HealthCare Roundtable e-News – August 23, 2021

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2021 Annual Conference

The Roundtable’s highly-regarded annual conference returns to Old Town Alexandria in November! The conference provides members and guests a unique opportunity to hear presentations by high level government officials and key experts – from Congress and the Administration, academics, benefit consultants, plan administrators, advocates and industry leaders in an intimate dialogue-oriented setting.

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Pelosi’s Fall Agenda Aims to Prioritize Passing Budget Resolution and Infrastructure Bill Together

As the House reconvenes in Washington this week, Speaker Nancy Pelosi (D-Calif.) told party members that she plans to hold a procedural vote on the $1 trillion bipartisan infrastructure legislation passed by the Senate and the $3.5 trillion budget resolution, teeing up Democrats’ reconciliation package.

Pelosi stated that the overall goal is to pass the budget resolution this week “so that we may pass Democrats’ Build Back Better agenda via reconciliation as soon as possible.” Pelosi noted that she has requested the Rules Committee explore the possibility of a rule that advances both the budget resolution and the bipartisan infrastructure package. (InsideHealthPolicy)

Some Democrats have been vocal about their stance that they will not vote on the budget resolution until the infrastructure bill has passed into law, while other more progressive members of the party have said that they will not consider a vote on the infrastructure bill until the Senate passes the reconciliation package. Pelosi is asking House members to provide feedback on their priorities prior to next month’s deadline for writing the reconciliation bill.

On the other side of the aisle, House Republicans have stated that they will not consider a vote on the reconciliation package until CMS releases its months-overdue Medicare Trustees report, which was originally intended to be published earlier this year. Senate Finance Committee ranking Republican Mike Crapo (ID) has pressed the Treasury Department for more transparency on when the report will be released, claiming that information on the trust fund is needed prior to lawmakers moving on any reconciliation package. CMS Administrator Chiquita Brooks-LaSure says that she expects the trustees report to be released later this month.

House E&C Committee Requests Explanation on Ever-Increasing Insulin Costs Following Investigation

Last week, House Energy & Commerce Committee lawmakers distributed letters questioning rising insulin prices to three leading manufacturers following an investigation launched by Democrats in 2019. Eli Lilly, Novo Nordisk and Sanofi were each questioned on whether enough has been done by the drug makers to lower their insulin prices since the launch of the investigation.

The letter, signed by Committee Chair Frank Pallone (D-NJ) and oversight subcommittee Chair Diane DeGette (D-Colo.), explained that the committee “is troubled that despite [the companies’] expressions of shared concern, insulin prices in the United States remain unacceptably high,” and that the manufacturers will be given until September 17 to update the committee on their efforts and how they have been working to alleviate rising insulin costs.

Each of the drug makers have blamed the increased prices on high rebates, which pharmacy benefit managers charge on behalf of their insurance company clients. As a result, the committee is requesting list and net price increases for insulin products since January 2019 and explanations for those price hikes. The lawmakers also want gross revenue and net profit figures on insulin products and a description of research and development plans for new insulin products. (InsideHealthPolicy)

The three drug manufacturers, as well as three pharmacy benefit managers, are also currently facing racketeering charges over claims they systematically hiked the price of insulin drugs.

HHS Report on Drug Price Competition Likely to Consider Common Billing Codes for Biosimilars

According to department staff, HHS is preparing to unveil its report that includes a potential proposal to require that Medicare put biosimilars and their reference biologics in Part B common billing codes. The report is part of an executive order targeting the FDA, CMS and FTC’s drug pricing competition efforts, which was signed by President Joe Biden last month.

The agency is expected to finalize its report this week that includes details around how the agency plans to control drug prices. As part of the executive order, CMS was directed to “prepare for Medicare and Medicaid coverage of interchangeable biological products, and for payment models to support increased utilization of generic drugs and biosimilars.” (InsideHealthPolicy)

Industry sources say that CMS’ Center for Medicare & Medicaid Innovation will likely test placing the two on the same billing codes, but not all groups support the initiative. Generic and brand drug companies have suggested common billing codes would lower biosimilar reimbursement to the point of ruining the market. Players argue that the industry can continue to introduce more biosimilars generating more savings to Medicare so long as they continue to be given their own billing codes.

Save The Date: 2021 Annual Conference
Monday, November 1 – Wednesday, November 3, 2021
The Alexandrian Hotel, Old Town Alexandria, VA
Registration will open in early August!