This Week in Washington: Senate Finance Committee reports out Modernizing and Ensuring PBM Accountability Act; House Ways and Means Committee reports out healthcare bills; Senate Appropriations Committee reports out FY 2024 Labor-HHS funding bill; Congress leaves for August recess

Congress

House

House Ways and Means Committee Marks Up Two Healthcare Bills

On July 26, the House Ways and Means Committee reported out two healthcare bills on a party line vote. The bills are:

H.R. 4822, the Health Care Price Transparency Act of 2023
This legislation would implement additional site-neutral payment cuts and regulatory measures on off-campus hospital outpatient departments. It would also impose Medicare sequester cuts on hospitals, codify hospital price transparency regulations, require healthcare plans to limit beneficiary cost-sharing for a month's supply of a drug covered under Medicare Part D, and establish an electronic prior authorization system for Medicare Advantage plans.

H.R. 3284, the Providers and Payers COMPETE Act
This legislation would require the Secretary of Health and Human Services (HHS) to submit an annual report to Congress outlining the effects of Medicare payment rules on provider and payer consolidation. The report would also detail the effects of payer and provider consolidation with respect to Centers for Medicare and Medicaid (CMS) Innovation Center models.

During the markup, the committee rejected four amendments. Among them was an amendment offered by Rep. Pascrell (D-NJ) that would have required the disclosure of hospitals and nursing homes owned by private equity entities.

For more information, click here.

House Energy and Commerce Committee Chairman Issues Drug Shortage Discussion Draft

On July 28, House Energy and Commerce Committee Chairman Cathy McMorris Rodgers (R-WA) released a discussion draft concerning drug shortages. The discussion draft outlines proposals that the committee developed from stakeholder feedback from a request for information (RFI) the Chair and Senate Finance Committee Ranking Member Mike Crapo (R-ID) issued on drug shortages in June.

Among the policy proposals are provisions that would:

  • Exempt certain specified drugs from increases in rebates under the Medicaid program;
  • Implement a cap on total rebates for certain generic drugs;
  • Exempt generic, sterile injection drugs from the 340B Drug Discount Program;
  • Direct the Government Accountability Office (GAO) to study the number of generic drugs that are subject to 340B penny pricing;
  • Direct the Health Resources and Services Administration (HRSA) to issue guidance on preventing drug diversions during shortages;
  • Reduce inflation rebate amounts for certain shortage drugs subject to rebate waivers under the Medicare program;
  • Direct the Department of Health and Human Services (HHS) to study Medicare coding policies for generic sterile injectables and other Part B drugs facing shortages;
  • Strengthen reporting requirements for Group Purchasing Organizations; and
  • Require the Food and Drug Administration (FDA) to issue noncompliance letters relating to drug volume reporting.

The committee is seeking public comment on the draft discussion and will accept comments until Aug. 25, 2023.

For more information, click here.

Senate

Senate Finance Committee Marks Up Modernizing and Ensuring PBM Accountability Act

On July 26, on a 26 to 1 vote, the Senate Finance Committee reported out of committee the Modernizing and Ensuring PBM Accountability (MEPA) Act. The legislation would update federal prescription drug programs and implement provisions aimed at reforming pharmacy benefit manager (PBM) practices. It would:

  • Prohibit PBMs and their affiliates from deriving income or renumeration for Medicare Part D covered drugs based on a manufacturer's price for the drug;
  • Require PBMs to define and apply drug and drug pricing terms in contracts with Part D plan sponsors in a transparent and consistent manner;
  • Strengthen PBM reporting requirements and expand the amount of information that PBMs provide to Part D plan sponsors and the Secretary of Health and Human Services (HHS);
  • Allow Part D plan sponsors to audit their PBM for compliance with contract requirements;
  • Require the HHS Secretary to implement standard Part D measures to assess network pharmacy performance;
  • Ban PBM spread pricing in the Medicaid program; and
  • Require retail community pharmacies to participate in the National Average Drug Acquisition Cost (NADAC) survey.

For more information, click here.

Senate Appropriations Committee Marks Up FY 2024 Labor-HHS Funding Bill

On July 27, the Senate Appropriations Committee reported out of committee the fiscal year (FY) 2024 Labor, Health and Human Services (HHS) and Education appropriations bill. The legislation would authorize $224.4 billion in total discretionary funding, of which $117 billion would go to the Department of Health and Human Services (HHS). In addition, it included $2 billion in supplemental funding. The bill would:

  • Authorize $47.8 billion in funding for the National Institutes of Health (NIH);
  • Authorize $5 billion in funding for opioid and substance use disorder treatment and prevention programs;
  • Authorize $1.5 billion in funding for the NIH Advanced Research Projects Agency for Health (ARPA-H);
  • Authorize $3.67 billion in funding for the Administration for Strategic Preparedness and Response (ASPR);
  • Retain funding for the Teen Pregnancy Prevention Program;
  • Increase funding for the Ending the HIV Epidemic Initiative;
  • Increase funding for childcare and mental health programs; and
  • Award $2 billion in additional emergency funding to HHS.

For more information, click here.

Senate HELP Committee Chairman Cancels Two Days of Mark Ups

On July 26 and 27, the Senate Health, Education, Labor and Pensions (HELP) Committee was scheduled to mark up legislation relating to primary care, health workforce development, and job and apprenticeship programs. However, both markups were canceled by committee Chairman Bernie Sanders (I-VT). Ranking Member Bill Cassidy (R-LA) raised concerns about the postponements.

The bills that were scheduled to be marked up include:

Primary Care and Health Workforce Expansion Act
This legislation would authorize $86.5 billion in funding for various health workforce development programs, including the National Health Service Corps and the Primary Care Training and Enhancement Program. It would also implement new prior authorization requirements, prohibit hospitals from charging facility fees when patients receive care from off-site physicians and place a cap on hospital and physician fees.

National Apprenticeship Act of 2023
This legislation would support the creation and expansion of registered, youth and pre-apprenticeship programs. It would also grant the Department of Labor Office of Apprenticeship (OA) additional statutory authority to support state apprenticeship programs and agencies.

Youth Apprenticeship Advancement Act
This legislation would support the expansion of youth apprenticeship opportunities available to high school students and would authorize an investment of $500 million in youth apprenticeship programs over the next five years.

JOBS Act of 2023
This legislation would expand Pell Grant eligibility to students who are enrolled in short-term job training programs that result in their obtaining industry-recognized credentials and certificates.

Gateway to Careers Act of 2023
This legislation would create a grant program aimed at strengthening job training. The grant program would support workforce partnerships established among community colleges, industry stakeholders and other community organizations.

For more information on the primary care legislation markup, click here.

For more information on the job and apprenticeship program legislation markup, click here.

Read more on healthcare policy in McGuireWoods Consulting's Washington Healthcare Update.

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