Shulkin has GOP Senator’s support

With help from Arthur Allen (@arthurallen202) and Darius Tahir (@dariustahir)

OMNIBUS HOLDUP: Negotiations delayed the release of the $1.3 trillion omnibus spending bill, which had not been filed as of midnight last night, POLITICO’s Sarah Ferris reports. Disagreements included the so-called grain glitch, left over from the GOP tax law, and bigger political battles such as funding for the Gateway tunnel project and border security, multiple members told Sarah. The House could still vote as planned on Wednesday.

SHULKIN HAS GOP SENATOR’S SUPPORT: Amid continued rumblings of Veterans Affairs Secretary David Shulkin’s possible firing, Sen. Johnny Isaksontold President Donald Trump that he had “full confidence” in Shulkin, POLITICO’s Burgess Everett reports.

Isakson, chairman of the Veterans Affairs Committee, has said he’s made a case for retaining Shulkin. The Washington Post has reported that Trump has been considering replacing Shulkin with Fox News personality Pete Hegseth, following reports that Shulkin improperly used taxpayer money to fund a trip to Europe.

Isakson said in an interview yesterday that Shulkin’s done a “great job,” adding, “Yes, there have been a few difficult times, but that’s because we’re making progress. I’ve talked to the president about my confidence in Shulkin.”

Republican aides have said Hegseth would be difficult to confirm as Shulkin’s replacement, Burgess reports. In the past, Hegseth has called Isakson a “so-called Republican” and a “Swamp-creature.”

Burgess’s full story, for POLITICO, here.

BIDEN ATTACKS TRUMP ADMINISTRATION FOR GAPS IN PROPOSED HEALTH IT POLICY: Former Vice President Joe Biden took to Fortune Magazine yesterday to decry the Trump administration’s recently announced health IT policy.

Biden criticized the presentation by White House aide Jared Kushner and CMS Administrator Seema Verma at HIMSS earlier this month for lacking specifics, he wrote in the op-ed.

“I agree with the administration’s stated goals, but real action is needed — and now is the time,” he wrote, explaining that providers should be required to produce patients’ medical records within 24 hours of request and that CMS’ Innovation Center should create a common data portal for patients to store their records. HHS should expand its pilots for research-related data-sharing, he wrote.

Verma, in contrast, has proposed data-blocking enforcement, increased access to patient claims data, use of application programming interfaces and scaled-back documentation and quality measures requirements.

More from eHealth’s Darius Tahir here.

MEDICARE HEAD TO TESTIFY ON VALUE-BASED CARE: Demetrios Kouzoukas, the director of CMS’ Center for Medicare, will testify Wednesday at a House Ways and Means health subcommittee hearing on MACRA’s physician payment policies, multiple people familiar with the agenda confirmed to POLITICO’s Adam Cancryn.

Kouzoukas will focus his testimony on the need to open up patients’ access to their own health records, improve interoperability and boost transparency so that people “know what they’re buying” when they go in for procedures, according to one person familiar with the agenda. Those initiatives, which the Trump administration is dubbing the move to “patient-driven value,” will be paired with efforts to roll back or overhaul a series of regulations deemed overly burdensome.

eHealth Tweet of the day: Erin Gilmer @GilmerHealthLaw I would love it if instead of just integrating AI, they would incorporate doctors and patients in design teams. Otherwise they’re just implementing more tech without understanding the end users Juan Fernández @juanfdezortega The next step in the evolution of the #EHR: integrating #ArtificialIntelligence into the #clinical #workflow to promote #quality, boost #patientsafety and facilitate #decisionmaking #HealthIT #eHealth #MachineLearning

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TRUMP TALKS DEATH PENALTY, BORDER WALL AND OPIOIDS: The president called for using the death penalty for drug dealers to crack down on opioid abuse, our colleagues Dan Diamond and Brianna Ehley report.

