HealthCare Roundtable e-News – February 9, 2021


Webinar Regarding Roundtable Response to Trump Administration Rebate Rule

Wednesday, February 10th at 2:00 PM (EST)

JC SCOTT
PRESIDENT & CHIEF EXECUTIVE OFFICER

JC Scott is the President & CEO of the Pharmaceutical Care Management Association (PCMA), the national association representing America’s pharmacy benefit managers, or PBMs.

Mr. Scott joined PCMA in the fall of 2018. Previously, he held senior association leadership positions at Washington-based organizations. Most recently, he served as Chief Advocacy Officer and Head of External Affairs for the Advanced Medical Technology Association (AdvaMed), where he led the government affairs, public affairs, and third-party ally development functions for the association. Prior to AdvaMed, Mr. Scott served as Senior Vice President of Federal Relations for the American Council of Life Insurers.

Mr. Scott also brings experience from his work in government. He served in various capacities in the U.S. House of Representatives, including as Deputy Director of Policy for the House Republican Conference, Committee Associate with the Select Committee on Homeland Security, and Legislative Director for former-Representative Deborah Pryce (R-OH). He has also worked as an associate for the law firm of Travis & Gooch.

Mr. Scott has an undergraduate degree in Public Policy Studies from Duke University, and a JD from the Georgetown University Law Center.

APRIL ALEXANDER
GENERAL COUNSEL & VICE PRESIDENT, STATE REGULATORY AFFAIRS

April Alexander is General Counsel and Vice President, State Regulatory Affairs. In this role, Ms. Alexander serves as PCMA’s chief legal counsel and leads advocacy strategy on state regulatory issues.

Prior to joining PCMA, Ms. Alexander served in various legal and governmental affairs roles in both the private and public sectors. Working with a large, publicly traded Medicaid managed care company, she directed legislative and regulatory advocacy for health plan subsidiaries and advised corporate leadership on health policy and political issues. Before that, she was responsible for regulatory advocacy on behalf of California’s managed care plans participating in state-sponsored health programs. Prior to entering the private sector, Ms. Alexander served as an attorney for the California Department of Managed Health Care and as a California Executive Fellow working on criminal justice policy issues.

Ms. Alexander holds a JD from the University of the Pacific – McGeorge School of Law and an undergraduate degree in Political Science from California State University, Chico. In her free time, she enjoys travel, live music, and all things related to fitness and health.


Given the significant impact the Rebate Rule will have on Roundtable members, we intend to continue to actively engage on the issue. The engagement will likely develop on three fronts, including: litigation regarding the lawfulness of the Trump rule; an advocacy strategy focused on the Biden Administration and Congress; and options for implementation of the rule should that be necessary.

To advance a discussion of these various strategic options, the Roundtable will hold a webinar tomorrow, Wednesday, February 10th at 2:00 PM (EST). The webinar will feature presentations by JC Scott and April Alexander of the Pharmaceutical Care Management Association (PCMA).

Roundtable members and friends are welcome to join the discussion at:

https://us02web.zoom.us/j/84812069323?pwd=QjBvMHVpSUpQU2JDSjZiMHlNRWwyUT09

Zoom Meeting ID: 848 1206 9323Passcode: Rebates


Roundtable Welcomes New Members

Alabama State Employees’ Insurance Board

State Employees' Insurance Board

Alabama Local Government Health Insurance Board

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Biden Seeks to Build Vaccine Manufacturing Facilities Producing Up to 100M Doses Monthly

According to a breakdown of President Biden’s pandemic relief fund, the administration is requesting $4 billion to build two state-of-the-art manufacturing facilities with the capacity to produce and fill 100 million COVID-19 vaccine doses per month. The plan is part of the president’s American Rescue Plan package, with $83 billion requested to support the development of—and access to—COVID-19 vaccines, testing, and therapeutics.

Biden’s plan includes an investment of $10 billion in domestic manufacturing of vaccines and other materials, which would include leveraging authorities under the Defense Production Act to ensure the availability of critical supplies. Around $4 billion of the $10 billion would be used to build the vaccine manufacturing facilities with the capacity to produce and fill a total of 100 million doses per month. At full capacity, the facilities are expected to be able to provide two doses for every American within six months. According to the proposal, about $2 billion is required to build and equip each facility. (InsideHealthPolicy)

“While we are working to vaccinate the population, we need to focus on what we know works. Testing is critical for controlling the spread of COVID-19 and identifying emerging strains. Testing is needed to get kids back into school, help businesses reopen, and protect the most vulnerable in settings like long-term care,” the document says.

