The Department of Health and Human Services (HHS) is ahead of schedule to reduce its Medicare Administrative Law Judge (ALJ) appeals backlog, as required by court order, but lawmakers are still looking for ways to improve the efficiency of the Medicare appeals process. Following a November 1, 2018 federal district court order in American Hospital … Continue Reading
Congress has completed action on federal fiscal year (FY) 2020 spending, and President Trump has signed the two domestic and national security funding packages into law. The major health care policy provisions included in the domestic spending package, HR 1865, the “‘Further Consolidated Appropriations Act, 2020” (the “Act”), are summarized below. Repeal of ACA Device, … Continue Reading
The House Energy and Commerce Committee held hearings December 10, 2019 to examine nine legislative proposals intended to expand health insurance coverage and reduce health care costs, including Medicare buy-in bills. The Committee also recently held hearings on FDA oversight of the US drug supply chain and regulation of cosmetics, along with public health preparedness … Continue Reading
President Trump has signed into law a short-term continuing resolution that funds the federal government and extends certain expiring health care programs through December 20, 2019. With regard to health care programs, the measure (HR 3055) delays a scheduled $4 billion reduction in Medicaid disproportionate share hospital allotments until December 21, 2019 and extends the … Continue Reading
The House of Representatives has approved — without objection — a series of bills intended to promote prescription drug pricing transparency and invest in the health care workforce. With regard to drug pricing transparency, the House approved HR 2115, the Public Disclosure of Drug Discounts Act, as amended to include HR 3415, the Real-Time Beneficiary … Continue Reading
Three House committees have approved drug pricing legislation that is a high priority of the House Democratic leadership. Specifically, HR 3, the Lower Drug Costs Now Act of 2019, has been approved by the Energy and Commerce Committee, the Ways and Means Committee, and the Education and Labor Committee. While the details of the committee-approved … Continue Reading
October Congressional hearings have focused on the following health policy topics: A House Ways and Means Committee hearing addressed “Investing in the U.S. Health System by Lowering Drug Prices, Reducing Out-of-Pocket Costs, and Improving Medicare Benefits.” A House Energy and Commerce Committee hearing, “Sabotage: The Trump Administration’s Attack on Health Care,” featured testimony from CMS … Continue Reading
On September 26, 2019 the Senate approved H.R. 4378, the Continuing Appropriations Act, 2020, and Health Extenders Act of 2019, which would fund the federal government through November 21, 2019. The House has already approved the legislation, and President Trump is expected to sign the bill. The legislation includes a number of health program funding … Continue Reading
On September 25, 2019, the House Energy and Commerce Committee is holding a hearing entitled “Making Prescription Drugs More Affordable: Legislation to Negotiate a Better Deal for Americans.” A background memo and text of the bills are available here. Likewise, a second House panel – the Education and Labor Health, Employment, Labor, and Pensions Subcommittee … Continue Reading
While the latest federal budget agreement signed into law earlier this month provides a reprieve from statutory budget caps for certain defense and domestic programs, it extends Medicare sequestration cuts for an additional two years. Specifically, section 402 of the Bipartisan Budget Act of 2019 (P.L. 116-37) extends the 2% across-the-board reduction to Medicare provider … Continue Reading
Prior to the 4th of July break, Senate and House Committees approved more than a dozen health policy bills, covering topics including: surprise medical bills, health pricing transparency, drug prices and competition, various Medicare policies, and public health program reauthorization, among others. The following are highlights of recent action. Note that none of the bills … Continue Reading
The House of Representatives has overwhelmingly approved H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act, which would finance extension of various Medicaid-related health programs by increasing manufacturer Medicaid drug rebate obligations. In terms of health programs, the legislation also would, among other things: Extend the “Money Follows The Person Rebalancing Demonstration” and … Continue Reading
On June 12, 2019, three Congressional committees have scheduled hearings on health care policy topics: The House Ways and Means Committee will hold a hearing entitled “Pathways to Universal Health Coverage.” The House Energy and Commerce Health Subcommittee will hold a hearing entitled “No More Surprises: Protecting Patients from Surprise Medical Bills.” The Senate Judiciary … Continue Reading
The House of Representatives has approved H.R. 987, the “Strengthening Health Care and Lowering Prescription Drug Costs Act,” which packages seven prescription drug and insurance-related bills recently approved by the House Energy and Commerce Committee. The legislation is intended to: increase generic drug competition; fund Affordable Care Act “Navigator” outreach and enrollment programs and state-based … Continue Reading
In a rare display of unity, President Donald Trump and bipartisan Congressional leaders have highlighted their shared commitment to tackling “surprise” medical billing – when an insured patient is subject to unexpectedly high out-of-pocket costs for out-of-network care that is beyond their control. Such surprise billing can occur when a patient receives emergency care from … Continue Reading
Representatives Jackie Speier (D-California) and Dina Titus (D-Nevada) have introduced HR 2143, the Promoting Integrity in Medicare Act of 2019 (PIMA), which – if enacted – would narrow the “Stark” law’s exceptions and have a direct impact on the services provided by physicians who self-refer for the performance of certain designated health services. The 2019 … Continue Reading
Recent Congressional hearings and markups have concentrated on prescription drug pricing, insurance access, and other health topics. For instance, last week the House Ways and Means Committee unanimously approved H.R. 2113, the Prescription Drug Sunshine, Transparency, Accountability and Reporting Act of 2019 (STAR Act). The legislation would, among other things: Require drug manufacturers to report their … Continue Reading
The House and Senate have both approved H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019, clearing it for President Trump’s signature. Notably, the legislation would: subject drug manufacturers to a new civil monetary penalty (CMP) for knowingly misclassifying or misreporting covered outpatient drugs under a Medicaid drug rebate agreement (such as by … Continue Reading
The Senate Finance Committee recently called for federal agencies to begin investigating physician owned distributors’ (PODs) alleged noncompliance with the U.S. Physician Payment Sunshine Act (Sunshine Act, or Open Payments). The letter is addressed to the head of the Office of Inspector General (OIG) and the Administrator of the Centers for Medicare & Medicaid Services … Continue Reading
As we have previously reported, prescription drug pricing is an early focus for Congressional hearings this year. This week the Senate Finance Committee held its second hearing on drug pricing, and the following hearings are on the schedule next week: On March 7, 2019, the Ways and Means Health Subcommittee is holding a hearing entitled … Continue Reading
Federal health policy is an early focus for Congressional committees. In addition to several hearings held in January, Congressional hearings in February have concentrated on the Affordable Care Act (ACA) and primary care, including the following: A House Energy and Commerce Committee hearing on the Texas v. United States court case challenging the constitutionality of … Continue Reading
As the new 116th Congress gets underway, four House and Senate committees are holding hearings to examine health policy issues, including two hearings focusing on prescription drug prices. Specifically, the following hearings are all scheduled for January 29, 2019: A Senate Finance Committee hearing on “Drug Pricing in America: A Prescription for Change, Part I,” … Continue Reading
President Trump has just signed into law HR 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. The bipartisan legislation includes almost 200 provisions intended to strengthen opioid prevention and treatment efforts and bolster law enforcement tools. Among many other things, the new law: Seeks to encourage … Continue Reading
The House of Representatives approved two “gag clause” bills on September 25, 2018 that would prevent insurers from restricting pharmacies from informing consumers about lower cost, out-of-pocket prices for their prescriptions. The bills were approved by the Senate earlier this month, and are now cleared for the President’s signature. Specifically, S 2553, the Know the … Continue Reading
