This morning, the United States Senate Committee on Finance questioned Pres. Biden’s nominee, Chiquita Brooks-LaSure, for Administrator for Centers for Medicare and Medicaid Services (CMS), as well as Andrea Palm, the nominee for Deputy Secretary of Health and Human Services (HHS).  CMS oversees and administers Medicare and Medicaid, the Children’s Health Insurance Program (CHIP), and the programs implemented as a result of the Affordable Care Act. 

• Opening Statements: Chairman Ron Wyden (D-OR); Ranking Member Mike Crapo (R-ID); Chiquita Brooks-LaSure; Andrea Palm.

• Priority issues raised in this hearing include Section 1332 waivers (Affordable Care Act); state innovation for health care best practices; school-based health clinics and community-based services; the future of telehealth and telehealth reimbursement rates; prescription drug pricing and bipartisan drug pricing legislation; implementation of the No Surprises Act (ending surprise medical billing); the importance of rural hospitals and healthcare services; the 340B program; and interest in lowering the Medicare age of eligibility.

• Chairman Ron Wyden and several other members raised the question of state innovation in health care (public option, etc.) and Section 1332 waivers, with respect to CMS’s authority over guidelines. Ms. Brooks-LaSure said she sees her role as a trusted partner and wants to make sure that states understand their options. The pandemic has provided an unexpected opportunity for experimenting with a variety of different innovations (e.g. telehealth). She will make it a priority to release guidelines for state waivers, and focus on lessons learned throughout the COVID-19 pandemic.

• Sen. Maria Cantwell (D-WA) and other members emphasized the importance of telehealth (both over the phone and virtually) for the future of medicine. Sen. Cantwell signaled that the committee is starting to look at the permanent implementation of telehealth in the industry, including the question of reimbursement rates. Ms. Brooks-LaSure highlighted its success in rural areas and agreed that reimbursement needs to have safeguards that have yet to be determined.

• Sen. Tom Carper (D-DE) and Sen. Chuck Grassley (R-IA) raised the timely issue of drug pricing and discussed the bipartisan work being done by the committee to lower prescription pricing and cap out-of-pocket costs. Ms. Brooks La-Sure gave her commitment to work with the committee and implement such legislation if passed.

• When questioned about disparities in the 340B health program by Sen. John Thune (R-SD), Ms. Brooks-LaSure stated that that CMS must partner directly with rural areas and with Indian Health Services (IHS) to ensure PBMs and manufacturers are not imposing conditions for reimbursement to the point of dysfunction.