Futzing Continues On Drug Pricing Efforts
The Centers for Medicare & Medicaid Services gave drug makers six more months to comply with a drug pricing regulation while Congress is still mulling changes in drug-pricing legislation. Air ambulance companies aren't happy about surprise billing law and are suing.
Modern Healthcare:
CMS Officially Delays Drugmakers' Best Price Requirement
The Centers for Medicare & Medicaid Services on Wednesday gave drugmakers six more months to comply with the Trump-era regulation requiring them to calculate the "best price" for drugs under Medicaid's drug rebate program using discounts they offer patients. The new final rule will officially delay best prices reporting from Jan. 1, 2022, to July 1, 2022. (Devereaux, 11/17)
Stat:
Moderate Dems Still Seek Changes To The Party’s Drug Pricing Package
Rep. Kurt Schrader, the Oregon Democrat who has played an outsized role in shaping his party’s new drug pricing compromise, is still pushing for changes to the proposal ahead of a key vote on the legislation expected as soon as this week. Schrader and a number of other Democrats are meeting Wednesday to discuss their proposed changes to the ultimate package, he said, hinting that moderates like Reps. Scott Peters (D-Calif.) and Kathleen Rice (D-N.Y.) could be in attendance. He declined to lay out the full list of meeting attendees. (Florko, 11/17)
Modern Healthcare:
Feds Require Health Plans To Report Drug, Coverage Costs Under New Rule
Health insurers, employers and other group health plan sponsors must report prescription drug and health coverage costs for consumers under a federal regulation published Wednesday. The interim finale rule is the fourth regulation to date implementing the No Surprises Act. The Health and Human Services Department, Labor Department, Treasury Department and Office of Personnel Management promulgated the regulation. (Goldman, 11/17)
KHN:
Public Opinion Is Unified On Lowering Prescription Drug Prices. Why Are Leaders Settling For Less?
Democrats and Republicans are crystal clear in polls that they want government to be allowed to negotiate down high drug prices. Americans pay nearly three times as much for drugs as patients in dozens of other countries. In the past two years, numerous Democratic candidates — including President Joe Biden — have campaigned on enacting such legislation. This year, the polling group at KFF asked respondents about support for drug price negotiations after giving them the commonly offered arguments, pro and con: On the pro side, lower prices mean people can better afford their medicines; on the con side, lower profits mean the possibility of less innovation and fewer new drugs. Large majorities supported the idea of Medicare negotiating with pharmaceutical firms to get lower prices for both its beneficiaries and people with private insurance: 83% overall, including 95% of Democrats, 82% of independents and 71% of Republicans. (Rosenthal, 11/18)
Also —
Modern Healthcare:
Congress Targets Uncompensated Care Pools In Non-Expansion States
Congressional Democrats are renewing a fight with states like Texas and Florida that haven't expanded Medicaid to low-income adults, targeting one of their key sources of funding for hospitals: uncompensated care pools. President Joe Biden's $1.75 trillion domestic policy package, which the House could vote on as soon as this week, would limit federal payments for uncompensated care in states that haven't expanded Medicaid. (Hellman, 11/17)
Axios:
Rep. Sewell: Expanding Health Coverage Could Be Key To Early Cancer Detection
Rep. Terri Sewell (D-Ala.) told Axios during an event Wednesday she hopes the extended premium tax credits from President Biden's social spending bill will be key to detecting cancers earlier, if the legislation passes. Sewell said some 300,000 people in her home state of Alabama fall into the "Medicaid gap" — meaning they make too much money to qualify for Medicaid, but too little to afford their own insurance. Sewell said the tax credit would give such people more "ability to get covered," meaning they could access preventative cancer care. (Garfinkel, 11/17)
Atlanta Journal-Constitution:
Georgia Reps. Greene, Clyde Rack Up Thousands In Mask Fines
Georgia U.S. Reps. Marjorie Taylor Greene and Andrew Clyde have logged tens of thousands of dollars in fines after refusing to wear masks on the House floor. Both are ultraconservative Republicans serving their first year in the House. Lately they have refused to wear masks on the House floor nearly every time a vote is called, defying precautions that Speaker Nancy Pelosi put in place during the coronavirus pandemic. (Mitchell, 11/17)
