Seema Verma steers millions of dollars toward GOP comms consultants Presented by

With help from Victoria Colliver, Alice Miranda Ollstein and Rachel Roubein

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— Seema Verma has steered millions of dollars toward GOP-connected communications consultants, including one well-known media strategist who's worked to burnish the CMS administrator's public profile.

— A judge blocked the Trump administration's association health plans, the health department's second significant loss this week in court.

— Replacing Planned Parenthood in Title X may pose challenges, as states prepare to find out who got funding in the family-planning program, perhaps as soon as today.

A message from PhRMA: Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives. More.

THANK GOODNESS IT'S FRIDAY PULSE — Or as PULSE likes to call it, "What-wild-health-news-is-coming-today"-day?

It's been a big week. What does today have in store? (Your author has his suspicions, but he's not gonna answer any questions.) Tips to [email protected].

SEEMA VERMA's USE OF GOP COMMS CONSULTANTS — The CMS administrator quietly directed millions of taxpayer dollars in contracts to Republican communications consultants — including hiring one well-connected GOP media adviser to bolster her public profile, POLITICO's Adam Cancryn and Dan Diamond write in an exclusive.

Verma — a longtime health consultant before being tapped to lead CMS two years ago — has used GOP contractors to write her speeches, pitch her interviews and accompany her on trips. In some cases, the use of contractors has come over objections from career staff, who raised concerns about directing federal funds to so many GOP consultants and to amplify coverage of Verma’s own work.

CMS has said the contractors were necessary because of long-running staffing gaps.

— The subcontracts, which haven't previously been disclosed, are within a larger $2.25 million contract with Porter Novelli, an international public relations firm that performs a wide variety of government services. Public spending records describe that contract simply as “strategic communications.”

CMS has its own large communications shop, including about two dozen federal workers who handle the press.

— The outside consultants bring a range of skills and connections. One consultant, Marcus Barlow, previously worked with Verma in Indiana and now helps write her speeches. Another consultant, Pam Stevens, specializes in setting up positive coverage for Republican women and has pitched Verma to outlets like Woman's Day magazine.

As consultants, Barlow and Stevens are paid between $185 and $200 per hour, said two individuals with knowledge of the arrangements — significantly higher than their federal communications counterparts.

Nahigian Strategies, led by a pair of prominent Republican brothers, has worked with Verma and CMS on a variety of initiatives, including setting up media appearances for Verma and having its staff extensively travel with her, including this week. Nahigian Strategies has been paid at least $2 million in the past two years, said one person with knowledge of the arrangement.

Another consultant, Brett O'Donnell, was let go last year after an incident when he barred a Modern Healthcare reporter from a CMS media call.

— Using consultants isn't illegal, but former CMS staff and watchdogs say there are ethical risks. "At CMS, which makes policy affecting large sectors of the health care industry, there is lots of 'market-moving' information from which individuals with early knowledge can profit," said Andy Schneider, a Medicaid expert who worked at CMS during the Obama administration.

"Contracts are supposed to be above reproach, with complete impartiality, and without preferential treatment, and the HHS Inspector General should review this [Porter Novelli] contract and the activities under it to ensure they are proper," said Scott Amey, general counsel of the Project on Government Oversight.

— CMS' new communications director, Tom Corry, told POLITICO that the contractors were needed because of staffing gaps in the communications office. Corry also said that Porter Novelli, not CMS, handled details like how much the contractors were paid.

Corry added that there are plans to wind down reliance on the communications consultants after two years. "Now that we’re fully staffed up, contractor resources are going to be used less than they were," he said.

Keep reading: More for Pros.

MEANWHILE: JUDGE STRIKES DOWN TRUMP's ASSOCATION HEALTH PLANS — It's the second Obamacare-related loss for the administration this week, just as the president has revived his drive to destroy and replace the 2010 health law, POLITICO's Paul Demko reports.

A federal judge ruled late Thursday in Washington that the administration’s efforts to expand the availability of health plans that don’t meet the coverage rules of the Affordable Care Act is a deliberate and illegal “end-run“ around the federal health care law. More.

THIS WEEK IN HEALTH CARE (SO FAR)

A quick shorthand to an eventful few days.

Monday: President Donald Trump's Justice Department urges the courts to strike down the Affordable Care Act

Tuesday: Trump promises that Republicans will be the "party of health care"

Wednesday: Trump's Medicaid work requirements are blocked in court.

Thursday: Trump's association health plans are also blocked.

Friday: Remains to be seen.

HOW POTUS SEES IT — The president told reporters on Thursday that he's counting on several Republican senators to help come up with a plan to replace Obamacare.

