HealthCare Roundtable e-News – April 27, 2021


CMMI Chief Fowler Renews Center’s Commitment to Health Equity and Transformation Initiatives

Last week, Center for Medicare and Medicaid Innovation chief Liz Fowler asked accountable care organizations for patience as CMMI evaluates its partnerships and models to align with White House priorities. Specifically, the Center has said it is focused on health equity and drug pricing initiatives.

At the recent ACO spring conference, Fowler said she understands the innovation center’s changes to model applications, start dates, and reviews of models might lead to questions on where the center is headed, but “I want to make clear that our commitment to value-based care has never been stronger.”

“I think we’re at a crossroads right now. Collectively, all of us need to draw on what we’ve learned from the last 10 years and chart a path for the future, together. And I’m asking for your help in charting this path forward, to getting back to a place where we have common goals and a shared vision. And I’m asking for your patience as we take time to review the portfolio of models, make adjustments where necessary, and make sure that our path forward is sustainable and meaningful,” Fowler told attendees. (InsideHealthPolicy)

At the conference, Fowler also raised the question of whether CMMI’s ultimate goal is expanding a model to become a permanent part of Medicare, or whether health care transformation is that goal. Clif Gaus, president and CEO of the National Association of ACOs, outlined the group’s own goals for the innovation center at the conference. Gaus praised Fowler’s position on transforming the delivery of health care at the conference, commenting that whether transformation requires a certified model or not, “is probably not that important.” (InsideHealthPolicy)

House E&C Committee Will Hold May 4 Hearing Drug Pricing Bill as Part of Infrastructure Package

The House Energy & Commerce Committee will look to hold a hearing on drug pricing legislation early next month, as part of an effort by Democrats to have a policy drafted into President Joe Biden’s announced infrastructure package. House leaders reintroduced the bill known as H.R. 3, last week, which includes similar drug pricing measures that were passed by lawmakers in 2019 but avoids mentioning Medicare benefits for vision, dental, and hearing—policies that were a part of Democrats’ plan last time.

The hearing, which is scheduled for May 4th, will give Democrats the opportunity to garner support around drug pricing measures; however, some have concluded that the White House is worried Democrats will not have enough votes to pass the bill. Separately, House Republicans reintroduced their own version of a drug pricing bill on Wednesday (April 21) that includes several bipartisan measures that are minor compared to what Democrats are expected to attempt. The proposed GOP bill also includes reforms that would have minimal impact on drug spending, and they would likely have no impact on people with commercial insurance, a drug pricing policy researcher said. (InsideHealthPolicy)

Democrats have been keen on passing the bill, which was first passed by the House in 2019 and may provide about $450 billion in savings to potentially help fund Biden’s infrastructure package, which is likely to come with the hefty price tag of $3 trillion. The plan is the first of a two-part proposal from the president as part of an effort to steer economic recovery from the COVID-19 pandemic. The President is expected to unveil his package focusing on the “care economy,” including investments in education and childcare in the next few weeks.

Senate Democrats Unveil New Medicare Part E Legislation

Lawmakers unveiled legislation last week introducing new Medicare Part E coverage to improve the affordability and quality of government-managed health care. If the bill is passed, it would extend the Affordable Care Act’s tax credits and cost-sharing subsidies, link the subsidies to the gold-level plans, cap Medicare out-of-pocket costs, and more.

The bill, known as the Choose Medicare Act, was introduced by Democratic Senators Chris Murphy (Colo.), Jeff Merkley (Ore.) and Dianne Feinstein (Calif.) and was co-sponsored by nine other Democrats. In a statement, Murphy called Medicare “the most efficient and affordable health care plan out there,” questioning why any individual or business should not have the right to purchase a plan.

“The Choose Medicare Act gives consumers the ability to decide whether they want to opt into Medicare or stay on their private insurance. It’s a great way to test the theory that Medicare is the best plan for everyone while allowing Americans to make the choice for themselves,” said Murphy. (InsideHealthPolicy)

Lawmakers say that all existing Medicare providers would be in-network under the bill, and HHS must also create a pathway for other providers to join the system. While the bill would boost federal assistance for ACA plans, it would not extend increased subsidies that were enacted under the American Rescue Plan. Instead, Part E would link the existing subsidies to gold-level products that have an 80% actuarial value and extend tax credits to families earning up to 600% of the poverty level, rather than 400% FPL. The bill would also enable HHS to be able to negotiate Medicare prescription drug prices. (InsideHealthPolicy)

Cornyn’s Concerns Over Texas Medicaid Waiver Leads to Tied Finance Vote On Brooks-LaSure Confirmation

Senate Finance Committee member John Cornyn (R-TX) asked the committee last week to postpone its hearing to confirm Chiquita Brooks-LaSure as CMS administrator after the senator raised questions regarding Brooks-LaSure’s stance on the agency’s recent decision to revoke the 10-year extension of a Texas 1115 Medicaid waiver granted in the final days of the Trump administration. The committee’s vote to confirm Brooks-LaSure was not postponed and resulted in a deadlock, with 14 votes in favor of confirming the CMS veteran and 14 opposed.

By process, the Senate majority leader or minority leader will be able to file a motion to bring Brooks-LaSure’s nomination. Cornyn said he had previously been looking forward to voting in Brooks-LaSure’s confirmation, but in light of the agency’s decision, he had asked Finance Chair Ron Wyden (D-Ore.) to postpone the vote to give him time to meet with the White House chief of staff Ron Klain. According to Cornyn, Klain has offered to speak with him regarding the waiver.

“Until Texas can receive an assurance that this action will be rectified, and the rug will not be pulled out from under our poorest patients, I cannot support the nominee at this time. I don’t know what else to do,” Cornyn said at the Finance Committee meeting. A spokesperson for HHS has said that the agency is working with Cornyn and has assured him that they will work with the state of Texas to resubmit its application. (InsideHealthPolicy)