fda

FDA hiring hamstrung

After DOGE’s firing spree led to the exit of 5,000 employees from the FDA, the Trump administration realized it had overdone it and set out to hire over 2,000 more employees. The problem: Many of the people who would hire those new employees are gone, and those who are left are hamstrung by DOGE’s centralization of what once were individual human resources offices at the FDA.

FDA employees also say there is a disconnect between the agency’s efforts to attract new talent and its treatment of current staff. The administration is aggressively attacking collective bargaining efforts by the unions that represent federal employees, politicizing the agency’s work, and strictly enforcing back-to-office mandates.

The result is that the agency is losing seasoned staff faster than it can hire new employees.

Read more of Margaret Manto’s great reporting.

Klomp’s two days in the Senate

Chris Klomp sat through two days of Senate confirmation hearings to be second in command at HHS. What became clear is the power he already wields, Chelsea Cirruzzo reports.

President Trump nominated Klomp to be deputy secretary of HHS.

But he’s already already played a major role in the Trump administration’s Make America Healthy Again agenda, negotiated drug pricing deals, conducted searches for high profile hires, and acted as a liaison between HHS and the White House.

Read more about Klomp’s responses to questions on how he would run the department and handle the often untrue claims his boss and President Trump have made about vaccines.

physician payment

Fixin’ for a doc fix

Republicans and Democrats on a House subcommittee spent Tuesday morning praising legislation that would pay doctors more in Medicare, and listening to a panel of witnesses who all want a pay hike.

Following the hearing, Energy and Commerce health subcommittee Chair Morgan Griffith (R-Va.) predicted that Congress would pass some of the doctor pay measures, but he cautioned about the need for “tweaks” due to their cost.

“Some of them may need a few tweaks, but I don’t think we would’ve done this today if we weren’t at least going to try to get some of them across the finish line during lame duck,” Griffith said after the hearing.

Griffith said it’s possible that some sort of physician payment reform legislation would be included in a bill to fund the government. The government is funded until Dec. 11.

The legislation would index Medicare doctor pay rates to a medical inflation measure. Other providers, such as hospitals and nursing homes, already receive inflation-linked pay increases.

Congress’ nonpartisan scorekeepers have not yet projected the cost of that measure, but the think tank Committee for a Responsible Federal Budget estimated that the approach under consideration would add $25 billion to the deficit over a decade.

Another measure under consideration would increase how much extra Medicare can spend annually on doctor services without cutting pay rates. The current “budget neutrality” threshold is $20 million and committee members discussed raising that to between $54 million and $58 million.

A revamp of the program that bases pay on doctor performance is also under consideration.

medicare advantage

MedPAC questioned

There was markedly less agreement between the parties at a House Ways and Means Committee markup of Medicare Advantage legislation on Wednesday.

The discord was over a bill, which passed along party lines, that would direct the Medicare Payment Advisory Commission to study the topic of MA overpayments in a manner that’s more favorable to insurers. Republicans say the bill would provide more accurate data on which to form Medicare Advantage policies; Democrats say it would mask the higher cost of the program in comparison to traditional Medicare.

The author of the bill, called the Apples to Apples Act, said the current way of studying MA expenditures is like “comparing apples to grapefruit.” In keeping with the metaphor, ranking Democrat Rep. Lloyd Doggett (Texas), called the bill a “rotten apple,” and at another point said it should be called the “apples to lemons act.”

Puns aside – who am I to judge? – it’s a serious debate that could impact Congress’ willingness and ability to control Medicare spending. Read more.