Health Brief: Eric Hargan Named as Acting HHS Secretary

Government Brief

  • President Donald Trump formally designated Eric Hargan to serve as acting secretary of the Department of Health and Human Services, taking over for Don Wright, who has held the job since the departure of former HHS Secretary Tom Price late last month. Hargan, a former corporate lawyer who served on Trump’s transition team, was confirmed by the Senate last week as deputy HHS secretary. (Bloomberg)
  • Food and Drug Administration Commissioner Scott Gottlieb, considered a top contender to succeed Price, said he believed he is most effective in the Trump administration in his current role, which he noted has been a difficult post to fill for previous administrations. Gottlieb declined to say whether the White House has approached him for the top job at HHS. (Reuters)
  • House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) said he would delay sending legislation to reauthorize the Children’s Health Insurance Program to the full House in the hopes of reaching a bipartisan agreement with committee Democrats on funding offsets. The committee voted on party lines to advance the legislation last week, with Democrats objecting to GOP-proposed offsets for the five-year CHIP extension. (Washington Examiner)

Business Brief

  • Iowa’s Republican leaders are anxiously waiting for the Trump administration to rule on its waiver request that could pose a critical test for the future of the Affordable Care Act. If approved, the small, conservative state would be allowed to scrap key Obamacare features — including its federally run exchange, subsidy structure and the law’s focus on providing affordable coverage for low-income individuals — and could serve as a model for other states to do the same. (The New York Times)
  • Insurer Molina Healthcare announced that Aetna’s former chief financial officer would become its new president and chief executive officer. Joseph Zubretsky will succeed interim CEO Joseph White, who was elevated to the post after the company ousted former CEO J. Mario Molina and former CFO John Molina in May. (Modern Healthcare)
  • Trade groups representing health insurers, hospitals and generic drugmakers sent a letter calling on congressional leaders to examine Allergan Plc’s patent deal with a Native American tribe. At least nine lawmakers have already denounced the deal, in which Allergan transferred its patents for its blockbuster drug Restasis to the Saint Regis Mohawk Tribe, whose sovereign immunity could protect the drug from patent challenges from generic drugmakers. (CNBC)

Chart Review

Events Calendar (All Times Local)

House Energy and Commerce subcommittee hearing on 340B 10 a.m.
Bipartisan Policy Center event on Medicare and Social Security 10 a.m.
House Energy and Commerce subcommittee hearing on the opioid crisis 10:15 a.m.
National MACRA MIPS/APM Summit 1 p.m.
National MACRA MIPS/APM summit 7 a.m.
U.S. Chamber of Commerce event on the opioid epidemic 8:30 a.m.
National MACRA MIPS/APM summit 7:30 a.m.

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Trump Names Hargan as Acting Health and Human Services Secretary
Michael B Marois, Bloomberg

President Donald Trump has formally designated Eric Hargan as acting secretary of the U.S. Department of Health and Human Services, taking over for a deputy who’s held the job since Tom Price resigned from the post late last month over his use of taxpayer dollars to travel in private jets. Hargan, a former corporate lawyer who served on Trump’s transition team, takes over for Don Wright, the deputy Health and Human Services secretary, who had been acting secretary since Price was forced to step down after just seven months on the job.

Food and drug chief Gottlieb skirts health secretary talk, says most effective at FDA
Toni Clarke, Reuters

U.S. Food and Drug Administration Commissioner Scott Gottlieb, considered a potential successor to recently departed Health and Human Services Secretary Tom Price, said on Tuesday he believed he could best serve the Trump administration in his current role. “I feel like I want to continue to follow through on the policies we’ve put out and it’s where I think I can be most effective,” Gottlieb told Reuters in an interview in New York.

Health insurers, hospitals and generic-drug makers ask Congress to examine Allergan patent deal
Meg Tirrell, CNBC

A coalition of 10 groups spanning hospitals, health insurers and generic-drug makers sent a letter to Congressional leaders Tuesday asking it to examine Allergan’s controversial patent deal with a Native American tribe, adding voices to a growing chorus denouncing the arrangement. “This issue deserves the prompt attention of Congress, and we encourage you to vigorously apply your oversight authority,” wrote the group, which included America’s Health Insurance Plans, American Hospital Association and the Association for Accessible Medicines.

FDA Commissioner Wants Closer Look at Health Claims on Packaging
Heather Haddon, The Wall Street Journal

Food and Drug Administration Commissioner Scott Gottlieb says he wants to take a close look at health claims that food manufacturers make on their packaging. “I want to see the agency take steps into adjudicating some of these important claims,” Dr. Gottlieb said Tuesday at the WSJ Global Food Forum.

Melania Trump tours West Virginia infant drug rehab center
John Raby, The Associated Press

First lady Melania Trump has toured a West Virginia drug addiction recovery center for infants in the heart of the nation’s opioid epidemic. Mrs. Trump visited Lily’s Place in Huntington on Tuesday.

Stocks Gain, With Japan at Decade High; Euro Rise: Markets Wrap
Robert Brand, Bloomberg

The euro held onto gains spurred by Catalonia’s pullback from an immediate declaration of independence from Spain, while the dollar drifted as investors awaited minutes from the last Federal Reserve meeting. Oil rose above $51 a barrel as OPEC predicted robust demand next year.


