Capsule: Religious Exemptions, Opioid Influence & Lost Profits

Welcome to Capsule—your weekly dose of health-care news, where we give you a recap of this week’s highs and lows for key players in the industry. You can expect us every Friday morning as a bookend for your week.

We’re happy to be a distraction for those of you nursing a hangover or post grill-out heartburn thanks to Fourth of July celebrations. Despite the holiday, it’s been a busy week in the courts. The court holding oral arguments July 9 over Obamacare announced this week which jurists will make up the three-judge panel.

That court, the Fifth Circuit, also decided not to delay the proceedings—a relief for our reporter Lydia Wheeler, who had already booked a flight to New Orleans to sit in on the arguments. Keep an eye on Wheeler’s twitter page next week for on-the-ground updates.

Here’s what ended the week on a high note:

Lyft

• Lyft and other ride-sharing companies could ferry Medicaid patients to doctors’ appointments in several states while the federal government postpones a plan to drop transportation requirements for the needy, Sam McQuillan reports. The company won approval from Arizona recently to become the first ride-sharing company that would give Medicaid patients a lift to their appointments.
• The trips cost Medicaid $1.5 billion in 2013, according to White House budget documents—one reason the Centers for Medicare & Medicaid Services plans to let states opt out of transportation requirements. But if every state’s Medicaid program worked with ride-sharing companies, the country could save $537 million a year, according to a study from the American Journal of Public Health.
• More states could soon follow. Lyft told McQuillan it is “currently enrolling and exploring opportunities in other states, including Texas and Florida.”

Truvada

• Makers of HIV prevention medication will no longer need to include some materials that warn users and health-care professionals about the drug’s risks, Madison Alder writes.
• Prescribers and users of Truvada, the only HIV prevention medication on the market, are now more familiar with its risks, so the FDA eliminated the requirement that the educational materials be included with the product. The warning, known as a risk evaluation and mitigation strategy, was also designed to educate users about other prevention methods they should follow.
• Meanwhile, three communities hard-hit by the HIV epidemic will receive $1.5 million each in federal funding to help reduce new infections and jump start the president’s plan to end the spread of the disease in the next decade, Alder reports.

Revolving-Door Opponents

• Sen. Elizabeth Warren (D-Mass.), a leading candidate for the Democratic presidential nomination, called on former Trump administration Food and Drug Administration Commissioner Scott Gottlieb to quit the board of drug giant Pfizer Inc, Anna Edney writes.
• Gottlieb left his post at the FDA on April 5 and less than three months later joined Pfizer’s board of directors. Pfizer is one of the world’s biggest drugmakers and was criticized sharply last year by President Donald Trump for price increases on many of its drugs.
• It’s standard for former FDA commissioners to partner up with pharmaceutical companies after their tenure at the agency is over. But opponents of that “revolving door” system are happy Warren is taking a stand against the practice, which some think creates conflicts of interest.

It was a bleak week for others. Here’s whose Thursday closed on a downswing:

Religious Exemptions

• Pennsylvania and New Jersey want a court to vacate the Trump administration rules that allow employers with religious or moral objections to opt out of providing employee health insurance that pays for contraceptives, Mary Anne Pazanowski reports. Separately, Oregon employers learned they can’t take advantage of federal rules that would allow them to opt out of covering birth control.

• Meanwhile, the Department of Health and Human Services told a federal court its rule allowing some health-care workers to deny treatment based on their religious beliefs won’t take effect until after lawsuits challenging it are resolved, Madison Alder writes.

• For those of you watching abortion access cases: States and providers are pushing a federal appeals court to affirm orders that allow family planning care providers to continue counseling clients about abortion, Pazanowski writes. The Trump administration is gaining steam on its rule to prevent health-care discussions about abortion, though. This week the HHS won the right to enforce it in Maryland.

Opioid Makers

• Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and ranking member Ron Wyden (D-Ore.) wrote to several pain advocacy groups and medical associations questioning their ties to opioid manufacturers, Colleen Murphy reports. They’re looking for potential conflicts of interest and whether drugmakers are influencing policy decisions.
• And in Minnesota, a law that took effect July 1 imposes annual fees of $55,000 on opioid manufacturers as a means of funding efforts to combat the addiction crisis, Valerie Bauman writes. The business license fees are expected to generate $20 million a year.
• The Drug Enforcement Administration is also trying to push through legislation that would permanently codify all new fentanyl-like substances as “schedule 1,” allowing the agency to stay on top of illicit sources of the highly addictive drugs.
• It’s not all bad for opioids, though. New research shows hydrocodone/acetaminophen—also known as Vicodin, Lorcet, or Lortab—is the most prescribed pain medication in the country, and it was the most popular drug in 11 states from January to March this year.

Home Infusion Companies

• Companies that provide treatment for Medicare patients who receive intravenous drugs at home say Medicare’s new reimbursement policy has created a revenue shortfall that’s causing some suppliers to turn away patients who need it, Tony Pugh reports.
• Payments from the government to the home infusion companies typically total about $262 million a year, according to the National Home Infusion Association. But under a Medicare reimbursement policy that took effect this year, payments to home infusion providers are expected to fall 77% in 2019 to about $60 million.
• The association sued the Centers for Medicare and Medicaid Services to invalidate the new payment policy and to reimburse home infusion suppliers for “any amounts improperly withheld as a result” of the policy change.

Thanks for joining us this week and have a great weekend. I’m all ears when it comes to your 2 cents, tips, critiques, or coordinating exclusive interviews. Send them my way at jlee1@bloomberglaw.com.