A key House panel advanced a slew of healthcare bills during a busy Wednesday on the Hill for health policy.
The House Energy and Commerce Subcommittee on Health approved seven bills Wednesday, consolidated down from 14 measures through amendments. Key provisions approved include price transparency regulations, site-neutral payment policies, changes for pharmacy benefit managers and updates to the 340B drug discount program.
Rep. Cathy McMorris Rogers, R-Washington, the committee’s chair, said in a statement that the group would “continue to plow the hard ground” on the biggest issues facing the country, including healthcare.
“I’m proud this committee is building on its rich, bipartisan history to come together on important priorities for the American people,” she said.
Here’s a look at some of the key policies advanced by the subcommittee:
A step toward site-neutral payments
A provision passed Wednesday would direct Medicare to pay providers the same amount for drugs administered in a hospital setting as it would for drugs administered in a physicians’ offices.
The measure is still a blow to hospitals, which have lobbied heavily against site-neutral payments, but does fall short of more aggressive policies that were proposed as amendments during the hearing.
In a statement, the American Hospital Association (AHA) said it is “extremely disappointed” to see the provision make it out of committee.
“This is simply not the time to cut payments to hospitals, many of which are still under severe financial pressure coming out of the pandemic,” Stacey Hughes, executive vice president of the AHA, said. “Reducing Medicare hospital payments to prevent cuts to the Medicaid DSH program is inappropriate.”
“While we support the subcommittee’s policy on Medicaid DSH, robbing Peter to pay Paul is not the way to achieve the objective and would add to the financial fragility of many hospitals,” Hughes said. “We look forward to working with Congress to eliminate these harmful cuts to hospitals that would further jeopardize access to care for patients and communities.”
New requirements for 340B
Another policy that passed the committee would institute new reporting requirements on providers in the 340B drug discount program. The updates passed by a tight 16 to 12 vote.
Hospitals have argued that installing new reporting requirements would be too onerous, as providers that participate in 340B must already recertify eligibility each year, participate in audits conducted by the Health Resources and Services Administration and maintain records of 340B and non-340B drugs.
Maureen Testoni, CEO of 340B Health, decried the changes in a statement.
“These are unnecessary and burdensome reporting requirements, and they will not paint an accurate picture of the many ways 340B savings help safety-net hospitals care for patients with low-incomes and rural communities,” she said.
Greater transparency for PBMs …
Pharmacy benefit managers continue to be under the microscope in Congress, and one of the bills approved Wednesday aims to inject greater transparency into the PBM space, requiring them to submit detailed data on drug spending and formulary rationale each year to employers.
The bill would would also ban spread pricing in Medicaid. Spread pricing, a payment model in which the PBM charges the payer or plan sponsor more than the drug cost at the pharmacy, has become a focus of reform. A bill passed recently in the Senate would fully ban the practice.
The Pharmaceutical Care Management Association, an industry group for PBMs, pushed back on the Senate’s ban, saying it would limit choice for plan sponsors.
“In addition, the legislation would create a one-size-fits-all contracting mandate that ignores the unique needs of patients and removes employer choice,” the group said. “Real solutions to existing gaps in prescription drug affordability could easily be included in a drug pricing bill that actually lowers costs.”
… and for providers
The legislative package also builds on Trump-era regulations for price transparency that require hospitals to disclose the prices they charge for services provided. A similar regulation for insurers requires them to post their negotiated rates for services.
Compliance has been an ongoing issue from both payers and providers. Ashley Thompson, AHA senior vice president of public policy analysis and development, said during a late April House hearing that 70% of hospitals are in compliance and that the association supports the measure.
“Hospitals are eager to continue their compliance efforts, and the Transparent PRICE Act affords an opportunity to continue to work together toward this goal,” Thompson said.