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How healthcare could quack in the lame duck. Congress returns today after their pre-election hiatus and will attempt to run out the clock on the rest of 2018. However, there is still potential for some major healthcare news in the next couple of weeks. For one thing, Congress and the White House have to make a new deal by Dec. 7 to fund the government. There is potential for some healthcare items to be added into this package. The most controversial would be an attempt by the pharmaceutical industry to roll back a requirement starting in 2019 that forces drug companies to give a larger discount for certain Medicare drugs. The March omnibus included an amendment that changes a coverage gap in Medicare called the “donut hole.” The coverage gap refers to when a senior’s drug costs reaches a certain level and then the senior’s out-of-pocket expenses for prescription drugs rises. Starting in 2019, pharma companies were supposed to offer a 50 percent discount for any drugs offered in this coverage gap. However, the March omnibus changed that figure to 70 percent. The pharma industry, taken by surprise at the addition to the omnibus, has been fervently trying ever since to get it taken out. During negotiations for the September spending deal, pharma lobbyists tried to bring the discount down to 63 percent but were rebuffed by lawmakers on both sides of the aisle. Now pharma’s opponents are warning that the industry will try to insert a change to the discount in December’s spending deal.

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Defeated Republican blames John McCain’s ‘no’ vote for loss of House. A Republican who lost his House seat in last week’s midterm election says the late Sen. John McCain helped Democrats win back the House by voting in 2017 against a GOP Obamacare repeal bill. “McCain’s last-minute decision prompted a ‘green wave’ of liberal special-interest money, which was used to propagate false claims that the House plan ‘gutted coverage for people with pre-existing conditions,’” Rep. Jason Lewis, R-Minn., who lost last week to Democrat Angie Craig, wrote in the Wall Street Journal on Sunday. “That line was the Democrats’ most potent attack in the midterms.” McCain, who died of brain cancer in August, voted with GOP Sens. Lisa Murkowski of Alaska and Susan Collins of Maine and all of the Senate’s Democrats to defeat a “skinny” repeal bill that the Senate brought up in July 2017.

Lewis’ op-ed does not note, however, that McCain did not vote against the American Health Care Act, which was the bill the House passed in 2017. The Senate immediately scrapped that bill but couldn’t decide on a replacement of its own. So the Senate GOP leadership brought up the “skinny” repeal bill that killed some of Obamacare’s mandates and taxes. The bill was meant to be a vehicle to head to conference talks with the House but it was defeated after McCain, Murkowski and Collins voted against it.

Meghan McCain calls op-ed ‘aborhorrent.’ Lewis’ claim that McCain should be blamed drew a sharp rebuke from the late senator’s daughter, Meghan McCain, who tweeted that “this is abhorrent.” Julie Tarallo, McCain’s former communication’s director, also blasted the op-ed as “absolutely disgraceful.” “Things that contributed to Lewis losing his seat by 6 points: calling women ‘sluts’ & shaming sexual assault survivors,” Tarallo tweeted. “Things that DIDN’T contribute: John McCain.”

Drug price reform group presses lawmakers on commitments. The Campaign for Sustainable Rx Pricing rolled out its first digital ad on Tuesday in a six-figure campaign that seeks to hold lawmakers who vowed to tackle drug prices accountable. The group’s campaign is called commitment and it presses lawmakers to follow through on action on drug prices to “hold big pharma accountable.” House Minority Leader Nancy Pelosi, who is making a run to return as speaker, said that drug prices would be a big topic when Democrats control the House in 2019. Several drug price advocates have also wanted Congress to take a run at giving Medicare drug price negotiating power. The Campaign for Sustainable Rx Pricing is a group whose membership ranges from insurance groups to the AARP and the American Hospital Association.

Trump administration wants states to get waivers to expand mental health services. The Trump administration is asking for states to step up participation a waiver program that rewards states for innovations in providing mental health coverage. Under the Trump administration, 13 waivers have been approved for states to make new methods of treating mental health, according to Health and Human Services Secretary Alex Azar. “At the federal level, this administration is willing to offer historic flexibility for programs to innovate,” Azar said at a conference of state Medicaid directors on Tuesday. “In return, we expect state commitments to invest in innovations and produce results.” CMS sent out a letter to state Medicaid directors on Tuesday laying out new opportunities for states to get payment for residential mental health treatment services. States can get authority to pay for short-term residential treatment in an institution for mental disease (IMD). For decades, Medicaid would not provide reimbursement to state mental health facilities that housed more than 16 patients. Now that ban was partially repealed in the legislation called the SUPPORT Act.

FDA eyes crackdown on flavored cigars. Food and Drug Administration Commissioner Scott Gottlieb hinted Tuesday at a crackdown on flavored cigars, saying that they are a “big problem” because of rampant use among minors. “We are looking at it very carefully and I think you can expect us to look at pursuing action in that,” Gottlieb said at a Washington Post event. He did not specify what action the agency would take, but the FDA is engaged in a broader crackdown on menthol cigarettes and e-cigarette use among minors. “The biggest segment of use among black teens is cigars,” Gottlieb said. “The flavored cigars are a big problem.” The Wall Street Journal reported last week that the FDA is planning to take the first step toward banning menthol cigarettes by requesting public feedback on a ban.

State and local governments beg for help with surprising spike in STDs. State and local officials are begging Congress and federal agencies to spend more money to halt an alarming rise in sexually transmitted infections, which have climbed steadily over four years to reach a record high. “We are basically all expressing the same concern and expressing the need for urgent action,” said Dr. Nate Smith, president-elect for the Association of State and Territorial Health Officials. “This is something that is not going to go away on its own.” There were more than 2.3 million cases of chlamydia, gonorrhea, and syphilis reported in 2017, according to preliminary data from the Centers for Disease Control and Prevention, nearly a 9 percent increase from the year before and a higher rate than those reported in other developed nations. State and local officials blame the soaring STD rates on a lack of federal funding. Over the past 15 years, the purchasing power of federal funding devoted to fighting STDs, which goes to state and local public health programs, has fallen by 40 percent.

Major doctor group softens position on drug re-importation from Canada. The doctor lobby group American Medical Association has softened its stance on the purchase of drugs from Canada in response to skyrocketing drug costs. The doctor group adopted at its interim meeting Monday a policy that supports “in-person” purchase of drugs from Canada. Drug re-importation has been a major point of contention in the debate over how to tackle high prices. The policy would enable consumers to buy  American-made drugs from Canada, where they are cheaper because of the country’s government-run healthcare program. But concerns around safety has hindered the idea from going far as most of the drugs purchased via re-importation would be from online pharmacies, which could be rife with fraud. The new AMA policy doesn’t support the importation of drugs from online or mail-order pharmacies. “The AMA already has policy opposing personal importation via the Internet until patient safety can be assured,” the group said in a statement. But the new policy does support the in-person purchase of prescription drugs from licensed “brick and mortar” Canadian pharmacies, but only if they are a limited quantity for personal use and have a valid prescription.

RUNDOWN

Axios Americans are not happy with their health insurance

The Hill Opioid crisis poses challenge for vets

Reuters Express Scripts offers new formulary for lower list-price drugs

WDRB Federal lawsuit challenging Kentucky abortion law begins Tuesday

New York Times Something happened to drug costs in the 1990s

Bloomberg Soaring healthcare costs forced this family to choose who would stay insured

CNN Parents accuse CDC of not reporting children’s death from polio-like AFM