"I have asked John Barrasso, senator; Bill Cassidy, who's a terrific health care person; Rick Scott and others to take a look, form a really great plan," Trump said. "We're winning the lawsuit to terminate Obamacare in Texas. … Hopefully, we'll win at the appellate division and go to the Supreme Court to terminate Obamacare."

MITCH McCONNELL TO TRUMP: Health care’s all yours. The Senate majority leader has no intention of leading the Trump's campaign to transform the GOP into the "party of health care," POLITICO's Burgess Everett reports.

“I look forward to seeing what the president is proposing and what he can work out with the speaker,” McConnell said in a brief interview Thursday, adding, “I am focusing on stopping the ‘Democrats' Medicare for none’ scheme." More.

REPLACING PLANNED PARENTHOOD IN TITLE X MAY POSE CHALLENGES — States could learn as early as today who will get Title X family planning funding for 2019, amid a legal battle over new rules from the Trump administration that would ban clinics that provide abortions or abortion referrals from participating.

The new rules could hit hardest in Utah, where Planned Parenthood has been the only Title X grantee for decades. The state health department is ineligible to step in, and community health centers say they don't have the capacity to take over as a Title X provider.

Major provisions of the new rules are set to take hold May 3, unless a federal court steps in to halt them. Planned Parenthood currently provides services for more than 40 percent of the roughly 4 million people who depend on Title X for birth control and other health care services, but the network says they will exit Title X entirely if the new Trump rules go forward. More for Pros from Alice Miranda Ollstein and Rachel Roubein.

Rick Scott's new drug pricing bill. The Florida GOP senator will unveil legislation this morning targeting high prices by requiring that manufacturers match lower international prices and insurers provide upfront costs to consumers, POLITICO's Sarah Owermohle reports.

The Transparent Drug Pricing Act is one of the more ambitious plans out of the Republican camp and comes just hours after Trump named Scott — a former chief executive of the country's largest private health care provider and two term governor before moving to the Senate in January — as one of four or five Republicans he's relying on to "form a really great plan" to replace Obamacare. More here.

… The bill also comes two days after Sen. Mike Braun (R-Ind.) announced a similar transparency effort that would require insurers to disclose the costs of health care services to their beneficiaries. Braun told POLITICO's "Pulse Check" podcast Wednesday that he is working closely with Scott on health care cost initiatives.

"He agrees [that] the industry is broken, and he has got an inside view because he was a part of it," Braun said.

Poll: Americans blame pharma, insurers and providers for high health costs. That's according to a new POLITICO/Harvard T.H. Chan School of Public Health poll, which found that most Americans are focused on what they're being charged for health care, not how much they or an aging population are consuming.

Respondents blamed drug companies, insurers, providers and even the federal government for surging costs while dismissing overuse as a central issue. That's at odds with what many politicians and health policy experts say needs to be addressed and raises questions about whether cost-cutting focused on overutilization could backfire politically. More for Pros. Read the whole poll here.

California hospitals to spend billions more on seismic upgrades. A new Rand Corp. report estimates that California’s more than 400 acute-care hospitals will have to spend between $35 billion and $143 billion to meet state-mandate earthquake safety standards by 2030, POLITICO's Victoria Colliver reports. Read the report, which was funded by the California Hospital Association, here.

SEAN DUGAN joins AHIP as vice president for federal affairs. Dugan currently serves as director of government affairs for Molina Healthcare. His resume also includes stints at the National Association of Insurance Commissioners and work for several Democratic lawmakers on Capitol Hill, including current House Energy and Commerce Committee Chairman Frank Pallone.

By Alice Miranda Ollstein

A Nevada bill could force all hospitals to accept Medicare and Medicaid, upsetting those that currently only cater to wealthy tourists, Megan Messerly reports for the Nevada Independent.

A federal judge's ruling striking down Medicaid work requirements in Arkansas and Kentucky is having a ripple effect across the country, including in Ohio, where officials are now wondering if their just-approved work rules will move forward, Andrew Tobias reports for the Cleveland Plain Dealer.

GOP appointees on federal appellate courts have become increasingly candid in recent rulings about their hostility to Roe v. Wade as they weigh cases potentially headed to the Supreme Court that could erode abortion access, Linda Greenhouse writes for the New York Times.

Trump's pick for a top DOJ job withdrew over her ties to an organization that supported abortion rights, NBC News reports.

An alleged Medicare fraudster is trying to use Trump's abrupt decision on the ACA's legality to build a case for why he should go free, Ian Millheiser reports for ThinkProgress.

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