Smart content. Deeper culture. Better access. Become a subscriber to the Washington Examiner magazine.
SIGN UP! If you’d like to continue receiving the Washington Examiner‘s Daily on Healthcare newsletter, SUBSCRIBE HERE: http://newsletters.washingtonexaminer.com/newsletter/daily-on-healthcare/
LAWMAKERS EYE TRANSPARENCY AS DRUG PRICING FIX: Congress has made addressing drug prices a top priority this year, and lawmakers are hoping that they can arrive at an agreement over various measures that ultimately would lower what patients pay when they arrive at the pharmacy counter. One of the areas of consensus that’s emerging is the need to strip away the confusing process that determines how drugs are priced and paid for.
On Tuesday, senators indicated during a Finance Committee meeting that they would be looking at ways to shed light on how pharmacy benefit managers, the middlemen who negotiate prices with drug companies, do their business, particularly in Medicare and Medicaid.
“The current system is so opaque that it’s easy to see why there are many questions about PBMs’ motives and practices,” said Sen. Chuck Grassley, R-Iowa. The committee’s ranking member, Sen. Ron Wyden, D-Ore., said: “Whether PBMs bring any real value to taxpayers is a mystery.”
Drug manufacturers have accused PBMs of being ultimately responsible for why patients are paying high out-of-pocket costs when they pick up their medicines. Drug companies say that these middlemen pocket the profits they make instead of passing on the savings to patients.
PBM executives representing CVS, Humana, Cigna, OptumRx, and Prime Therapeutics, countered on Tuesday that they are effective at lowering prices and premiums. They warned that the way they negotiate rebates should be kept under wraps so that they could keep their leverage against drug companies. They instead pushed for more drug competition.
Over in the House on Tuesday, a bill called the Prescription Drug STAR Act advanced out of the Ways and Means Committee that would require pharmaceutical companies to justify large price increases for existing drugs and high launch prices for new drugs. The bill also gives federal agencies more power to study and collect information on drug pricing.
On Wednesday morning, the House Energy and Commerce Committee is holding a hearing with the three large insulin manufacturers and with PBMs on the rising price of insulin. (Tune in.)
The way lawmakers are proceeding has been largely bipartisan, but tensions lie ahead.
House Speaker Nancy Pelosi, D-Calif., told the American Hospital Association on Tuesday that her party would be insisting on legislation to allow the secretary of Health and Human Services to negotiate drug prices. House Democratic leaders haven’t released their drug pricing proposals yet, so it’s not clear what form the negotiation would take — whether it would apply only to specific drugs or whether it would mean asking for similar rebates that programs such as Medicaid get.
The idea of extending the government’s role in negotiating drug prices does not have support from Republicans. President Trump said during his campaign that he wanted Medicare to negotiate drug prices, but he has since backed off that position. The Congressional Budget Office has predicted that the federal government wouldn’t be more adept at lowering drug prices than the current private health insurers are unless the government had the power to turn down drug companies entirely, as they do in other countries.
Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at [email protected]. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.
NO NEW CO-SPONSORS ADDED TO THE MEDICARE FOR ALL ACT: Sen. Bernie Sanders unveiled Wednesday an updated version of his Medicare for All Act that includes expanded healthcare benefits, but he did not pick up additional support from Democrats in the upper chamber.
Fourteen senators have co-sponsored the legislation to enroll everyone living in the U.S. onto a government plan, compared to an unprecedented 16 last year for a proposal that Sanders, a Vermont independent, had gone at alone for years.
Sen. Jeanne Shaheen, D-N.H., is the one senator no longer listed as a co-sponsor for the Medicare for All Act after signing on last year, and her office did not respond to queries about her stance on the matter. Sanders also has failed to pick up the support of Sen. Tina Smith, D-Minn., who replaced former co-sponsor Al Franken after he resigned his seat following accusations of sexual misconduct.
The Medicare for All Act unveiled Wednesday goes even further than the previous iteration: It adds benefits for long-term care, which would cover people living in nursing homes as well as people with disabilities. The plan would overhaul Medicare’s operation by billing the government for all healthcare services without charging patients. It also would cover more services than Medicare does now, including prescription drugs, dental care, vision care, abortion, and maternity care.
ANOTHER CONSERVATIVE PAID LEAVE BILL IS INTRODUCED: Rep. Andy Biggs, R-Ariz., introduced a bill Tuesday along 12 GOP co-sponsors that would allow health savings accounts to be used during the birth or adoption of a child, or when a family member is sick. The bill, the Freedom for Families Act, stands in contrast to other ideas that Republicans have introduced allowing new parents to draw early from Social Security.
RUBIO PAID FAMILY LEAVE PLAN WOULD HAVE NEGLIGIBLE EFFECT ON SOCIAL SECURITY FINANCES, ADMINISTRATION ESTIMATES: A paid family leave bill from Sen. Marco Rubio, R-Fla., that would let new parents tap into their Social Security in exchange for delaying retirement would not harm Social Security’s finances, according to an analysis released Tuesday by the Social Security Administration.
The analysis does note, though, that after about 10 years, which Social Security’s combined trust funds near exhaustion, new parents wouldn’t be able to continue getting as much in funding after that time, as is also expected for those who are retiring.
IDAHO TO SCALE BACK VOTER-APPROVED MEDICAID EXPANSION WITH WORK REQUIREMENT: Idaho Gov. Brad Little signed a bill into law Tuesday to obligate certain Medicaid beneficiaries under Obamacare work as a condition of receiving government healthcare. “We must encourage self-sufficiency among those receiving public assistance,” Little, a Republican, wrote in a letter outlining his approval of the bill.
