(7/23/2021): Telehealth hits its peak
- One pandemic-era phenomenon that may have peaked: virtual doctor visits, Axios' Courtenay Brown writes.
(7/23/2021): INFRASTRUCTURE BILL WOULD DELAY TRUMP-ERA REBATE RULE
— Senators negotiating the bipartisan infrastructure deal will lean on a Trump-era drug pricing provision to generate savings for the package — though they’re still unsure exactly how much, POLITICO’s Alice Miranda Ollstein reports.
(7/22/2021): DEMS’ PARTY-LINE SPENDING PACKAGE COULD GROW
— A planned $3.5 trillion bill that would expand Medicare benefits could get even bigger if negotiations over a smaller, bipartisan infrastructure deal fall apart, POLITICO’s Marianne LeVine, Sarah Ferris and Heather Caygle report.
(7/21/2021): HEALTH PROVISIONS IN PERIL WITHOUT BIPARTISAN BILL
— The possible defeat of the bipartisan infrastructure package in a test vote on Wednesday has Democrats weighing options if they must rely on a party line bill brought through the reconciliation process, Alice Miranda Ollstein reports.
(7/20/2021): Biden's July executive order includes drug pricing provisions. But will they do enough?
- President Joe Biden’s July 9 executive order included various steps toward making good on campaign promises to take on pharmaceutical companies by allowing the importation of prescription drugs and curbing the high cost of medicines.
(7/20/2021): Biden to crackdown on hospital price transparency violations
- Hospitals who flout the price transparency rules could face thousands or millions of dollars in proposed fines.
(7/20/2021): BIDEN ADMIN KEEPS TRUMP’S CUTS TO DRUG DISCOUNT PROGRAM
— The agency is also proposing to continue a nearly 30 percent cut in reimbursement for drugs purchased through the 340B program. Hospitals have fiercely opposed the policy and sued to strike it. But a D.C. Circuit Court of Appeals upheld the cuts last summer, and the Supreme Court earlier this month said it would take up the case during its next term.
(7/20/2021): BIDEN ADMIN WANTS TO STIFFEN PENALTIES ON HOSPITALS FOR HIDING PRICES
— CMS is proposing harsher fines for hospitals that don’t publish the prices they charge, strengthening a new Trump-era transparency measure opposed by the industry, Rachel Roubein writes.
(7/20/2021): SENATORS CIRCLE DRUG SAVINGS FOR MASSIVE RELIEF BILL
— Months after rumors first circulated that drug-pricing provisions could provide major savings for coronavirus relief packages, they’re back in play for infrastructure legislation.
Politico (7/16/2021): SENATE INFRASTRUCTURE BILL — Speaker Nancy Pelosi has vowed that the House will not move forward on the bipartisan infrastructure package until the Senate passes a budget setting up the $3.5 trillion social spending package.
Politico Pro (7/16/2021): HOUSE PANEL ADVANCES DIVISIVE HEALTH SPENDING BILL — The Appropriations Committee approved a more than $253.8 billion spending bill for fiscal 2022 after nearly two hours of debate on a measure that would roll back the Hyde amendment, a longstanding ban on federal funding for abortions — including Medicaid coverage. The bill designates $3 billion for President Joe Biden's proposed Advanced Research Projects Agency for Health, or ARPA-H — less than half of what the president proposed in his budget plan.
Modern Healthcare (7/16/2021): Senate Democrats' plan boosts spending on Medicare, ACA subsidies, long-term care- The budget package Democrats are assembling in Congress would likely provide the biggest jolt to the American healthcare system since the passage of the Affordable Care Act in 2010, according to sources familiar with work on the plan.
Modern Healthcare (7/16/2021): Biden right-to-repair executive order could reduce healthcare costs- Providers could seek amendments to their existing contracts that funnel repairs through medical device makers, which could reduce maintenance costs
Politico (7/15/2021): DRUG PRICING TROUBLES AROUND THE BEND? — In a sign of the obstacles awaiting the spending bill, 15 swing-district Democrats wrote to Speaker Nancy Pelosi and Senate Majority Leader Chuck Schumer urging them to include a provision empowering Medicare to negotiate drug prices.
The Hill (7/15/2021): Vulnerable House Democrats call for Medicare drug price negotiation in reconciliation plan - A group of some of the most vulnerable House Democrats sent a letter to Democratic leaders urging them to include sweeping drug pricing reforms in the upcoming reconciliation bill, which could help pay for the $3.5 trillion package.
