United States: Capitol Hill Healthcare Update - July 15, 2019

Last Updated: August 20 2019
Article by Christian B. Jones and Adam J. Higgins

Below is this week's "Capitol Hill Healthcare Update," which is posted on Mondays when Congress is in session.

SENATORS RACE TO FINISH DRUG PRICING BILL AS TRUMP PLANS STALL

With only 15 legislative days before a scheduled monthlong recess, Senate leaders are scrambling this week to seek consensus on ambitious legislation to lower prescription drug prices, particularly after major pharmaceutical industry initiatives by the Trump administration were derailed last week.

Senate Finance Committee leaders Charles Grassley, R-Iowa, and Ron Wyden, D-Ore., have been working for months on a package of bills to lower drug prices – and they are hinting a deal is close.

The senators appear to have agreed on the outlines of a plan that would impose inflation caps on prices for drugs in the Medicare Part D program by requiring manufacturers to pay rebates to the government if prices rise faster than inflation. Multiple price transparency provisions are also expected to be included.

The Senate HELP Committee and Senate Judiciary Committee already approved separate measures on drug pricing, and senators hope to package those bills with the Finance Committee product for a vote on the Senate floor this month.

But the sticking point remains allowing for government negotiation of drug prices. That's a nonstarter for most Senate Republicans but a key priority for Democrats – each of the seven senators seeking their party's presidential nomination have endorsed it. All but one Democrat on the Finance Committee – Sen. Robert Mendez, D-N.J. – sent a letter last week to Grassley and Wyden urging them to include government negotiation, too.

It's not clear that Senate Democratic leaders would allow drug pricing legislation to advance to a vote if it falls short of government negotiation, even if the underlying bill included other significant reforms.

HOUSE PANEL TO ADVANCE SURPRISE BILLING, DRUG PRICING LEGISLATION

The House Energy and Commerce Committee this week is expected to vote on 10 different bills addressing prescription drug costs, surprise medical billing and reauthorization of public health programs.

The Health Subcommittee last week advanced the legislation as a series of separate bills.

But amid broad bipartisan agreement on the need to protect patients from surprise medical bills, disagreements over how to do so could hamper progress. The subcommittee approved legislation authored by Energy and Commerce leaders Frank Pallone, D-N.J., and Greg Walden, R-Ore., but negotiations are ongoing over the mechanism to settle payment disputes. Two doctors on the panel, Reps. Raul Ruiz, D-Calif., and Larry Bucshon, R-Ind., want independent mediation while the Pallone-Walden legislation calls for a federal benchmark rate to settle disputes. The Senate HELP Committee last month approved legislation using the Pallone-Walden approach.

The committee also is expected to approve an amended version of legislation by Rep. Jan Schakowsky, D-Ill., that would require drugmakers to justify price increases of more than 10% in one year or 25% in three years.

Also scheduled for a vote is legislation by Rep. James Langevin, D-R.I., to reauthorize federal funding for the Lifespan Respite Care Act, which provides state grants to support caregivers nationwide who provide care for loved ones with chronic, disabling health conditions. First introduced by former Rep. Mike Ferguson, R-N.J., and enacted in 2006, the law has led to grants in 37 states and the District of Columbia. (Ferguson is now the leader of BakerHostetler's Federal Policy team.)

BILL WOULD DROP DEVICE SAMPLES FROM SUNSHINE REPORTING

In a win for the medical device industry, the House Energy and Commerce Committee this week is scheduled to vote on drug pricing legislation that requires pharmaceutical manufacturers – but not device companies – to disclose the value of product samples given to physicians.

A separate committee in April approved a package of drug pricing bills that would expand the Sunshine Act's reporting requirements to include both drug and device samples – setting up a potential clash as the underlying drug pricing bills move to the House floor.

Advocates of requiring manufacturers to report on product samples said they want visibility into the correlation between drug samples provided to doctors and the prescriptions physicians write.

Since the April vote, the device industry has argued there is no evidence linking samples to increased utilization. Also, manufacturers of contact lenses and syringes argued it could disrupt the practice of medicine as physicians use samples to educate patients on proper usage. If companies were forced to catalogue and disclose the value of samples – something they're not currently doing – they could stop providing samples to avoid the compliance costs.

The Energy and Commerce Health Subcommittee last week approved an amended version of legislation that would require reporting on drug price increases and drug samples, but not device samples.

HOUSE TO VOTE ON 'CADILLAC TAX' REPEAL BILL

The House is scheduled to vote Wednesday on legislation to repeal the Affordable Care Act's excise tax on high-cost health plans, a priority for congressional Democrats and their political allies in organized labor, which often negotiate robust health insurance coverage for their members.

Repealing the so-called Cadillac tax comes with a huge price tag – reducing government revenue by $193 billion over a decade, according to the Congressional Budget Office.

Introduced by Rep. Joe Courtney, D-Conn., the repeal bill has 359 co-sponsors in the House.

The tax would impose a 40% surcharge on employer-provided plans costing more than $11,200 for individuals and $30,100 for families. The tax is scheduled to take effect in 2022 after already being delayed twice by Congress.

While the Senate is not likely to pass the bill, its House passage would give Senate Republican leaders a tactical advantage. Under the Constitution, all tax bills must originate in the House; the Senate could amend the Cadillac tax bill with any other tax provisions and send the amended bill back to the House.

BIPARTISAN SENATE LEGISLATION WOULD SPEED GENERIC INSULIN

Legislation introduced in the Senate last week would speed Food and Drug Administration approval of generic and follow-on insulin.

Introduced by Sens. Dick Durbin, D-Ill., Tina Smith, D-Minn., and Kevin Cramer, R-N.D., the bill would require the FDA to continue to review applications for generic insulin even after the agency's internal March 2020 date to end consideration. The FDA established that date as an application termination cliff in part to promote biosimilars.

As Congress examines the prescription drug issue, the price of insulin – first discovered in 1921 – has been the subject of congressional hearings. Insulin prices have increased tenfold since 2001.

The Senate legislation won the endorsement of the Diabetes Patient Advocacy Coalition, the National Diabetes Volunteer Leadership Council and Children with Diabetes.

SENATORS INTRODUCE BILL TO REFORM PALLIATIVE AND HOSPICE CARE

Bipartisan legislation introduced in the Senate last week would increase federal funding for palliative care research and to train a nationwide hospice workforce.

Introduced by Sens. Tammy Baldwin, D-Wis., and Shelley Moore Capito, R-W.Va., the bill aims to enhance training for new and existing physicians, and for those who teach palliative care.

The legislation also would provide academic and career awards to incentivize the practice and study of palliative and hospice care.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Authors
Similar Articles
Relevancy Powered by MondaqAI
 
In association with
Related Topics
 
Similar Articles
Relevancy Powered by MondaqAI
Related Articles
 
Related Video
Up-coming Events Search
Tools
Print
Font Size:
Translation
Channels
Mondaq on Twitter
 
Mondaq Free Registration
Gain access to Mondaq global archive of over 375,000 articles covering 200 countries with a personalised News Alert and automatic login on this device.
Mondaq News Alert (some suggested topics and region)
Select Topics
Registration (please scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.

Disclaimer

The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.

General

Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions