Overnight Health Care — Sponsored by PCMA — Health chief grilled on Trump drug pricing plan, ObamaCare case

Overnight Health Care — Sponsored by PCMA — Health chief grilled on Trump drug pricing plan, ObamaCare case
© Camille Fine

Welcome to Overnight Health Care, sponsored by the Pharmaceutical Care Management Association.


Half of D.C. seemed to be in the streets for the Washington Capitals parade and rally today, but we stuck it out on Capitol Hill to bring you today's health news.

Trump's health secretary faced a grilling on the administration's drug pricing plan, opioid bills moved through Congress, and the makers of OxyContin got hit with another lawsuit. But first...


AMA endorses assault weapons ban

The country's largest physician group on Tuesday endorsed a ban on assault weapons as part of a sweeping package of measures aimed at combatting the epidemic of gun violence.

Under pressure from members, delegates from the American Medical Association took a strong stance on gun control measures at the group's annual policy conference.

Also: The group endorsed a ban on bump stocks, which are mechanisms that allow semi-automatic rifles to fire more rapidly. Bump stocks came under scrutiny last year, after a gunman used such a device in the shooting in Las Vegas that left 59 people dead.

Key quote: "The AMA must not back down from addressing gun violence," outgoing president David Barbe said in a speech.

We have more on the decision here.



Sponsored content - Pharmaceutical Care Management Association

Drugmakers set and raise the price of prescription drugs unrelated to the rebates they negotiate with pharmacy benefit managers (PBMs).  The most direct way for drugmakers to reduce costs and improve access is to simply cut their own prices.



Warren hits Azar over missing "massive" drug price drops that Trump promised

Sen. Elizabeth WarrenElizabeth Ann WarrenDemocrats opposed to Pelosi lack challenger to topple her More Massachusetts Voters Prefer Deval Patrick for President than Elizabeth Warren Trump's trade war — firing all cannons or closing the portholes? MORE (D-Mass.) put the heat on Health and Human Services Secretary Alex Azar on Tuesday over the "massive" price cuts that President TrumpDonald John TrumpGrassley: Dems 'withheld information' on new Kavanaugh allegation Health advocates decry funding transfer over migrant children Groups plan mass walkout in support of Kavanaugh accuser MORE said were coming. The two week anniversary of Trump saying cuts are coming in two weeks is tomorrow.

"He said there would be massive decreases in prices within two weeks," Warren said during a Senate Health Committee hearing. "It's been two weeks and there have been no decreases and an indication of increase."

Azar countered at the hearing that there are drug companies working on price decreases.

"There are actually several drug companies that are looking at substantial and material decreases in drug prices," he said.

Azar said the holdup is that negotiators known as pharmacy benefit managers (PBMs) are actually discouraging price decreases because that could reduce the amount of rebates that the PBMs get.

"Oddly, the fear is that they would be discriminated against for decreasing their price," Azar said.

Read more here.


Azar was also pressed about the administration's decision not to defend the ACA in court

Context: The Justice Department wrote in a filing last week that it would not defend ObamaCare's protections for people with preexisting conditions, siding in large part with a challenge to the law brought by a coalition of Republican-led states.

"The position articulated by the attorney general is a constitutional and legal position, not a policy position," Azar said.

Addressing Sen. Maggie HassanMargaret (Maggie) HassanHouse panel advances DHS cyber vulnerabilities bills Chris Pappas wins Democratic House primary in New Hampshire Overnight Health Care: Manchin fires gun at anti-ObamaCare lawsuit in new ad | More Dems come out against Kavanaugh | Michigan seeks Medicaid work requirements MORE (D-N.H.), who asked about the case, Azar said: "We share the view of working to ensure individuals with preexisting conditions can have access to affordable health insurance. The president has always shared that. We look forward to working with Congress under all circumstances toward achieving that."

We have more on his comments here.


Breaking - Senior DOJ official resigns.

A senior career Department of Justice (DOJ) official has resigned after the Trump administration announced last week it would argue key parts of ObamaCare are unconstitutional, according to The Washington Post.

Last week, the DOJ wrote in a filing that it wouldn't defend ObamaCare's protections for people with pre-existing conditions. The move broke with historical practice, where the DOJ defends federal laws, and sided in part with a challenge to the law brought by a coalition of Republican-led states.

A DOJ official confirmed that Joel McElvain resigned and his last day is July 6, but declined to comment on if the resignation was due to last week's announcement.

More here.



Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellGrassley: Dems 'withheld information' on new Kavanaugh allegation Kavanaugh accuser set to testify Thursday McConnell told Trump criticism of Kavanaugh accuser isn't helpful: report MORE tried to deflect attacks from Democrats, who want to tie the administration's decision to Republicans ahead of the November midterms.

"Everybody I know in the Senate -- everybody -- is in favor of maintaining coverage for preexisting conditions. There is no difference in opinion about that whatsoever," McConnell said Tuesday at his weekly press conference with reporters.

Dems though believe the issue can pay political dividends.

Despite a flurry of North Korea news on Tuesday, Senate Minority Leader Charles SchumerCharles (Chuck) Ellis SchumerTrump, GOP regain edge in Kavanaugh battle READ: President Trump’s exclusive interview with Hill.TV The Hill's 12:30 Report — Trump slams Sessions in exclusive Hill.TV interview | Kavanaugh accuser wants FBI investigation MORE (D-N.Y.) started his weekly news conference with reporters by talking about health care, saying his caucus would not be "diverted."


