By Chelsea Cirruzzo and Ben Leonard

With Erin Schumaker, Daniel Payne and Robert King

Dr. Monica Bertagnolli started her training as a cancer surgeon in the 1980s when it was still a boy’s club but racked up accolades and leadership roles. | Jeff Chiu/AP

NIH HEARING SCHEDULED — The Senate HELP Committee will hold a hearing on the White House’s pick to lead the National Institutes of Health after months of holdup.

Nominee Monica Bertagnolli, who directs the National Cancer Institute, will appear before the committee Wednesday — about five months after she was first nominated.

Background: Sen. Bernie Sanders (I-Vt.), chair of the Senate Health, Education, Labor, and Pensions Committee, had blocked a hearing for Bertagnolli until the Biden administration agreed to his demands to more aggressively slash drug costs. In September, Sanders relented after the administration said that if biotech company Regeneron, which signed a multimillion-dollar contract with HHS, develops a next-generation monoclonal antibody therapy against Covid-19, prices would be equal to or lower than those in other major countries.

When reached Wednesday for comment, Sanders’ office pointed to his September statement in which he said, “I look forward to meeting with Dr. Bertagnolli to discuss what she is prepared to do at the NIH to substantially lower the outrageous price of prescription drugs in America.”

The White House did not respond to a request for comment.

Bertagnolli’s record: The Boston cancer surgeon was tapped to replace longtime director Francis Collins in May and has broad support within the scientific community, Erin reported. And President Joe Biden has lauded her achievements as head of the NCI on advancing the cancer moonshot, launching early-detection and childhood-cancer programs and expanding clinical research.

While the NIH has traditionally enjoyed bipartisan support from Congress, she’ll run a health research organization in an era when alternative truths and alternative facts are normalized, even at the congressional level.

What to expect: Beyond questions on drug pricing from Sanders, Bertagnolli is likely to face questions from Republicans on Covid’s origins and their theory that NIH grants supported Chinese researchers’ virus studies. And, if confirmed, she would be tasked with restoring trust in the nation’s premier health research agency.

Other potential lines of inquiry could include Bertagnolli’s focus on cancer versus other diseases, how she’ll work with the year-old Advanced Research Projects Agency for Health and her priorities as director in light of the agency's constrained budget.

WELCOME TO THURSDAY PULSE. Dutch scientists are using artificial intelligence to diagnose brain tumors while a patient is on the operating table. We’re curious how else AI could change the health care landscape. Send your tips, scoops and feedback to [email protected] and [email protected] and follow along @_BenLeonard_ and @ChelseaCirruzzo.

TODAY ON OUR PULSE CHECK PODCAST, host Lauren Gardner talks with Alice Miranda Ollstein about the impact of Ohio's upcoming vote on abortion rights when voters will decide whether to add abortion protections into the state constitution — and why anti-abortion groups are pinning their hopes on the Buckeye State.

A message from Coalition to Protect America’s Health Care:

Access to care is on the line. Congress is considering legislation that would cut billions of dollars in funding for hospitals. No other provider is open 24/7 to all who need care, with the ability to treat sicker and more complicated patients, while still responding to emergencies, natural disasters, and more. It’s time to reject cuts to care and stand up for America’s hospitals.

Rep. Michael Burgess, co-chair of the GOP Doctors Caucus, says the group's policy proposal aims to make it easier for doctors to "participate in a payment system that best serves them." | Francis Chung/POLITICO

A NEW IDEA FOR DOCTORS’ PAY — The GOP Doctors Caucus released a policy proposal Monday of legislation that would rethink how Medicare pays doctors, Robert and Daniel report.

The proposal would change the Physician Fee Schedule, the rule that outlines Medicare pay, by offering more leeway in how much money CMS can spend, which is currently limited by a budget neutrality requirement.

It would also update Medicare’s calculation of how much it costs to run a practice. Doctors have complained about steadily declining Medicare rates since 2015, when Congress last addressed the issue.

“Our goal is to ensure a stable reimbursement structure by making it easier for physicians to participate in a payment system that best serves them,” Rep. Michael Burgess, co-chair of the caucus, said in a statement about the draft.

The new proposal reflects a top lobbying priority for doctors groups going into the end of the year. However, its path to final passage remains unclear amid uncertainty about what will be in a year-end legislative package.

