HEALTH CARE BRIEFING: HHS Top Lawyer to Defend Vaccine Mandates

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The Department of Health and Human Services’ new top lawyer will step into thousands of high-profile legal challenges that test the bounds of the agency’s authority as it targets novel public health threats with unprecedented policies.

The Senate voted 49-43 Thursday to confirm the nomination of Samuel Bagenstos to serve as general counsel. He will defend the agency against litigation over vaccine mandates, efforts to end surprise medical billing, and payment cuts to hospitals participating in a federal drug discount program.

The experiences of Bagenstos’s predecessors highlight the challenges an HHS general counsel can face, including the Covid-19 pandemic, implementation of the Affordable Care Act, and 9/11.

“Each of us has probably started with some sort of vision of what we wanted to do,” said Robert Charrow, who was general counsel in the Trump administration and is now a shareholder at Greenberg Traurig LLP. “Each of our visions have been disrupted by some sort of catastrophe.” Read more from Allie Reed.

Happening on the Hill

Key Senator Seeks to Tie Mental Health to Gun Effort: The head of the influential Senate Finance Committee wants to tack Medicaid and telehealth policies onto a bipartisan gun violence package being debated, possibly accelerating the timeline for key mental health legislation, Alex Ruoff reports.

Sen. Ron Wyden (D-Ore.) told reporters Thursday he’s pitched expanding tele-mental health coverage and bolstering Medicaid as part of the gun violence package. He did not offer details but pointed to policies previously unveiled by Finance members.

“There’s an opportunity to tackle mental health in the next few weeks in a valuable way,” Wyden said.

The Finance Committee has been trying to advance bipartisan mental health legislation this year, releasing a series of recommendations for policies that could potentially clear the Senate. In May Wyden and Sen. Mike Crapo (R-Ind.) released a slate of recommendations for expanding Medicare and Medicaid coverage of telehealth services.

If these policies find their way onto a gun violence package it would mean fast-tracking legislation originally eyed for later in the year, Wyden said.

Asbestos Ban Bill Criticized Over Need for It to Make Chlorine: A tug of war between legislation aimed at reducing asbestos’ deadly effects and concerns that the bill’s timeline to ban the chemical could jack up drinking water costs and impede medicine production played out during a Senate hearing Thursday.

Asbestos is used to make the chlorine used to disinfect drinking water. Chlorine can be made in other ways, but the bill’s requirement to phase out asbestos imports in two years would reduce chlorine supplies and raise costs, Robert J. Simmon, a vice president of the American Chemistry Council said at a Senate Committee on Environment and Public Works subcommittee hearing on the Alan Reinstein Ban Asbestos Now Act of 2022 (S. 4244). Pat Rizzuto has more.

What Else to Know

Drugmakers Urge Appeals Court to Limit ‘Off the Rails’ Discounts: Drug manufacturers should be allowed to impose limits on the steep discounts they offer off-site pharmacies under a federal program designed to help low-income patients afford drugs, two pharmaceutical companies told the D.C. Circuit.

The consolidated lawsuit, filed by Novartis Pharmaceuticals and United Therapeutics, is one of the many challenges drugmakers have brought against the Department of Health and Human Services. Allie Reed breaks down the case.

FTC to Weigh Drug Rebates, AI to Combat Online Harm on June 16: An open meeting of the Federal Trade Commission will be held virtually June 16 at 1 pm ET with time for members of the public to address the commission, according to the agency Thursday. The Commission will vote on whether to make a policy statement on rebates and fees paid by drug manufacturers to pharmacy benefit managers and other intermediaries in exchange for disfavoring lower cost drug products. Read more.

Highest-Value Contract Opportunities: Bloomberg Government presents potential new business for federal contractors. Opportunities range in size from an $89 billion ceiling on management of the Frederick-based cancer research lab to USAID’s $2.5 billion Comprehensive Technical Assistance for Health Supply Chain and Pharmaceutical Management (COMP TA) contract. Read more from Paul Murphy.

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To contact the reporter on this story: Giuseppe Macri in Washington at

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