August 13, 2021
Newsletter | Tea Leaves

D.C. News:

  • During a speech yesterday, President Biden called on Congress to act on ‘outrageously’ high drug prices. The president said that Medicare should be able to negotiate lower prescription prices, and those prices should apply to people with private insurance through their jobs as well. He also appeared to back a feature of House Democrats’ legislation that would impose a steep tax of up to 95 percent if drug companies refused to come to the table and negotiate. (Articles here, here, here, and here)
  • HHS announced it will require more than 25,000 of its clinical and research staff to be vaccinated against COVID-19. The requirement will be in place for all staff at the Indian Health Service and the National Institutes of Health who serve in federally operated health care and clinical research facilities and interact with patients, or even have the potential to come into contact with them, as well as members of the U.S. Public Health Service Commissioned Corps so they are prepared for potential deployment as emergency responders. (Press release here; Articles here, here, here, here, here, and here)
  • The Supreme Court refused to block Indiana University’s requirement that students receive a COVID-19 vaccine to attend classes in the fall semester. Eight Indiana students asked the court for an emergency order, arguing that the risks associated with the vaccine outweighed the potential benefits to the population in their age group. Similar lawsuits brought by students are pending in federal courts. According to a The Chronicle of Higher Education, more than 670 of the nation’s colleges and universities now require students to be vaccinated. (Articles here, here, and here)

Inequities and SDOH:

  • The American Medical Association (AMA) announced the formation of a new advisory group focused on improving equitable innovation in health care and among marginalized communities. The Equity and Innovation Advisory Group will guide the AMA’s vision for a health care innovation sector that embodies two main ideas: prioritization of resources and allocation for meaningful solutions that advance health, racial and social justice; and ensure that race, ethnicity, sexual orientation and gender identity of innovators and investors are reflective of the U.S. population. (Press release here)

Life Sciences:

  • The FDA amended the emergency use authorizations for both the Pfizer-BioNTech and Moderna COVID-19 vaccines to allow for an additional dose in certain immunocompromised individuals. The agency specified that the additional does is intended for solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise. (Articles here, here, here, here, here, and here)
  • The Pharmaceutical Care Management Association (PCMA) filed a lawsuit that challenges parts of the Trump administration’s insurer price transparency rule. The PCMA is directly challenging a part of the rule that would require its pharmacy benefit manager members to report the historical pricing data on prescription drugs. The group said it was not challenging other transparency tenets in the rule. (Article here)


  • The Department of Labor announced that UnitedHealthcare will pay $15.6 million to settle federal and state investigations into mental health parity. The investigation revealed that UnitedHealthcare would reduce reimbursement rates for out-of-network behavioral health services and would flag members who were undergoing mental health treatment for utilization reviews. The settlement includes $13.6 million in payments to members for wrongfully denied claims as well as just over $2 million in penalties and legal fees. (Press release here; Articles here and here)

Transition to Value:

  • CMS leadership outlined a new vision for value-based care in a Health Affairs article. After conducting an exhaustive review of more than 50 models, the leaders concluded that offering too many models has been an issue and that the Center for Medicare and Medicaid Innovation (CMMI) the must reevaluate how it designs financial incentives. The agency also wants to put health care equity at the centerpiece in every model going forward. (Article here)