Drug Pricing, Health Care Costs Talks Begin in Senate

Bipartisan leadership of the Senate Finance and Senate Health, Education, Labor, and Pensions (HELP) committees met last week to begin discussions on the integration of their panels’ drug pricing and health care costs packages before the measures are brought to the Senate floor for a vote. The lawmakers are also working with relevant committee leadership in the House of Representatives on similar work taking place across the Capitol. They hope to get legislation passed this fall after Congress returns from the five-week August recess. Senate Minority Leader Chuck Schumer (D-N.Y.) has said that Democrats will demand votes on allowing the Medicare program to negotiate drug prices ahead of any floor vote on health care legislation this year.

Finance Chairman Chuck Grassley (R-Iowa) is also working with Sen. Dick Durbin (D-Ill.) to include a provision to require manufacturers to disclose the price of drugs in direct-to-consumer (DTC) advertising. The legislation is not within the jurisdiction of the Senate Finance Committee, and the administration’s attempt to implement a similar policy was blocked in court.

Lawmakers Launch Comprehensive Care Caucus

Sens. Jacky Rosen (D-Nev.), John Barrasso (R-Wyo.), Deb Fischer (R-Neb.), and Tammy Baldwin (D-Wis.) announced the launch of the Comprehensive Care Caucus last week. The caucus aims to raise awareness about the benefits of palliative care, address caregiver-specific issues, and improve access to palliative care.

Democrats to Force Vote on Waiver Regulation

Senate Democrats have introduced a Congressional Review Act (CRA) resolution that would roll back the implementation of the administration’s 1332 waiver rule, which would allow states to offer subsidies for of short-term, limited duration plans and expand the availability of health insurance that is not required to comply with the Affordable Care Act’s (ACA) consumer protections. Democrats plan to force a majority-threshold vote on the resolution after August recess to put Republicans on the record regarding their support for protections for pre-existing conditions.

Ways and Means Push Action on Hospice Oversight, Air Ambulance Surprise Billing

House Committee on Ways and Means Chairman Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-Texas) have sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting information on the agency’s work to address recent reports from the HHS Office of the Inspector General (OIG) of deficiencies in the quality of hospice care. The OIG’s findings indicated that 87 percent of hospices had at least one care deficiency between 2012 and 2016, and 20 percent had at least one serious deficiency, meaning that the health and safety of a beneficiary were in jeopardy or the hospice was limited in its capacity to deliver adequate care. The report also found that CMS lacks sufficient reporting and enforcement requirements. The lawmakers urge CMS to address the recommendations contained in the OIG’s report, and request that CMS provide information on its data collection and reporting practices; oversight of patient harm; plans to improve the process for beneficiaries and caregivers to make complaints; and strategies to develop better measures for hospice quality and outcomes. The lawmakers request a response before August 15.

Ways and Means leadership also sent a letter to the Department of Transportation (DOT), urging Secretary Elaine Chao to convene the Air Ambulance and Patient Billing (AAPB) Advisory Committee. The task force was created by the FAA Reauthorization Act of 2018, and the DOT was charged with establishing the group within 60 days of enactment of the law. The purpose of the task force is to make recommendations to protect patients of air ambulance transports from receiving high-cost bills. The DOT has yet to take any action in regard to the task force except to issue a call for potential membership, which had deadline of January 15.

E&C Makes Inquiries Into Possible Heparin Shortages, Environmental Health at the CDC

Bipartisan leadership of the House Energy and Commerce Committee have written to Acting Commissioner of Food and Drugs Ned Sharpless to request briefings on potential shortages in the U.S. supply of heparin. Heparin, which is the only anticoagulant used for open-heart surgeries and kidney dialysis, is derived from animal sources. The lawmakers raise concerns about the impact of the current outbreak of African swine fever in China’s pig population on heparin supply in the U.S. Nearly 80 percent of the world’s heparin ingredient supply is made in China. The letter asks how the Food and Drug Administration (FDA) is monitoring the adequacy of the U.S. heparin supply, and what the agency’s plans are to address a potential shortage and the threat of "economically-motivated adulteration."

Chairman of the House Energy and Commerce Committee Frank Pallone (D-N.J.) has requested a briefing from the Centers for Disease Control and Prevention (CDC) regarding the agency’s environmental health division. Rep. Pallone expresses concerns about recent reports that the CDC’s reorganization of the division could diminish the effectiveness of certain public health programs, including the Climate and Health Program. He requests a briefing from CDC officials on program changes by August 12, 2019.

Dems Continue Inquiry Into Religious Conscience Protections Rule

Democratic leadership of the House Energy and Commerce Committee, Education and Labor Committee, Oversight and Reform Committee, and Senate HELP Committee have written to HHS Secretary Alex Azar regarding the administration’s recent conscience protections rule which would expand religious protections for health workers. The lawmakers ask for information regarding the policy’s potentially discriminatory impact on patients, and what the Department would do to mitigate those effects. They request a response from HHS by Aug. 15.

Senators Urge Caution on FCC Rural Health Program

A bipartisan group of senators is requesting that the Federal Communications Commission (FCC) delay changes to the Rural Health Care Program, which subsidizes rural health care providers’ broadband internet connections. The lawmakers express concerns that a recent proposal from the FCC "does not address the need for more funding, set forth the methodology for calculating rural and urban rates, nor provide adequate maps to determine the rural area boundaries needed to determine pricing."

Lawmakers Release Draft Bill Linking Drug Costs to Federally Funded Research

Sens. Chris Van Hollen (D-Md.) and Rick Scott (R-Fla.) have released draft legislation that would require pharmaceutical manufacturers to discount products that have benefited from federally-funded research. The bill, which would put price controls on drugs that have patents directly tied to or supported by the National Institutes of Health (NIH), would only impact future medications. A committee of experts would be created to determine a reasonable price for applicable medicines. Sen. Van Hollen has said that the legislation could apply to as much as a quarter of new drugs.

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