In news on abortion —
The Hill:
More Than 100 Democrats Sign Onto Bill Ensuring Access To Birth Control
More than 100 Democrats in the House and Senate signed onto a bill aimed at ensuring access to birth control and preventing pharmacies from refusing to provide contraceptives. Democratic lawmakers on Wednesday reintroduced the bicameral legislation designed to protect people’s ability to get Food and Drug Administration-approved birth control, including emergency contraception and medication, from pharmacies. (Coleman, 11/17)
AP:
Texas Abortion Ban Stays In Force As Justices Mull Outcome
More than two weeks have passed since the Supreme Court’s extraordinarily rushed arguments over Texas’ unique abortion law without any word from the justices. They raised expectations of quick action by putting the case on a rarely used fast track. And yet, to date, the court’s silence means that women cannot get an abortion in Texas, the second-largest state, after about six weeks of pregnancy. That’s before some women know they’re pregnant and long before high court rulings dating to 1973 that allow states to ban abortion. There has been no signal on when the court might act and no formal timetable for reaching a decision. (Sherman, 11/18)
The Wall Street Journal:
Catholic Bishops Drop Effort To Ban Communion For Politicians Who Support Abortion Rights
The Catholic bishops of the U.S. ended a nearly yearlong debate Wednesday over whether to bar politicians who support abortion rights from receiving the Eucharist, passing new guidance on Communion that doesn’t address the issue. The measure passed by a vote of 222-8 and was followed by applause at a gathering here of the U.S. Conference of Catholic Bishops. The vote was the culmination of a debate that has taken most of the year and exposed deep ideological divisions in the church—particularly between U.S. bishops and Rome. (Lovett and Rocca, 11/17)
And in administration news —
Modern Healthcare:
Air Ambulance Trade Association Sues Feds Over Surprise Billing Law
The Association of Air Medical Services sued the federal government to block regulations shaping a new law that wouldn't make patients pay for unexpected out-of-network charges associated with emergency care. The air ambulance trade association alleged that the "overreaching" interim final rules unilaterally adopted by HHS, the U.S. Labor Department and other federal agencies would give insurers too much power in the arbitration process, force the air ambulance providers to accept "deflated" rates and limit access to emergency care, according to a complaint filed Tuesday in a Washington D.C. federal court. The No Surprises Act, which levels cost-sharing across in-network and out-of-network claims, holds patients harmless from balance bills and provides an independent resolution process, will go into effect Jan. 1. (Kacik, 11/17)
The Wall Street Journal:
SEC Investigating Cassava Sciences, Developer Of Experimental Alzheimer’s Drug
The Securities and Exchange Commission is investigating claims that Cassava Sciences Inc., SAVA -23.70% the sixth-best performing U.S. stock this year, manipulated research results of its experimental Alzheimer’s drug, according to people familiar with the matter. Cassava disclosed Monday in a securities filing that it is cooperating with government investigations, without naming any agency. Cassava said an investigation isn’t a sign that wrongdoing occurred. An SEC spokeswoman declined to comment. The National Institutes of Health, which awarded $20 million in grants to Cassava and its academic collaborators since 2015 for drug development, is also examining the claims, according to the company’s chief executive officer. (Michaels and Walker, 11/17)
Politico:
Poll: Voters' Doubts Rising About Biden’s Health, Mental Fitness
Voters have increasing doubts about the health and mental fitness of President Joe Biden, the oldest man ever sworn into the White House, according to a new POLITICO/Morning Consult poll. Only 40 percent of voters surveyed agreed with the statement that Biden “is in good health,” while 50 percent disagreed. That 10-percentage-point gap — outside the poll’s margin of error — represents a massive 29-point shift since October 2020, when Morning Consult last surveyed the question and found voters believed Biden was in good health by a 19-point margin. (Caputo, 11/17)