HealthCare Roundtable e-News – May 9, 2022

 

Top News

This week, the Senate Commerce, Science, and Transportation subcommittee on Consumer Protection, Product Safety, and Data Security held a hearing on “ensuring fairness and transparency in the market for prescription drugs.” The hearing primarily focused on the role of pharmacy benefit managers (PBMs) in the drug supply chain and whether “anti-competitive” practices are driving up health care costs. In the hearing subcommittee chairman, Sen. Richard Blumenthal (D-CT) said PBMs are just one player in a “broken supply chain.” Sen. Blumenthal stated that he is concerned that patients are rarely seeing or feeling benefits from PBMs because drug prices continue to rise, and their insurance premium continue to “eat into incomes.” Pushing back on this notion, Pharmacy Care Management Association (PCMA) President and CEO, J.C. Scott, said “the PBM industry is the only stakeholder in the chain dedicated to seeking lower costs.” Highlighting that PBMs do this work for the employer, union health plan, and government clients who hire them and most importantly, the patients for whom the health plans cover. J.C. Scott further argued that PBMs return $10 in savings for every $1 dollar spent on their services and will lower the cost of health care by $1 trillion this year alone. Copies of the witness statements and hearing recording can be found here.

Administrative Action

The White House Office of Science & Technology Policy (OSTP) released its “Community Connected Health Stakeholder Engagement Summary Report.” The report covers responses between January through April 2022, in partnership with the Health Resources & Services Administration (HRSA), which were collected via a Request for Information (RFI) and three formal stakeholder roundtable discussions. The roundtables were composed of plenary and breakout sessions. The roundtable plenary sessions were open to the public, during which speakers provided additional context for the RFI as well as real-time question submission and response. Further input can be emailed to connectedhealth@ostp.eop.gov.

The Department of Health and Human Services’ (HHS) Assistant Secretary for Planning and Evaluation (ASPE) released an issue brief on health care workforce challenges that are exacerbated by the COVID-19 public health emergency (PHE). The issue brief highlights that workforce shortages are expected to deepen dramatically by 2030, as the workforce is expected to age, and the number of teaching faculty will shrink. Hospitals said staffing shortages, especially among nursing staff, were affecting patient care and the mental health of their staff. Within the issue brief, ASPE included several future recommendations to implement workforce policy, including understanding the maldistribution of workforce assets, retaining COVID-19 flexibilities, scholarships, and loan repayment, and developing a pipeline to ensure adequate personal protective equipment.

Congressional Action

The Healthy Future Task Force co-chairs, Representatives Brett Guthrie (R-KY) and Vern Buchanan (R-FL) released the Task Force’s solutions to lower drug costs promote the development of innovative therapies. The Task Force specifically recommends (policy fact sheet) lower drug costs for Americans by passing H.R. 19, the Lower Costs More Cures Act, new innovative medicines, devices, and diagnostics for patients by speeding up the FDA approval process, expanded Medicare coverage for breakthrough drugs and devices, the development of cancer early detection diagnostics among other proposals, and the promotion of American-made medicines.

Senator Maria Cantwell, (D-WA) Chair of the Committee on Commerce, Science, and Transportation, released on Tuesday a Committee report (press release here) which urged Congress to restore the Federal Trade Commission’s (FTC) decades-long authority to return money to consumers victimized by illicit scams, fraud, and other unfair or deceptive practices. In April 2021, the Supreme Court eradicated the FTC’s Section 13(b) authority in AMG Capital Management LLC. V. FTC, which had previously been utilized to return more than $11 billion dollars to consumers between 2015-2020. Section 13(b) allowed the FTC for more than 40 years to go directly to federal court on behalf of consumers and business owners to tackle unfair acts, such as telemarketing fraud, anticompetitive practices, data security, and privacy scams. Prior to the Supreme Court’s action, the FTC’s 13(b) authority was critical in tackling Big Tech and Pharma’s ability to disrupt consumers and businesses.

The House Energy & Commerce Committee unveiled a comprehensive legislative package to reauthorize the Food and Drug Administration (FDA) user fee agreements (section-by-section text). Representatives Anna G. Eshoo (D-CA) and Brett Guthrie (R-KY) will introduce the Food and Drug Amendments of 2022 this week, which the Health Subcommittee intends to mark up next week. The legislative package reauthorizes the Prescription Drug User Fee Act (PDUFA), the Generic Drug User Fee Act (GDUFA), the Biosimilar User Fee Act (BsUFA), and the Medical Device User Fee Act (MDUFA). Additionally, the bipartisan agreement includes many provisions led by Energy and Commerce Committee members. 

Marketplace

Both notable insurance and provider trade groups penned a letter to Congressional leadership requesting a permanent extension of the enhanced Affordable Care Act (ACA) tax credits, which are set to expire December 31, 2022. The American Rescue Plan Act expanded access to these credits by guaranteeing that no one spends more than 8.5% of their income on premiums, as well as making credits more generous for lower-income families. Trade associations signing onto the letter included the American Academy of Family Physicians, American Hospital Association, American Medical Association, AHIP, Blue Cross Blue Shield Association, and the Federation of American Hospitals.

Medicaid

The Government Accountability Office (GAO) announced four new members of Medicaid and CHIP Payment Access Commission (MACPAC) and two reappointments of current MACPAC members. MACPAC’s policy and data analyses inform the recommendations submitted to Congress, supporting Medicaid and CHIP program accountability. The terms of these six members will extend until April 2025. New members include Sonja L. Bjork, JD, Jennifer L. Gerstorff, FSA, MAAA, Angelo P. Giardino, MD, PhD, MPH, and Rhonda M. Medows, MD. Both Tricia Brooks, MBA, and Dennis Heaphy, MPH, MEd, MDiv have been reappointed.