{"id":2064,"date":"2021-06-28T14:43:50","date_gmt":"2021-06-28T14:43:50","guid":{"rendered":"https:\/\/thornrun.com\/health-policy-report-6-28\/"},"modified":"2023-08-08T21:25:34","modified_gmt":"2023-08-08T21:25:34","slug":"health-policy-report-6-28","status":"publish","type":"post","link":"https:\/\/thornrun.com\/health-policy-report-6-28\/","title":{"rendered":"Health Policy Report (6\/28)"},"content":{"rendered":"\n

House lawmakers will reconvene today to wrap up the June legislative session ahead of what is shaping up to be a hectic month of July. President Joe Biden endorsed a bipartisan Senate infrastructure\u00a0deal<\/a>\u00a0(fact sheet<\/a>) last week, and leadership in both chambers indicated that they will try and push this across the finish line prior to the August district work period. Democrats will also be kicking off the budget resolution process next month to craft legislation on the President\u2019s American Jobs Plan<\/a>\u00a0and\u00a0American Families Plan<\/a>, including policies on home and community-based services<\/a>, child care, education, paid leave, climate change, and health care, among\u00a0others<\/a>. In addition to the Biden administration’s agenda, Congress must also resume its work on fiscal year (FY) 2022 appropriations, the National Defense Authorization Act (NDAA), as well as budgetary issues stemming from the American Rescue Plan and the expiring debt ceiling suspension.<\/p>\n\n\n\n\n\n\n\n

On the floor this\nweek, House lawmakers will take up the Transportation & Infrastructure\nCommittee’s surface transportation reauthorization measure. The INVEST In America Act <\/a>would\nauthorize spending of $547 billion for the Department of Transportation\u2019s (DOT)\ninvestments over the next five years, including $343 billion for roads and\nbridges, $109 billion for transit, $95 billion for freight rail, and roughly\n$14.7 billion for Member Designated Projects<\/a>.\nThe bill also includes $51.25 billion toward wastewater infrastructure, as well\nas $117 billion for drinking water and assistance programs. Congress has until\nSeptember 30, 2021 to pass a reauthorization before funding expires. Meanwhile,\nSenators have adjourned for the Independence Day state work period, and will\nresume legislative business on Monday, July 12.<\/p>\n\n\n\n

Senate Finance\nReleases Drug Pricing Principles<\/strong><\/p>\n\n\n\n

Last Tuesday, Senate\nFinance Committee Chairman Ron Wyden (D-OR) released a document<\/a> outlining principles\nfor future legislation aimed at lowering prescription drug prices. His goals\naddress the Department of Health and Human Services (HHS) drug pricing\nnegotiation authority, Medicare Part D rebates and restructuring, drug price\nincreases, private insurance, and funding for drug research and development\n(R&D). <\/p>\n\n\n\n

\u201cCongress has critical\nwork in the weeks ahead to craft legislation that will finally deliver relief\nto Americans who are paying too much for their prescription drugs,\u201d Wyden said\nin a press release<\/a>. \u201cToday\u2019s\nrelease reflects the core principles that will guide my work this summer: let\nMedicare negotiate, limit price gouging, provide relief to consumers at the\npharmacy counter, ensure those with individual and employer insurance also\nbenefit, and reward scientific research for those who are truly innovating. I\nlook forward to working with members of the Senate and the House to deliver\ntrue drug pricing reform to President Biden\u2019s desk this year, as he called for\nin his joint address to Congress.\u201d <\/p>\n\n\n\n

Specifically, Wyden\u2019s\nprinciples call for establishing clear criteria for what constitutes a \u201cmarket\nfailure\u201d with regard to drug pricing that would trigger price negotiations and\ndefining what a \u201cfair price\u201d would be. It also calls for the creation of\n\u201cincentives\u201d for pharmaceutical manufacturers to participate in such\nnegotiations. Chairman Wyden expressed discontent with the current structure of\nPart D plans and pharmacy benefit manager \u201cmiddlemen\u201d and said that formularies\ndo not pass savings onto plan beneficiaries. He said that forthcoming\nlegislation would outline patient savings for insulin and would discontinue\nrebate practices that \u201climit competition and patient access\u201d as well as create\ngreater supply chain transparency. Furthermore, Chairman Wyden called for\nrequiring rebates on price increases that exceed inflation, similar to what was\ncontained in legislation he introduced with former Finance Chairman Chuck\nGrassley (R-IA) in the last Congress. Chairman Wyden also said that drug\npricing reform should benefit all Americans, and that drug pricing should reward\ninnovation \u2014 not \u201cgaming\u201d of the patent system. <\/p>\n\n\n\n

