Hospitals, insurers resist Trump’s executive order

With help from Rachel Roubein, Adam Cancryn and Dan Goldberg

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Quick Fix

— Hospitals and insurers pushed back on President Donald Trump’s executive order on price transparency, arguing that disclosing negotiated rates would hurt competition and even increase prices.

— A bipartisan group of House lawmakers want FDA to explain several opioid decisions, including a long-ago move to expand access to Oxycontin.

— Provider groups announced a new coalition to prevent surprise medical bills, the latest effort to shape debate around the issue.

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Driving the Day

HOSPITALS, INSURERS PUSH BACK ON DISCLOSING NEGOTIATED RATES — Both industries weren’t shy about criticizing Trump’s executive order on health cost transparency over a particular measure.

— What Trump wants to do: The order calls for HHS to issue a rule requiring hospitals to make public information based on negotiated rates. Exactly what level of detail this will entail will be hammered out in the rule-making process, senior administration officials said on a call with reporters.

— Why hospitals and insurers aren’t happy: The American Hospital Association and America’s Health Insurance Plans said opening the books on these secretive prices could reduce competition and actually increase prices, because providers will demand the highest payments any rival receives. “If implementing regulations take the wrong course ... it may undercut the way insurers pay for hospital services resulting in higher spending,” the Federation of American Hospitals warned.

— Senior administration officials argue that patients have the right to know pricing information before they receive medical care.

FIRST IN POLITICO: HOUSE E&C WANTS FDA TO EXPLAIN OPIOID MOVES — The bipartisan leaders of the Energy and Commerce Committee and its Health and Oversight subcommittees are asking for briefings on FDA decisions surrounding Insys Therapeutics’ fentanyl products and Purdue Pharma’s Oxycontin.

“Last year, the Committee initiated investigations of both Insys and Purdue Pharma,” the House members wrote to acting FDA commissioner Ned Sharpless today. “Information from FDA could be pertinent to these oversight interests as well as to continuing interest in FDA’s efforts to combat the opioid epidemic.”

— What they’re seeking to learn: Why the FDA decided in 2001 to allow Oxycontin to cover chronic, long-term pain

They’re also curious how the FDA is safeguarding against use of fentanyl produced by Insys and other pharma firms. Insys recently agreed to pay $225 million in a settlement of allegations the company falsely marketed and bribed doctors to prescribe Subsys, a highly addictive fentanyl nasal spray for patients with cancer.

PROVIDER GROUPS FORM COALITION ON PREVENTING SURPRISE MEDICAL BILLS — There’s another new coalition to end unexpected medical bills, which has dubbed itself “Out of the Middle,” POLITICO’s Rachel Roubein reports.

The specialist physician groups behind the coalition say they’re banding together to fight for an independent mediator to resolve payment disputes between providers and plans. On Monday they began a social media and digital ad campaign targeting the home districts of key House lawmakers.

— A top priority: a bipartisan proposal from Reps. Raul Ruiz (D-Calif) and Phil Roe (R-Tenn.), modeled after New York’s “baseball-style” arbitration law, a coalition spokesperson tells Rachel. The congressmen, both physicians, introduced a bill outline last month.

— The coalition includes the American College of Emergency Physicians, American Society of Anesthesiologists, College of American Pathologists, American Academy of Ophthalmology, American Association of Orthopaedic Surgeons, the American Association of Neurological Surgeons and Congress of Neurological Surgeons.

— PULSE take: It’s the latest indicator that surprise bills have moved to the health policy forefront. Multiple coalitions and ad campaigns have launched in recent weeks — all trying to shape legislation that looks likelier by the day. But the White House has made it clear it doesn’t like an arbitration approach.

In Congress

Today in the House: Closed-door session on drug pricing. Democratic Caucus Chair Hakeem Jeffries (D-N.Y.) is convening a conversation with the American Medical Association’s Gerry Harmon, the American Hospital Association’s Lynn Eschenbacher, SEIU’s Ilene Stein and Katie Mahoney of the U.S. Chamber of Commerce.

“The focus is on gaining more insight on various stakeholders’ perspectives and exposing newer members to groups who can provide key insight,” said a spokesperson for Jeffries.

Democrats propose funding bump for public health fund. Rep. Doris Matsui (D-Calif.) and Sen. Richard Blumenthal (D-Conn.) are introducing a bill to fully fund the Prevention and Public Health Fund designed to support public health initiatives, including vaccination programs, POLITICO’s Adam Cancryn reports.

Matsui and Blumenthal want to earmark $2 billion a year for the fund — restoring it to the level originally envisioned when it was established as part of Obamacare. The fund currently sits at about $800 million, after Congress in previous years siphoned money from it to help pay for the 21st Century Cures Act and cover short-term costs for the Children’s Health Insurance Program.

House Ed and Labor to look at religious freedom, health care intersection. This morning’s hearing will feature testimony from Rep. Joe Kennedy (D-Mass.), Rachel Laser of Americans United for Separation of Church and State, Matt Sharp of Alliance Defending Freedom and other witnesses.

One expected focus of the hearing: The Trump administration’s moves to empower religious workers to deny care if it conflicts with their beliefs.

Around the Nation

New York City: Health department official warns of medical exemptions for vaccines. The city plans to pay close attention to parents looking to secure medical exemptions for child vaccinations after the state banned religious exemptions this month, said Demetre Daskalakis, deputy health commissioner for disease control.

New York’s recent ban on non-medical exemptions for vaccines comes amid the state’s worst measles outbreak in about 30 years and mimics a 2015 California law that lead to an increase in vaccination rates, POLITICO’s Amanda Eisenberg reports.

Names in the News

HERMINIA PALACIO tapped to lead the Guttmacher Institute. Palacio, New York City’s deputy mayor for health and human services, will be Guttmacher’s next president and CEO, POLITICO’s Dan Goldberg reports.

Palacio will become the sixth president in the 50-year history of the organization, which supports reproductive choice. She’s slated to take the helm later this summer, amid Republican efforts to limit abortion rights.

Coalition Against Socialized Medicine triples its membership. The conservative alliance that’s fighting Medicare for All and other coverage expansion proposals announced today that it’s gained 16 more members, including the Center for Innovation and Free Enterprise and the Center for a Free Economy.

What We're Reading

By Rachel Roubein

HHS is taking custody of hundreds of migrant children who were staying at a border patrol station before an outcry over its poor living conditions, the NYT’s Caitlin Dickerson reports.

Nearly 75 medical and public health groups, including the American Medical Association and the American Heart Association, are warning that climate change is a “health emergency,” the AP’s Elana Schor writes.

Writing in the WSJ, former FDA Commissioner Scott Gottlieb lays out the challenges facing the agency on vaping.

Many of the world’s largest pharmaceutical companies are now helping give their drugs to poorer countries – but more could still be done, the NYT’s Donald G. McNeil Jr. reports.

Oklahoma officials have agreed that the $85 million in settlement money the state will receive from Teva Pharmaceuticals will be spent solely on efforts to curb the opioid crisis, WaPo’s Lenny Bernstein reports.

WaPo’s Laura Reiley explores the CBD-infused waters and teas now hitting store shelves.