Lawmakers Continue to Press CMS on Part B Drug Payment Model

Members of the House and Senate continue to contact the Centers for Medicare and Medicaid Services (CMS) regarding the agency’s proposed Part B drug payment model. Sen. Heidi Heitkamp (D-N.D.) led a letter signed by eight other democrats urging CMS not to move forward with the demonstration until concerns about the size and scope of the model, as well as beneficiary access to physician-administered drugs, are resolved. Rep. Diana DeGette (D-Colo.) and 12 other democratic members of the House Energy and Commerce Committee wrote to express concerns about medication access and the impact of the proposal on small practices and providers in rural and underserved areas, but they do not ask CMS to pause or withdraw the model. The DeGette letter encourages CMS “to tailor the demonstration to an appropriate size capable of gathering meaningful data.” Also, it states their preference that CMS “plan to prevent …problems on the front-end rather than as problems arise.” Similarly, Rep. Richard Neal (D-Mass.) led a letter signed by more than 50 democrats asking for resolution to 11 questions, on topics ranging from beneficiary and physician impact to potential shifts in sites of service and emphasizes that “these questions require careful and detailed resolution before CMS moves forward with either phase of the demonstration.” Rep. Jan Schakowsky (D-Ill.) and 19 other House Democrats wrote to the administration defending the demonstration project, explaining that they believe the proposal will “not only help to fix the current and flawed status quo but will also help combat the increasingly unaffordable prices that drug companies are charging for their products.” The House Energy and Commerce Health Subcommittee will hold a hearing on the Part B demo this Tuesday. The hearing will consider the experiment as well as H.R. 5122, legislation introduced by Rep. Larry Bucshon (R-Ind.) that would block the proposal from advancing. Witnesses for the hearing include Dr. Michael Schweitz (on behalf of the Coalition of State Rheumatology Organizations and the Alliance of Specialty Medicine); Marcia Boyle (on behalf of the Immune Deficiency Foundation); Dr. Debra Patt (on behalf of Texas Oncology, The US Oncology Network, the Community Oncology Alliance (COA) and the American Society of Clinical Oncology (ASCO)); and others. The hearing will be webcast and may be viewed at http://energycommerce.house.gov/.

House Passes Package of Legislation to Combat Opioid Abuse

Last week, the House of Representatives passed a package of legislation aimed at combating the prescription drug and heroin abuse epidemic. The chamber began by advancing H.R. 4641, a bipartisan bill offered by Energy and Commerce Committee members Susan Brooks (R-Ind.) and Joseph Kennedy (D-Mass.). The legislation would establish an inter-agency task force to review, modify, and update best practices for pain management and how pain medication is prescribed. It was agreed to by a vote of 412-4. The House also passed an additional 10 bills under suspension of the rules:

  • H.R. 4978 – NAS Healthy Babies Act
  • H.R. 3680 – Co-Prescribing to Reduce Overdoses Act of 2016
  • H.R. 3691 – Improving Treatment for Pregnant and Postpartum Women Act of 2016
  • H.R. 1818 – Veteran Emergency Medical Technician Support Act of 2016
  • H.R. 4969 – John Thomas Decker Act of 2016
  • H.R. 4586 – Lali’s Law
  • H.R. 4599 – Reducing Unused Medications Act of 2016
  • H.R. 4976 – Opioid Review Modernization Act of 2016
  • H.R. 4982 – Examining Opioid Treatment Infrastructure Act of 2016
  • H.R. 4981 – Opioid Use Disorder Treatment Expansion and Modernization Act

These bills would address a wide array of issues surrounding the drug abuse crisis, such as neonatal abstinence syndrome, access to addiction treatment, and disposal of unused medications. H.R. 5046, the Comprehensive Opioid Abuse Reduction Act of 2016, was passed later in the week. This bill would award $100 million in grants to state and local governments to provide opioid abuse services, and would help increase collaboration between criminal justice and substance abuse agencies. Finally, the House considered S. 524, the Comprehensive Addiction and Recovery Act of 2016 (CARA) before adjourning for the weekend. CARA is a wide-ranging bill that would help states prevent drug abuse, treat addiction, and reduce overdose deaths. The House passed the legislation by a vote of 400-5. It was previously passed by the Senate in March. The House will next vote on conferencing with the Senate to resolve the differences between the packages of bills each chamber passed to address the addiction epidemic. The legislation is likely to be signed into law by President Obama, despite some objection that the bills do not include sufficient funding to address the problem of opioid abuse. Also last week, the president of the American Medical Association (AMA) encouraged doctors to avoid beginning new patients with chronic non-cancer pain on opioids, and to limit the amount of opioids prescribed in post-operative and acute settings to the lowest effective dose for the shortest period of time necessary. This is the first time the AMA has made a statement in preference of non-drug or non-opioid pain treatments.

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