By Chelsea Cirruzzo and Ben Leonard

Senate Majority Leader Chuck Schumer is readying a health care package, but his first priority will be to prevent a government shutdown. | Mariam Zuhaib/AP Photo

WHAT TO WATCH FOR ON CAPITOL HILL — Congress’ sprint to fund the government and preserve several health programs is officially on.

Lawmakers must fund the government by Sept. 30 to avoid a shutdown that could hurt Fall vaccination campaigns and force federal agencies to furlough large chunks of their workforce.

As lawmakers hash out spending differences, they’ll also grapple with a sweeping health care package that House Republicans are expected to push this fall and an eventual health care package from Senate Majority Leader Chuck Schumer. Government funding will take precedence over those proposals.

The House legislation is focused on transparency measures, particularly with respect to hospitals, insurers and pharmacy benefit managers, which negotiate discounts with drugmakers.

It’s drawn some compliments from key Democrats, though some want it to go further.

Senate Health, Education, Labor and Pensions chair Bernie Sanders (I-Vt.), who caucuses with Democrats, told Ben that the House legislation is a “step in the right direction” but wants it to do “a lot more,” pushing for lawmakers to address health care workforce issues.

Senate Finance Chair Ron Wyden (D-Ore.), who has his own PBM proposals with ranking member Mike Crapo (R-Idaho), told Ben he has to review the differences between the two proposals. A spokesperson for Sen. Frank Pallone (D-N.J.), ranking member of the Energy and Commerce Committee, has said he’s happy about provisions giving more money to federal programs but disappointed about some transparency provisions being “weaker than existing regulations.”

Additionally, several provisions could lapse at the end of the month without reauthorization, including: 

— PEPFAR: Senate Foreign Relations chair Bob Menendez (D-N.J.) is aiming for a minimum three-year extension of the global HIV/AIDS program instead of the usual five and lobbying Republicans, including Sen. Lindsey Graham (R-S.C.). Menendez told Ben Thursday that he hasn’t spoken with committee ranking member Jim Risch (R-Idaho) about it “lately.” Asked whether three years was OK, Graham told Ben, “We’ll see.”

— The SUPPORT Act: The package would continue several programs related to the opioid epidemic, including funding for comprehensive opioid recovery centers.

ALSO ON THE SENATE AGENDA — Schumer is moving forward with a procedural vote on President Joe Biden’s nominee for the VA’s No. 2 position despite a hold Sen. Chuck Grassley has had in place since July.

Schumer has scheduled a Monday cloture vote — one to end debate — on the nomination of Tanya Bradsher to be the VA’s deputy secretary. That means he’s using precious floor time instead of having the chamber approve the nomination by unanimous consent, which Grassley’s hold is preventing him from doing.

Schumer’s office and the White House didn’t immediately respond to requests for comment.

WELCOME TO FRIDAY PULSE. It’s Chelsea and I’m planning to spend my weekend focusing on the most pressing news of the week: Joe Jonas and Sophie Turner’s breakup. Oh, and reading Bunny by Mona Awad. Follow me on Goodreads!

Send your noncelebrity gossip tips, scoops and feedback to [email protected] and [email protected] and follow along @_BenLeonard_ and @ChelseaCirruzzo.

TODAY ON OUR PULSE CHECK PODCAST, host Alice Miranda Ollstein talks with POLITICO deputy health care editor Dan Goldberg about the alarming personal medical debt in the U.S. and what some state legislators are doing about the growing crisis.

A message from PhRMA:

Middlemen can profit from where patients fill their prescriptions. Because insurance companies and PBMs own pharmacies, too.

Cases of Vibrio in the U.S. in 2022

CDC WARNS ABOUT DEADLY BACTERIA — After multiple reports of Americans infected by rare flesh-eating bacteria this year, the Centers for Disease Control and Prevention has alerted providers to look out for the infection and public health officials to warn the public about the risks.

Five things to know: 

1. The bacteria, Vibrio, thrives in warm coastal waters, including salt and brackish waters. One species, Vibrio vulnificus, infects 150 to 200 people each year in the U.S. and kills 1 in 5 people, usually within a day or two.

2. The infection, called vibriosis, is mainly transmitted when someone with an open wound comes into contact with water containing the bacteria, but occasionally, people can get infected by eating undercooked or raw seafood like oysters.

3. This year, infections, including fatal ones, have been reported in states along the eastern seaboard, including Connecticut, New York and North Carolina.

4. Extreme climate and rising water temperatures can play a role in increasing risk for the infection. For example, Hurricane Ian pushed coastal water into inland Florida in 2022, resulting in a notable rise in vibriosis cases.

5. Between 1988 and 2018, infections from Vibrio vulnificus have increased eightfold, the CDC said, with the geographic range of infections creeping further into northern waters each year.

