DEA on track to meet special registration deadline

With help from Arthur Allen (@arthurallen202), Darius Tahir (@dariustahir) and Kayla Sharpe (@KaylaNSharpe)

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Quick Fix

It’s been a busy week in Washington, with drop-ins from Facebook executives, the formation of new health tech advocacy groups, and buzz surrounding certain provisions of last year’s opioid package. Coming up next week, the VA hosts an innovation-themed event on new technology in health care. Here’s what we’ve got:

— DEA on track for special registration rules: A senior official tells POLITICO that the agency is drafting a proposal on the process by which doctors can register to virtually prescribe controlled substances to patients they haven’t met.

— Telehealth lactation study finds promise for rural mothers: A new study in Academic Pediatrics finds that women enrolled in a telehealth-based lactation support program are more likely to breastfeed than a control group.

— AdvaMed’s new Center for Digital Health: The medical device trade group’s new advocacy center plans to tackle topics such as reimbursement and health data privacy.

eHealth tweet of the day: Dave deBronkart, @ePatientDave, “The legendary ⁦@katherinekleon⁩ recounts discovering her chart calls her ‘pleasant, anxious woman.’ ‘Well, yeah, I just had a heart attack...’ #s4pm2019"

It’s FRIDAY at Morning eHealth, where your author is surprised to learn that less than a fifth of health care executives are “very familiar” with upcoming interoperability and information blocking rules — at least, according to an Accenture survey. Send other reminders that Washington isn’t, in fact, the center of the health IT universe to [email protected]. Tweet the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

GOOD NEWS FOR TELEMAT? — Doctors and telehealth advocates eagerly awaiting federal rules on the virtual prescription of controlled substances — some of which could help patients overcome opioid dependence — may be in luck. The DEA is drafting a proposal on the “special registration” process, a senior agency official told Morning eHealth.

If the proposal makes it to OMB by next Friday, the DEA will have fulfilled its requirement under the massive opioid package signed into law last year. More than a decade ago, a law known as the Ryan Haight Act banned telemedicine prescription of controlled substances except under certain circumstances, including when a doctor has a special registration; but the agency hasn’t ever promulgated a final rule on special registration.

The DEA “recognizes it is part of our requirement” to promulgate a rule proposal within a year of the SUPPORT Act, the official said. “And we will do just that.”

...There’s still a way to go once the DEA completes the proposal. It’ll go to OMB for review and will eventually be made available for public comment. Several telehealth groups had requested that the DEA publish a draft well before the deadline to give providers and companies more time to prepare; with a week left, it looks like that won’t happen. Still, “[w]e’re cautiously optimistic that we’ll have something by the end of October as we know everyone is excited about how virtual services can help mitigate this public health crisis,” ATA CEO Ann Mond Johnson told Morning eHealth.

DESALVO TO JOIN GOOGLE — Google has hired former ONC chief Karen DeSalvo as its first chief health officer, CNBC reports. Her appointment follows former FDA Commissioner Robert Califf’s; Califf will lead strategy and policy at Google Health and Verily Life Sciences.

HIGHER THAN NORMAL UPTAKE FOR TELEHEALTH IN LACTATION SUPPORT — In one of the first studies to evaluate breastfeeding support delivered via videoconference, researchers found promising but not statistically significant evidence that telelaction can lead women to breastfeed at higher rates. The study recruited about 200 women in a critical access hospital and randomized them to receive either telelactation or normal care.

In general, researchers found that about 33 percent of subjects exposed to telehealth services used them, “which is quite high when you consider that when telehealth is offered to population, you typically see uptake of <1%-20%,” researcher Lori Uscher-Pines told Morning eHealth in an email. But "[g]iven that the trial was underpowered, results are promising but not definitive.”

ADVAMED RAMPS UP DIGITAL HEALTH ADVOCACY — The new Center for Digital Health plans to undertake broad policy issues related to reimbursement, data privacy and data storage, AdvaMed leaders told reporters during a call this week. “Digital health is not a vertical,” said Andy Fish, chief strategy officer. “Data is now the coin of the realm.”