Democrats Unveil Senate Bill to Subsidize COBRA Coverage

Last month, a group of Democratic Senators unveiled a bill that would enable employees who have lost job-based health coverage due to layoffs and furloughs to get fully subsidized COBRA coverage. Led by Majority Whip Dick Durbin (Ill.) and Catherine Cortez Masto (Nev.), the bill is also supported by Democratic Sens. Jeanne Shaheen (N.H.), Jeff Merkley (Ore.), Michael Bennet (Colo.), Tammy Duckworth (Ill.), Richard Blumenthal (Conn.), Bob Menendez (N.J.), Jack Reed (R.I.), Sherrod Brown (Ohio), Jacky Rosen (Nev.), Tina Smith (Minn.), and Amy Klobuchar (Minn.).

Biden had proposed some subsidies in his pandemic relief package, but experts worried that there would be many left behind or not encouraged to take them up. According to Stan Dorn of Families USA, “Fifteen percent of an employer-based plan could still be more than $200 per month for family coverage…people may not be able to afford it, and the enrollment could be mainly people with health problems, which isn’t good.”

The senators estimate that close to 14 million employees could be helped by the bill, known as the Worker Health Coverage Protection Act, which will allow employees enrolled in federal- and state-sponsored insurance plans governed by the Employee Retirement Income Security Act (ERISA), and access to subsidized COBRA coverage for those who were furloughed or laid off over the course of the pandemic. (InsideHealthPolicy)

Senate Passes Final Budget Resolution with Bipartisan Health Provisions

Last Thursday (Feb. 4), the Senate added several non-binding health provisions to the resolution. Among the bills passed are additional funds for provider relief, a deficit-neutral fund for expanding the use of health savings accounts (HSAs), and new commissions tasked with improving the solvency of the federal trust funds.

Congressional leaders unanimously supported a proposal from Sens. Ben Cardin (D-Md.) and Rob Portman’s (R-Ohio) to fund a public awareness campaign related to vaccine administration and require the government to disclose how the COVID-19 relief funding is being spent.

“With this budget resolution, we took an important step forward in our mission to deliver the President’s rescue plan to a struggling nation in need,” House Budget Chair John Yarmuth (D-Ky.) said. “As I discussed with President Biden and congressional leaders in the Oval Office this morning, the enormity of the crises we face make it clear that there is no such thing as going too fast or too bold in our efforts to ensure workers, families, small businesses, and hard-hit communities get the relief they need.” (InsideHealthPolicy)

Congressional Republicans in the past have pushed for legislation enabling HSAs to cover more services and products, with most Democrats opposing expanded uses citing that HSAs largely benefit wealthier Americans. GOP Sens. Mike Lee (Utah) and Tim Scott (S.C.) pushed for an amendment expanding HSA that passed 53-47. The budget resolution was ultimately passed with a tie-breaking vote cast by Vice President Kamala Harris.

Former Health Officials Pen Drug Pricing Recommendations for Biden Administration

A group of former health officials representing the National Academy of Medicine of pulling together recommendations for both FDA and CMS policies the Biden administration can implement to help lower drug costs. NAM suggests in an article for Health Affairs that CMS test new Medicare Part B policies, outcome-based payments and reference pricing, and that FDA adopt policies to speed generic drug and biosimilar access.

“Although difficult trade-offs are inevitable, we believe there are opportunities to simultaneously improve access, affordability, and equity,” said the group in Health Affairs. “When identifying policy recommendations, we aimed to identify those most likely to yield balanced improvements across all three areas”

Among the authors representing NAM is former Trump administration FDA Chief Scott Gottlieb, who was the sole former FDA commissioner alongside two former CMS administrators. During Gottlieb’s term, FDA released the Drug Competition Action Plan and the Biosimilars Action Plan, two strategies with similar goals to the recommendations proposed by NAM. According to the authors, FDA should harmonize regulatory filing requirements for generic medicines with regulators in other countries.

Senate Not Expected to Schedule Confirmation Hearing This Week for HHS Nominee Becerra

Congressional leaders have yet to set a confirmation hearing for HHS nominee Xavier Becerra, the California Attorney General nominated by Biden ahead of his inauguration. According to the office of incoming Senate Finance Chair Ron Wyden (Ore.), congressional staff are working to schedule a confirmation hearing “as quickly as possible”, considering statements made by Wyden and his team on the topic of Becerra’s nomination after their initial meeting in December.

In an op-ed for USA Today, contributors and former HHS Secretaries Kathleen Sebelius and Donna Shalala said that strong leadership from Becerra “is exactly what our federal agencies need right now, and in the fight against the virus, other than the President, there is perhaps no job more critical than Secretary of Health and Human Services. As soon as possible, we need someone in that role who understands these challenges and can inspire the career public servants in the department to pull together for the fight of their lives: defeating COVID-19.”

Becerra’s nomination has faced some opposition, with Senate Minority Leader Mitch McConnell (Ky.), calling out Becerra’s criticism of the Trump administration’s handling of COVID-19 vaccine distributions and the attorney general’s limited health policy experience. However, Sebelius and Shalala argue Becerra’s accomplishments in expanding health care as a lawmaker will bring a unique, Latino perspective to the office.” (InsideHealthPolicy)