CDC director nominee faces questions during Senate committee hearing

Erica Schwartz, President Donald Trump's nominee to lead CDC, faced questions from the Senate HELP committee about her stances on vaccines and whether she can restore trust in the agency.

Schwartz is a physician who holds a medical degree from Brown University and a law degree from the University of Maryland. She served as deputy surgeon general under the first Trump administration and spent more than two decades in the military, starting with the U.S. Navy before joining the U.S. Public Health Service Commissioned Corps and the U.S. Coast Guard.

During the hearing, committee chair Sen. Bill Cassidy (R-La.) criticized HHS Secretary Robert F. Kennedy Jr. and said that the country needs "a CDC director that will actually stand up to crazy, stupid things being said that will undermine faith in immunization," adding that it's "evil" to promote misinformation about vaccines.

"Are you that person?" Cassidy asked Schwartz. Schwartz repeatedly said she didn't believe Kennedy or Trump would ask her to do anything that would hurt public health or break the law, a response that didn't appear to satisfy Sen. Maggie Hassan (D-N.H.).

"There are multiple examples of the president actively instructing people to break the law over and over again," Hassan said, adding that it was "not a satisfactory response to say he would never do that."

During the hearing, Schwartz repeatedly stated that she believes in the safety and efficacy of vaccines, including the mRNA technology used in COVID-19 vaccines. She also expressed support for giving vitamin K shots to newborns at birth to prevent internal bleeding, something that has become a growing focus in vaccine hesitancy.

She also said she accepted the evidence that vaccines do not cause autism but didn't say she would remove wording on CDC's website saying the issue remains unresolved, something that Kennedy introduced.

"I will never betray the science," Schwartz said in her opening statement. Later, she referred to her oath as a physician to do no harm, saying "[i]f I'm confirmed as a CDC director, the nation's health and well-being will take primacy, and I will never compromise on that."

(Mandavilli, New York Times, 7/15; Huang, NPR, 7/15; DeGroot, Roll Call, 7/15)

CMS freezes over $1B in Medicaid funding to California and Minnesota

CMS on Tuesday announced it is withholding over $1 billion in Medicaid funding to California and Minnesota over suspected fraud. Officials say the states can access the funds if they provide documentation for some claims the department flagged as suspicious. Specifically, CMS is withholding $867.5 million in Medicaid payments to California and $199 million to Minnesota.

HHS Secretary Robert F. Kennedy Jr. said that if California Gov. Gavin Newsom (D) or Minnesota Gov. Tim Walz (D) want to access the funding, "all they have to do is provide documentation showing that these services are legitimate and not fraudulent."

CMS Administrator Mehmet Oz said the funding that was targeted is linked to services at high risk for fraud, including personal care services delivered in the home. Oz added that in Minnesota, some of the deferred funding was linked to more than 3,000 providers who were disenrolled from Medicaid following a state audit.

"This raises questions about the claims tied to the providers before they were removed," Oz said, who noted the majority of the $199 million in frozen payments were linked to the disenrolled providers.

Walz said his state is being politically targeted. "The Trump Administration is cutting more money in healthcare than they've prosecuted for fraud. The math doesn't add up," Walz said. "They're not punishing fraudsters, they're punishing children, seniors, working families, and people with disabilities."

Similarly, Newsom's press office said that California is "being targeted for political reasons" and added that the state is saving money "by keeping seniors and people with disabilities out of far more expensive nursing homes."

(King, POLITICO, 7/21; Whyte, Wall Street Journal, 7/21)

However, he added that there are concerns that HHS Secretary Robert F. Kennedy Jr. would add "more speculative or weakly supported conditions" to a COVID-19 injury table.

"If HHS listed broad neurologic syndromes, POTS/dysautonomia, chronic fatigue-type conditions, autoimmune conditions, sudden cardiac death theories, or loosely defined 'vaccine injury' categories without strong evidence, that could be used to claim that the federal government has affirmed causation," Hughes said.

(Cirruzzo, STAT+ [subscription required], 7/8; Fiore, MedPage Today, 7/9)

HHS moves forward with effort to curb antidepressant usage

HHS is moving forward with its effort to help Americans stop taking psychiatric drugs. Federal health officials met with dozens of mental health professionals earlier this month to map out future clinical guidance to help providers instruct patients how to come off antidepressants.

During those meetings, officials and mental health professionals reviewed evidence from European nations and worked on recommendations for nonmedication-based options for patients to address their mental health, including therapy. One senior HHS official who spoke to STAT said they discussed gaps in the research around deprescribing selective serotonin reuptake inhibitors (SSRIs), including the side effects a person could experience.

In May, HHS Secretary Robert F. Kennedy Jr. announced several initiatives aimed at reining in the prescription of SSRIs, which he argued are exceptionally hard to quit. These initiatives include new trainings, reimbursement mechanisms, and clinical guidelines aimed at pushing healthcare providers to help patients stop taking SSRIs and consider nonpharmaceutical interventions like therapy, nutrition, and exercise.

A senior HHS official who spoke to STAT said that forthcoming federal guidance will not discourage people from taking SSRIs if they want to do so. Rather, they said HHS wants to put patients at the center of the conversation on what they can expect before they start SSRIs and when they want to come off of them.

Nicole Lamberson, medical director of the Benzo Information Coalition, attended a prep call before the meeting with federal health officials but declined to describe what was discussed. However, she noted that resources on how to help a patient through tapering off SSRIs is needed.

"A lot of physicians who reach out, even just for resources, are like 'I've got this patient, they're in terrible Paxil withdrawal, I don't even know, like, where do I look, what do I do?' They say, 'I wish I would have information on this, nobody taught me this in medical school. I had no idea this was even possible," she said. "That's where this guidance will fill that gap."

(Cirruzzo/Lawrence, STAT+ [subscription required], 7/13)