POLICY BRIEFINGS


Senators Request Data to Inform Surprise Billing Legislation


A bipartisan group of senators are asking insurance companies and medical providers for information about billing and payment procedures. The lawmakers plan to use the data as they draft legislation to protect patients from surprise medical bills, while preventing disruption in the health care system. They request responses by Feb. 18. The letter was signed by Sens. Bill Cassidy (R-La.), Michael Bennet (D-Colo.), Todd Young (R-Ind.), Tom Carper (D-Del.), Lisa Murkowski (R-Alaska), and Maggie Hassan (D-N.H.).


Grassley Reintroduces Bipartisan CREATES, ACE Kids Legislation


Sens. Chuck Grassley (R-Iowa) and Patrick Leahy (D-Vt.) have reintroduced the CREATES Act, a bill that aims to speed the entry of generic drugs to the market. CREATES currently has 28 co-signers in the Senate. The ACE Kids Act was also reintroduced last week, by Grassley and Sen. Michael Bennet (D-Colo.). The legislation would improve care coordination and health outcomes for children with complex medical conditions in the Medicaid program.


Senators Urge CMS to Strengthen MA Program


A bipartisan group of over 60 senators have written to the Centers for Medicare and Medicaid Services (CMS) to urge the administration to strengthen and stabilize the Medicare Advantage (MA) program. For plan year 2020, the lawmakers encourage CMS to “implement policies that promote innovation, provide predictable funding to support longterm, value-based arrangements, and ensure that any substantive changes include sufficient time for thorough evaluation and stakeholder engagement.” The letter was led by Sens. Cory Gardner (R-Colo.), Catherine Cortez Masto (D-Nev.) and Mike Crapo (R-Idaho).


Pallone, Wyden Request Clarification on 1332 Guidance


House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) and Senate Finance Committee Ranking Member Ron Wyden (D-Ore.) have written to the Government Accountability Office (GAO) questioning whether the administration’s 2018 guidance on 1332 State Innovation Waivers is subject to the Congressional Review Act (CRA). State Innovation Waivers allow states to waive some of the Affordable Care Act’s (ACA) requirements in order to test innovative strategies for providing health insurance coverage to their residents. The 2018 guidance expands the scope of such waivers and loosens the standards states must meet to receive waiver approval from CMS. The lawmakers argue that the guidance is a rule, as defined by the Administrative Procedure Act (APA), because it is applicable to all states, it is designed to interpret and implement existing law, and it establishes substantial new policies and revises CMS’ interpretation of the law.


Pharma Companies to Appear Before Senate Finance


All seven pharmaceutical companies invited by Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) will testify before the panel in a Feb. 26 hearing, the second Finance Committee hearing in a series on drug pricing. Lawmakers will hear from AbbVie, AstraZeneca, Johnson & Johnson, Bristol-Myers Squibb, Pfizer, Sanofi, and Merck. House Oversight and Reform Committee Chairman Elijah Cummings (DMd.) also plans to invite manufacturers to testify before his panel, but a date has not been set and the specific companies to be invited have not been named.


Brown, Doggett, Introduce Medicare Negotiation Legislation


Sens. Sherrod Brown (D-Ohio) and Tammy Baldwin (D-Wis.), alongside Rep. Lloyd Doggett (D-Texas), have introduced legislation that would allow Medicare to negotiate prescription drug prices and to license generic versions of products when a pricing agreement cannot be reached. Doggett, Chairman of the House Ways and Means Health Subcommittee, plans to bring the measure before his panel in March.


House Dems Introduce Bill to Block Expansion of Short-Term Plans


Reps. Lauren Underwood (D-Ill.) and Mark DeSaulnier (D-Calif.) have introduced legislation that would block the Trump administration’s recent rule to expand short-term, limited-duration health plans that are cheaper than traditional insurance but are not required to comply with the ACA’s consumer protections, such as coverage of pre-existing conditions. Under the recent Trump administration rule, insurers are allowed to sell the plans for up to one year at a time and renew the plans for another three years. The availability of such plans was previously limited to three months. Democrats characterize the plans as “junk” insurance and have raised concerns that expansion of short-term insurance plans will raise costs for individuals who remain in the ACA marketplace. While the measure could garner enough support to pass the House, it is unlikely to be taken up in the Republican-controlled Senate.



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