February 1, 2023

PROGRAMMING NOTE: We’ll be off next week for the holidays but will return to your inboxes on Tuesday, Jan. 3.

Congress’ fiscal 2023 spending bill offers certainty for the health care industry that there’s bipartisan support for retaining rules adopted during the Covid-19 pandemic which permit easier access to virtual and at-home care.

The bill, which lawmakers plan to pass this week, will extend through 2024:

– eased Medicare rules allowing expanded access to telehealth. Those rules were previously scheduled to expire five months after the end of the Covid public health emergency, which could come next year. The Department of Health and Human Services permitted Medicare patients easier access to telehealth at the outset of the pandemic and Congress bolstered that decision in a March 2020 Covid relief law.

– a rule allowing high-deductible health plans to offer subscribers telehealth appointments before they’ve hit their deductibles. The rule previously would have expired at year’s end. Congress first allowed high-deductible plans to pay for virtual visits in the March 2020 law. Lawmakers allowed the provision to expire at the end of 2021 before passing another extension in March.

– waivers permitting hospitals to treat some emergency department and inpatient hospital patients from their homes. The move, adopted by the Centers for Medicare and Medicaid Services in November 2020, was aimed at expanding hospital capacity as health care organizations were slammed with Covid-19 patients. The waivers would have expired with the end of the public health emergency.

Yes, but: Those are all big wins for health care industry groups. But some took a loss as well. The bill sustains a prohibition against creating a national patient ID that providers and health technology firms say is needed to ensure a safe and seamless transition to electronic medical records.

This is where we explore the ideas and innovators shaping health care. 

We can now get our medical records and results in cool mobile apps — great, right? But if they’re written in medicalese, the average person won’t be able to understand them. So, whose job is it to translate our medical histories into something intelligible? Let Ruth know.

Share news, tips and feedback with Ben Leonard at [email protected], Ruth Reader at [email protected], or Carmen Paun at [email protected].

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Today on our Pulse Check podcast, Ben talks with Mark Cuban, famous for his “Shark Tank” reality TV show on ABC and one of America’s most prominent investors, about the Cost Plus Drug Company he founded with Alex Oshmyansky to take on the pharmaceutical market and lower drug prices.

The U.S. will remain atop the list of donors to global health causes if Congress, as expected, passes the fiscal 2023 spending bill this week.

But the 7 percent boost in funding the State Department and Agency for International Development will oversee comes amidst huge needs stemming from the Covid-19 pandemic, during which the fight against infectious diseases, such as measles, polio and HIV, was disrupted.

Of the $10.5 billion for State and USAID in the year-end spending package:

– The biggest boost, $445 million, will go to HIV/AIDS programs, for a total of $6.7 billion. The Global Fund to Fight AIDS, Tuberculosis and Malaria, got the biggest percentage increase with $440 million, raising the U.S. contribution to $2 billion for next year.

– Global health security will get $200 million more, for a total of $900 million. The money will go to programs seeking to build the capacity of other countries to prevent, detect and respond to infectious disease outbreaks. At least some of it is expected to go to the World Bank’s Pandemic Fund.

– Tuberculosis programs will get a $23.5 million increase to nearly $395 million.

– Malaria programs will receive $795 million, a $20 million increase. Polio programs will get $85 million, a $10 million hike.

– Funding for family planning and reproductive health programs remained flat at $575 million. The U.S. will also contribute $32.5 million to the United Nations Population Fund.

The Department of Health and Human Services and Centers for Disease Control and Prevention will also get nearly $700 million in global health funds.

California could be the third state to decriminalize “magic mushrooms” if Democratic state Sen. Scott Wiener’s new bill becomes law.

Wiener, who represents San Francisco and environs, wants to make it legal to possess plant-based psychedelic substances, including psilocybin, dimethyltryptamine (DMT), ibogaine and mescaline, for personal use by adults 21 or older.

Psychedelics are on the frontier of drug legalization:

– Oregon, in 2020, and Colorado, earlier this year, decriminalized psychedelics. Both changes were the result of ballot initiatives.

– Oakland, Santa Cruz and San Francisco in California; Ann Arbor, Detroit and Hazel Park in Michigan; Somerville, Cambridge, Easthampton and Northampton in Massachusetts, and Washington, D.C., no longer treat possession of psychedelic plants as a crime.

Wiener’s bill excludes LSD and MDMA, or ecstasy, two synthetic drugs that alter perception and are currently being tested for use in treatment for anxiety and post-traumatic stress disorder, respectively.

The bill includes penalties for transporting the substances it decriminalizes onto school grounds or giving them to anyone under 21.

The Health Information Technology Advisory Committee that Congress created to advise HHS on how to improve the flow of medical data is about to get more diverse.

Comptroller General Gene Dodaro appointed seven new members to the committee on Monday, five of them women.

Last year, the GAO announced an all-male group of nominees, which sent some in the health IT world into an uproar. The new group will move the panel toward greater balance, as it currently has 19 men and eight women appointees.

The new members will get three-year terms on the committee. They are:

Deven McGraw, lead for data stewardship and sharing at Invitae, a genetic testing company, and a former high-ranking official in HHS’ Office for Civil Rights privacy division

Kikelomo Belizaire, chief medical officer at Pegasystems, a software company, and former medical director of insurer Anthem’s commercial unit

Shila Blend, health information technology director of the North Dakota Health Information Network and former deputy chief of staff for the state’s Covid-19 response

Hannah Galvin, chief medical information officer of Cambridge Health Alliance, the Massachusetts health care provider, and former senior manager of clinical effectiveness at athenahealth

Anna McCollister, a patient advocate and former chief advocate for participatory research at Scripps’ Translational Science Institute

Bryant Karras, chief medical informatics officer at Washington state’s health department and a former University of Washington assistant professor

Naresh Sundar Rajan, chief data officer at CyncHealth, which aids in information exchange among providers in Nebraska and neighboring states

Why it matters: Congress established the advisory committee via the 21st Century Cures Act six years ago.

The panel advises HHS’ National Coordinator for Health Information Technology on policies, standards and certification criteria relating to implementing health information technology with the goal of improving electronic access, sharing and health data usage.