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PEOPLE WITH DISABILITIES FACE BIAS — Four in 10 adults with disabilities say they experienced unfair treatment in health care settings or when applying for public benefits because of their disability in 2022, a new report says.

The report by the Urban Institute, released Wednesday, found that such discrimination can disrupt care. Seventy-one percent of adults with disabilities who say they received unfair treatment in health care delayed or skipped needed treatment or didn’t follow clinical recommendations. Black and Hispanic adults with disabilities were more likely to report unfair treatment, the report also found.

“These findings show that experiences of unfair treatment were common among people with disabilities — causing disruptions in healthcare and employment, and delays in accessing public benefits to help them meet their basic needs,” said Dulce Gonzalez, Urban Institute research associate, in a statement.

Why it matters: Melanie Fontes Rainer, HHS’ Office for Civil Rights Director, told reporters in September that complaints made to the office, including those regarding disability-based discrimination, have risen since Covid-19.

An HHS proposed rule would update a 50-year-old law to prevent disability-based discrimination in federally funded programs, including in health care settings.

A message from Coalition to Protect America’s Health Care:

FDA PROBING DIGITAL HEALTH — The FDA announced Wednesday it’s creating an advisory committee tasked with providing outside expertise on Digital Health technologies, including artificial intelligence, digital therapeutics and wearables, POLITICO’s David Lim reports.

The agency is soliciting nominations for industry representatives, consumer organizations and voting members to the new digital health advisory committee. The FDA aims to have the outside panel fully operational in 2024.

“As digital health technologies advance, the FDA must capitalize on knowledge from inside and outside of the agency to help ensure we appropriately apply our regulatory authority in a way that protects patient health while continuing to support innovation,” Jeff Shuren, director of the FDA Center for Devices and Radiological Health, said in a statement.

Once filled, the digital health advisory committee will have nine core voting members. Temporary members can be added for individual meetings.

A NEW POLITICO PODCAST: POLITICO Tech is an authoritative insider briefing on the politics and policy of technology. From crypto and the metaverse to cybersecurity and AI, we explore the who, what and how of policy shaping future industries. We’re kicking off with a series exploring darknet marketplaces, the virtual platforms that enable actors from all corners of the online world to traffic illicit goods. As malware and cybercrime attacks become increasingly frequent, regulators and law enforcement agencies work different angles to shut these platforms down, but new, often more unassailable marketplaces pop up. SUBSCRIBE AND START LISTENING TODAY.

ANTI-OBESITY PARTNERSHIPS COMING — A White House official says the administration will soon announce additional commitments from the private and public sectors to meet its goal of reducing diet-related disease by 2030.

Background: Last September, the White House announced more than $8 billion going toward private and public entities that pledged to combat food insecurity, target better nutrition and reduce diet-related diseases. The commitments included pharmaceutical company Novo Nordisk, which said it would invest $20 million into local initiatives like a nutrition literacy program at community health centers, and the makers of the app MyFitnessPal, which pledged to enroll patients at community centers into its fitness and nutrition program at no cost.

A second call for commitments was launched in April, Will McIntee, the White House’s senior adviser for public engagement, said at an event in Washington on the state of obesity Wednesday. An announcement is expected later this fall.

“In this round, we’ve called both for commitments that result in systemic long-term change, but as well as your opportunities to fill the gaps where the federal government may not be able to,” McIntee said. He added that this could include the health care industry.

“We’ve encouraged health insurance companies to expand coverage of nutrition services and to consider partnering with retailers and independent grocers to make healthy food like fruits and vegetables more available at a lower cost or through efforts such as some of the produce prescription programs,” he said.

The White House did not respond to requests for more details.

The New York Times reports that illicit e-cigarettes are flooding stores faster than the FDA can regulate them.

Bloomberg reports that nursing homes are closing in rural towns, leaving long-term care deserts.

STAT reports on how one abortion provider is using its limited resources.

A message from Coalition to Protect America’s Health Care:

When it matters most, will the care be there? Hospitals are the cornerstones of our communities, but supply chain challenges, high inflation, and workforce shortages have pushed them to the brink – especially those in rural and underserved communities. Now, some in Congress are proposing billions of dollars in cuts to hospital-based care. Nowhere else do patients have access to quality, around-the-clock care, regardless of their ability to pay. America’s hospitals and hospital systems care for sicker patients, provide more complex procedures, are ready on standby during emergencies, and, for many, are the only trauma care centers for miles. Protect care for all to ensure it is there, when it matters most.

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