Association board of directors.   A message from PhRMA: Patients. Not Politicians. The Inflation Reduction Act (IRA) lets politicians decide what medicines are valuable and which diseases get researched. This could risk future treatments, including possible cures. No one should stand between you and your medicine. Get more details.   WHAT WE'RE READING POLITICO’s Burgess Everett reports that Senate Republicans aren’t interested in former President Donald Trump’s call to overturn the Affordable Care Act. The Wall Street Journal reports on how an entrepreneur went from selling burritos to founding a $7 billion telehealth startup. KFF Health News reports on the struggle of people with autoimmune disorders to pay for care.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Evan Peng @thepngfile Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Megan R. Wilson @misswilson   Follow us

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