Azar at Ways and Means

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

PROGRAMMING NOTE: Morning eHealth will not publish on Monday, Feb. 19. The newsletter will return Tuesday, Feb. 20.

AZAR AT WAYS AND MEANS: New HHS Secretary Alex Azar dropped by the House Ways and Means Committee Wednesday to discuss his department’s budget proposal. Azar was mostly smooth and courteous — even when being vociferously criticized by the panel’s Democrats — while letting few concrete plans about HHS’s eHealth direction slip:

— Fraud software: Calling it a “great passion of mine,” Azar said CMS would be investing further in anti-fraud analytic software. Such software can inspect CMS’s big data, “look for where trends are out of whack,” and thereby prevent or catch payments to fraudsters.

CMS has made investments in such software in the past. Their software, called the Fraud Prevention System, was generally touted by the agency — but a September 2017 report from HHS’s Office of the Inspector General concluded that HHS lacked the metrics to accurately assess the program’s quality.

— Telehealth access and pay-for-value: Each merited vague, positive comments from Azar.

— Joking, we think: “You’ve been on the job, what, 13 days?” asked Rep. David Schweikert. “So you should know everything.” We think the gentleman from Arizona was joking, but we’ll admit we’re not entirely sure.

SHULKIN’S EUROPEAN JAUNT DIDN’T MEET ETHICAL GUIDELINES: VA Secretary David Shulkin’s summer 2017 jaunt to Europe crossed ethical guidelines, the department’s Office of the Inspector General concluded in a report released Wednesday.

The trip — which included Shulkin, his wife, his staff — featured stops in England and other destinations on the continent, with sojourns to Wimbledon and other nice spots. The OIG report concluded that Shulkin improperly accepted tickets to the famed tennis tournament, and accused his chief of staff of falsifying details in order to ease ethics officials’ approval of the trip.

In an interview with POLITICO, Shulkin denied the charges, saying that the purportedly incriminating email may have been hacked, and that the OIG gave him too little time to respond to the report’s allegations. He claimed that he had spoken about a draft version of the report with President Donald Trump, who he said still has his back, though he “didn’t indicate any particular direction” about the report.

In a letter accompanying the report, Shulkin argued it “reeks of an agenda.”

Nevertheless, he is complying with the recommendations and paying back the U.S. Treasury for the cost of the Wimbledon tickets, he wrote in a response to the Inspector General.

The OIG report comes at a delicate time for Shulkin. As regular Morning eHealth readers know, the secretary has been attempting to steer the VA into a new digital age with its Cerner contract. Lawmakers from both sides of the aisle have directed increasingly pointed questions in his direction about the cost and strategy of a Cerner implementation.

And there has been some chatter about friction between Shulkin and the White House, with the Washington Post saying last week that the folks at 1600 Penn want to remove Shulkin’s deputy as a “warning shot” pour encourager les autres.

eHealth tweet of the day: Jon White @pjonwhite My love for you is open, without special effort #healthpolicyvalentines

THURSDAY: We here at Morning eHealth are hoping you all had a nice Valentine’s Day , with much joy and no disappointment. Share your most thoughtful gestures at [email protected]. Complain about despoiling consumerism at @ravindranize, @arthurallen202, @dariustahir, @POLITICOPro, @Morning_eHealth.

MORE WHITE HOUSE INTEROPERABILITY DISCUSSIONS: The White House Office of American Innovation is hosting its third meeting on health care data interoperability today, along with CMS, ONC and VA officials.

Participants in the series of meetings, which began in December, have been required to sign non-disclosure agreements, two of them told POLITICO. A White House official, who later denied participants had been told not to discuss the meetings, said the meetings were geared toward gathering information from industry and “could have significant benefits for American citizens.”

WHITE HOUSE PICK FOR DRUG CZAR PANNED: The White House pick to serve as “drug czar” is being widely questioned for a lack of public health expertise, our Health Care colleagues Sarah Karlin-Smith and Brianna Ehley reported Wednesday. Jim Carroll, has already spent time in three different White House posts in the year-old Trump administration. While Carroll has prosecuted drug cases, he doesn’t really have a public health role, leading some to question whether he has the public health chops to make a dent in the crisis. Advocates are also questioning the administration’s renewed plans to gut funding for the Office of National Drug Control Policy, whose director is known as the czar. Pros can get the rest here.

COMINGS, GOINGS AT ATA: Health tech executive Ann Mond Johnson will lead the American Telemedicine Association starting in March, replacing Jon Linkous, who stepped down last year after 24 years as CEO, the lobbying group announced Wednesday.

Johnson tells POLITICO that she plans to push to make telemedicine more available to patients. Telemedicine is “not some side specialty or side show,” she said.
She was previously CEO of Zest Health, a Chicago-based company that provides a concierge service linking patients to telemedicine, and before that an executive at various other health tech firms.

Jon Pearce, CEO of telemedicine provider Zipnosis in Minneapolis and a member of the ATA search committee that selected Johnson, told POLITICO the association looked forward to “growing telemedicine’s visibility” under Johnson. Her appointment has drawn praise from other virtual care groups: Krista Drobac, executive director of the Alliance for Connected Care, said Johnson’s private sector experience could help rebrand the remote care option, which “is still considered in some cases to be a rural issue.” More for Pros here.

— Goings: Gary Capistrant, the chief policy officer of the American Telemedicine Association, is leaving his position after nearly nine years, he told POLITICO Wednesday. Capistrant said he planned to “promote health technology to improve patient care, public speaking about leadership and the Presidents, DC tour guiding — and grandfathering. “

NIST BEARISH ON MEDICAL DEVICES’ UPTAKE OF CYBERSECURITY STANDARDS: Manufacturers are only slowly implementing standards designed to defend medical devices from cyber attack, a new report from the technical standards agency NIST concludes. To be fair, medical devices have plenty of company — most categories of connected devices examined by the report have few standards and slow uptake of those that are floating around. NIST is part of an interagency working group, established in December 2015, that coordinates the U.S. role in global discussions about cyber standards. The new report is the product of an IoT committee the working group created in April 2017.

SILICON VALLEY UPDATES: Google’s lobbying dollars are shifting towards health policies, an analysis from Bloomberg finds … Former Anthem CEO Joe Swedish is joining the board of digital pill startup Proteus.

WHAT WE’RE CLICKING ON:

—Two docs, writing in New England Journal of Medicine, aren’t entirely comfortable with using real-world evidence to approve medical devices.

—California’s upgraded prescription drug monitoring program database isn’t ready for prime time.

—Direct-to-consumer genetic testing took off in 2017.