CBO Releases CSR Analysis

Last week, the Congressional Budget Office (CBO) released a report analyzing the potential effects of terminating costsharing reduction (CSR) payments. Ending the payments to insurers would increase the deficit by $194 billion over the next decade. It would also cause insurers to raise premiums by approximately 20 percent to cover costs. While the Administration characterized the report as flawed, the White House nevertheless announced its decision to keep paying the CSR payments through August. The President has previously threatened to end the subsidies if Congress did not successfully repeal the Affordable Care Act (ACA), and the future of the payments, estimated to total $7 billion this year, is still uncertain. Without congressional appropriation, the Administration could choose to stop the payments in any month

ONC to Hold Meetings on Interoperability

The Office of the National Coordinator (ONC) plans to hold two stakeholder forums before the end of the year focusing on a nationwide framework for electronic health-data exchange. Full adoption of interoperability is a high priority for the ONC, particularly in order to support providers participating in value-based payment programs. The first meeting is likely to be scheduled before the end of September.

Dems Launch Investigation into MS Therapy Costs

Democrats on the House Committee on Oversight and Government Reform have launched an investigation into the rising cost of treatments for Multiple Sclerosis (MS). Reps. Elijah Cummings (D-Md.) and Peter Welch (D-Vt.) are requesting information from Bayer, Biogen, EMD Serono, Novartis, Roche Holding, Sanofi and Teva Pharmaceutical about corporate profits, expenses, pricing strategies, patient assistance programs, and drug distribution systems. While annual sales of MS drugs doubled between 2008 and 2012, the cost of the average MS therapy rose from $16,050 per patient in 2004 to more than $60,000 per person in 2015. The lawmakers requested a response by August 31, 2017.

DoJ Finalizes Mylan Settlement

Last week, the Justice Department finalized Mylan’s $465 million settlement of a case claiming that the company defrauded the Medicaid program through its misclassification of its EpiPen product as a generic drug. The settlement has been criticized by lawmakers on both sides of the aisle. Sen. Chuck Grassley (R-Iowa) expressed his disappointment with both Mylan for overcharging taxpayers, and with the Centers for Medicare and Medicaid Service (CMS) for failing to follow through when made aware of the problem. Rep. Lloyd Doggett (D-Texas), chairman of the Prescription Drug Task Force, also criticized the news, describing Mylan as a price gouger operating at the taxpayer expense.

Upcoming Congressional Hearings and Meetings

Field Hearing: VA Home Telehealth: Looking Behind the Numbers; Subcommittee on Oversight and Investigations (Committee on Veterans’ Affairs), Wednesday, August 30, 2017 (8:30 AM local time), Garfield Charter Township Board Room, 3848 Veterans Drive, Traverse City, MI 49684

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