The Hill (7/14/2021): Senate budget deal to provide new funding for Medicare, Medicaid, ObamaCare - The $3.5 trillion budget deal reached by Senate Democrats will include funding for a range of major health care priorities, from expanding Medicare and Medicaid to extending enhanced ObamaCare subsidies.
Politico (7/14/2021): DEMS GO BIG ON HEALTH SPENDING — Senate Democrats’ massive spending package would fund a slew of health care priorities, highlighted by a major expansion of Medicare benefits, POLITICO’s Caitlin Emma, Sarah Ferris and Anthony Adragna report.
The Hill (7/14/2021): What we know so far about the $3.5 trillion budget deal - Top Senate Democrats on Wednesday pitched their colleagues on a $3.5 trillion budget resolution that would pave the way to pass a wide-ranging spending package without any Republican votes.
Modern Healthcare (7/13/2021): Medicare telehealth access preserved in physician pay rule—for now-Among a slew of changes, doctors will get smaller pay rises next year as pandemic stimulus funding ends.
The Hill (7/16/2021): Employer and health groups push Congress to pass drug price revamp - Dozens of employer and health groups teamed up on Tuesday to pressure congressional leaders to pass legislation to revamp drug pricing, in what they called a “unique and time-limited” opportunity to lower costs.
Modern Healthcare (7/13/2021): Dueling opinions: What about drug prices in America? - According to a 2021 RAND Corp. study, drug prices on average in the U.S. are 2.5 times those paid by 32 other nations in the Organization for Economic Co-Operation and Development.
Politico (7/13/2021): SENATORS INTRODUCE STANDALONE PART D BILL - New Jersey Democrat Bob Mendez and Louisiana Republican Bill Cassidy will today reintroduce a bill that they put forward last Congress aimed at restructuring Medicare Part D so that patients pay less out-of-pocket for pricey medications
Politico (7/13/2021): ALZHEIMER’s DRUG COST COULD HIT MEDICAID HARD — While most of the concern over Biogen’s $56,00-a-year Aduhelm has been trained on Medicare, the government program for millions of seniors, Medicaid could also shoulder millions of dollars in payments for the new therapy according to a Kaiser Family Foundation analysis by Rachel Dolan and Elizabeth Williams.
Politico (7/13/2021): CMS PITCHES TEMPORARILY KEEPING SOME TELEHEALTH BENEFITS— The agency proposes continuing to cover some telehealth benefits until the end of 2023 to give it time to decide whether those services should become permanent, Rachel reports. The proposal, tucked into the annual Medicare’s physician fee rule, also would require some in-person mental health visits to complement telemental visits.
Politico (7/12/2021): EMPLOYER GROUPS PRESS FOR DRUG PRICE OVERHAUL— Dozens of employer and health groups are urging congressional leaders to pass a major drug price crackdown, warning that any legislation that fails to lift Medicare’s ban on negotiating prices will be unacceptable
Politico (7/12/2021): SENATORS PROBE PHARMA COMPETITION- The Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights held a hearing on Tuesday, July 13, on how drug company practices — like “pay-for-delay” tactics to keep generics out of the market — have contributed to the rising cost of their medicines.
Axios (7/12/2021): Medicare has started the process of determining whether it will deny, limit or allow full coverage of Alzheimer's drug Aduhelm- The federal government will make a final coverage decision by no later than next April, and the public can submit comments now and after a proposed decision in January, Axios’ Bob Herman writes.
Modern Healthcare (7/12/2021): Safety-net hospitals hit hard by the pandemic could lose access to low-cost drugs- Some hospitals receiving heavily discounted outpatient drugs through the 340B program could lose that status after last year’s impact on the patient mix, a blow for safety-net organization serving large numbers of low-income patients.
Modern Healthcare (7/12/2021): CMS considering coverage of Aduhelm- CMS could pay upwards of $29 billion a year to fully cover Aduhelm, even though experts are weighing the drug’s benefits.
The Hill (7/9/2021): Biden to direct moves on drug importation, call for plan to lower drug prices - President Biden on Friday will direct the Food and Drug Administration (FDA) to work with states on importing prescription drugs from Canada, and direct officials to develop a “comprehensive plan” to lower drug prices in 45 days.
Politico Pro (7/8/2021): House Democrats highlight pharma spending in renewed push for drug pricing bill - Top House Democrats on Thursday renewed vows to pass drug pricing reforms this year as they released a report aimed at disproving industry arguments that the leading House bill would squelch innovation.
