One year after overhauling a key group of vaccine advisers, Health Secretary Robert F. Kennedy Jr. is poised to put his stamp on another critical health panel, one whose recommendations determine which screenings millions of Americans can get for free.
The Department of Health and Human Services is preparing to announce eight new members of the U.S. Preventive Services Task Force and plans to let the group meet in late August, according to a notice sent out last Thursday and confirmed Monday by HHS.
It will be the group’s first meeting in 17 months, after the administration canceled four prior meetings, ousted two of the task force’s vice chairs in May and didn’t replace other members as their terms expired. Normally composed of 16 experts, the task force has shrunk by half in recent months.
Kennedy has previously called the task force “lackadaisical” and “negligent” — a similar criticism he had of the Advisory Committee on Immunization Practices, which he replaced last year with handpicked panelists, several of whom have associations with the anti-vaccine movement.
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Now, former Preventive Services Task Force members say they’re concerned the forthcoming changes will hinder the panel’s ability to make timely, evidence-based recommendations.
“Kennedy is doing the same thing as he did for ACIP,” said Mike Silverstein, who was a third co-chair of the task force before his term ended in March. “But he’s doing it in slow motion and he’s doing it in a way that doesn’t generate a big splash.”
Potential new members are being screened primarily by a political appointee, Agency for Healthcare Research and Quality Director Roger Klein, and his staff, including career medical officers, without the usual input from task force vice chairs. Kennedy dismissed former vice chairs Esa Davis and John Wong in May. Davis said she reapplied but hasn’t been contacted for an interview.
The arm of HHS that oversees the task force is also operating with roughly 70 percent fewer staff, according to numbers from the Department of Personnel Management.
“This feels more like a political process now,” said John Ruiz, a psychologist whose task force term ended in January. “Whoever ends up [on the task force] may or may not be qualified. But the process had been so transparent before.”
Klein is seeking specialists — a marked departure from the usual practice of appointing primary care doctors with experience considering large, diverse patient populations.
That shift toward specialists, which HHS previewed in an April notice, has alarmed stakeholders, who have watched medical specialties lobby for years to have a seat on the panel.
It would be “a huge shift” to appoint specialists, said Aaron Carroll, who follows the task force closely as president of AcademyHealth, a nonprofit representing health policy researchers.
“If you put a kidney doc on, that’s great when you’re focusing on a recommendation for kidney disease, but not expertise for anything else,” Carroll said.
NOTUS previously reported the administration was considering appointing Mark Shirley, whose daughter Malia Shirley works at HHS and is involved in the appointment process.
An HHS spokeswoman confirmed that the task force meeting originally scheduled for July had been postponed until late August, but didn’t provide a date for that meeting or respond to a question about when the new members will be named.
The task force plays a major role in determining how easily Americans can access screenings for cancer and other illnesses by issuing recommendations and giving them grades based on the level of confidence in their net health benefit.
State Medicaid expansion programs and most private insurers must cover services graded “A” or “B” without charging patients any copays or deductibles. Recommendations with these high grades include mammograms, colonoscopies, pap tests and screenings for a range of other conditions.
When the task force does meet in August, it will face a backlog of recommendations to consider, former members said.
The group had intended to vote over the past four canceled meetings on recommendations for prostate cancer screening and weight loss counseling for adults, among other topics. Members said they had been meeting informally but haven’t been allowed to vote.
Updated recommendations on cervical cancer screenings, perinatal depression, alcohol abuse and fall prevention for the elderly are also in limbo, finalized by the task force before meetings were frozen but not published or made formal by HHS.
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