House committee delays sending children’s health insurance bill to floor
Robert King, Washington Examiner

A House committee said it will delay sending a bill to reauthorize the Children’s Health Insurance Program to the full House to give bipartisan talks on funding more time. The House Energy and Commerce Committee will delay sending the bill it marked up last week to the House floor, Chairman Greg Walden, R-Ore., said Tuesday.

In New Test for Obamacare, Iowa Seeks to Abandon Marketplace
Abby Goodnough, The New York Times

With efforts to repeal the Affordable Care Act dead in Congress for now, a critical test for the law’s future is playing out in one small, conservative-leaning state. Iowa is anxiously waiting for the Trump administration to rule on a request that is loaded with implications for the law’s survival.

Molina picks former Aetna exec as new CEO
Modern Healthcare

Molina Healthcare announced Tuesday that Joseph Zubretsky, Aetna’s former chief financial officer, will take over as its new president and CEO, effective Nov. 6. Zubretsky will succeed interim CEO Joseph White, who took over after the insurer ousted CEO Dr. J. Mario Molina and Chief Financial Officer John Molina, the sons of the company’s founder, in May.

West Virginia gets approval to expand substance abuse treatment coverage
Nathaniel Weixel, The Hill

The Trump administration has approved a request by West Virginia to expand Medicaid coverage for treatment of substance abuse disorders, state officials announced Tuesday. West Virginia has the highest rate of drug overdose deaths in the country, and officials said the waiver will contribute to a “comprehensive statewide strategy” to combat prescription drug abuse and opioid use disorders.


Delivery system reform hampers ACO progress on risk-based contracts
Maria Castellucci, Modern Healthcare

Accountable-care organizations are participating more and more in risk-based contracts, but that progress has been stalled by sluggish care delivery changes, a new survey suggests. Roughly 50% of ACOs are involved in at least one downside risk contract, such as shared savings and capitation contracts, according to a Leavitt Partners and National Association of ACOs report recently published in Health Affairs.

Doctors may fear losing their license for seeking mental health care
Ronnie Cohen, Reuters

Nearly 40 percent of U.S. physicians are reluctant to seek mental health care out of fear that it might imperil their medical license, a recent study suggests. The reluctance was more pronounced in states where licensing applications questioned doctors about mental health conditions going back more than a year.

Pharma, Biotech and Devices

Battle over drug prices shifts back to the states
Rachel Roubein, The Hill

President Trump has derided pharmaceutical companies as “getting away with murder,” but there’s been little action in Washington to rein in the costs of prescription drugs. Some states are taking matters into their own hands.

Pharma’s Puerto Rico problems could mean drug shortages: FDA chief
Bill Berkrot, Reuters

The head of the U.S. Food and Drug Administration said on Tuesday the country may start to see a small number of drug shortages within two or three weeks due to delays in restoring manufacturing operations in Puerto Rico, where 10 percent of drugs prescribed in the United States are made. Hurricane Maria slammed into the Caribbean island on Sept. 20, knocking out electricity and causing widespread damage to homes and infrastructure.

Health IT

Drones will deliver defibrillators to 911 callers to help treat cardiac arrest
Lora Kolodny, CNBC

A start-up called Flirtey delivers pizzas, Slurpees and other sundries by drone. But now the company is embarking on lifesaving work as a medical courier in the U.S.

Opinions, Editorials and Perspectives

CMS’ 340B Reform Proposal Is a Good – Long Overdue – First Step
Ted Okon, Morning Consult 

The 340B Drug Discount Program is an innocent-sounding program with the best of intentions. But behind it lies a classic tale of government run amok.

Drug cocktail
John Foley and Neil Unmack, Reuters Breakingviews

Painkillers and pile cream: these are either the recipe for a terrible night in, or a potentially good corporate deal. Pfizer, the $215 billion U.S. drugmaker, has tasked investment banks with looking into a spinoff or sale of its consumer-goods division, which makes Advil and Preparation H.

Weakening the Affordable Care Act will boost hospitals’ financial burden
Joel S. Weissman et al., Stat News

While the Trump administration and the Republican-led Congress failed to repeal and replace the Affordable Care Act, a number of ACA-weakening strategies put forward by the administration are already underway. These include inadequate enforcement of the individual mandate, imposition of work requirements on Medicaid recipients, and failure to promote enrollment through advertising and outreach.

How the EMR Is Increasing Innovation and Creativity in Health Care
A. James Bender and Robert S. Mecklenburg, Harvard Business Review

Americans are both undertreated and overtreated in a health care system that wastes up to $1 trillion a year and delivers profoundly uneven quality: Current estimates indicate that preventable medical errors are the third leading cause of death in the United States. Fifty-eight percent of patients referred to Virginia Mason, our medical center in Seattle, for back surgery would be more appropriately treated without an operation.

Research Reports

Much Activity, Uncertainty Remains
Timothy Stoltzfus Jost, Health Affairs

Bipartisan market stabilization negotiations gave way to a last-gasp attempt at repeal and replace; the ACA emerged intact but buffeted by uncertainty.