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Busy week ahead for healthcare. Enjoy the Labor Day holiday while you can, because Washington is in for a busy four days when it gets back. Here is a rundown of top events for the week of Sept. 4:

• Brett Kavanaugh’s confirmation hearings begin. The Senate Judiciary Committee will hold confirmation hearings on Kavanaugh’s nomination to the Supreme Court from Sept. 4 to 7. Expect pointed questions from Democrats regarding Kavanaugh’s views on abortion and Obamacare. Democrats have claimed that Kavanaugh will roll back abortion rights and will vote to gut Obamacare if he reaches the high court.
• Pivotal court hearing on Obamacare lawsuit. Meanwhile, in a courtroom in Fort Worth, Texas, a federal judge will hear a pivotal challenge to Obamacare. The judge will hear a preliminary injunction from Texas and 19 other states to end federal enforcement of Obamacare while a lawsuit to end the entire law makes its way through the courts. The main crux of the suit is the repeal of the individual mandate penalty starting next year. The lawsuit argues that without the mandate penalty the rest of Obamacare is unconstitutional. California and a collection of 16 states are defending Obamacare in the hearing and will argue that if Congress wanted to get rid of Obamacare it would have done so when it zeroed out the individual mandate as part of tax reform.
• The House comes back. The House Energy & Commerce Committee’’s health subcommittee will hold a hearing on Wednesday to consider several healthcare bills. Chief among them is a bill to end “gag clauses” that insurers and drug middlemen insert into contracts with pharmacies that prevent pharmacists from telling consumers it is cheaper to buy drugs with cash than through insurance. A Senate version has already passed the Senate Health, Education, Labor and Pensions Committee.
• Senators may take up opioid legislation. Earlier this week, Sen. Lamar Alexander, R-Tenn., said that all Senate Republicans have agreed to support a package to fight the opioid crisis. Now the Senate waits to see if any Democrats have objections to the package. Sen. Patty Murray, D-Wash., is tasked with garnering support for the package, which likely would pass the chamber with massive support. The Senate and House then likely would go to conference to iron out differences between the Senate version and a slew of bills that passed the House in June.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email [email protected] for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

House panel probes impact of hospital mergers on Medicare. Republicans on the House Energy & Commerce Committee want a federal advisory commission to look whether hospital mergers mean that “patients end up paying higher prices due to consolidation for no identifiable benefit to the beneficiary.” Committee chairman Rep. Greg Walden, R-Ore., and subcommittee chairmen Reps. Gregg Harper, R-Miss., and Michael Burgess, R-Texas, signed the letter sent on Thursday.

Hospital mergers have increased rapidly since the passage of Obamacare in 2010. From 2002 to 2009, there were an average 55 mergers per year. In 2017, there were a record 115 announced deals, according to a report from the insurance research firm National Council on Compensation Insurance. But the lawmakers charge there is conflicting information on the impact that these mergers have played on healthcare costs. The letter cites a 2016 study that found that consolidation can lower costs by 15 to 30 percent, but some studies also conclude that consolidation nullifies competition and increases prices. “Even more concerning is a study that suggested merging hospitals resulted in 40 percent higher prices than non-merger hospitals,” Thursday’s letter said. So the lawmakers want the advisory committee, which looks at various Medicare issues, to weigh in.

House panel also wants answers from PBMs on drug price impact. Walden, Burgess and Harper also wrote on Thursday to the drug middlemen known as pharmacy benefit managers and insurers calling for answers about their roles in exacerbating high drug prices. Committee leaders sent letters to PBM and pharmacy chain CVS, and PBMs Express Scripts, Envision Rx Options, Procure Pharmacy Benefit Manager Inc., and Prime Therapeutics. It also sent letters to insurance giants Humana and UnitedHealth. The committee is probing the companies’ roles in negotiating price discounts with drug makers, and follow a series of hearings on the companies. “Based on the testimony we received in our hearings and ongoing examination across the drug supply chain, we request your assistance in order to better understand the relationship of a drug’s list price with the price negotiated and the different incentives that are offered encourage reductions in list price,” committee leaders said in a statement.

Vape shops pass first surprise inspections, but may be mislabeling products. The Food and Drug Administration has finished its first spate of surprise inspections of vape shops and found they need to do a better job of monitoring quality and training, the latest in a wide crackdown on e-cigarette makers and retailers. Inspectors found a “lack of quality assurance programs, standard operating procedures, and full labeling of ingredients by the inspected manufacturers suggest that consumers might not receive complete information regarding product contents,” the agency said Friday. The FDA conducted surprise inspections in 2016 of 31 retailers that only sold finished products and 28 manufacturers of e-cigarette and vaping products. The agency has been increasing enforcement of e-cigarette makers and retailers as some lawmakers have complained they are not doing enough to regulate e-cigarette use. The FDA found that all the vape shops were in compliance with the agency’s regulatory requirements in effect at the time of inspection. At the same time, they flagged their quality monitoring and labeling.

Patty Murray slams Trump administration’s move to shorten family planning grants as a ‘gimmick.’ Sen. Patty Murray, D-Wash., alleged that the Trump administration’s plan to shorten family planning grants from one year to six months is part of a larger strategy to cut funding to Planned Parenthood. “Shortening these grants is a gimmick, plain and simple — and it’s all about moving as quickly as possible to undermine healthcare access for millions of people and to gag providers from discussing the full range of reproductive care options with patients,” she said in a statement Thursday. The Trump administration released earlier this year a series of proposed changes to the family planning grant program, which offers funding to clinics to provide contraception and preventive health services. The administration sought to cut funding to Planned Parenthood and clinics that provide abortions. It also wants to restrict doctors from referring patients for abortions.

RUNDOWN

Los Angeles Times These lawsuits could change healthcare nationwide if the make it to the Supreme Court

STAT News A drug distributor flagged a pharmacy’s suspicious drug orders. A federal court says it has to keep shipping the pills

CNN FDA issues warning about food prepared with liquid nitrogen

Reuters FDA approves two new HIV drugs from Merck

Axios Federal Trade Commission faces pharma antitrust battle

Kaiser Health News The $109,000 heart attack bill is down to $332. But what about the other surprise bills?

New York Times How modern medicine has changed the Supreme Court