DeGette and Upton\nRelease Cures 2.0 Discussion Draft<\/strong><\/p>\n\n\n\n

Last week, Reps. Diana\nDeGette (D-CO) and Fred Upton (R-MI) released a discussion draft of their Cures\n2.0 legislation, intended to follow up on 2016\u2019s 21st<\/sup> Century Cures Act (discussion draft<\/a>, section-by-section<\/a>). The\nbill includes provisions related to clinical trials, further work on the\npandemic, telehealth, treatment of new products, and more. It also includes\nlegislation to authorize the creation of the Advanced Research Projects Agency\nfor Health (ARPA-H), a Biden administration priority that was included in the\nWhite House\u2019s FY 2022 budget proposal. Reps. DeGette and Upton have long\ndiscussed developing a Cures 2.0 bill, including releasing a request for input\nto stakeholders last Congress. <\/p>\n\n\n\n

\u201cThe federal\ngovernment has amazing resources at its disposal,\u201d said DeGette and Upton in a press release<\/a>. \u201cNow is\nthe time to put the full weight of those resources to use to cure some of the\nworld\u2019s most devastating diseases, such as cancer, diabetes, Alzheimer\u2019s, and\nmore. Developing and delivering new lifesaving cures is a mission that must\nunite all of us.\u201d <\/p>\n\n\n\n

This discussion draft,\nand any subsequent release of the legislation, may present stakeholders a\nplatform for elevating important issues. As a draft, the legislation is ripe\nfor changes and suggestions from stakeholders. However, the bill\u2019s future in\ngoing through the markup process and ultimately receiving any vote is not\ncertain. However, certain items from the bill may ultimately be packaged into\nother legislative vehicles based on committee and leadership interest,\nstakeholder input, and the needs of members.<\/p>\n\n\n\n

HHS, Treasury, DoL\nSeek Feedback on New Prescription Drug Reporting Requirements<\/strong><\/p>\n\n\n\n

Last Monday, the\nDepartments of Health and Human Services (HHS), Treasury, and Labor (DoL)\nissued a call for input on recent new reporting requirements related to\nprescription drugs with the highest associated spending. The request for\ninformation (RFI<\/a>) concerns provisions\npassed as part of the Consolidated Appropriations Act of 2021 which mandated\nhealth plan reporting on the most frequently prescribed drugs and the most\ncostly prescription drugs. It seeks input on the implementation of the new\nrequirements, including the level of detail of information to require, the\ndefinitions of terms included in the new requirements, and general\nimplementation concerns. <\/p>\n\n\n\n

In brief, the new law\nrequires private health plans and insurers, including Exchange plans and\nemployer plans, to report general information on the plan coverage, including\nthe beginning and end dates of the plan year, the number of participants,\nbeneficiaries, or enrollees (as applicable), and each state in which the plan\nor coverage is offered. Health plans and issuers must also report: (1) the 50\nmost frequently dispensed drugs under a plan; (2) the 50 most costly\nprescription drugs for the plan by annual spending; (3) the 50 prescription\ndrugs with the greatest increase in expenditures over the past year; (4) total\nplan spending broken down by category; (5) the impact on premiums made by\nrebates, fees, and other remuneration from drug manufacturers to a plan; (6)\naverage premiums; and (7) reductions in premiums and out-of-pocket costs\nassociated with rebates and other remuneration.<\/p>\n\n\n\n

The RFI will be open\nfor 30 days, with comments tentatively scheduled to close on July 22, 2021.\nFollowing responses from stakeholders, the three Departments will need to issue\nguidance or rulemaking to implement the new reporting requirements in advance\nof the December 27, 2021 deadline for the first reporting period. <\/p>\n\n\n\n

SCOTUS Rejects Review\nof Insurers\u2019 CSR Case<\/strong><\/p>\n\n\n\n

The Supreme Court announced last Monday that it would not take up review of an appeals court decision finding the government can mitigate its obligation to reimburse insurers for Affordable Care Act (ACA) cost-sharing reduction (CSR). The denial will require that insurers prove whether 2018 premium increases and the related increase in ACA premium tax credits resulted from the government\u2019s actions or other forces. Furthermore, the denial impacts several other cases that had been put on hold pending the Supreme Court\u2019s decision to take up the appeal and will require plaintiffs in all cases confer with the Department of Justice (DOJ) on next steps. <\/p>\n\n\n\n

At issues is an August 2020 decision by an appeals court panel that found the government must pay all CSRs owed insurers in the final Quarter before the Trump administration stopped the payments but stated the government could deduct additional tax credits insurers received when they increased premiums to help make up for the losses. In February, Maine Community Health Options and Community Health Choice from Texas asked SCOTUS to review the decision, noting that the circuit court ruling undermined the principles that the government should pay its obligations. The Biden administration weighed in via an April 9 brief, telling the Supreme Court that the appeals court had properly deferred to contract law in its decision. The case now moves to the federal court of claims to determine the amount of premium increases and resulting tax credits attributable to the government\u2019s failure to pay out CSRs.\u00a0 <\/p>\n","protected":false},"excerpt":{"rendered":"