The Hill (7/8/2021): House report: Drug companies spent more on buybacks, dividends than research - House Democrats on Thursday released a report that found that the 14 leading drug companies paid out more in stock buybacks and dividends from 2016 to 2020 than they spent on research and development.
Modern Healthcare (7/8/2021): Telehealth use falls for third straight month, in-person appointments increase - A slow return to in-person care and a lack of incentives to use telehealth are driving down utilization rates for virtual care.
(7/8/2021): UnitedHealth's limits on out-of-network care seen as surprise billing ban reaction
- The big insurer unveiled restrictions on out-of-network coverage just days before CMS published an interim final rule banning much surprise billing.
(7/8/2021): Cancer death rates fall amid warnings about obesity
- Overall cancer death rates have dropped in the past two decades amid improvements in medical research and treatments, according to the American Cancer Society’s annual report, though researchers warn that obesity poses a risk factor that could lead to increased cases of certain kinds of the disease.
(7/8/2021): Some wins — and losses — against cancer
- Death rates for lung cancer and melanoma continued to drop for men and women in the U.S. between 2014 and 2018, Axios' Marisa Fernandez writes from an annual report by the National Cancer Institute.
(7/8/2021): HOUSE DEMS DROP NEW DRUG PRICING REPORT
— The House Oversight and Reform Committee is publishing a staff report focused on more than a dozen of the nation’s largest drug companies, amid a renewed push to crack down on the cost of medicines.
Politico (7/7/2021): Democrats race to push bipartisan infrastructure bill through Senate
- The White House’s long sought-after bipartisan infrastructure deal could hit the Senate floor as early as the week of July 19, according to multiple House and Senate Democratic sources with knowledge of the conversations.
(7/7/2021): Paper industry, drugmakers spar over requirement to print prescribing information
- Drugmakers are resuming their annual lobbying battle with the paper industry over an obscure clause slipped into a key spending bill.
(7/7/2021): SENATE PANEL TURNS TO PHARMACEUTICAL ANTITRUST
— The Judiciary Subcommittee on Competition Policy, Antitrust and Consumer Rights will put the drug industry in the hot seat with a Tuesday hearing titled “Cracking Down on Anticompetitive Conduct in Prescription Drug Markets.”
(7/6/2021): Biden faces headwinds bringing critical drug manufacturing to U.S.
- President Joe Biden wants more essential drugs to be made in the United States. But it's not clear whether there's enough political will in Congress, or money, to make that happen.
(7/6/2021): Supreme Court to hear cases on Medicare and 340B payments
- Medicare providers payments and 340B drug discounts will be before justices this year.
(7/6/2021): Key surprise billing ban details still murky for providers, insurers
- The healthcare industry is waiting for the Biden administration to hammer out critical details on the surprise billing ban that takes effect next year.
(7/6/2021): Providers vs. patients
- Among the new rules in the surprise billing law set to take effect Jan. 1 is a requirement patients give consent before their doctor is allowed to bill them for out-of-network services.
(7/5/2021): Skeptics question if Biden’s new science agency is a breakthrough or more bureaucracy
- If President Joe Biden’s last big science project was a moonshot, his new one has goals that are light years further. The proposed Advanced Research Projects Agency would deliver breakthrough treatments for cancer, Alzheimer’s, diabetes and other diseases and reshape the government’s medical research efforts, by adding a nimble new agency modeled on the Pentagon’s Defense Advanced Research Projects Agency, or DARPA, which laid the groundwork for the internet.
(7/5/2021): Progressives ramp up Medicare expansion push in Congress
- Progressives are ramping up their push to expand Medicare in an upcoming legislative package, with the goal of lowering the eligibility age and adding new benefits.
(7/2/2021): CMS bans surprise billing
— The rule will affect people with job-based coverage or individual health plans who unwittingly receive care from out-of-network providers.
(7/2/2021): Ads target moderate Dems, pharma allies
— One Democratic defector in the Senate could sink the party's effort to lower prescription drug prices, and a series of new ad campaigns are giving strong hints about who advocates are most worried about, Axios' Caitlin Owens writes.
(7/2/2021): THE BEGINNING OF THE END FOR ‘SURPRISE’ MEDICAL BILLS
— Biden’s HHS is out with its first of several rules for enforcing a long-awaited ban on “surprise” bills — a complex undertaking that will have far-reaching consequences for health care in the U.S.
