Congress, Administration Continue Focus on Drug Pricing

A bipartisan group of senators have written to Office of Management and Budget (OMB) Director Mick Mulvaney requesting his help in lowering the cost of prescription drugs. The lawmakers believe that the OMB can use existing authority to lower drug prices. The senators also ask Director Mulvaney to work with U.S. Department of Health and Human Services (HHS) Secretary Tom Price to certify importation of prescription drugs from Canada in cases when the drug is off patent or no longer marketed in the U.S. by the innovator company that developed it, when there are significant and unexplained increases in price, when there is no competitor drug that would benefit the market, or when the drug is produced in another country by a manufacturer that commonly sells pharmaceutical products in the U.S. The letter was sent by Sens. Amy Klobuchar (D-Minn.), John McCain (R-Ariz.), and Chuck Grassley (R-Iowa). Also last week, a bipartisan group of senators reintroduced legislation that would require companies to notify HHS before raising the price of certain drugs. The Fair Accountability and Innovative Research (FAIR) Drug Pricing Act would require drug manufacturers to submit a report 30 days in advance of increasing the price of certain products that cost at least $100 by 10 percent or greater in one year or 25 percent or greater over three years. It would also require the company to disclose manufacturing, R&D, and marking costs, in addition to the profits associated with the drug. The bill is sponsored by Sens. Tammy Baldwin (D-Wis.) and John McCain (R-Ariz.) in the Senate (S. 1131), and Rep. Jan Schakowsky (D-Ill.) in the House (H.R. 2439). The Trump Administration is also in the process of holding listening sessions on ways to combat rising drug prices. The White House has invited industry groups and advocates to meet with Secretary Price, who requested feedback from attendees once the Administration decides on a proposal.

White House Budget Proposal Expected This Week

The Trump Administration plans to release its full proposed fiscal year (FY) 2018 budget on Tuesday, May 23. The budget is expected to balance within the next decade, largely due to predicted cuts to mandatory spending. It is likely that the plan will face opposition from lawmakers of both parties. The Trump skinny budget, which outlines discretionary spending levels and was released earlier this year, included $15 billion in cuts to the U.S. Department of Health and Human Services (HHS), with $6 billion coming from the National Institutes of Health (NIH). Sen. Patty Murray (D-Wash.) spearheaded a letter to HHS Secretary Tom Price warning against cuts to public health, and outlining possible implications on the implementation of the 21st Century Cures Act. Chairman of the House Appropriations HHS Subcommittee Tom Cole (R-Okla.) has also expressed concerns about the proposed cuts to medical research. The President’s budget request will be used as a starting point for lawmakers to begin crafting their own budget resolution. House Budget Chairwoman Diane Black (R-Tenn.) has expressed interested in the inclusion of changes to Medicaid payments in the budget, and Speaker of the House Paul Ryan (R-Wis.) would like to tackle some Medicare reforms through the appropriations process. House Appropriations Committee member Mike Simpson (R-Idaho), however, predicted that Congress would be forced to pass a continuing resolution (CR) for FY 2018, due to disagreements among Republicans on the appropriate spending level. Office of Management and Budget (OMB) Director Mick Mulvaney will testify at the House Budget Committee’s hearing on the President’s budget on May 24. The 2018 fiscal year begins on October 1st.

CHRONIC Care Act Advanced through Finance Committee

The Senate Finance Committee has advanced legislation to expand home health care and telehealth reimbursement by Medicare. S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 aims to help health care providers better coordinate care for the chronically ill. It would expand a home care program known as Independence at Home, and would allow beneficiaries receiving home dialysis to receive assessments through telehealth services. It would also allow doctors participating in Medicare Advantage (MA) and accountable care organizations (ACOs) to offer telehealth visits. Additionally, the bill expands ACOs ability to use prospective assignment to enroll beneficiaries. The bill is a product of the Finance Committee’s chronic care working group, spearheaded by Sens. Johnny Isakson (R-Ga.) and Mark Warner (D-Va.). The CHRONIC Care Act would be paid for between 2018-2022 through funding from the Medicare Improvement Fund and the Medicaid Improvement Fund. During the markup, the Committee approved one amendment that would allow Part D drug plan sponsors to obtain Part A and B data in order to advance care coordination and improve medication use. There is no immediate schedule to consider the legislation on the floor of the Senate.

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