TESTER PUSHES GRASSLEY ON VA NOM HOLD — Senate Veterans’ Affairs Committee chair Jon Tester (D-Mont.) told Pulse Wednesday he isn’t happy about Sen. Chuck Grassley’s (R-Iowa) hold on the Biden administration’s nominee to be the No. 2 official at the VA. “I wish he would lift it,†Tester said. Grassley isn’t showing signs of backing down — he’s still “strongly opposed†to Tanya Bradsher’s nomination, spokesperson Clare Slattery said, adding that he will likely divulge more reasons for his opposition this week. Sen.Jerry Moran (R-Kan.), the panel’s ranking member, who’s opposed her nomination, told Pulse Tuesday that he hadn’t thought about whether Grassley should lift the hold yet. Grassley has been holding up Bradsher’s nomination since July, citing whistleblower testimony saying Bradsher failed to properly oversee a correspondence system that he believes mishandled veterans’ personal health information. If confirmed, Grassley noted, Bradsher would oversee a much more substantial effort to upgrade the VA’s beleaguered electronic health records system. Bradsher has defended herself against the criticism, saying that the VA has enhanced security, bolstered training and limited access to better protect veterans’ information. CHECK YOUR PRIORS — A group of lawmakers is awaiting a final rule from CMS on prior authorization, Ben and POLITICO’s Robert King report. Doctors have long complained to Congress about the time-consuming paperwork and delayed care that comes when insurers fail to authorize costly procedures or treatments. A bipartisan bill from Sen. Roger Marshall (R-Kan.) and Rep. Suzan DelBene(D-Wash.) would require Medicare Advantage plans and other public payers, such as those managing state Medicaid plans, to implement an electronic process for approving medical treatments in a bid to reduce delays in care and save doctors time. But its price tag — $16 billion over 10 years, according to the Congressional Budget Office — stalled its momentum last year after it unanimously passed the House. In December, CMS proposed a rule similar to the legislation. If finalized, the government’s baseline spending, which the CBO measures new legislation against, would be significantly higher to account for the new rule. That would mean the Marshall-DelBene legislation would add substantially less to the federal budget. A Marshall aide, granted anonymity to discuss some bill details, told POLITICO that based on discussions with CBO, Marshall expects the legislation would cost $4 billion over a decade if CMS’ finalized rule doesn’t include a “real-time†process for routinely approved items and a 24-hour response time for “urgently needed†care. But if the final rule included such provisions, which more than 230 House members and 61 senators are pushing, the legislation would have negligible cost, the aide said. CMS Press Secretary Sara Lonardo told POLITICO that the agency appreciates the feedback from lawmakers, but she wouldn’t comment on the rule’s timing of the rule or whether CMS would agree to the changes. CBO declined to comment. Not everyone’s on board. Ceci Connolly, CEO of the Alliance of Community Health Plans, stressed that lawmakers should focus on creating as standard of a prior authorization process as possible between different types of plans. She also said that time requirements for prior authorization could lead to a rise in care being denied.
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