SANOFI TO OFFER LESS EXPENSIVE INSULIN: Drug manufacturer Sanofi will be charging $99 a month for its product, compared with the $149 it charged before. The announcement came shortly before one of the company’s top executives was set to testify in Congress.
BARR SUGGESTS ADMINISTRATION WON’T SUCCEED IN CALLING FOR COURTS TO STRIKE DOWN ALL OF OBAMACARE: Attorney General William Barr suggested Tuesday that the Trump administration will not succeed in its lawsuit to strike down all of Obamacare. Rep. Matt Cartwright, D-Pa. asked Barr in a House hearing if the administration had considered the effects of throwing out a law that provides healthcare to millions, and the attorney general downplayed the likelihood of that scenario, saying, “Do you think it’s likely we are going to prevail?”
FEDERAL AGENTS BUST BILLION-DOLLAR MEDICARE SCAM: Federal agents on Tuesday broke up a billion dollar Medicare scam aimed at selling unneeded back, shoulder, wrist, and knee braces to hundreds of thousands of seniors. Two dozen people were charged, including doctors accused of writing bogus prescriptions. The scam relied on international call centers to gather Medicare numbers from beneficiaries. Telemarketers would contact seniors and convince them to buy unnecessary medical braces. Call centers would then collect telemedicine prescriptions, sell them to medical equipment companies to ship to beneficiaries, and then bill Medicare.
OKLAHOMA SUPREME COURT JUSTICE BENEFITTED FROM WIFE’S HEALTHCARE COMPANY WHILE LEADING SUIT AGAINST OBAMACARE: Patrick Wyrick, an Oklahoma Supreme Court justice and nominee for a federal post, is under scrutiny for not disclosing to Congress that he was financially benefiting from his wife’s healthcare company in Oklahoma while he led the state’s lawsuit against Obamacare as Oklahoma’s solicitor general. Wyrick did not tell the Oklahoma Ethics Commission about the financial ties, which is a requirement for all state supreme court judges.
FDA RELEASES GUIDELINES TO TAPER OFF OPIOID DOSES: The Food and Drug Administration issued a plan Tuesday to change opiate prescribing information for physicians seeking to safely lower dosages for patients. The FDA’s plan says that physicians must work closely with patients to taper doses, as a drastic change could make withdrawal symptoms worse.
NYC DECLARES HEALTH EMERGENCY AMID MEASLES OUTBREAK: New York City declared a health emergency Tuesday after a measles outbreak was reported in an Orthodox Jewish neighborhood in Brooklyn. The city has seen 285 confirmed cases since the outbreak began in the fall. A total of 21 of those cases led to hospitalizations, including five admissions to the intensive care unit. The city said Tuesday it would fine or possibly shut down Jewish schools in the Brooklyn neighborhood that do not mandate the measles vaccination.
ANTI-CRIB DEATH GROUP WARNS THAT TRUMP TARIFFS THREATEN THE LIVES OF SLEEPING BABIES: Judith Bannon, executive director of Cribs for Kids, wrote in a Monday op-ed that Trump’s tariffs on Chinese products are interfering with its mission and risking infant deaths. Bannon’s nonprofit organization produces a small, portable crib called a “cribette” made to prevent sudden infant deaths, and they are only available in China. Bannon says that it cannot afford to sell the cribs for less but that the higher prices have discouraged some partners, including hospitals, from paying for them.
ALL BUT TWO IMMIGRANT CHILDREN SEPARATED FROM PARENTS HAVE BEEN REUNITED DESPITE ELIGIBILITY: HHS: Only two of the 2,814 immigrant children who were separated from their parents during the Trump administration’s implementation of the “zero tolerance” policy last spring remain in federal custody because they could not be reunified, according to a senior HHS official. The ACLU sued Immigration and Customs Enforcement, which is where families who have been taken into CBP custody are transferred. ICE can legally hold families for up to 20 days before they must release people into the country.
TRUMP SAYS HE WILL NOT RESUME FAMILY SEPARATIONS AT THE US-MEXICO BORDER: Trump said Tuesday that he is not planning to reintroduce the policy of family separations at the U.S. border with Mexico, tamping down speculation earlier in the week that he would do so. But the president also suggested that family separations could be an effective deterrent to illegal immigration.
The Rundown
Chicago Tribune Officials urge caution amid outbreak of deadly fungus in Chicago area. Here’s what you need to know about Candida auris.
Bangor Daily News After years of work, Bangor health center will offer same-day access to Suboxone
Boston Globe In Boston visits, Trump health officials ridicule ‘Medicare for All” plans
The Dallas Morning News Blue Cross Blue Shield of Texas tries new way to trim health costs: Opening its own medical centers
NPR Researchers are surprised by the magnitude of Venezuela’s health crisis
Calendar
WEDNESDAY | April 10
April 10-12. Marriott Marquis. Business Health Agenda Conference. Agenda.
House and Senate in session.
10:30 a.m. 2322 Rayburn. House Energy and Commerce Committee’s Oversight and Investigations Subcommittee hearing on “Priced Out of a Lifesaving Drug: Getting Answers on the Rising Cost of Insulin.” Tune in.
MONDAY | April 15
House and Senate in recess.
WEDNESDAY | April 17
Noon. Dirksen G-50. Alliance for Health Policy event on “Right Care, Right Patient, Right Time: The Role of Comparative Effectiveness Research.” Details.
