HealthCare Roundtable e-News – July 14, 2021


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2021 Congressional Forum
Monday, July 26, 2021

Registration is now open for the Roundtable’s 2021 Virtual Congressional Forum. The Forum will take place on Monday, July 26th. The two-hour event will convene at 11:00 AM (EDT) and will include a keynote address, a panel presentation, a discussion of Roundtable priorities, and tips on communicating your priorities to Members of Congress and their staff.

Attendees will be encouraged to schedule Zoom appointments with staff for members of their Congressional delegation. Contact information for key health care staff members will be provided to each registered participant.

Click here to see a preliminary agenda — specific speakers will be announced in the coming days.

Click here to register for the Forum.


Schumer: Dems’ $3.5 Trillion Budget Deal Includes New Medicare Benefits

Senate Budget Committee Democrats late Tuesday agreed on a $3.5 trillion budget resolution that includes funding to add dental, hearing and vision benefits to Medicare, Senate Majority Leader Charles Schumer (D-NY) said following a two-hour meeting with the committee. President Joe Biden plans to meet with senators on the plan during their lunches Wednesday. (InsideHealthPolicy)

“We have ‘white smoke over the Vatican’ in the budget committee,” Sen. Sheldon Whitehouse (D-RI) tweeted at about 9:30 pm. “On to the caucus, and to reconciliation, and to success.”

The $3.5 trillion agreement is a sharp drop from the $6 trillion Senate Budget Chair Bernie Sanders (I-VT) had proposed, but the top-line had been expected to clear the committee. The deal largely will be paid for with tax changes, senators suggested. It’s unclear how much of the package will be devoted to health care priorities.

Schumer said the budget resolution includes priorities the president laid out in his American Jobs Plan and American Families Plan, plus a “robust expansion of Medicare, including money for dental, vision and hearing.” This presumably means the upcoming reconciliation bill will permanently extend the increased Affordable Care Act tax credit from the American Rescue Plan and invest $400 billion in home-and-community-based care.

Together, those policies could cost around $600 billion, but Schumer’s office would not confirm by press time whether they were all in the budget. Extending Medicare benefits to hearing, dental and vision would cost another $300 billion.

Biden Signs Executive Order Calling for Review of Hospital Merger Guidelines

On Friday (July 9), President Joe Biden signed an executive order calling on the Department of Justice and the Federal Trade Commission to review healthcare merger guidelines for hospitals to protect patient interests and reduce health costs. The order also directs HHS to work with states and support existing hospital price transparency rules and finish putting into place surprise hospital billing policies.

According to a fact sheet provided by the administration, hospital consolidation has raised health care costs above an affordable threshold for many Americans, especially in rural communities. The sheet also states that “unchecked mergers” the ten largest healthcare systems now control nearly a quarter of the market, claiming that hospitals in consolidated markets “charge far higher prices than hospitals in markets with several competitors.”

Erin Fuse Brown, a law professor at Georgia State University and director of the school’s Center for Law, Health & Society, suggested the guidelines are in need of a much-needed update in light of the types of consolidation that’s actually happening within the healthcare industry. In particular, Fuse Brown said she would like to see more instruction on how to control vertical integration between hospitals and other types of providers like physician practices or outpatient clinics. (InsideHealthPolicy)

Groups like the Federation of American Hospitals and the American Hospital Association (AHA), however, have called the executive order misguided, with AHA suggesting that the executive order doesn’t recognize the value health systems provide to patients and communities, including those in rural areas. AHA President and CEO Rick Pollack said in a statement that “hospital mergers and acquisitions undergo an enormous amount of rigorous scrutiny from the federal antitrust agencies and state attorneys general.” (InsideHealthPolicy)

FDA, HHS, FTC Directed by Biden to Promote Generic and Biosimilar Competition in Executive Order

Last week, President Biden directed federal agencies to promote generic drug and biosimilar competition and boost markets in an effort to lower drug costs. The effort is part of a broad, competition-focused executive order taking aim at pricing and anti-competitive practices signed by the president on Friday.

