HEALTH CARE BRIEFING: Manchin’s Covid May Affect Drug, ACA Vote

Sen. Joe Manchin (D-W.Va.) said Monday he has Covid-19, the latest in a string of Senate Democrats to be absent from the Capitol due to the coronavirus.

Manchin’s diagnosis highlights the challenge Democrats will face in mustering the 50 votes they’ll need to pass a drug price and Obamacare subsidy bill before the start of August recess. Any further Covid cases among Democrats could throw their plan for the drug bill into doubt, Erik Wasson reports.

Still, Schumer yesterday signaled Democrats will vote before they leave for the summer break on the legislation (H.R. 5376).

Senate Democrats were also waiting on Monday for a ruling from the Senate parliamentarian on whether the drug bill—which allows Medicare to negotiate prices it pays for drugs for the first time and limits out of pocket costs for seniors—will be allowed in the fast-track budget process.

SEC Enriches Fraudsters, Lawyers as Secrecy Shrouds Tips Program

An SEC whistleblower program—written into the Dodd-Frank reform law of 2010 and championed by Sens. Elizabeth Warren (D-Mass) and Chuck Grassley (R-Iowa)—often ignores its own rules, shields much of its work from the public, and has been a financial boon for law firms that hired former agency officials, a Bloomberg Law investigation has found.

One lawsuit from 2018 filed by a claimant in the case of Teva Pharmaceutical Industries contended that the agency began redacting more information from public disclosures to hide the slow pace of its investigations, rather than to protect whistleblowers, after The Wall Street Journal used the agency’s public notices to show long delays in paying informants. Teva paid a fine of over $500 million, but the whistleblower waited years without hearing anything from the SEC, according to the complaint.

“There is no public interest check on this program, and the secrecy makes it impossible to measure its success or to provide a check on what it’s doing,” said Reuben Guttman, a Washington attorney who has represented whistleblowers in medical, pension and pharmaceutical fraud cases. “The program calls out for massive congressional oversight.”

Bloomberg Law’s John Holland offers a deep dive of the SEC’s practices in this exclusive investigative report .

Graphic: Jonathan Hurtarte/Bloomberg Law

Happening on the Hill

Tuesday’s Hill Hearings:

• The Senate Health, Education, Labor and Pensions Committee holds a Tuesday hearing on the nation’s fentanyl crisis. Assistant HHS Secretary Miriam Delphin-Rittmon is among those scheduled to testify.

Burr Wants Audit of Biden’s Covid PSAs: Republicans want an audit of the White House’s public education campaign for the coronavirus, as the administration seeks more pandemic aid funds. “It is incredible that HHS and the Biden administration would partner with partisan political organizations and Democrat-affiliated campaign consultants on a $10 billion taxpayer funded vaccine confidence public education campaign, ostensibly intended to appeal to all Americans,” the letter says.

The top Republican on the Senate Health, Education, Labor, and Pensions Committee—Sen. Richard Burr (R_N.C.)—is leading the effort, which also includes senior Republicans on House Energy and Commerce Committee. Read their letter here.

Ways & Means Announces Medicare Advantage Markup: The House Ways and Means panel announced a markup Wednesday of a bill (H.R. 3173) with more than 300 cosponsors that aims to streamline prior authorization rules for Medicare Advantage plans.

What Else to Know Today

Many Parents Reluctant to Vaccinate Kids: A large number of parents said they definitely won’t vaccinate their children under 5 against Covid, in the latest findings that indicate parents are less swayed by the highly contagious BA.5 variant and more by their own children’s experiences with the disease. The findings released Tuesday from the Kaiser Family Foundation found 43% of parents with children in that age group said they will “definitely not” take their kids to get Covid shots. Read more from Jeannie Baumann.

MORE ON THE CORONAVIRUS

• Biden Symptoms Improve: Biden’s Covid symptoms have “almost completely resolved,” his doctor said four days after the president, 79, first tested positive. Read more from Akayla Gardner.
• Tyson Appeals Ruling: Tyson Foods has asked the Supreme Court to consider overturning an Eighth Circuit appeals court decision finding that a Trump administration executive order did not protect the meatpacking giant from Covid-19 liability cases filed by families of workers who died after contracting the virus in Tyson facilities. Bruce Rolfsen has more.

Medicare Proposal Could Boost Coordinated Care: A proposal from the Biden administration could boost cost-cutting efforts to help steer traditional Medicare beneficiaries—and their doctors—away from the program’s fee-for-service payment model roots. The proposed 2023 Medicare physician fee schedule rule, if finalized, would provide new financial and programmatic incentives for health-care providers to form or join accountable care organizations, or ACOs. Read more from Tony Pugh.

MORE REGULATION & LEGAL NEWS

• LGBTQ Health Care: Transgender and other LGBTQ people would again be protected from discrimination in health care under a new proposal the Biden administration announced on Monday. It would restore gender identity and sexual orientation as protections from discrimination under the Affordable Care Act. Read more from Shira Stein.
• Abortion Ban Cases: An 1870 West Virginia law criminalizing most abortions must be reinstated, Attorney General Patrick Morrisey (R) told the West Virginia Supreme Court of Appeals in a brief urging it to overturn a state judge’s decision blocking the law’s enforcement. Meanwhile in Kentucky, Jefferson Circuit Court Chief Judge Mitch Perry blocked the state from enforcing a trigger ban and a ban on abortions beginning at about six weeks into a pregnancy. He had previously issued a temporary restraining order. Mary Anne Pazanowski has more.
• Pfizer Kickback Case: Pfizer’s proposed program to cover copays for an expensive heart drug violated federal anti-kickback law even though it didn’t evince corrupt intent, the Second Circuit ruled, Christopher Brown reports.

More Headlines:

• Talc Victims Call J&J Unit’s Claims Estimation Pitch ‘Pointless’
• Georgia to Address Tax Implications of Fetal Heartbeat Law
• Medical Patent Case Raising Contract Conflict Triggers Lawyer Skepticism

With assistance from Jeannie Baumann and Alex Ruoff

To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com