| The hospital industry, particularly nonprofit ones, are on defense in Washington. They’re pushing back against proposals to overhaul the 340B discount drug program in ways that appear to favor drugmakers. They’re also grappling with changes to health insurance programs and funding streams that have made patients more costly to treat. But there’s one area where a subset of hospitals is playing offense. America’s Essential Hospitals, a group that represents hospitals that treat a large number of lower-income Americans, has made it a top policy priority to enact a federal definition of what it means to be “essential.” The idea is supported in bipartisan legislation introduced by Reps. Lori Trahan (D-Massachusetts) and David G. Valadao (R-California) for the second consecutive Congress. Why it matters: The designation could ultimately unlock more federal funds and protections for these hospitals, which advocates say make up just 17 percent of all hospital systems in the country — while offering nearly 70 percent of the free or highly discounted charity care provided by facilities nationwide. It would join a number of other specific hospital designations that help steer policy, such as children’s hospitals, psychiatric hospitals and long-term care hospitals. → In order to qualify for the “essential” label, a hospital or health system would have to be a nonprofit that consistently serves an unusually large number of Medicaid, uninsured or other low-income patients, as measured by existing Medicare formulas. “We feel it’s really important just to get this definition into law, and I would say not attaching it to one specific payment mechanism in the statutory language actually gives policymakers flexibility,” Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, told reporters Monday. The biggest thing this proposal has going for it: It doesn’t cost any money. Many health policy advocates are already eyeing potential opportunities to attach their pet projects to the massive legislative vehicle that Congress usually moves at the end of the year. And provisions that require government cash can face tougher scrutiny for inclusion. “Congress does not operate in a spectrum where they spend more money without recouping it from somewhere else, so that zero-sum game makes it very challenging,” Feldpush said. “That is part of the reason why, in pushing the designation effort, we are not asking for any dollars attached to it.” → An “essential” designation could also potentially be used to identify hospitals most able to benefit from the 340B discount drug program, which was created to help hospitals stretch resources further. Drugmakers are required to give certain hospitals discounts on medications, but have alleged that well-heeled nonprofit hospitals are abusing the system. America’s Essential Hospitals informed reporters that they would not be pushing to use the designation in this way. A federal advisory committee last week recommended that the Food and Drug Administration loosen restrictions on compounding pharmacies, which would allow them to make six peptide products that have become popular treatments for insomnia, obesity, wound healing and other ailments. But what happens next is less clear as there is not a required timeline for the FDA to decide whether to accept the recommendation. The votes are not “a green light to compound with these peptides,” Ilisa Bernstein, a former deputy director of the FDA’s drug compliance office, told The Post’s Daniel Wu. “FDA must keep their eye on the science, data, and patient safety as they consider their options and next steps.” In the lead-up to the advisory committee meetings, career FDA scientists concluded that there wasn’t enough evidence on the peptides’ safety and efficacy to support widening access. But those findings bump up against the Trump administration’s goal to expand peoples’ ability to get them — and the growing demand among consumers for the treatments. Health Secretary Robert F. Kennedy Jr. has said he’s a “big fan” of peptides and has used them himself. He criticized the Biden administration for clamping down on the industry, vowing to end the “war on peptides.” Proponents of the peptide industry say the debate extends beyond the treatments themselves, arguing the advisory committee’s vote reinforces broader principles of patient choice, medical freedom and ensuring access through a regulated pathway. “This decision has potential ramifications for other areas of health care, not just peptides,” Lee Rosebush, the chair of the American Academy of Peptide Medicine, tells me. If regulators do decide to move forward, the process could take up to nearly two years to complete. But there are no requirements around that regulatory process, either. While there is some expectation that political and public pressure could cause the FDA to move to add the peptides to the list of products able to be compounded, Edgar J. Asebey, a partner at Frier Levitt who helps clients navigate FDA enforcement and compliance, says it is “unlikely” that the agency “will go against its own scientists’ recommendations.” But that doesn’t mean it’s a dead-end: If the FDA doesn’t move to broaden access, Asebey tells me that Kennedy has the authority to place the peptides on the list of bulk substances compounding pharmacies are able to make. However, “this authority is arguably meant to remove unsafe substances, not fast-track new ones,” Asebey added. “Therefore, such a move could garner litigation.” Rosebush said putting these products on the temporary “bulks list” would address concerns that FDA scientists raised regarding how peptides are made and a lack of adverse event reporting. These large compounding pharmacies “are legally required to report adverse events and make their products under CGMP [Current Good Manufacturing Practice], the same standard as pharma,” Rosebush added. “Some people are getting shut out when it comes to GLP-1 drugs. Here’s why.,” The Post’s Christopher Rowland reports. “67 boat strikes. 221 dead. The cocaine hasn’t slowed, officials report.,” report The Post’s Alex Horton, Terrence McCoy, Samantha Schmidt and Dylan Moriarty. “Taylor Farms Called White House to Try to Delay Cyclospora Recall,” Sabrina Siddiqui, Jesse Newman and Josh Dawsey report at the Wall Street Journal. “RFK Jr. says the cyclospora outbreak is ‘under control.’ It’s not.,” Food Fix’s Helena Bottemiller Evich writes. “Almost all of HCA’s Affordable Care Act patients are going uninsured. Here’s how that affected Q2.,” Rebecca Pifer Parduhn reports at HealthCare Dive. 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