HealthCare Roundtable e-News – October 28, 2019



Amendment Supporting Biosimilar Reimbursements Passes House Energy & Commerce Committee

Last week, the House Energy and Commerce Committee added an amendment to the Lower Drug Costs Now Act to temporarily increase Medicare Part B reimbursements for biosimilars. The bill, which aims to lower prescription drug costs by giving the federal government the ability to negotiate the price based on an international pricing index, was previously passed by the Education and Labor Committee.

The policy was initially introduced as a separate bill, the Bolstering Innovative Options to Save Immediately on Medicines (BIOSIM) Act , last month and is currently the only amendment adopted by the Energy & Commerce Committee during the markup. Biosimilar manufacturers and stakeholders shared their enthusiasm for the amendment’s acceptance. (InsideHealthPolicy).

“This is a major step forward and the fact it was the only amendment adopted underscores why biosimilars are a clear, recognized and bipartisan solution to reducing drug costs for patients and taxpayers,” said Juliana Reed, the president of the Biosimilars Forum. (InsideHealthPolicy).

The bill, which was sponsored by Reps. Kurt Schrader (D-Ore.) and Greg Gianforte (R-Mont.), is expected to be marked up by The House Ways and Means Committee later this week with a full House vote later this month, according to reports.

House W&M Committee Passes Legislation to Include Additional Part B Benefits

Last Tuesday (Oct. 22), the House Ways & Means Committee passed legislation that adds vision, hearing and dental benefits to Medicare Part B plans. W&M Committee Chair Richard Neal (D-Mass.) suggested that the additions were among the “biggest positive changes to Medicare in a generation,” and that the committee is looking to the savings from the drug price negotiation proposal from House Speaker Nancy Pelosi’s (D-Calif.) to pay for the changes. (InsideHealthPolicy). 

“We know from decades of research that when beneficiaries cannot afford these costs on their own, they forgo care. And that leads to worse health outcomes. Untreated hearing impairment leads to social isolation. Untreated dental disease affects cardiovascular health, and nutrition,” Neal said. “Today, we can lay the groundwork to move forward one of the biggest positive changes to Medicare in a generation.” 

Jennifer Goldberg, deputy director of Justice in Aging, told reporters that the group is excited about adding the dental benefits to Medicare Part B. Justice in Aging had sent a letter to the House Ways & Means and Energy & Commerce Committees in strong support of H.R. 3 and the benefit expansion bills that were passed by both committees. (InsideHealthPolicy). 

Some representatives have raised concerns about the costs of expanding Medicare coverage. W&M ranking Republican Kevin Brady (R-TX), suggested that lawmakers shore up the trust fund before Medicare is expanded, which other Republican lawmakers agreed with. (InsideHealthPolicy).

Senate Still Working on Surprise Billing Compromise After Industry Meeting

Senators and industry stakeholders met last Tuesday (Oct. 22) to discuss a compromise on surprise billing legislation, which has stalled in recent months over the inclusion of arbitration in the policy. While surprise billing legislation has received much bipartisan support since the bill’s passing by the Senate Health, Education, Labor, and Pensions Committee earlier this year, the session ended without a solution. Lawmakers, still, are hopeful that the groups will come to an agreement on the bill before the end of the year. (InsideHealthPolicy). 

“The difference between now and this summer is that we’re closer to the end of the year and there’s a hardcore contingent in the Senate and House that want to get something done,” said a lobbyist who attended the group session. (InsideHealthPolicy). 

During the meeting, Sen. Bill Cassidy (R-La.) sought to win over opponents of arbitration and attempted to draw a distinction between his proposal’s version of arbitration and the arbitration amendment introduced by Reps. Raul Ruiz (D-Calif.) and Phil Roe (R-Tenn.). Based on an internal email from the Congressional Budget Office, Ruiz and Roe’s plan would cost tens of billions of dollars, but Cassidy’s would save $20 billion over 10 years. 

Despite the timing of the bill and where the Senate is expected to shift focus to the President’s impeachment trial in the next few weeks, lawmakers still hope to pass a surprise billing fix before year-end. (InsideHealthPolicy).

‘Patent Thicket’ Drug Pricing Legislation Creates Partisan Backlash

Senate Republicans and Democrats are clashing on a bill aimed at preventing drug companies from using tactics — such as the obtaining of duplicative patents just as old products are running off-patent — in order to delay similar, cheaper prescriptions from reaching the market. The Affordable Prescriptions for Patients Act of 2019, which would authorize the Federal Trade Commission to sue such drug companies, would lower federal spending by $507 million over a decade, according to projections from the Congressional Budget office. 

The Senate Judiciary Committee had previously advanced the bill in June, but efforts to further advance the bill have since been blocked by Democrats looking for assurances the chamber’s GOP leaders will consider additional legislation to address increasing drug costs. 

“I think the rationale is they want it to be part of the larger prescription drug bill,” Sen. John Cornyn (R-TX) said. “But given the uncertainty of impeachment and the schedule, I’d like to go ahead and get this done since it has bipartisan support and I think it would actually do some good.” 

Sen. Richard Blumenthal (D-Conn.), a co-sponsor of the bill, suggested that the resistance between the two parties was due to miscommunication and that the pair is looking to determine a solution in the coming weeks. 

Roundtable Senior Policy Advisor, Andrew MacPherson, spoke at a recent Capitol Hill briefing hosted by the Coalition for Affordable Prescription Drugs in support of the legislation

CMS Administrator Verma Testifies at House E&C Oversight Committee, Reveals No Details on ACA Replacement Plan

Last Wednesday (Oct. 23), Democrats on the House Energy & Commerce oversight subcommittee grilled CMS Administrator, Seema Verma, during a hearing on the Trump Administration’s plans for an Affordable Care Act replacement policy. The committee members questioned Verma, asking why CMS has not defended parts of the ACA that protect coverage for people with preexisting conditions. (InsideHealthPolicy). 

Committee members spent most of the hearing asking questions directed at the administration’s support of the ongoing case to undo the ACA, Texas v. United States. Many committee members accused the administration of not having a backup plan for ACA, should the case prove successful in overturning the policy. Verma deflected many of the committee’s questions and often referred back to the cost-savings and other successes the administration has achieved. 

During the hearing, Rep. Raul Ruiz (D-Calif.) addressed Verma stating, “You have no plan, you can’t produce a document, you can’t give us detail, you’re skirting the issues and all we are getting are talking points.” 

Verma countered by stating, “We have a plan for a number of different scenarios, but we need to hear from the courts. The president has made this commitment clear that he wants to make sure people with preexisting conditions have protections.”