House lawmakers will reconvene today to wrap up the June legislative session ahead of what is shaping up to be a hectic month of July. President Joe Biden endorsed a bipartisan Senate infrastructure\u00a0deal\u00a0(fact sheet) last week, and leadership in both chambers indicated that they will try and push this across the finish line prior to […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,7],"tags":[],"acf":[],"yoast_head":"\nHealth Policy Report (6\/28) - thornrun<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/thornrun.com\/health-policy-report-6-28\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Policy Report (6\/28) - thornrun\" \/>\n<meta property=\"og:description\" content=\"House lawmakers will reconvene today to wrap up the June legislative session ahead of what is shaping up to be a hectic month of July. President Joe Biden endorsed a bipartisan Senate infrastructure\u00a0deal\u00a0(fact sheet) last week, and leadership in both chambers indicated that they will try and push this across the finish line prior to […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/thornrun.com\/health-policy-report-6-28\/\" \/>\n<meta property=\"og:site_name\" content=\"thornrun\" \/>\n<meta property=\"article:published_time\" content=\"2021-06-28T14:43:50+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-08T21:25:34+00:00\" \/>\n<meta name=\"author\" content=\"Thornrun\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Thornrun\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/thornrun.com\/health-policy-report-6-28\/\",\"url\":\"https:\/\/thornrun.com\/health-policy-report-6-28\/\",\"name\":\"Health Policy Report (6\/28) - thornrun\",\"isPartOf\":{\"@id\":\"https:\/\/thornrun.com\/#website\"},\"datePublished\":\"2021-06-28T14:43:50+00:00\",\"dateModified\":\"2023-08-08T21:25:34+00:00\",\"author\":{\"@id\":\"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772\"},\"breadcrumb\":{\"@id\":\"https:\/\/thornrun.com\/health-policy-report-6-28\/#breadcrumb\"},\"inLanguage\":\"en\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/thornrun.com\/health-policy-report-6-28\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/thornrun.com\/health-policy-report-6-28\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/thornrun.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Health Policy Report (6\/28)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/thornrun.com\/#website\",\"url\":\"https:\/\/thornrun.com\/\",\"name\":\"thornrun\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/thornrun.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772\",\"name\":\"Thornrun\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en\",\"@id\":\"https:\/\/thornrun.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g\",\"caption\":\"Thornrun\"},\"sameAs\":[\"https:\/\/thornrun.com\"],\"url\":\"https:\/\/thornrun.com\/author\/thornrun\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Health Policy Report (6\/28) - thornrun","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/thornrun.com\/health-policy-report-6-28\/","og_locale":"en_US","og_type":"article","og_title":"Health Policy Report (6\/28) - thornrun","og_description":"House lawmakers will reconvene today to wrap up the June legislative session ahead of what is shaping up to be a hectic month of July. President Joe Biden endorsed a bipartisan Senate infrastructure\u00a0deal\u00a0(fact sheet) last week, and leadership in both chambers indicated that they will try and push this across the finish line prior to […]","og_url":"https:\/\/thornrun.com\/health-policy-report-6-28\/","og_site_name":"thornrun","article_published_time":"2021-06-28T14:43:50+00:00","article_modified_time":"2023-08-08T21:25:34+00:00","author":"Thornrun","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Thornrun","Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/thornrun.com\/health-policy-report-6-28\/","url":"https:\/\/thornrun.com\/health-policy-report-6-28\/","name":"Health Policy Report (6\/28) - thornrun","isPartOf":{"@id":"https:\/\/thornrun.com\/#website"},"datePublished":"2021-06-28T14:43:50+00:00","dateModified":"2023-08-08T21:25:34+00:00","author":{"@id":"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772"},"breadcrumb":{"@id":"https:\/\/thornrun.com\/health-policy-report-6-28\/#breadcrumb"},"inLanguage":"en","potentialAction":[{"@type":"ReadAction","target":["https:\/\/thornrun.com\/health-policy-report-6-28\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/thornrun.com\/health-policy-report-6-28\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/thornrun.com\/"},{"@type":"ListItem","position":2,"name":"Health Policy Report (6\/28)"}]},{"@type":"WebSite","@id":"https:\/\/thornrun.com\/#website","url":"https:\/\/thornrun.com\/","name":"thornrun","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/thornrun.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en"},{"@type":"Person","@id":"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772","name":"Thornrun","image":{"@type":"ImageObject","inLanguage":"en","@id":"https:\/\/thornrun.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g","caption":"Thornrun"},"sameAs":["https:\/\/thornrun.com"],"url":"https:\/\/thornrun.com\/author\/thornrun\/"}]}},"_links":{"self":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts\/2064"}],"collection":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/comments?post=2064"}],"version-history":[{"count":1,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts\/2064\/revisions"}],"predecessor-version":[{"id":3267,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts\/2064\/revisions\/3267"}],"wp:attachment":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/media?parent=2064"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/categories?post=2064"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/tags?post=2064"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}