HealthCare Roundtable e-News – April 15, 2020


COVID-19 Update Webinar

Thursday, April 30th, 2:00 PM (EDT)

Based on the success of our most recent webinar, Andrew and I thought it would be good to keep this discussion going during this unprecedented period of time. We know that you’re all dealing with unique challenges presented by the Coronavirus pandemic and we’re interested in learning more about how you’re handling them.

We’re also working on a letter for Congress that we want to share with you and seek your feedback. In that context, Andrew will provide an update on current Congressional discussions and potential legislation.

So, I have two requests:

First, if you have a few moments to share some thoughts about your current experiences – decisions you’re making, services that you’ve modified, innovate communication strategies you’ve initiated – , we’d appreciate your feedback. Nothing fancy is required… drop a quick email Andrew or me

Second, since we’re going to use a Zoom platform for this meeting, we’ll need to send you the meeting address. In order to get on that list, please just send me your email address.

Stay healthy!

Tom Lussier

CARES Act Prohibits Hospitals from Surprise Billing COVID-19 Patients

According to the terms and conditions of the CARES Act released by HHS last week, providers must agree to not surprise bill coronavirus patients in order to receive the $100 billion allocated to them by the bill. The requirement comes as HHS suggested that many patients suffering from the virus will likely be forced to receive out-of-network care at out-of-network facilities. Additionally, as announced earlier this month, the Provider Relief Fund will reimburse hospitals at Medicare rates for treating uninsured COVID-19 patients.

The ERISA Industry Committee (ERIC) expressed their support for the decision to institute billing protections and is asking lawmakers to consider a more permanent solution once the pandemic passes. In a statement, ERIC CEO Annette Guarisco Fildes said the practice of not protecting patients “takes advantage of Americans during their most vulnerable moments,” and shared her hope that Congress would follow the administration’s lead. (InsideHealthPolicy)

Providers have 30 days to sign the terms and conditions and certify that they will not collect patients’ out-of-pocket expenses in an amount greater than what the patient would pay at an in-network provider.

Public Health Experts Say At-Home COVID-19 Tests Key to Economic Recovery

Public health experts are calling on the rapid production of at-home COVID-19 infection and antibody test kits in an effort to get individuals with antibodies and potential immunity to the virus back into the workforce and resuming other activities. According to experts, antibody tests could allow people who have recovered from the disease to interact with those who are sick, possibly even taking a more active role by caring for those with COVID-19, or donating antibody-rich plasma.

While the FDA said it does see the value in expanding the tests’ availability, the agency has also shared its concerns about the technique and how individuals will ensure that collection and transport of specimens to labs still provide for accurate test results. An FDA spokesperson wrote that false results “can lead to significant adverse public health consequences, especially during an unprecedented public health emergency such as this.” (InsideHealthPolicy)

The FDA confirmed it has been working on validating serology tests aiming to determine whether a recovered COVID-19 patient and others who may have unknowingly had the disease have antibodies in their blood that might make them immune to the disease. HHS Assistant Secretary for Health Brett Giroir noted that tens of millions of serology tests could be available and widely deployed by May if the currently available tests are validated. (InsideHealthPolicy)

Hospitals Concerned About Lack of Administration Guidance on $100B Funding in Third Coronavirus Stimulus Package

Last month, the House approved a third coronavirus stimulus package including a $100 billion Provider Relief Fund, but many hospitals across the country are concerned about the lack of guidance on which the funds are to be used. Some groups have called on the administration to prioritize getting uninsured people into coverage and to dispense the money directly to hospitals, where others have asked the funds to go directly to providers.

Last week, CMS administrator Seema Verma commented that $30 billion of the CARES Act funding will be distributed and divvied up to providers based on their Medicare revenue, but some groups, including America’s Essential Hospitals, claim that Verma’s method would pull funding away from hospitals that cover Medicaid patients, as well as the uninsured. The American Hospital Association also criticized the funding plans coming from HHS, questioning why the group opted to use part of the fund for the uninsured instead of opening a special enrollment period for the federal exchanges or encouraging states to expand Medicaid. (InsideHealthPolicy)

The Kaiser Family Foundation last week estimated that, under Azar’s plan, up to 40% of the $100 billion would go towards paying for the treatment of the uninsured. Meanwhile, House lawmakers are currently pushing for another $100B to be included in the fourth stimulus package, which will go towards resources like COVID-19 tests and personal protective equipment.

Generic Drug Prices Likely to Increase Over the Long-Term Due To COVID-19

According to a recent joint report from the Congressional Research Service and industry analyst SVB Leerink, prices for generic drugs will be more likely to increase due to supply disruptions caused by the coronavirus pandemic. Notably, most generic drug active pharmaceutical ingredients (APIs) are made in China, and the country’s role as the primary supplier of APIs is likely to increase the overall costs of generic pharmaceuticals for consumers in the U.S. in the short-to-medium term.

Generic drug industry analyst Ami Fadia of SVB Leerink says it’s not clear that generics could sustain higher prices long-term and that consumer behavior will likely be impacted. In a note, the group says that consumers “are likely to be compelled to pay higher prices for generics near term due to COVID-19 related disruptions; however, even in the longer term, we don’t rule out the possibility that customers may be willing to consider higher prices for more reliable supply.” (InsideHealthPolicy)

India, another large supplier of APIs, restricted exports last month of 26 pharmaceutical ingredients and drugs, but then last week lifted restrictions on all but two of them: the painkiller paracetamol and the autoimmune treatment hydroxychloroquine, which President Trump had touted as a form COVID-19 treatment. Concerns over increasing generic prices and foreign dependencies on APIs have opened discussions amongst lawmakers on returning drug manufacturing to the U.S. (InsideHealthPolicy)

Drug Makers Resistant to Trump’s Drug Importation Plan Say Rule Violates Constitution

Resistance to drug importation is growing in the U.S. as drug makers are calling on the Trump administration to suspend its plan to import drugs from Canada. The groups have claimed that the administration’s pending rule includes labeling requirements that violate the first amendment by requiring drug makers to include details on the labels that they may not agree with. Other concerns about the rule are a matter of safety, suggesting that importing drugs with specific safety concerns could hurt public health and cause confusion among patients. (InsideHealthPolicy)

Drug importation and the use of an International Pricing Index have been two key components of the administration’s efforts to tackle drug pricing in the U.S., both of which have come to a halt since before the coronavirus crisis began. The Pharmaceutical Research and Manufacturers of America (PhRMA) has argued that the rule exceeds the FDA’s legal authorities in several ways and the agency lacks authority to implement several parts of the proposed rule.

Despite the criticism of the rule from drug makers in the U.S. and Canada, states have taken matters into their own hands enact drug importation policies. Vermont, Colorado, Florida, and Maine currently have measures to import drugs and other states are planning to follow suit, though Pfizer and other drug makers claim that several studies have failed to prove the rule would result in any cost savings and it may come at a cost to the state. (InsideHealthPolicy)