Opioid bills still occupying Congress

With help from Arthur Allen (@arthurallen202) and Mohana Ravindranath (@ravindranize)

OPIOIDS ACTIVITY IN CONGRESS: Legislation addressing the opioid crisis continues to advance through Congress. The House is scheduled to consider a big package the week of June 11, a spokesperson for House Majority Leader Kevin McCarthy told our Health colleague Brianna Ehley Tuesday.

That package will likely include several of the roughly 60 bills that have advanced by the Energy and Commerce and Ways and Means committees that we’ve been tracking of late. The health IT-relevant bills among that group include an overhaul of privacy protections for behavioral health data, potential increased Medicare reimbursement for telehealth targeted at substance use patients, and much more.

— Senate: Meanwhile, Sen. Mark Warner unveiled a set of bills Tuesday aiming to increase access to telemedicine-based treatment for substance abuse disorders. One measure would ease the originating site restrictions on Medicare reimbursement for telehealth treatment. Another directs the HHS secretary to clarify how Medicaid funds can be used for virtual substance abuse treatment. A final bill requires CMS to report on ways to reduce barriers to telehealth treatment for pediatric patients.

OTHER CONGRESSIONAL HAPPENINGS: Besides opioids-related matters, Congress is working on other matters of interest for health IT heads. Here’s the rundown:

— FDA funding: A Senate Appropriations subcommittee approved a 5 percent boost to FDA for fiscal year 2019 Tuesday. Much of the details are still under wraps – we’re get more after the full committee markup tomorrow – but the level is slightly below the House. The lower chamber’s Appropriations Committee approved a 10 percent funding raise for fiscal year 2019.

— HHS spending allocation is out: House appropriators plan to unveil and approve subcommittee spending levels at a meeting on Wednesday, signing off on those so-called 302(b) allocations for fiscal 2019, our colleague Jennifer Scholtes reports. The newly disclosed totals include $177.1 billion for Labor-HHS-Education — no change from fiscal 2018.

— Rural wireless bill hits speedbump: Sen. Mike Lee is planning to block a bill intending to boost rural wireless service, his office told our Tech colleague John Hendel Tuesday. The bill — the Rural Reasonable and Comparable Wireless Access Act, S. 2418 (115) — directs the FCC to establish a national standard on whether rural and urban areas get comparable wireless broadband speeds. A companion House bill hasn’t gotten out of committee. Fast broadband is a telemedicine priority.

— School’s in for summer: The Senate’s typical August recess might get scrapped this year, the GOP caucus thinks, per a report from our Congressional colleague Burgess Everett. One item that might be on the agenda? A new big health care bill.

eHealth tweet of the day: Melanie Evans @_melaevans “.@EricTopol tried to get his medical records. He used a company to get his data from 16 providers in three cities. But he doesn’t own his records, @EricTopol says, and he has to go to the company’s service to see the data. #wsjhealth”

WEDNESDAY: It’s rare that current music and policy intersect, which is why your correspondent is taking the opportunity to bump George Clinton and Parliament’s new album: “Medicaid Fraud Dogg.” Listen to the album here. Discuss how funk can target high health care costs at [email protected]. Or would Earth Wind and Fire be better suited to bend the curve (at least on the 21st night of September)? Discuss socially at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro, @Morning_eHealth.

POLITICO and the South China Morning Post are partnering to expand coverage of U.S.-China relations. Read our note from POLITICO Editor-in-Chief John Harris and Editor Carrie Budoff Brown to learn more.

ATHENAHEALTH CORPORATE MANEUVERING CONTINUES: The Janus Henderson Group — EHR vendor athenahealth’s largest shareholder, with an 11.9 percent stake — wants the company to consider a sale. In an SEC filing late last week, Janus disclosed that it had met with athenahealth’s board, and have argued that a formal sale process was in the best interest of the company’s shareholders.

Though the disclosure doesn’t specifically mention Elliott Management, the activist investment group with an 8.9 percent stake that proposed in early May to take over the vendor, Janus met with athenahealth just about a week after the activists made their offer. Athenahealth has not formally responded to the bid; they tell Morning eHealth they’re analyzing the proposal and have reviewed Janus’s recent filing.

HHS GOINGS: Bruce Greenstein, HHS’s chief technology officer, is leaving the department in June after a year to return to the private sector. FierceHealthcare reports that deputy CTO Ed Simcox is set to take over Greenstein’s responsibilities in June after he starts his new job as chief innovation and technology officer at a Louisiana-based in-home health care services company, the LHC Group. Greenstein is expected to work on value-based care models and develop new arrangements with managed care partners, the company said in a news release.

ONC REPORTING CHALLENGE: ONC wants users to report safety issues with EHRs much more easily. In a blog post today, the office’s chief medical officer, Andrew Gettinger, said the challenge would encourage development of a platform-agnostic app that can ease reporting of usability and safety concerns without undue workflow disruptions.

The office is giving a total of $80,000 to contest winners, with a deadline for submissions of Oct. 15.

PDMP WORK: More academic and think tank attention being paid to prescription drug monitoring programs:

— Pew Charitable Trusts: The Trusts released a fact sheet based on focus groups with 21 program administrators Tuesday. The administrators discussed various potential tweaks to make to the program’s software, such as more fine-grained alerts. (Some programs alert providers when an opioid is prescribed beyond a limit. But administrators note that different guidelines have different limits; and different practice settings — general practice versus pain clinics — might have needs for different limits.)

Despite the various new features being contemplated, there are a few barriers. Cost, of course, is one. Yet administrators are also wary about usurping clinicians’ independence.

“We walk a fine line between empowering the user and appearing to make decisions on their behalf,” one participant said. While the programs are giving out information, the presentation of that information naturally affects decisions. “We have to be very wary of labeling a patient ... [a] misuser, even if not in those terms, if we do not have diagnosis or other background information to see the bigger picture.”

— Annals research: In a new paper in Annals of Internal Medicine, a group of researchers found that it’s difficult to zero in on any one indicator of misuse of opioids contained in a prescription drug monitoring program database. Several — such as a patient having prescriptions with more than five pharmacies — are suggestive of problems, but there’s no definitive metric.

The researchers examined a sample of Medicare beneficiaries and matched their eventual outcomes (e.g. overdose) to their prescription patterns. A patient fulfilling the criteria of any one worrisome metric might be using their medications responsibly, they note. Therefore, they suggest PDMPs use dashboards with a variety of potential indicators of misuse for clinicians’ consideration.

CANCER DEATH RATES CONTINUE THEIR FALL: The death rate continues to fall, the latest annual report on the disease’s mortality rate from a group of governmental and non-governmental organizations shows. From 1999 to 2015, overall cancer death rates decreased 1.8 percent per year among men and 1.4 percent among women. Of course, with continuing efforts in genomics research, the health care sector hopes to drive the death rate down further.

WHAT WE’RE CLICKING ON

— LifeBridge Health admits to the breach of 500,000 patient’s data.

— Automated health care might help save patients from shame — but is that really for the best?

— Kaiser Health News reports on Geisinger’s health sequencing plans.