House panel advances transparency and PBM bills
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The House Energy and Commerce Committee on Wednesday advanced a series of health care measures to promote price transparency and overhaul regulation of pharmacy benefit managers (PBMs) in a mostly bipartisan markup.
Driving the news: The measures advanced on a unanimous 49-0 vote addressed:
- Codifying and strengthening Trump-era rules to require hospitals and insurers to make negotiated prices more easily available.
- Imposing new transparency requirements on PBMs and banning PBMs' ability to charge more than they pay for a drug and keep the difference in Medicaid.
- Providing funding for community health centers and graduate medical education, as well as putting off cuts in disproportionate share hospital payments that offset some facilities' uncompensated care costs.
Yes, but: Two bills advanced on largely party-line votes, with one to increase hospital reporting requirements in the 340B drug discount program adopted 29-22.
- The split between top Democratic Reps. Anna Eshoo (Calif.) and Frank Pallone (N.J.) over a bill to facilitate value-based arrangements in Medicaid for high-cost drugs continued, with most Democrats siding with Pallone against the measure. It still passed 31-19 due to GOP support.
What we're watching: Even the more modest site-neutral policies that were considered, like equalizing payment for physician-administered drugs, drew concerns from New York Democratic Reps. Paul Tonko and Yvette Clarke, who warned of the effects on hospitals.
- That highlights the even tougher lift facing the bigger site-neutral payment policies that were left out for now and address the way hospitals charge more for the same services private doctors deliver in their offices.
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