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Health funding battles & two CBD developments



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Everything you need to know about health care in this week’s government funding bill

Republicans prevailed in the fight over user fee legislation to fund the FDA, my colleague Rachel Cohrs reported last night. It’ll be a clean one after all.

But lawmakers teed up another FDA policy fight in December, as a number of FDA programs were only extended through then, alongside the short-term government funding bill. Get the list of what’s going to be on the table later this year in Rachel’s story.

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Another quick update: Rural hospitals can breathe a sigh of relief, as two soon-to-expire programs worth about $600 million will also get extended through December, according to three hospital lobbyists and two congressional aides.

Hospitals had pushed for the two programs, called the Medicare-Dependent and Low Volume Hospital programs, to be extended for a number of years or even made permanent, but the short-term extension at least ensures they won’t expire.

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Between fights over physician pay, FDA policy, rural hospital programs, mental health, and pandemic preparedness… buckle up for December.

Biden tees up nutrition policy overhaul

President Biden on Wednesday will call on Congress and health agencies to expand school and family food programs, start a Medicare pilot for medically-tailored meals and target food habits contributing to diseases like cancer and diabetes.

The question is, how. Officials are touting Wednesday’s White House meeting on hunger and nutrition as the first major summit on the subject since a similar event helmed by President Richard Nixon more than 50 years ago. Calls for secure school lunches and a broader definition of food insecurity come amid a divided Congress that recently let school lunch programs lapse.

The proposal to expand free school meals to 9 million more kinds, for instance, could take years to finance with Congress, said a senior official who painted it as a 10-year strategy in a call with reporters. “This really is a longer-term vision.”

Similarly, officials pointed to congressional legislation to spur the proposal to introduce a Medicare pilot on medical food plans.

There are also signals that the president will use his remarks to press once again for a longtime personal priority, the cancer moonshot. The conference will bring leaders together to “achieve the goal of ending hunger and reducing diet-related diseases in the United States by 2030,” the administration said in a statement echoing the moonshot 2.0 goals of halving cancer deaths and vastly curbing new cases in the coming 25 years.

The fight over federal regulation of CBD just got more interesting

Nick Florko here with two new interesting developments on the FDA’s sloooooow efforts to regulate CBD foods and dietary supplements.

First, the FDA has hired a bonafide cannabis expert, Norman Birenbaum, to focus on “advancing [FDA’s] efforts related to research and regulation of cannabis,” according to an agency announcement shared with the media. Birenbaum previously led cannabis policy for both New York state and Rhode Island – in fact he’s apparently such a cannabis nerd he even founded the Cannabis Regulators Association, according to the FDA note.

Second, Paige Figi, who gained national fame in 2013 after treating her young daughter’s seizure disorder with CBD, is restarting the Coalition for Access Now, per a new registration.

Figi founded the coalition in 2015 to advocate for allowing children living in states other than Colorado to access CBD for serious illnesses. CBD is now available nationwide largely thanks to the group’s advocacy: A version of its signature bill was included in the 2018 Farm Bill that made it legal to grow cannabis, so long as the crops were not high in THC, the compound in marijuana that makes you high.

Now Figi’s coalition is reorganizing to support a bipartisan bill that would legalize CBD supplements. Figi’s involvement is catching our eye not just because of her national notoriety in the cannabis world – her daughter was even featured on the cover of High Times – but because of her unique perspective on the FDA’s often confusing CBD rules: Figi treated her daughter in 2013 with a CBD supplement, but the FDA’s 2018 decision to approve a CBD-based pharmaceutical drug to treat the exact condition Figi’s daughter suffered from – ironically enough – made it illegal to sell CBD as a dietary supplement. The bill Figi is now supporting would essentially override that rule.

Mental health reforms inch forwards

Four senators last week issued the latest discussion draft in a series to shape legislation aimed at expanding mental health care, this one centered on growing the behavioral health workforce. Earlier drafts from the three Democrats and a Republican focused on telehealth and youth mental health access, while Oregon Democrat Ron Wyden suggested in a statement that cost parity could be the next target.

The latest proposed language includes plans to add 400 Medicare-funded psychiatry positions to teaching hospitals, update Medicare payment policies to boost coverage and create a Mediaid demo program to expand access for underserved communities.

Those goals parallel Biden administration efforts to ramp up mental health care through a recent batch of grants and the newly-launched 988 behavioral health hotline, though they are first to say more funding is needed. This month, HHS Secretary Xavier Becerra gathered a half-dozen officials in front of the health agency’s headquarter to tout early successes with the two-month-old 988 and a swathe of grants.

While there’s been an expected spike in calls with the new hotline — a 45 percent jump on the same period last year — Becerra and SAMHSA head Miriam Delphine-Rittmon told me there’s also been an explosion in texts to the hotline, attributing it to teens’ comfort with the medium.

That said, it’s too early to analyze the substance and trends of these calls, which can range from mental health crises to substance misuse issues, Delphine-Rittmon told STAT after the event.

What we’re reading

  • Experts are rallying against insurance industry claims that Medicare Advantage saves taxpayers money, STAT
  • Many of the country’s nonprofit hospitals aren’t acting like it, operating instead like for-profit companies with revenue targets and staff squeezes, The New York Times
  • An innocuous virus, practically as common as weeds, is the focal point of some researchers’ efforts to fight and cure diseases, STAT
  • What’s your doctor writing in your medical records? It could include social status, character descriptions and other embedded biases that impact future care, Kaiser Health News





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