Broader pandemic aid fight could ensnare long covid funding

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Good morning, y’all. The answer to yesterday’s question: Chocolate and Chip. Those weren’t among the guesses we received, but there’s always next year. 

Today’s edition: Newly revealed federal audits show millions in Medicare Advantage overcharges. Some of the largest drug companies stopped buying ads on Twitter after the Eli Lilly spoof. But first … 

More covid funding isn’t on GOP’s holiday wish list

The federal health department released a report on long covid yesterday that includes a sweeping call to help the millions of Americans suffering from the sometimes debilitating condition. 

To better fulfill that mission, Biden officials have asked Congress for $750 million aimed at accelerating research and treatments for long covid, part of a broader $9.25 billion request for emergency aid to combat the pandemic. 

But securing more money is an uphill battle on Capitol Hill. Aides on both sides of the aisle, who spoke on the condition of anonymity to be candid, suggested it was unlikely that Congress would approve the administration’s pandemic request during December’s lame-duck session.

A senior Democratic aide said that “Republicans have been very resistant to any new covid funding.” On the GOP side, a Senate health committee aide said the administration hasn’t made a convincing argument on why the new emergency spending is needed. The office of House Minority Leader Kevin McCarthy (R-Calif.) pointed to comments he made to Punchbowl News last month where he said he would oppose any requests for new covid funding. 

It’s the latest salvo in the months-long battle between the Biden administration and congressional Republicans for more pandemic aid. Several outside experts contend more federal funding is needed to speed up the country’s understanding of long covid, since researchers don’t yet understand the mechanism causing the condition.

Some public health officials view long covid as a growing crisis. The number of Americans with the condition — which can consist of chest pain, brain fog, lingering fatigue and tremors — is expected to rise as the virus becomes entrenched in the country. In October, roughly 7 percent of U.S. adults said they were currently experiencing long covid, according to a Centers for Disease Control and Prevention survey. 

The Department of Health and Human Services says its funding request is aimed at efforts like helping vulnerable patients get the care they need by investing in places like health centers, primary-care providers and other community-based organizations. The dollars would also be aimed at continuing to invest in a National Institutes of Health initiative to understand long covid and other efforts, like researching how to best provide care to smaller communities, an HHS spokesperson wrote in an email. 

Republicans have repeatedly called on the Biden administration to explain how it has spent dollars Congress allocated to fight the pandemic. Yet, some advocates on and off the Hill say they’ll be pushing hard for more cash to address long covid despite the dim prospects for covid aid on Capitol Hill. 

  • “I’ve got it on my short to-do list between now and the end of the year, to make sure that the long covid number is as robust as it can be,” Sen. Tim Kaine said in an interview. The Virginia Democrat has been open about his experience with long covid, which has come in the form of a constant nerve tingling that leaves every nerve ending in his body feeling like it’s had “five cups of coffee” since he contracted covid-19 in the spring of 2020.

Researchers don’t know the answer to some major questions, such as why certain people are affected and whether there’s a way to reduce the risk of persistent health problems. 

“Progress has been frustratingly slow,” said Harlan Krumholz, a professor at the Yale School of Medicine. 

In December 2020, Congress approved roughly $1.15 billion for NIH to launch a four-year project to study long covid. The effort is aimed at creating large studies across the country and enrolling thousands of patients — and is likely to take time.

Meanwhile, the Biden administration announced its long covid strategy last spring, directing HHS to coordinate a government-wide action plan to address the condition. Some advocates say they want to see Congress pass the administration’s requested $750 million, but cautioned it’s critical to ensure the funding is spent wisely.

“I think we need that money to actualize President Biden’s plan that was laid out last April because otherwise we’re just in a holding pattern — but yet it’s important that it be used carefully,” said Diana Güthe, founder of Survivor Corps, a patient advocacy group that has been collaborating with researchers.

Audits reveal millions of dollars in Medicare Advantage payment errors

A newly released analysis of federal audits by Kaiser Health News reveals the government has shelled out millions of dollars in overcharges and other errors in payment to Medicare Advantage health plans, an increasingly popular alternative to traditional Medicare for seniors that is primarily run by private insurance companies.

