Gregg's Top Three Health Policy Articles

If you can only read three things about health policy this week, I suggest...

The Top Three...

Politico: House Panel Advances HHS 2025 Budget Despite Democratic efforts to slam the brakes on Republican plans to limit abortion access and restructure the NIH, the House Appropriations Committee approved the fiscal 2025 HHS spending plan along party lines on Wednesday. The budget proposal, unveiled last month by Republicans, includes $107 billion for HHS — a 7 percent cut. It would streamline the NIH, slash Title X family grants and increase funding for substance-use disorder prevention block grants. (Cirruzzo and Leonard, 7/11)

Modern Healthcare: Doctors Hit With Proposed 2.9% Medicare Pay Cut For 2025 Medicare physician payments would decline 2.9% in 2025 under a proposed rule the Centers for Medicare and Medicaid Services published Wednesday. The draft regulation provoked sharp criticism from the American Medical Association and other medical societies, which renewed their calls for Congress to come to their aid. The proposed rule also includes significant policies related to the Medicare Shared Savings Program and telehealth reimbursement. (Early, 7/10)

The New York Times: F.T.C. Slams Middlemen for High Drug Prices, Reversing Hands-Off Approach The Federal Trade Commission on Tuesday sharply criticized pharmacy benefit managers, saying in a scathing 71-page report that “these powerful middlemen may be profiting by inflating drug costs and squeezing Main Street pharmacies.” The regulator’s study signals a significant ramping up of its scrutiny of benefit managers under the agency’s chair, Lina Khan. It represents a remarkable turnabout for an agency that has long taken a hands-off approach to policing these companies. (Abelson and Robbins, 7/9)

For a Deeper Dive...

Modern Healthcare: Physician Fee Schedule Proposal Renews Telehealth Flexibilities Advocates for telehealth viewed the proposed physician payment rule from the Centers for Medicare and Medicaid Services as a win but emphasized the need for Congressional action. CMS’ proposed regulation of the 2025 Medicare physician fee schedule, published on Wednesday, renewed a series of telehealth flexibilities that started during the public health emergency amid the COVID-19 pandemic. But telehealth advocates say more actions will be needed by Congress before the industry can operate with certainty. (Turner, 7/11)

Los Angeles Times: FTC Preparing Suit Against Drug Middlemen Over Insulin Rebates The Federal Trade Commission is preparing a lawsuit against the three largest drug intermediaries over their use of rebates for insulin and other drugs, according to a person familiar with the probe. The agency has been investigating whether the rebate practices of insulin manufacturers and three pharmacy benefit managers — units of CVS Health Corp., Cigna Group and UnitedHealth Group Inc. — violate federal law, said the person, who asked not to be named discussing an ongoing probe. (Nylen and Tozzi, 7/10)

Fierce Healthcare: Physician Burnout Drops Below 50% For First Time Since 2020, AMA Poll Finds The portion of physicians surveyed by the American Medical Association (AMA) who report at least one symptom of burnout has dropped below 50%, a first since the onset of the COVID-19 pandemic. The group’s annual survey shows consistent declines in doctor burnout in the wake of an all-time high of 62.8% in 2021. Reported burnout dropped to 53% in 2022 and, as of the most recent 2023 survey, now sits at 48.2%. (Muoio, 7/9)

The Wall Street Journal: Insurers Pocketed $50 Billion From Medicare For Diseases No Doctor Treated Private insurers involved in the government’s Medicare Advantage program made hundreds of thousands of questionable diagnoses that triggered extra taxpayer-funded payments from 2018 to 2021, including outright wrong ones, a Wall Street Journal analysis of billions of Medicare records found. The questionable diagnoses included some for potentially deadly illnesses, such as AIDS, for which patients received no subsequent care, and for conditions people couldn’t possibly have, the analysis showed. Often, neither the patients nor their doctors had any idea. (Weaver, McGinty, Mathews and Maremont, 7/8)

For the Visual Among Us...

A few years ago I started a weekly e-mail for friends

and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD