United States: Congressional Committees Advance Multiple Bills Addressing Surprise Medical Billing, Prescription Drug Policy, And Other Health Policy Issues

Prior to the 4th of July break, Senate and House Committees approved more than a dozen health policy bills, covering topics including: surprise medical bills, health pricing transparency, drug prices and competition, various Medicare policies, and public health program reauthorization, among others. The following are highlights of recent action. Note that none of the bills has yet been considered by the full House or Senate, and all are subject to change during the legislative process.

Senate HELP Committee

The Senate Health, Education, Labor and Pensions (HELP) Committee approved S 1895, the Lower Health Care Costs Act of 2019. This high-profile, bipartisan legislation would hold patients harmless from "surprise" medical bills for out-of-network services provided at an in-network facility, with payment to out-of-network providers set at the median contracted rate for in-network providers in the geographic area (a controversial "benchmark rate" proposal). The bill contains separate protections regarding costs for emergency room and air ambulance services. Additionally, S 1895 seeks to improve health care transparency by, among other things, banning what are described as "anticompetitive" terms in contracts between insurers and providers; providing patients with additional information on out-of-pocket costs; and regulating certain pharmacy benefit manager (PBM) pricing practices. The legislation also includes numerous provisions intended to promote generic drug and biosimilar biological product innovation; improve health information exchange and strengthen health entity cybersecurity practices; and authorize various public health programs. The Committee approved the bill on June 26, 2019 on a vote of 20-3. Committee Chairman Lamar Alexander expressed hope for full Senate consideration of the bill in July.

During the same markup, the HELP Committee also approved S 1173, the Emergency Medical Services for Children Program Reauthorization Act, and S 1199, the Poison Center Network Enhancement Act of 2019.

Senate Judiciary Committee

The Senate Judiciary Committee approved the following four bills that are intended to help reduce prescription drug prices:

  • S 1227, the Prescription Pricing for the People Act of 2019, which would require the Federal Trade Commission (FTC) to study the role of PBMs in the pharmaceutical supply chain and provide Congress with related policy recommendations.
  • S 440, the Preserving Access to Cost Effective Drugs Act, which would bar patent owners from asserting sovereign immunity, including the sovereign immunity accorded to an Indian tribe, in certain drug patent disputes.
  • S 1224, the "Stop STALLING Act," to authorize the FTC to take action against entities that file "sham" citizen petitions to attempt to interfere with approval of a competing generic drug or biosimilar.
  • S 1416, Affordable Prescriptions for Patients Act of 2019, which would authorize the FTC to challenge certain brand manufacturer practices (e.g., "product hopping" and "patent thickets") that could discourage generic drug and biological use.

House Ways and Means Committee

The House Ways and Means Committee recently passed the following health policy bills:

  • HR 3417, the Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019, which would, among other things: expand Medicare telehealth services for mental health treatment; require Part D drug plans to provide for real-time electronic transmission to prescribing health care professionals of individual-specific formulary and benefit information (including cost-sharing and utilization management requirements and clinically-appropriate alternatives included in the formulary); provide transitional Part D coverage for certain low-income Medicare beneficiaries; modify requirements for new medical residency training programs for hospitals in rural areas; revise requirements for the Medicare skilled nursing facility value-based purchasing program; and improve beneficiary outreach and education prior to Medicare enrollment,
  • HR 3429, the HEARTS and Rural Relief Act, which would provide Medicare coverage for prostate cancer DNA Specimen Provenance Assay tests; provide additional transparency regarding decisions to exclude procedures from the ambulatory surgical center approved procedure list; exclude complex rehabilitative manual wheelchairs from Medicare competitive bidding; extend a delay in CMS's direct supervision rule for critical access hospitals; and revise certain TRICARE eligibility requirements.
  • HR 3436, the Improving Chronic Care Management Act, which would eliminate Medicare coinsurance requirements for chronic care management services.
  • HR 3414, the Opioid Workforce Act of 2019, to add 1,000 new graduate medical education residency slots to train addiction specialists to help combat the opioid crisis.
  • HR 3439, the Protecting Access to Information for Effective and Necessary Treatment Act of 2019, to authorize and fund the Patient-Centered Outcomes Research Institute (PCORI).

House Energy and Commerce Committee

The House Energy and Commerce Health Subcommittee approved legislation to reauthorize four health programs:

  • HR 1058, which would reauthorize autism spectrum disorder research, detection, prevention, treatment, education, and disability programs across several health agencies.
  • HR 2507, to reauthorize the Newborn Screening Saves Lives Act.
  • HR 776, to reauthorize the Emergency Medical Services for Children Program.
  • HR 2035, to reauthorize the Lifespan Respite Care program.

Committee Hearings

In addition to these markups, there have been a number of recent health policy-related hearings, including:

  • A House Oversight and Reform Committee hearing entitled "Medical Experts: Inadequate Federal Approach to Opioid Treatment and the Need to Expand Care."
  • An Energy and Commerce Health Subcommittee hearing on "Strengthening Health Care in the U.S. Territories for Today and Into the Future."
  • A Senate Aging Committee hearing entitled "The Complex Web of Prescription Drug Prices, Part III: Examining Agency Efforts to Further Competition and Increase Affordability."

This article is presented for informational purposes only and is not intended to constitute legal advice.

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