The details: KHN obtained summaries of 90 audits examining billings from 2011 through 2013 through a three-year Freedom of Information Act lawsuit settled in late September. Those audits are the only ones CMS has completed in the past decade. 

  • The audits uncovered about $12 million in net overpayments for the 18,090 patients sampled. There were net overpayments in 71 of the 90 audits.
  • In 23 of those audits, plans overbilled the government more than $1,000 per patient a year on average.

CMS officials have said for over a decade that the agency intends to use the samples to extrapolate overpayment rates across each plan’s entire roster, an effort that could recoup an estimated $650 million in taxpayer dollars. But that has yet to happen and likely won’t until at least early next year. 

Mary Beth Donahue, president of the Better Medicare Alliance, a group that advocates for Medicare Advantage, contended that the data is more than a decade old and said that more recent research shows that plans are more responsible with Medicare dollars. 

But KHN’s Fred Schulte and Holly Hacker point out that the results mirror more recent findings that allege continued payment errors in Medicare Advantage plans that have cost the government billions of dollars.

Ted Doolittle, former deputy director of CMS’s Center for Program Integrity:

Big Pharma cuts Twitter ad spending

Almost all of the drug industry’s top advertisers have dramatically cut their spending on Twitter over the last two weeks over fears of brand impersonation and the stability of the social media company following its takeover by new owner Elon Musk, Endpoints News reports.

The sudden change comes after a fake corporate account claimed the pharmaceutical giant Eli Lilly would give insulin away for free, sparking panic at the drugmaker’s headquarters and a firestorm online.

Here’s the rundown for the 18 biggest drug advertisers in the U.S. market, reports Beth Snyder Bulik.

  • Twelve drugmakers eliminated their Twitter ad spending for the week beginning Nov. 14, including Merck, Pfizer and Eli Lilly.
  • Six other companies showed some spending on Twitter ads last week, but for most, it’s just a few hundred or a few thousand dollars.
  • The sole outlier was Bayer, which increased its spending to $480,000 last week, according to Pathmatics, which tracks data on prescription drug and corporate ad spending. However, the data for Bayer also captures over-the-counter drug ad spending, which could skew the results.

House Democrats urge DOJ to boost efforts to counter threats to children’s hospitals

Roughly three dozen House Democrats are pressing the Justice Department to step up efforts to address threats against several children’s hospitals that provide treatment for youth seeking gender transition.

In a letter to Attorney General Merrick Garland, the lawmakers asked the agency to outline the steps it’s taking to counter both in-person and online anti-transgender threats of violence and to provide further guidance to health care providers on how to protect their staff and patients from such threats.

The letter was led by Del. Eleanor Holmes Norton (D-D.C.) and Democratic Reps. Ayanna Pressley (Mass.) and Dwight Evans (Pa.).

Key context: Multiple pediatric hospitals that treat transgender youth have reported threats, such as Boston Children’s Hospital, which last week received its third bomb threat of the year. Several major medical associations, including the American Academy of Pediatrics and the American Medical Association, have sent joint letters urging the DOJ to investigate the entities coordinating such threats. At the same time, the number of children seeking gender transition treatments has skyrocketed, raising concerns among parents and some clinicians given a lack of research into how such treatments can affect children long term.

  • Nonprofit aid groups are working to stock vending machines with the overdose reversal drug Narcan with the hopes of increasing public access to the medication and stemming the nation’s drug-related deaths, the Wall Street Journal reports.
  • Georgia may soon become the only state in the nation to implement a work requirement for Medicaid coverage, after Republican Gov. Brian Kemp won his reelection bid and the Biden administration decided against appealing a federal court ruling to challenge the plan, Kaiser Health News reports.
  • Oregon Gov. Kate Brown (D) announced yesterday that the state will grant pardons for prior offenses of simple possession of marijuana, weeks after Biden urged governors nationwide to use their authority to do so, The Post reports.

How infectious disease experts are responding to Covid nearly three years in (By Helen Branswell | Stat)

The Monkeypox Cases That Might Have Been Missed (By Apoorva Mandavilli | The New York Times)

American evangelicals open a new antiabortion front — in Israel (By Shira Rubin | The Washington Post)

Thanks for reading! See y’all tomorrow.

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