The center isn’t just an organization, Fish said — it also represents AdvaMed’s recognition that digital health issues cut across industries and roles in health. The group also plans to encourage private insurers to cover more digital health services and is working on a white paper laying out barriers to technology adoption in health.

CORTEZ MASTO TELLS CMS TO CLEAN UP ITS WEBSITE — Sen. Catherine Cortez Masto (D-Nev.) called out CMS’ Plan Finder website this week in a letter to Administrator Seema Verma demanding more information on concerns that it includes misleading information about cost and plan structure. The letter, sent at the start of Medicare’s open enrollment window, also asks CMS what steps it’s taking to ensure data accuracy.

CHECKING IN ON GERMANY’S DIGITAL HEALTH REVAMP — Germany’s Health Minister Jens Spahn has made digitizing health care one of his top priorities, but the plan hasn’t been without setbacks, our POLITICO EU colleague Carmen Paun reports. This week, the German parliament’s health committee hashed out the draft Digital Supply Law that Spahn proposed earlier this year with doctors, insurers and health industries’ representatives.

It includes a provision that would require German insurers to pay for diabetes management apps, which has been opposed by the Bavarian State Medical Association. The legislation would also encourage doctors using telemedicine to make patients aware of the option and would reimburse doctors more for medical correspondence via email.

...The German health ministry also wants to create an electronic health record for all insured patients by 2021. The government plans to introduce a separate law on protecting data in electronic health records by early 2021, according to the ministry.

ZUCKERBERG’S WEEK IN WASHINGTON — It’s been a tough week for the social media giant, with #DeleteFacebook trending following POLITICO’s report that CEO Mark Zuckerberg has been meeting with conservative pundits. Elsewhere, Public Citizen filed an amicus brief arguing that the $5 billion FTC settlement that protects executives from potential wrongdoing prior to June “gives away too much” and allows “past violations to escape without remedy.”

...Zuckerberg also talked about free speech at Georgetown on Thursday, signaling a hesitation to proactively moderate political speech, our POLITICO colleague Nancy Scola reports.

Cybersecurity

DO NO HARM — Cybersecurity is as much a tech issue as a patient safety one, New America argues in a report published this week. The think tank is proposing 17 recommendations to improve cyber hygiene in health care, upgrade infrastructure and solve workforce shortages.

They include bolstering FDA requirements for medical device security, creating government-subsidized cyber health care apprenticeships, and offering tax incentives for health care organizations that retain cybersecurity staff. Several other recommendations urge CMS, HHS and other agencies to provide regulatory guidance for the health sector.

In the States

IN THE STATES — Lots of health and technology news this week. Here’s a taste:

— California health system Sutter Health reached an agreement with the state and a union trust, avoiding a trial hinging on whether its negotiations with health plans amounted to anti-competitive behavior, our colleague Victoria Colliver reports. Terms won’t be released until February or early March.

...The settlement would resolve a lawsuit filed in 2014 by the trust that pays health care costs on behalf of the United Food and Commercial Workers union and self-funded employers, and a separate suit filed in 2018 by Attorney General Xavier Becerra. “The case became a symbol of concern over big hospital chains that require insurers to access their networks on an all-or-nothing basis and make it harder for plans to steer patients to lower-cost competitors,” Victoria writes. Sutter, a nonprofit operating 24 hospitals that had $13 billion in operating revenue last year, would have risked damages that could exceed $1 billion by going to trial.

— Florida’s Department of Children and Families is asking lawmakers for $93 million to upgrade its IT systems, our POLITICO colleague Matt Dixon reports. DCF Secretary Chad Poppell told Florida’s House Health Care Appropriations Subcommittee that some of the state’s systems are old and need replacing, and budget documents show that some are are based on 1980’s technology.

What We're Reading

— Some doctors are calling for leadership term limits in medical schools to encourage diversity, Stat’s Shraddha Chakradhar reports.

— Karen Hao and Jonathan Stray demonstrate why algorithmic fairness can be challenging in the MIT Technology Review.