Grassley Leaving Finance Hatch to Take Over

With Senator Charles Grassley (R-IA) set to leave as Ranking Member of the Senate Finance Committee to take over as Ranking Member of the Senate Judiciary Committee, some have questioned what will happen to the congressional oversight into physician-industry collaboration, disclosure, and payments. Many of Grassley’s investigations have centered on fraud in the Medicare and Medicaid programs and problems at the Food and Drug Administration (FDA).

While he may be switching roles, Grassley told the Congressional Quarterly HealthBeat that he “wants to play as aggressive a role” in overseeing the health care industry. According to the HealthBeat, Grassley “is expected to continue serving on the Finance Committee, just not as its ranking member.”

U.S. Senator Orrin G. Hatch (R-UT) told the HealthBeat last week in an interview that he will be taking over Grassley’s investigatory role on the panel, adding that “we’ll be doing pretty much the same” as Grassley did. “In the minority you have very little opportunity to hold hearings, but you can have an investigatory staff,” Hatch said.

Over the past several years, we have covered many of Grassley’s investigations into FDA and HHS, as well as pharmaceutical and device companies and individual health care practitioners. However, the HealthBeat recognized that it remains to be seen whether Hatch “will play the same bulldog role that Grassley did.” They noted that there is also the possibility that “Baucus and his staff will pick up the slack on the oversight side.”

Hatch has experience with an investigatory staff, as he once chaired the Labor and Human Resources Committee, which is the Senate Health, Education, Labor and Pensions Committee today. He described this experience however as one in which half of the time his “investigatory staff was getting him in trouble.” As a result, Hatch asserted that he is “very wary of investigative staffs,” and that if he is going to investigate, he “wants to have total justification for the investigation.”

Nevertheless, the Senator from Utah recognized that he and Grassley share a similar philosophy and desire to do what is right and noted that he agreed with Grassley “on most everything.” But he clarified that his way of handling investigations will be different because he approaches things “a little bit differently” than Grassley.

In his interview, Senator Hatch noted that he has “always overseen FDA, and will continue to do that.” He made the distinction however, that he thinks the agency “does an incredible job, and that he did not think there was too much room for criticism there as sometimes happens.” Nevertheless, he still acknowledged the need to review the agency. Senator Hatch also acknowledged that he will probably move to a new investigations staff.

With respect to the possibility of Grassley overseeing FDA, Medicare and Medicaid from Judiciary, he noted that “would be kind of a case of what you could do from within the jurisdiction of the committee.” Grassley noted his history of oversight on the committee by work he did in the 1980s investigating the Defense Department and unearthing excessive Pentagon spending, which led to strengthening antifraud provisions in the False Claims Act in the 1980s. Accordingly, Grassley told HealthBeath that “even in his role at the Judiciary Committee, he would have the ability to go after Medicare and Medicaid fraud.” This is quite possible given that many of the recent fraud settlements with pharmaceutical and device companies fall under the False Claims Act.

Despite his past success, Grassley’s staff budget on Judiciary will be half a million dollars less than Finance, but he’s hoping to move some people around, especially with more Republicans in the Senate. A Grassley aide told the HealthBeat that the senator has had five investigatory and oversight positions on the Finance Committee. It is unclear how many he will have at Judiciary.

With Republicans focused on changing many of the provisions in the Affordable Care Act, priorities may be different on the Senate Finance Committee, and oversight may be put on the back burner. Given Grassley’s continued presence on the committee, this might have influence whether Hatch continues his legacy, and takes a different path. However, recent settlements and reports coming from HHS and the Office of the Inspector General indicate that fraud and abuse in Medicare is still a top priority of the Obama administration.

Accordingly, with many of the largest companies already under corporate integrity agreements with the Department of Justice and OIG, it may be more likely that the investigations are not as prominent, and rather oversight on these agreements and enforcing compliance may take the forefront. This will still require investigation, but resources and staff will likely come from the agencies rather than the committee.

Additionally, as more payment information is analyzed and gathered, this data may dictate future legislation and recommendations for agencies and institutions to combat fraud and abuse. As companies begin to reform their structures and academic medical centers change their conflict of interest policies, physician-industry collaboration and payments are likely to remain at the forefront as media sources continue to cover this issue in the backdrop of health care reform.