Subject: POLITICO Pulse, presented by National Community Pharmacists Association (NCPA): Committee plans mental health markup — Insurer debt doubles — The NFL hits back after House report
From: POLITICO Pulse <[email-masked]>
To: <[email-masked]>
Date: Tue, 24 May 2016 08:02:02 -0600

By Dan Diamond | 05/24/2016 10:00 AM EDT

The U.S. obesity rate has increased by nearly 60 percent in the past two decades, and the NFL hits back after a damaging House report. But first: A mental health reform bill is back after months of being stalled in committee.

HOUSE E&C TO MARK UP MENTAL HEALTH BILL IN JUNE - After months of being in limbo, the House's major mental health reform bill will get a full Energy and Commerce Committee markup next month, aides tell Pro's Brianna Ehley. 

It was six months ago when the E&C health subcommittee approved Rep. Tim Murphy's bill (H.R. 2646) after a grueling 10-hour markup, during which lawmakers sparred over patient privacy rights and court-ordered outpatient treatment programs. Cost was also a major issue. 

Aides said Chairman Fred Upton, Murphy and others are working out controversial elements and developing a manager's amendment that could satisfy most members. 

More for Pros here: http://go.politicoemail.com/?qs=830cc015b4b1409522a518a9963cd30010a1d61619689975dcc337189e660faa

INSURER DEBT NEARLY DOUBLES - Health insurers' debt levels have nearly doubled since 2011, reaching $6.3 billion in borrowed funds at the end of last year, according to an analysis by A.M. Best Company.

The primary driver is industry consolidation, with Anthem's planned takeover of Cigna and Aetna's pending acquisition of Humana poised to further increase debt levels. But Obamacare's exchanges are another major factor. A.M. Best's analysts point out that programs designed to protect insurers entering the new marketplaces typically don't pay out right away. 

 ... In addition, there's been some "timing fluctuations" in payment of direct government subsidies. "Therefore, health insurance carriers offering exchange products had to utilize more of their own liquid funds to pay claims, while recording sizeable receivables for future payments from the government," the report notes. 

THIS IS TUESDAY PULSE - Where we're still marveling over WSJ's John Carreyrou's track record on Theranos: 16 months investigating the company, multiple lawsuit threats - and despite writing two dozen stories, not a single reporter correction. Theranos, on the other hand ... Tips to [email-masked] or @ddiamond on Twitter.

With help from Paul Demko (@PaulDemko), Brianna Ehley (@BriannaEhley) and Brett Norman (@BrettNorman).

NATIONAL HEALTH INTERVIEW SURVEY: WHERE AMERICANS STAND ON KEY MEASURES - CDC is out today with its latest update of key health measures, and here's a quick look at some of the data points.

Obesity: About 30.4 percent of American adults age 20 and older were obese in 2015, a slight uptick from 29.9 percent in 2014. Overall, the U.S. adult obesity rate increased about 57 percent between 1997 and 2015.

Smoking: About 15.1 percent of American adults age 18 and older were cigarette smokers in 2015, down from 16.8 percent in 2014. Overall, the U.S. adult smoking rate declined about 39 percent between 1997 and 2015.

Coverage: The percentage of Americans reporting they skipped medical care because they couldn't afford it fell to 4.5 percent in 2015, down from 6.9 percent in 2010.

See the CDC's National Health Interview Survey: http://go.politicoemail.com/?qs=bf572db470b6f925c8f0034db02ac3b766796402598282f79859f18a468ec056

THE NFL HITS BACK - The nation's most profitable sports league says that Democratic members of the Energy and Commerce Committee got it wrong when they accused the NFL of trying to influence a government study on concussions.

According to an E&C staff report, NFL officials tried to quietly persuade the National Institutes of Health to yank a $16 million research grant for Dr. Robert Stern, a prominent Boston University researcher who has been vocally critical of the league and its approach to the dangers of concussions. 

But while the NFL acknowledges that it raised concerns, it says that the committee's allegations aren't true and the funding decisions were made through appropriate channels. "It is deeply disappointing the authors of the Staff Report would make allegations directed at doctors affiliated with the NFL Head, Neck and Spine Committee without ever speaking to them," an NFL spokesperson told POLITICO.