Opioid update:

  • The Senate Finance Committee unanimously passed its Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018.

The bill aims to ensure Medicare and Medicaid beneficiaries receive better education, prevention and treatment about pain and addiction; let Medicare beneficiaries know about non-opioid treatments for pain; expand and clarify how Medicaid can treat those with an addiction.

  • The House began voting today on a slate of bills to address the opioid epidemic, votes which will continue for the rest of the week and into next. Examples of bills passed today: Student loan repayment of up to $250,000 for those who work as a substance use disorder treatment professional in areas in need and another to establish a database of the nation's efforts to combat the opioid epidemic.


The National Institutes of Health has a blueprint for how it will spend the $500 million Congress gave it specifically for combating the opioid epidemic.

NIH leaders outlines their plan Tuesday in an opinion piece in the American Medical Association's JAMA.

They'll focus on two main items: improving treatments for opioid misuse and addiction and bolstering strategies to manage pain.

Experts have said treatment and the development of non-addictive ways to manage pain are critical components of a comprehensive response to combat the opioid epidemic, which is contributing to thousands of deaths each year.

Read more here.


Deaths related to pregnancy are on the rise -- and Rep. Jaime Herrera BeutlerJaime Lynn Herrera BeutlerWashington’s Dem governor invites Trump to come campaign for GOP candidates Dems see wider path to House after tight Ohio race Record numbers of women nominated for governor, Congress MORE (R-Wash.) wants to address the fact that these rates are higher than other developed countries.

Herrera Beutler says she has a commitment from leadership that her bill aimed at addressing the rise in maternal death rates will get a vote on the House floor before August.

"I'm in the trust but verify camp, so if you're helping us advocate for this, don't let up," Herrera Beutler said Tuesday at an event hosted by The Hill and sponsored by AMAG Pharmaceuticals.

What the legislation will do: Track and investigate pregnancy-related deaths in every state in an effort to understand why women are dying. More specifically, the bill would help states establish or support Maternal Mortality Review Committees to examine these deaths and find ways to prevent them.

Status: The House bill has 137 cosponsors (105 Democrats and 32 Republicans.) There's a companion bill in the Senate, which Senate Health Committee ranking member, Sen. Patty MurrayPatricia (Patty) Lynn MurraySenate Dem: Republicans have 'predetermined' outcome of Kavanaugh hearing Sunday shows preview: Trump sells U.N. reorganizing and Kavanaugh allegations dominate Overnight Health Care: HHS diverts funds to pay for detaining migrant children | Health officials defend transfers | Lawmakers consider easing drug company costs in opioids deal MORE (D-Wash.), has said the panel will vote on.

Read more here.


Massachusetts became the first state to personally name Purdue's executives in an opioid lawsuit. 

Massachusetts Attorney General Maura Healey (D) announced a lawsuit against Purdue Pharma as well as 16 current and former directors and executives, including CEO Craig Landau and members of the Sackler family, which owns the company.

The lawsuit claims that Purdue, under the leadership and direction of the directors and CEOs, deceived prescribers and patients to get more people to use Purdue's opioid products, at higher doses and for longer periods.

We've got more on the lawsuit here.



Sponsored content - Pharmaceutical Care Management Association

Pharmacy benefit managers (PBMs) have outlined several policy solutions to ensure patients receive opioid prescriptions when safe and medically appropriate. One important solution would be requiring e-prescribing of controlled substances in Medicare (S. 2460 / H.R. 3528, the Every Prescription Conveyed Securely Act). A study by the Opioid Safety Alliance finds this could save taxpayers $13 billion over 10 years.



CDC chief on Ebola. 

Centers for Disease Control and Prevention Director Robert Redfield spoke about vaccines, public service and Ebola at an event hosted by PATH, an international health organization, on Monday, reports The Hill's Caroline Gardner.

On Ebola, Redfield praised public health officials in the Democratic Republic of Congo, who he said quickly identified both the disease and the specific strain of Ebola as it resurfaced in April. "We saw what happened and a lot of people were nervous when this outbreak started, that maybe we were going to go down the same path," he said.

But because the CDC and the Democratic Republic of the Congo "built a partnership over the years," Redfield said the outcome was different than the last outbreak.

"16 years of investment" helped keep the recent outbreak from spreading quickly, Redfield said. "We need to replicate that investment in future countries around the world."


What we're reading

The new ObamaCare lawsuit could undo far more than protections for pre-existing conditions (The New York Times)

Anti-vaccine hotspots thrive in states that make it easy to opt out (NBC News)

Sally YatesSally Caroline Yates NY Times, McCabe give Trump perfect cover to fire Rosenstein, Sessions Time for sunshine on Trump-Russia investigation New Yorker disinvites Bannon from festival following backlash MORE: When darkness falls -- my dad's battle with depression (CNN)


State by state

New Mexico health exchange attracts additional competitor (US News)

State, nursing homes reach potential settlement in Medicaid lawsuit (The Providence Journal)

New Hampshire's treatment providers say Medicaid reimbursement rate must be increased (wmur.com)


From The Hill's opinion pages

Congress needs to do something about improper Medicare billing practices

Let's not rely on vaccines, here's how we can prepare for epidemics now