ARTICLE
23 April 2019

MLS Weekly Preview: Congress Keeping Its Focus On Drug Costs

M
Mintz

Contributor

Mintz is a general practice, full-service Am Law 100 law firm with more than 600 attorneys. We are headquartered in Boston and have additional US offices in Los Angeles, Miami, New York City, San Diego, San Francisco, and Washington, DC, as well as an office in Toronto, Canada.
This week, Congress will continue to look at lowering health costs.
United States Food, Drugs, Healthcare, Life Sciences

 This week, Congress is keeping its eye on drug pricing with a reported hearing in the House Ways & Means Committee. This comes on the heels of the full E&C Committee advancing six pieces of bipartisan legislation for full floor consideration. The legislation centers mostly on requiring various disclosures, such as requiring drug manufacturers justify drug price increases or legislation to require PBMs disclose aggregate rebates. This issue will stay relevant among policymakers and the Administration for the foreseeable future. In fact, several of the bills have already been introduced in the Senate.

Last week, Senator Lamar Alexander, Chairman of the Senate HELP Committee, signaled he intends to draft a broad package with the Finance Committee to lower drug costs. Among the proposals being considered include expanding the Administration's point-of-sale rebate proposal to the commercial market. This proposal currently would only apply to Medicare and Medicaid. It's important for stakeholders to closely monitor legislative markers put forth by both Democrats and Republicans on the committees of jurisdiction as this effort ramps up.

Meanwhile, the Administration is still committed to pursuing a new health care plan, and the hope is to get key senators on board who are so far hesitant to restart the failed 2017 effort with the 2020 election just on the horizon. Even if an Administration health care proposal is put forth, expect significant headwinds as House Democrats would undoubtedly juxtapose the plan with a plan of their own, some of which was on display in the E&C hearing last week.

On the opioid front, Senators Chuck Schumer (NY) and Tom Cotton (AK) introduced legislation that would impose sanctions on foreign traffickers of opioids. It would also provide tools for law enforcement to crack down on traffickers of synthetic opioids.

SURPRISE BILL PACKAGE NEARS

Following an information gathering hearing in the House Education & Labor Committee, introduction of a highly anticipated surprise billing legislative package seems imminent. Key House policymakers, as well as members of the Senate HELP Committee, will continue to play a part in the development of the bill, which is expected to be unveiled in the next few weeks.

Hospital and insurance stakeholders will continue to frame the issue as the proposal remains in the development stage. Rep. Frederica Wilson (D-FL), Chair of the Ed & Labor Health subcommittee, noted that cracking down on out-of-network specialists at hospitals is one way to look at this issue.

It remains to be seen whether a package such as this could pass as a standalone bill – or would need to be attached to a broader legislative vehicle.

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