HOUSE DIPPING INTO HHS MACRA FUND TO PAY FOR ZIKA - That's according to a letter from HHS Secretary Sylvia Mathews Burwell to the House Appropriations Committee, as first reported by the Morning Consult.

The House's $622 million package to fight Zika virus is offset with about $352 million of leftover Ebola funding and $270 million of HHS funds - most of which would come from the nonrecurring expenses fund.

According to Burwell, the agency had planned to use $108 million in the fund to implement Medicare's new physician payment law. The nonrecurring expenses fund is often used by HHS to support capital investments and other infrastructure items. If the House package stands, it would be the first time that Congress has dipped into the nonrecurring expenses fund to offset other initiatives.

Read Burwell's letter: http://go.politicoemail.com/?qs=830cc015b4b140959d6274d58714f18392620632a5906f42fcd14060b2e897b2

What HHS says: "The nonrecurring emergency fund supports vital initiatives across HHS," an HHS spokesperson told PULSE. "Secretary Burwell's letter lays out the real potential costs to the American people - and to priorities Congress itself has identified - of an approach to the Zika crisis that robs Peter to pay Paul."

E&C MEMBERS LAUNCH PEDIATRIC TRAUMA CAUCUS - The bipartisan caucus kicks off with a hearing at 3 p.m. today. Witnesses include an NIH expert, several children's hospitals and the Childress Institute for Pediatric Trauma.

- Why do we need a pediatric trauma caucus? "We've all seen stories of head injuries, concussions and trauma in professional sports in the news, but most people don't know that this is also a very serious issue for our children," Rep. Richard Hudson, a caucus co-founder, tells PULSE. "In the United States, pediatric trauma is the number one killer of children."

** A message from National Community Pharmacists Association (NCPA): More transparency is needed into generic drug pricing and reimbursement rates set by drug plan middlemen. Bipartisan legislation (H.R. 244) would enhance oversight of federal health programs and help ensure pharmacy reimbursement for generic drugs reflects market fluctuations. Visit www.ncpanet.org/pharmacyaccess. **

EMA PULLS "BLACK TRIANGLE" WARNING ON RX SMOKING CESSATION DRUG - A study published last month in the Lancet found that Pfizer's Chantix and other prescription drugs to help smokers quit don't carry a significant increased risk for suicide or less drastic psychiatric side effects. 

The results prompted the European Medicines Agency on Monday to lift its requirement for a "black triangle" warning on the drug's label - the EMA version of FDA's most serious black box caution. Chantix had been dogged in the decade since it was introduced by anecdotes of violence and suicide associated with its use, but that was undercut by the large scale study requested by the FDA that compared the drug head-to-head with placebo and nicotine patch treatments. Pfizer has said the data show that the black box warning is no longer warranted in the United States, but the FDA has yet to act. 

Pfizer's release: http://go.politicoemail.com/?qs=e7c99c42991aec600e785b0e2ebe25e3e4c1a795b1dd7e725b986ee715e68541 

LAWSUIT PLAINTIFFS COMMISSION DAMAGING FITBIT STUDY - Back in January, plaintiff's firm Lieff Cabraser filed a class-action lawsuit against Fitbit, charging the wearable tech company with shipping inaccurate heart rate monitors. The plaintiffs received a bit of scientific validation Monday with the unveiling of a study - commissioned by them - that purports to show major inaccuracies with the heart-rate-tracking of Fitbit's Charge and Surge devices, when compared with an electrocardiogram.

During exercise, the study claims, the Charge's heart rate differed from the electrocardiogram by a mean of 15.5 beats per minute, while the Surge differed by 22.8 beats.

Researchers and users have long faulted fitness trackers for their inaccuracy; for example, some Iowa State professors dinged the industry for their poor calorie-tracking, while bloggers have often taken the devices to task.

GATES FOUNDATION CEO: PROGRESS ON KEY HEALTH ISSUES 'SOONER THAN YOU THINK' - In a new letter, Sue Desmond-Hellman writes that the foundation is making dramatic progress in combating tobacco and neglected tropical diseases around the world.

For example, Desmond-Hellman cites improvements in fighting "sleeping sickness," a parasitic disease transmitted by the tsetse fly in sub-Saharan Africa and with a near-100 percent fatality rate if untreated.

