HealthCare Roundtable e-News – October 1, 2019

Senate Finance Committee Releases Text for Drug Pricing Bill, But CBO Says Not to Expect Estimate Anytime Soon

Last week, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) released text laying out the groundwork for the committee’s highly anticipated drug pricing bill. While the committee advanced the bill by a 19-9 vote earlier this year, some Republicans – including Senate Majority Leader Mitch McConnell (R-Ky.) – are hesitant to get on board due to controversial caps on price increases in Medicare parts B and D.

“President Trump has called on Congress to work together on a bipartisan bill to lower prescription drug prices. And there’s only one bipartisan bill in Congress to lower prescription drug prices that’s passed the committee process,” Grassley said. “This is it.”

The Congressional Budget Office has stated it will take some time to estimate the financial and economic impact of the Committee’s proposed bill, despite the office’s tradition of releasing estimates around the same time as the bill text. Some lobbyists have pointed out that the estimate has been held up in part due to differing numbers than what the committee had initially hoped for the bill. (InsideHealthPolicy).

“The analysis will take some time, however, and we will keep the committee apprised of the status of that analysis as we continue our work,” states a CBO letter to the Senate Finance Committee. (InsideHealthPolicy)

Senate Passes Continuing Resolution to Fund Government Through November 21st

Last Thursday, the Senate passed a resolution to fund the government and several health extenders through November 21st by an 82-15 margin. The House had previously passed the measure, and President Trump is expected to sign the resolution in accordance with the funding deadline.

The continuing resolution includes several reforms to Medicaid drug-pricing, as well as a short term delay of the Medicaid Disproportionate Share Hospital pay cuts, a revision that has been praised by America’s Essential Hospitals. AEH President and CEO Bruce Siegel praised the Senate for “acting today to forestall a devastating cut to vital support for the nation’s more than 300 essential hospitals and the vulnerable people and communities they serve.” (InsideHealthPolicy).

Senate Appropriations Chairman Richard Shelby (R-Ala.) had previously warned that bipartisan agreement on those bills could elude lawmakers if Congress and the White House aren’t able to reach an agreement on border security, including Trump’s wall. During a full committee markup of the Senate’s Interior-Environment, State-Foreign Operations, Commerce-Justice-Science, Homeland Security and Legislative Branch spending bills, Sen. Shelby eluded that the government could be moving “toward a full-year continuing resolution,” if those conditions aren’t met.

Questions Arise on How the House’s Impeachment Inquiry Will Impact Pelosi’s Drug Price Negotiation Plan

House Democrats are keeping their sights set on pushing House Speaker Nancy Pelosi’s (D-Calif.) drug pricing negotiation plan, despite the current setback surrounding the recent announcement of an impeachment inquiry into President Trump’s overseas activities. Pelosi commented last week that the administration could still be open to working with Congress to pass comprehensive drug pricing legislation.

White House officials have declined to comment on whether the President will continue to support Pelosi’s drug pricing negotiation plan released last week. White House Press Secretary Stephanie Grisham commented that House Democrats “have destroyed any chances of legislative progress for the people of this country by continuing to focus all their energy on partisan political attacks.” (InsideHealthPolicy).

Another matter currently up in the air is whether the administration will support other forms of drug pricing legislation, as analysts have confirmed that both parties were far from reaching an agreement on any of the talked about bills prior to the impeachment inquiry announcement.

“If Democrats use impeachment proceedings as a basis to not act on policy that will directly benefit Americans like the USMCA or lowering prescription drug prices, that would prove they’re more interested in politics and opposing the president at all costs than serving the American people,” Sen. Chuck Grassley (R-Iowa) said. (InsideHealthPolicy).

ACO Program Generates Significant Savings in 2018, Says CMS Administrator Verma

CMS Administrator Seema Verma announced yesterday that savings from Medicare’s accountable care organization (ACO) program amounted to nearly a net $740 million last year. As of July 2019, the program serves nearly 11 million beneficiaries receiving care through an ACO, according to the agency.

As part of the program, ACOs agree to be held accountable for the quality, cost, and experience of care of an assigned beneficiaries. Currently there are more than 200 ACOs that participate, and Verma, who was a former critic of the program prior to the Trump administration’s overhaul of the program, had called for more commitment from ACOs to accept increased “downside risk” to boost the program. Those that did take on more risk outperformed ACOs that did not.

“Patients are receiving better care as a result of these efforts, and we look forward to continuing on this journey,” Verma said.