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ATA TAKING OVER EHI — Executives for Health Innovation, which in May announced it would be winding down and giving its assets to others, has picked the American Telemedicine Association to receive its assets, Ben reports.

The advocacy group that had promoted the adoption of health technology for more than 20 years will transfer its members to the telemedicine group. EHI’s board members have included executives from Google, UnitedHealth Group, athenahealth and the American Academy of Family Physicians.

Ann Mond Johnson, CEO of ATA, told Pulse that it’s important to keep as many organizations under the same tent as possible to benefit the telehealth policy advocacy community. She said it would offer a “glide path” for assets EHI put together, including reports, recordings and interviews.

Seventeen percent of EHI’s leadership council was also a part of ATA, she added.

A message from PhRMA:

HOME HEALTH FALLS GO UNREPORTED — Home health agencies aren’t reporting more than half of Medicare patient falls that result in major injury, HHS’ Office of Inspector General said in a new report this week.

Background: Since 2019, home health agencies have been required to report falls with major injury in their patient assessments to CMS. Fall rates were later included in quality measures for Care Compare, which allows consumers to assess the quality of home health agencies.

Now, the OIG says those quality measures aren’t accurate because 55 percent of Medicare claims involving falls go unreported to CMS’ home health assessments.

The report also found that reporting was lower among for-profit home health agencies, patients under age 65 and Black, Hispanic or Asian patients. Additionally, many patients hospitalized for falls had no record of their hospitalization in CMS’ patient assessments.

CMS said it will crack down on the completion and accuracy of patient assessments, use other data sources to improve quality measures related to falls and require home health agencies to submit patient assessments when a patient is hospitalized.

OVERHAULING DISABILITY DISCRIMINATION — HHS’ Office for Civil Rights is pushing to update a 50-year-old law to prevent disability-based discrimination in federally funded programs, Chelsea reports.

The department proposed on Thursday that Section 504 of the Rehabilitation Act, which prohibits discrimination against people with disabilities in such programs, be updated to prevent disability-based bias.

Under the Biden administration, HHS’ civil rights arm has focused on tamping down discrimination against people with disabilities — reversing revisions the previous administration made using Section 1557 of the Affordable Care Act — restoring broader protections against discrimination based on disability.

It also comes as the office experiences an increase in complaints. Last year, the office got 51,000 complaints, the highest ever received, HHS OCR Director Melanie Fontes Rainer told reporters Thursday. Rainer also said the office has a backlog.

The proposed rule clarifies certain aspects of Section 504 in health and human services settings, including:

— Outlining that federally funded medical providers can’t discriminate based on disability when making medical decisions

— Defining accessibility for web and mobile applications used by federally funded health programs and services

— Establishing enforceable standards for accessible medical equipment, including adjustable exam tables and weight scales that can accommodate wheelchairs, with a two-year implementation timeline

JOIN US ON 9/12 FOR A TALK ON THE NEW AGE OF TRAVELING: In this new era of American travel, trending preferences like wellness tourism, alternative lodging and work-from-anywhere culture provide new but challenging opportunities for industry and policy leaders alike. Join POLITICO on Sept. 12 for an expert discussion examining how the resilience of the tourism and travel industries is driving post-pandemic recovery. REGISTER HERE.

The American Society of Human Genetics has elected Sarah Tishkoff, a professor in genetics and biology at the University of Pennsylvania, as its 2024 president. Dr. Christine Eng, professor at the Baylor College of Medicine; Scott Williams, professor at Case Western Reserve University School of Medicine; Krystal Tsosie, assistant professor at Arizona State University; and Rebecca Meyer-Schuman, a postdoctoral associate, have also been elected to serve on its board of directors.

Barbara Kowalcyk is joining the Milken Institute School of Public Health at George Washington University as its inaugural director of the Center for Food Safety and Nutrition Security. She previously was director of the Center of Foodborne Illness Research at Prevention at Ohio State University.

Julie Simon Miller has been named interim CEO at AHIP, the main trade association for health insurers, Megan R. Wilson reports. Miller, the group’s general counsel, takes the mantle from Matt Eyles, who told Megan earlier this year that he would retire in October.

POLITICO’s Arek Sarkissian writes about the future of abortion access in Florida as the state Supreme Court weighs whether Florida’s 15-week abortion ban should be upheld.

The Washington Post reports on the masking, dining out and other habits of Covid-19 experts.

STAT News reports on how patients access ketamine treatment for suicidal ideation.

A message from PhRMA:

Insurance companies and pharmacy benefit managers (PBMs) are putting their profits before your health. That’s because the largest PBMs own or are owned by the largest insurance companies, and they own pharmacies, too. First the PBM can deny coverage for your medicine in favor of one that makes them more money. Then, they steer you to the pharmacy they own. Without you ever knowing why it all happens this way. See what else they do.

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