“If we don’t get tougher on drug dealers, we are wasting our time … and that toughness includes the death penalty,” Trump said — one of six times he invoked the death penalty during remarks yesterday in New Hampshire, a state hit hard by the addiction crisis.

Democrats are skeptical about whether the Trump administration will actually push lawmakers to add new funding to the opioid initiative. White House counselor Kellyanne Conway told reporters that the administration is seeking the full $13 billion requested in the president’s budget proposal earlier this year.

Trump’s plan largely mirrors policies first developed during the Obama administration, including proposals for a nationwide database to monitor for patients who seek multiple opioid prescriptions.

Dan and Brianna’s full story here.

NONPROFIT DRUG VENTURE COULD TAKE A THIRD OF THE HOSPITAL MARKET: A fast-rising nonprofit generic drug company could soon count one-third of U.S. hospital operators as its members, our colleague Sarah Karlin-Smith reports.

Dan Liljenquist, vice president at Intermountain Healthcare, one of the lead institutions behind the project, said yesterday that seventy hospital systems have expressed interest in joining the venture since its launch about six weeks ago.

The nonprofit — led by Intermountain with Ascension, SSM Health, Trinity Health and the Department of Veterans Affairs — plans to directly ship to hospitals, bypassing group purchasing organizations and wholesalers. It won’t use a rebate system and will publish product prices. There will be a single market price and justifications for increases driven by higher raw material costs or investments in new manufacturing, similar to how public utilities justify rate adjustments.

It could also get rolling sooner than expected. “We initially thought it would take us five years to get 10 drugs to market, but we’re now thinking it will be a lot faster than that,” Liljenquist said yesterday.

The nonprofit will be incorporated this summer and should begin operating in the fall, focusing on the lowest-hanging fruit: off-patent drugs deemed essential medicines by groups like the World Health Organization that are in short supply.

Liljenquist has been pitching the idea in Washington, meeting with the full bipartisan staff of the Senate HELP Committee last week, as well as with Hatch, Sens. Mike Lee (R-Utah) and John Thune (R-S.D.) and House Majority Leader Kevin McCarthy‘s offices last week. “We said we don’t need anything from you. We just want to make sure FDA rules are applied to use as fairly as anyone else,” Liljenquist said.

Sarah’s full story, for Pros, here.

HEALTH IT PERSONNEL MOVES:

— Chris Liddell tapped as deputy chief of staff for policy coordination: The White House said Monday that Chris Liddell, previously chief financial officer at Microsoft Corp. and General Motors Co., has been asked to serve as deputy chief of staff for policy coordination, POLITICO’s Andrew Restuccia and Eliana Johnson report.

Lidell joined the administration to work in Jared Kushner’s Office of American Innovation, which has convened working groups related to EHR interoperability this year.

— ONC’s Jon White on loan to CMS: ONC deputy national coordinator for health IT Jon White will be on detail to CMS to help with Kushner and Verma’s wide-ranging health IT initiative, according to that agency.

At Verma’s request, White will be on an 80 percent delegation for the next three months, ONC head Don Rucker wrote in an internal memo, citing White’s “significant experience in translating policy into practice.”

White was acting National Coordinator from January until April 2017, having joined in 2014 as acting director of the Office of Clinical Quality and Safety.

— UPMC’s Rasu Shrestha to lead VA’s API push: The chief innovation officer at the University of Pittsburgh Medical Center will take the helm of the VA’s new effort to promote API use, the VA announcedyesterday.

We covered the VA’s API pledge — an agreement that 11 health care providers signed, asserting their commitment to open data and pledging to avoid information blocking — at HIMSS a couple weeks ago.

The VA has planned a roundtable discussion with providers who have signed the pledge for April.

WHAT WE’RE CLICKING ON

— Some question if NIH’s All of Us biobank is too expensive and too ambitious (a piece that has inspired lively discourse on Twitter)

— VR could boost radiologists’ confidence

— Inside the world of prescription apps