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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: HHS is not complying with Congress\u2019 intentions for USPSTF by canceling meetings, an expert said. But there are no codified regulations requiring HHS to comply or avoid political interference in the task force. It has been nearly a year since the U.S. Preventive Services Task Force released new recommendations, and experts remain concerned about its future. HHS removed the chair and vice chair of USPSTF last month, which came after three task force meetings were canceled under HHS Secretary Robert F. Kennedy Jr.\u2019s tenure.
HHS is not complying with Congress\u2019 intentions for USPSTF by canceling meetings, an expert said. Image: Adobe Stock
Alex H. Krist, MD, MPH, a former USPSTF member, previously told Healio that the task force now consists of eight members, although no chairs or vice chairs remain. The USPSTF usually consists of 16 members, but it has been a while since new members were appointed. The task force\u2019s procedure manual states that the USPSTF is led by a chair and two vice chairs, but it does not specify how long the task force can operate without these roles filled, according to Carmel Shachar, JD, MPH, faculty director at Harvard Law School. Without leadership, Krist said he is concerned that incoming members will not receive the necessary training and education. \u201cThere was a process where every new task force member was assigned a senior task force member as a mentor. That\u2019s been an established process used internally for decades,\u201d he said. \u201cThe mentor is really helping to make sure that new members are able to adopt and adhere the task force\u2019s methods and approach, be able to do the volume of work effectively and focus on the things that matter. The chairs were so instrumental at training and leading.\u201d Healio spoke with Shachar to understand what HHS\u2019 legal obligations are for USPSTF, if it could face consequences for incompliance and more. Healio: What are HHS\u2019 legal obligations to maintain a functioning task force? Shachar: HHS has an obligation to carry out Congress\u2019 intent and directives. It\u2019s circumventing it by maintaining a USPSTF that doesn\u2019t ever meet. Even if it technically meets the letter of the law \u2014 because the statute doesn\u2019t mandate exactly how many times a year they should meet \u2014 it doesn\u2019t meet the intent. There is also the fact that USPSTF needs to meet in order to issue recommendations, and recommendations have to be issued so that they are incorporated into the no-cost preventive care mandate. There isn\u2019t language in the authorizing statute or the Affordable Care Act (ACA) saying that you need to keep the USPSTF in good working order, but it implied throughout. Healio: If it\u2019s implied, is HHS not complying with its duties, and could it face any legal consequences? Shachar: One of the challenges here is that a lot of USPSTF procedures are in their procedural manual, but those are not codified into regulation, so it doesn\u2019t have the force of law. That means that even though you could point to saying things like, \u201cThe manual requires that USPSTF meet three times a year,\u201d but those meetings haven\u2019t been occurring, you can\u2019t really take HHS to court the way that you could if it was codified into the regulation. Another part of the challenge is that the way our government works is that Congress writes a statute, but the statute isn\u2019t the full recipe. The statute is the bare bones: \u201cHere\u2019s what we absolutely want to see, here\u2019s the purpose in doing this,\u201d and then it\u2019s usually up to the agency to flesh that out through regulations. Healio: Are there laws that prohibit political interference within the task force? Shachar: This was actually an issue that was part of the Kennedy v. Braidwood Management Inc. case a couple years ago. The ACA has language saying that the USPSTF needs to be independent from political interference. What exactly that meant was debated in front of the Supreme Court about how much that language insulates the USPSTF from political pressures. It\u2019s supposed to be just a nonpartisan panel of experts, but as I think we\u2019ve seen over the last couple of years with USPSTF and Advisory Committee on Immunization Practices, it is hard to completely insulate an advisory group from political pressures. Healio: Do you have anything else you\u2019d like to add? Shachar: The important thing to understand is that there are some rules in how the USPSTF operates. For example, they need to review scientific evidence and consider best practices from a variety of sources like the CDC and NIH as well as the medical societies. So, it\u2019s not that there\u2019s absolutely no rules here and it\u2019s a wild west, but that the challenge there is that it\u2019s just a manual, it\u2019s not regulations. Editor\u2019s note: HHS has not yet responded to Healio\u2019s questions about when the task force is expected to meet or issue new recommendations For more information: Carmel Shachar, JD, MPH, is a faculty director of the Health Law and Policy Clinic at the Center for Health Law and Policy Innovation and an assistant clinical professor of law at Harvard Law School. She can be reached at primarycare@healio.com. Sources\/Disclosures Source: Healio Interviews References:
Disclosures:
Shachar reports no relevant financial disclosures.
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