(7/1/2021): PROGRESSIVE GROUP HITS SENATE MODERATES WITH DRUG-PRICING ADS
— Patients For Affordable Drugs Now is out with a new six-figure ad campaign to pressure moderate Democrats in the Senate who haven’t yet endorsed Finance Chair Ron Wyden’s plan to empower Medicare to negotiate drug prices.
(6/30/2021): Hospitals decry extending Medicare cuts to pay for infrastructure bill
— The American Hospital Association and other hospital groups are urging the Senate to abandon a plan to pay for a bipartisan infrastructure bill with cuts to Medicare providers.
(6/30/2021): Hospitals' warning shot on infrastructure plan
— The nation's largest hospital groups really don't want the Senate to pay for its infrastructure deal with funding that would otherwise go to them, Axios' Caitlin Owens writes.
(6/30/2021): HOSPITALS BLAST BIDEN’s INFRASTRUCTURE PAY-FORS
— Nine hospital organizations are criticizing the White House’s plan to fund billions of dollars in new infrastructure spending as part of a bipartisan deal.
(6/29/2021): Virtual care becomes a common cause in a divided Congress
— Congress appears poised to let millions of Medicare recipients continue to video chat with their doctors after the pandemic is over. A set of telemedicine policies the Trump administration adopted during lockdowns is emerging as an unexpected bipartisan rallying point as lawmakers begin to weigh life after Covid-19. The coverage policies are due to lapse once the health emergency ends, which could limit telehealth payments to rural providers and doctors with existing relationships with patients.
(6/29/2021): WATCHDOG RELEASES REPORT ON INDUSTRY INFLUENCE ON PATIENT GROUPS
— Patients for Affordable Drugs, one of the progressive groups pushing for legislation that would empower Medicare to negotiate pharmaceutical prices, released a new report today documenting the industry’s financial ties and influence on patient advocacy groups and charitable groups like the American Cancer Society and the Patient Advocate Foundation.
(6/29/2021): Biden wants to tweak Obamacare marketplaces to expand coverage
— A CMS proposed rule would expand the annual open enrollment period and allow low-income people to enroll in subsidized coverage every month.
(6/29/2021): DRUG PRICING GROUP REPORT ON INDUSTRY TIES TO PATIENT ADVOCACY GROUPS
— Patients for Affordable Drugs Now, a progressive group pushing for significant drug-pricing reforms, released a report today documenting the pharmaceutical industry’s influence on patient advocacy groups and charitable groups like the American Cancer Society and the Patient Advocate Foundation.
(6/29/2021): Biden pitches new plans for boosting ACA enrollment
— The Biden administration is looking to extend Obamacare’s annual enrollment season and allow some of the poorest marketplace customers to buy coverage essentially whenever they want, under a new proposal aimed at bolstering the health care law.
(6/28/2021): Alzheimer's drug presents Democrats' new policy dilemma
— With a $56,000-a-year price tag, Biogen's newly approved Alzheimer's drug Aduhelm is dovetailing into the debate on Capitol Hill over how to lower prescription drug prices.
(6/28/2021): BIDEN RUSHES TO REHAB INFRASTRUCTURE BILL
— The bipartisan group of Senate negotiators “did not want to go along with any of my Family Plan issues, the human infrastructure that I talk about," Biden said Thursday, in comments that set off a weekend firestorm. The president had to dial up members of Congress himself to patch things up, two people with knowledge of the calls told our Natasha Korecki and Christopher Cadelago, and on Saturday he issued a formal reversal of what Republicans had taken as a veto threat. That seems to have been good enough for GOP senators, who have since signaled their support, Burgess Everett reports.
(6/26/2021): Georgia senators back federalized Medicaid expansion in infrastructure legislation
—Georgia’s Democratic senators are urging lawmakers to use upcoming infrastructure legislation to provide health coverage to low-income adults in the states refusing Medicaid expansion, according to a letter provided to POLITICO.
(6/25/2021): Drug Price Negotiations’ Staying Power
—What makes drug price negotiation a powerful idea — with bipartisan support from more than 80% of the public — is not the budgetary savings policymakers covet. It’s the potential to lower costs for patients and businesses paying for health benefits, Kaiser Family Foundation’s Drew Altman Writes.
(6/25/2021): Democrats Propose $400 Billion Medicaid Boost for Home Care
—States would have to opt in to the program to receive a 10 percentage point increase in the federal Medicaid match that must go to expanding home- and community-based services.