October 31,2019
Grassley, Rubio Seek Answers on HHS Funded Genetic Testing Connected to China, Russia
WASHINGTON
– Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Sen. Marco
Rubio (R-Fla.) wrote to Department of Health and Human Services (HHS) Secretary
Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator
Seema Verma seeking an update on the status of a congressionally-mandated
report which requires CMS to detail the circumstances in which CMS may be
funding entities that process Americans’ genome or exome data in China or
Russia.
Earlier
this year, Grassley and Rubio urged the HHS Acting Inspector
General to examine potential payments made to U.S. entities with partnerships
to genomics companies affiliated with the Chinese government, including WuXi
and BGI. Both WuXi and BGI have publicly touted their partnerships with the Chinese
telecom company Huawei, a state-directed actor allegedly used by the Chinese
government and Communist Party to undermine U.S. companies and steal
intellectual property and trade secrets. The FBI has identified national
security risks related to sharing genomic data, and recognizes China as a
country that is a primary source of those risks.
In
today’s letter, the senators expressed concern that CMS may “[B]e providing
payments for genetic testing or analysis to U.S. entities that have domestic
partnerships with WuXi, BGI, and other genomics companies with ties to the
Chinese government.” The letter also requests that CMS expand the scope of its
report to include payments for genome or exome analysis to domestic Medicare
and Medicaid providers that have partnerships with Chinese genomics companies.
The
full text of the letter is below.
Dear
Secretary Azar and Administrator Verma:
We
write in regards to the Centers for Medicare and Medicaid Services’ (CMS)
failure to comply with a congressionally mandated report which requires CMS to
detail the circumstances in which CMS may be funding entities that process
Americans’ genome or exome data in China or Russia.
Specifically,
the Joint Explanatory Statement (“Statement”) accompanying legislation
appropriating funding for the Department of Health and Human Services for
Fiscal Year 2019 (P.L. 115-245) states, “Each department and agency funded in
this Act shall follow the directions set forth in this Act and the accompanying
statement, and shall not reallocate resources or reorganize activities except
as provided herein.” The same Statement directed the Secretary of Health
and Human Services to issue a report within 90 days of the bill’s enactment
detailing instances in which CMS may have provided funding to entities that
process Americans’ genome or exome data in China or Russia. This congressionally-mandated
report also directed the Secretary to coordinate with other relevant agencies
to examine the potential effect of allowing beneficiaries’ genome or exome data
to be processed in China or Russia on U.S. national security, U.S. intellectual
property protections, HIPAA privacy protections, future biomedical development
capabilities and competitiveness, and global competitiveness for U.S.
laboratories.
More
than a year has passed since this appropriations bill was enacted. Yet, CMS has
failed to submit the report.
As
you may know, the Federal Bureau of Investigation (FBI) Weapons of Mass
Destruction Directorate has identified national security risks related to
sharing genomic data, and recognizes China as a country that is a primary
source of those risks. The FBI also identified the Shenzhen BGI Technology
Company (BGI) and WuXi Nextcode Genomics (WuXi) as companies that have ties to
the Chinese Government.
As
we previously noted to the Inspector General, we are concerned that CMS may be providing
payments for genetic testing or analysis to U.S. entities that have domestic
partnerships with WuXi, BGI, and other genomics companies with ties to the
Chinese government. In 2016, WuXi was the first genetic sequencing facility in
China to gain CLIA (Clinical Laboratory Improvement Amendments) certification
from CMS. It has since gained a foothold in the U.S.
Similarly, BGI has publicly announced partnerships with leading American health
care systems, including those that accept Medicare and Medicaid patients. In
2013, BGI acquired Complete Genomics, a U.S. company which later became part of
MGI Tech (MGI), a BGI subsidiary. In March 2019, MGI announced
plans to expand into the U.S. market by the end of 2019, making it all the more
necessary to determine whether CMS payments are negatively impacting the
interests of the United States.
Both
BGI and WuXi also have publicly touted their partnerships with Huawei to expand
genomic analytics. As you know, Huawei is a State-directed Chinese telecommunications
company that, according to the heads of six U.S. intelligence agencies
including the CIA, FBI, NSA, and the Director of National Intelligence,
possesses the capabilities to “maliciously modify or steal information” and “to
conduct undetected espionage.” This is the same company that the U.S.
recently charged with conspiring to defraud our nation and stealing trade
secrets, among other crimes. WuXi and BGI’s U.S.-based partnerships
give them unique access to genomic data, including Americans’ genomic
data. Therefore, it is particularly alarming that these two companies
have partnered with Huawei.
As
of March 2019, the Congressional Budget Office estimates that the federal
government’s gross spending on Medicare in 2018 was $712 billion, while federal
Medicaid expenditures were $389 billion, not including the states’ Medicaid
spending. Together, these two programs totaled more than $1.1 trillion in
federal outlays in 2018. Taxpayers cover the costs of CMS payments and have
every right to know if their money has gone to entities connected to the
Chinese or Russian governments.
Accordingly,
we request that you provide an update on the status of this report by November
14, 2019. In addition, we request that you expand the scope of this report to
include payments for genome or exome analysis to domestic Medicare and Medicaid
providers that have partnerships with Chinese genomics companies, including but
not limited to BGI and WuXi.
Along
with the update on the status of the report, please provide responses to the
following questions no later than November 14, 2019:
1. Does CMS require
providers to notify CMS of all labs it contracts with for services covered by
Medicare or Medicaid? If not, why not?
2. Does CMS require
providers to notify CMS if beneficiaries’ genetic information is sent or stored
outside of the United States? If not, why not?
3. As a condition of
obtaining or retaining CLIA certification, does CMS require labs to notify CMS
of all partnerships it maintains to perform services covered by Medicare or
Medicaid? If not, why not?
Sincerely,
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