"In 2006, there were nearly 300 cases" of sleeping sickness in Uganda, she writes. "By 2013, that number had dropped to 10. This year, we've seen only four."

Read the letter: http://go.politicoemail.com/?qs=0f62c414f89b569756000caa45fbdf57e23693c6163270f73591d7f3196ac188 

BIPARTISAN POLICY CENTER ON HEALTHY AGING IN AMERICA - The organization on Monday announced new recommendations on how to integrate health care and housing for seniors. For example, the center suggests that CMS launch an initiative to coordinate care for seniors living in publicly assisted housing and scale an existing demonstration to coordinate care at home for frail seniors, given the risk of patient falls.

See the infographics: http://go.politicoemail.com/?qs=98828e349563a8bf0d95de9b3d885e1d290c05f27b24575984134988daae95e5
Read the report: http://go.politicoemail.com/?qs=98828e349563a8bf00eb906a6fc9b76ff50fe2b878eeb16b613db418f638635c

$34 billion. That's the approximate annual health care cost resulting from seniors' falls. About one in three seniors fall per year.

JILL BIDEN IN BOSTON - The Second Lady will visit the PatientsLikeMe headquarters this afternoon, where she will learn more about the company's work to build online patient networks and boost research. She'll also deliver remarks at the Massachusetts General Hospital Cancer Center's 2016 One Hundred Gala this evening.

ON THE HILL TODAY

- Sens. Joe Manchin, Amy Klobuchar, Jeanne Shaheen, Angus King, Heidi Heitkamp and Tammy Baldwin will hold a 9:30 a.m. press conference on the introduction of their Budgeting for Opioid Addiction Treatment Act (LifeBOAT), which is intended to establish a permanent funding stream to provide and expand access to substance abuse treatment. Watch live.

CORRECTION - Monday's PULSE said that 30,000 physicians already have participated in CMS's MACRA seminars. While more than 30,000 people have attended the seminars, that number includes more than just physicians.

THE HEALTH BENEFITS OF BREAKFAST MAY BE PROFOUNDLY OVERRATED - That's according to Aaron Carroll, who blames misinterpreted research and biased studies for the widespread belief that breakfast is the most crucial meal of the day for personal health.

"The bottom line is that the evidence for the importance of breakfast is something of a mess," Carroll writes. "Breakfast has no mystical powers." http://go.politicoemail.com/?qs=4b725b04286ededd445c7329eda347bdc8dba09e0cf827a5ea4ff9347d5562c0

WHAT WE'RE READING

Inside the top drugmakers' approach to Zika: http://go.politicoemail.com/?qs=4b725b04286ededd21f46496cf73eb336b44d36642295ca3a700e63bc40fddfb

Patrick Soon-Shiong, thought to be the wealthiest physician in the world, is becoming a media baron: http://go.politicoemail.com/?qs=4b725b04286ededd887306be460ce3c0845cd0a54674719a72e54f3a5dd0b6bb 

Ed Silverman makes the case for cash prizes to encourage pharma to fight superbugs: http://go.politicoemail.com/?qs=2d2778723fb8c7c1ffe16196e5131fcc14cfa6569b318a020bc66140da2710aa 

Single-payer health care proposals are arguably more popular than ever, and Harold Pollack explores what's next: http://go.politicoemail.com/?qs=2d2778723fb8c7c168e5bceb738ab6df26f022c7b6ac3a9e7665a581a55d2f0d 

Samsung - yes, that Samsung - is trying to expand into the U.S. pharma market with a new arthritis drug: http://go.politicoemail.com/?qs=847e9929af9979d9049cf8af2e9f3901711becf8f519ed33505cd6f32935b0bd

** A message from National Community Pharmacists Association (NCPA): While approximately 80 percent of prescription drugs dispensed are generic drugs, the reimbursement system for these medications is largely unregulated and a mystery to pharmacists and patients. The lack of transparency also raises questions as to whether drug plan middlemen, pharmacy benefit manager (PBM) corporations, are overpaid by Medicare and other federal health programs. Moreover, when generic drug prices spike, PBM corporations are slow to update reimbursement rates, leaving community pharmacies with payments that don't cover costs and unsustainable financial losses. H.R. 244 would increase transparency and
 facilitate timely payment updates. Learn more at www.ncpanet.org/pharmacyaccess. **

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