The FDA, HHS and the Federal Trade Commission are expected to team up to address efforts that hinder the entrance of biosimilars and generics into the marketplace and curb “false, misleading, or otherwise deceptive statements” about the efficacy and safety of those products. To assist in combating anti-competitive practices, Biden is calling on the FDA and FTC to issue Covered Product Authorizations (CPAs) to help generic drug developers obtain brand drug samples needed to support their applications, and relay any patent concerns to the U.S. Patent and Trademark Office.

Past FDA officials have come forward expressing their concerns about the spread of misinformation by some brand drug companies in order to reduce competition. Former FDA chief Scott Gottlieb has stated that he was worried branded companies sometimes either deliberately or unintentionally call into question the safety and effectiveness of unbranded biologics. (InsideHealthPolicy)

While the FDA is waiting to release guidance on obtaining a CPA, the agency suggests in the meantime that generic drug makers submit requests as a controlled correspondence to the drug center’s NextGen Collaboration.

Bipartisan Infrastructure, Budget Resolution Expected to Move to Senate Floor as Soon as July 19

The Senate returned from recess on Monday with the ambitious goal of moving President Biden’s infrastructure bill to the Senate floor by July 19th. White House legislative affairs director Louisa Terrell and deputy legislative affairs director Shuwanza Goff informed lawmakers last week that they should expect the bipartisan bill and fiscal 2022 budget resolution as early as the next two weeks, according to sources.

Senate Majority Leader Chuck Schumer (D-N.Y.) opened the Senate by saying “progress was being made” on both a bipartisan $1.2 trillion infrastructure plan, as well as a primarily Democrat-backed initiative to raise taxes in order to do it. While it’s still unclear which Medicaid, Medicare and drug-pricing provisions might be included in the bill that reaches the floor, the size and framework of the budget resolution could drive which health care provisions are ultimately included in Democrats’ upcoming reconciliation bill. (InsideHealthPolicy)

Senate Minority Leader Mitch McConnell (R-Ky.) said there was “a decent chance” the bipartisan bill could gain traction but warned the spending must somehow be financed without adding to the national debt. McConnell had promised a “hell of a fight” over the initiative to raise taxes to support the bill while leaving open the possibility of his support for the bipartisan infrastructure bill.

Lawmakers including House Majority Whip Jim Clyburn (D-S.C.) have been pushing for a federal solution to the Medicaid gap in addition to expansion of Medicare benefits. A Democratic Senate aide confirmed that leadership is keen to close the Medicaid coverage gap in states that haven’t expanded Medicaid eligibility under the Affordable Care Act. Lawmakers supporting the provision are currently reviewing options for the best path forward. (InsideHealthPolicy)

Doggett Proposes Bill Seeking Medicare Expansion of Dental, Vision, Hearing Coverage

House Ways & Means health subcommittee Chair Rep. Lloyd Doggett (D-Texas) unveiled a bill last week (July 6) that pushes for the inclusion of dental, vision and hearing benefits to Medicare. The initiative has been supported by key Senate leaders who hope to see the bill passed through to reconciliation later this year.

“This bill offers more care from Medicare responding to basic dental, hearing, and vision impairments for seniors and individuals with disabilities. It fulfills the original purpose of Medicare – to assure dignity – helping those who have difficulty seeing, hearing, or eating,” Doggett said in a statement. (InsideHealthPolicy)

Doggett’s bill would expand Medicare coverage by repealing the statutory exclusion that currently prohibits the program from covering vision, dental and hearing services. There would be no cost-sharing for preventative care and no more than a 20% copay for all other services, according to a press release. It is unclear whether other Medicaid and Medicare reforms will be passed through to reconciliation while lawmakers attempt to close the Medicaid coverage gap in the bipartisan infrastructure bill (see above). Despite not being listed as a bill sponsor, Rep. Anna Eshoo (D-Calif.), chair of the Energy & Commerce health subcommittee, said she would like to see both Medicaid and Medicare reforms included in the reconciliation bill. (InsideHealthPolicy)

Save The Date: 2021 Annual Conference
Monday, November 1 – Wednesday, November 3, 2021
The Alexandrian Hotel, Old Town Alexandria, VA
Registration will open in early August!