HealthCare Roundtable e-News – August 6, 2019

Today: Roundtable Webinar on Drug Pricing 

Given the amount of recent legislative and regulatory activity regarding a variety of issues relative to drug pricing, the Roundtable will present a webinar today at 4:00 PM (EDT).

The upcoming Congressional summer recess provides an opportunity for us to step back and review recent legislative and regulatory activity regarding critical Roundtable priorities. The webinar will include a discussion of the bipartisan drug pricing bill advanced today by the Senate Finance Committee and other pending House and Senate proposals. In addition, we’ll discuss what we expect to see when Congress reconvenes in September.

Click here to register for this timely and informative webinar.

Schedule Notice:

Due to the current Congressional recess, the Roundtable’s Weekly e-News will suspend publication until Labor Day. In the event of significant Administrative activity we will provide an update as needed.

Also, watch your e-mail for important information regarding our 15th Annual Conference.

Roundtable Joins Multi-Stakeholder Effort to Address ‘Surprise’ Medical Bills

The Roundtable is pleased to announce we have formally joined the “Coalition Against Surprise Medical Bills,” a multi-stakeholder organization recently formed to ensure fair, local, market-based approach to protect patients and families from surprise medical billing. The Coalition consists of health plans, consumer organizations, unions, and many others working together to urge policymakers to protect patients from surprise bills.

To kick-off our support for addressing the issue and participation in the Coalition, the Roundtable joined a group sign-on letter sent to lawmakers yesterday (Monday, Aug. 5) requesting they implement a fair, local, market-based benchmark that would protect patients, families and taxpayers, while rejecting arbitration proposals that would give a green light to certain out-of-network providers to continue charging exorbitant rates for care.

Please don’t hesitate to be in touch with Roundtable Senior Policy Advisor, Andrew MacPherson (, with questions.

Trump Administration Announces New Drug Importation Plan

The Trump administration recently unveiled a plan to enable safe importation of certain drugs into the United States, as stated in an announcement from Health and Human Services and the Food and Drug Administration. HHS has long been reluctant to consider drug importation in the past due to concerns over safety; however HHS Secretary Alex Azar told reporters last week that the agency is ready to shift its focus.

The two major pathways for the plan focus on Canadian importation demonstration projects, which allows states and wholesalers to import prescription drugs from Canada as long as they are safe and save consumers money, and a second pathway enables drug makers to import drugs intended for distribution abroad but can instead be sold in the US at a lower price. The plan’s requirements include assurance that the drug is properly labeled and can be tracked. (InsideHealthPolicy).

Drug companies were quick to reject the President’s plan, citing concerns over how importation could negatively affect the country’s current opioid crisis.  

“There is simply no way to adopt an importation scheme that doesn’t jeopardize the health and well-being of America’s patients,” said BIO president Jim Greenwood. “This is a misguided attempt to keep a ill-informed campaign promise.” Other critics of the plan claimed it would do little to lower drug costs under the voluntary, industry-driven track and also slow current state importation efforts. (InsideHealthPolicy).

Ways and Means Leaders Urge Immediate Formation of Air Ambulance and Patient Billing Advisory Committee

Last week, Ways and Means Committee Chairman Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-TX) requested that Transportation Secretary Elaine Chao convene the Air Ambulance and Patient Billing (AAPB) Advisory Committee. In a letter to the Secretary, both representatives noted that the Department of Transportation (DOT) was required to establish the advisory committee within 60 days of the enactment of the FAA Reauthorization Act of 2018, for which it has now been 10 months since and the requirements have not been met.

Reps. Neal and Brady cited a recent report from the Government Accountability Office which stated that nearly 70 percent of analyzed air ambulance transports conducted in 2017 for privately insured patients were out-of-network, leaving them exposed to surprise bills with exceptionally high out-of-pocket costs.

“This information is critical as Congress considers appropriate steps to find the best solution to protect consumers from surprise bills,” Brady and Neal wrote in the letterto Secretary Chao. “However, the committee has failed to convene, let alone produce a report. Additionally, Congress mandated the Secretary of DOT to submit a report to the appropriate committees of Congress on air ambulance oversight, which has also yet to be provided.”

The committee has requested that the DOT provide upcoming dates and deadlines for which it plans to enact the committee with 14 days.

Big Pharma Executives Look to Push Part D Rebate Proposal into Revised Senate Finance Health Packaging Rejected by Trump Administration

Drug manufacturers are uniting to push revisions to the Senate Finance Committee’s anticipated drug pricing package, with the hopes of Trump’s Part D rebate plan being reconsidered and included in the final product. Concerns over the risk of higher premiums had initially kept the bill out of the package, but drug lobbyists have been pushing members of the GOP to reconsider the bill as part of their primary concern to lower patients’ drug costs. 

‘[W]e noted that in the Senate bill there was the unanimous support — almost unanimous — support to introduce a comprehensive rebate reform into this bill. This is very, very positive and I believe that will be one of the very meaningful tools that the Senate Committee has in their hands to reduce out-of-pocket costs,” Pfizer CEO Albert Bourla said on the earnings call, according to a transcript from Seeking Alpha. (InsideHealthPolicy).

Drug makers have repeatedly stressed that the package, in its current form, doesn’t fully benefit patients and instead only generates savings for the government. While elements of the Finance Committee’s package would hurt big pharma, pharmacy benefit managers would potentially bear the brunt of its impact.

CMS Administrator Bashes Single-Payer, Public Option After Democratic Debates

Seema Verma, Administrator for the Centers for Medicare and Medicaid Services (CMS) and one of President Trump’s top health officials, denounced single-payer and the public option in a recent speech to the Better Medicare Alliance. Verma claimed that the proposals would require “force of government price-setting” to remove private insurers from the marketplace altogether to achieve the goal, which the administration sees as unrealistic.

“The fact that the program is going to run out of money in seven years should be a cause for concern, and lawmakers should focus on that,” Verma added. Earlier this year, Verma criticized the plan stating that “stripping around 180 million Americans of their private care and adding them to Medicare won’t fix the problem.”

The CMS administrator had also recently called out former Vice President and Democratic Presidential candidate Joe Biden’s proposal for a public healthcare option, which Verma denounced as another version of Medicare for All. While supporters of Biden’s proposal claim that the public option is better because patients have the option to hold onto their private healthcare plan, Verma contends that the proposal will strong-arm hospitals into accepting below-market rates. (InsideHealthPolicy)