HealthCare Roundtable e-News – June 24, 2024

 

Top News

Projected $5 Billion Savings Boosts Momentum for Anti-Competitive Drug Reform Bills in Congress

A series of bills targeting anti-competitive practices by brand drug makers, such as product hopping and patent thickets, is now projected to save the government about $3 billion, significantly more than initially estimated. This increased savings, along with an additional $2 billion from two other drug competition and patent reform bills, raises the likelihood of these bills being included in a year-end health care spending package. The Affordable Prescriptions for Patients Act, the Preserve Access to Affordable Generics and Biosimilars Act, and the Stop STALLING Act aim to curb tactics like pay-for-delay agreements and sham citizen petitions that delay generic and biosimilar market entry. These reforms, supported by bipartisan efforts and advocacy groups, are gaining momentum in Congress and have been emphasized by the Federal Trade Commission as essential to reducing prescription drug prices and enhancing market competition.

 

CMS Announces Conclusion of CHOPD Payments

The Centers for Medicare & Medicaid Services (CMS) announced that payments under the Accelerated and Advance Payment (AAP) Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will conclude on July 12, 2024. The CHOPD payments, initiated in early March, aimed to mitigate cash flow disruptions for Medicare providers and suppliers, including hospitals, physicians, and pharmacists, following a major cyberattack that disabled Change Healthcare in February. To date, over $2.55 billion has been issued to 4,200 Part A providers and more than $717.18 million to 4,722 Part B suppliers. CMS has already recovered over 96% of the CHOPD payments. After July 12, 2024, CMS will no longer accept new applications for CHOPD payments.

Administrative Action

  • The National Center for Health Statistics (NCHS) under the Centers for Disease Control and Prevention (CDC) released the “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2023.” The report uses National Health Interview Survey (NHIS) data from 2023 to estimate health insurance coverage for the non-institutionalized American civilians. A key highlight showed that 7.6 percent of all people were uninsured in 2023, which is lower than the 2022 rate of 8.4 percent.

 

  • The Centers for Disease Control and Prevention (CDC) released a National Health Statistics Report examining changes in telemedicine use among U.S. adults between 2021 and 2022. The study found that the percentage of all adults who used telemedicine in the past 12 months decreased from 37.0 percent in 2021 to 30.1 percent in 2022. However, women, adults with a college degree or higher, and adults living in more urban areas were all more likely to use telemedicine in 2022.  In 2021 and 2022, uninsured adults between the ages of 18 and 64 were less likely to utilize telemedicine compared with those who had private or public insurance, while Medicare beneficiaries 65 years and older were less likely to use telemedicine compared with those with other types of insurance.

Congressional Action

The House Committee on Energy & Commerce Subcommittee on Health recently held a hearing “Checking-In On CMMI: Assessing The Transition To Value-Based Care.” Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation (CMMI) Dr. Elizabeth Fowler testified to the successes of CMMI including continuous development of innovative programs that improve quality of care, reduce costs, and promote health equity. Generally, Republican Representatives focused their questioning on the limited cost savings CMMI has yielded, the few models that have been approved for broader implementation, and concerns about agency overreach. With their line of questioning, Democratic Representatives generally highlighted successes CMMI has brought including increased coverage, improved health equity, improved quality of care, and some models demonstrating moderate cost savings. Healthsperien covered the hearing and detailed notes are provided here.

Research

study published in JAMA Internal Medicine by researchers from the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institutes of Health’s (NIH), National Institute on Drug Abuse (NIDA), Centers for Medicare & Medicaid Services (CMS), and the Centers for Disease Control and Prevention (CDC) shares critical insights into post-overdose care among Medicare beneficiaries. Key findings indicate that gold-standard interventions, such as medications for opioid use disorder (MOUD) and naloxone, significantly reduce the likelihood of a fatal overdose. Recent policy changes aim to improve access to these treatments, including the removal of federal waivers for prescribing buprenorphine and FDA approval of over-the-counter naloxone. Enhanced funding and updated regulations are also supporting expanded overdose prevention efforts and behavioral health services.


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