Legislative Activity

Senate Republicans Eye Obamacare Repeal Measures In Reconciliation Bill

Senate Majority Leader Mitch McConnell (R-KY) has scheduled a meeting on Monday, November 30, for Republican senators to discuss repealing parts of the Affordable Care Act (ACA). Senate Republican leaders are hoping to consider the Senate substitute amendment to the House-passed reconciliation bill, H.R. 3762, on December 2; however, the Senate Parliamentarian would first need to approve the changes to the bill to ensure they do not run afoul of the Byrd Rule, which prohibits “extraneous matter” from reconciliation bills. The Senate substitute may modify the House-passed bill and contain provisions that repeal Medicaid expansion, scale back or abolish exchange subsidies, and/or repeal taxes created by the ACA.

This Week’s Hearings:

• Wednesday, December 2: The House Committee on Oversight and Government Reform will hold a hearing titled “Office of National Drug Control Policy: Reauthorization.”

• Wednesday, December 2: The Senate Committee on Veterans’ Affairs will hold a hearing titled “Consolidating Non-VA Care Programs.”

• Thursday, December 3: The House Committee on Armed Services Subcommittee on Military Personnel will hold a hearing titled “Stakeholder Views on Military Health Care.”

Regulatory Activity

HHS-OIG Evaluates 340B Payments 

On Wednesday, November 25, the U.S. Department of Health and Human Services – Office of Inspector General (HHS-OIG) published a report titled “Part B Payments for 340B-Purchased Drugs.” This report follows past HHS-OIG work, which found that Medicare payments to providers for 340B-purchased drugs “substantially exceeded” costs to providers. While the 340B program permits providers to retain the difference between what Medicare pays and what it costs to acquire the drug, some policymakers have questioned whether a portion of the savings ought to be passed on to the Medicare program. This report found that in 2013, Medicare Part B paid $3.5 billion for 340B-purchased drugs. The Part B payment amounts were, in the aggregate, 58 percent more than the 2013 ceiling price, resulting in covered entities retaining approximately $1.3 billion. The report explored three shared-savings scenarios, which could have reduced total Part B drug expenditures to $1.1 billion while allowing covered entities to retain between $211 million to $1.1 billion.

CMS Releases Notice Of 2017 Benefit And Payment Parameters

On Wednesday, December 2, the Centers for Medicare and Medicaid Services (CMS) will publish in the Federal Register a proposed rule titled “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017.” Among other provisions, this proposed rule establishes for the 2017 benefit year the benefit and payment parameters for qualified health plans and the premium stabilization programs. Of note, this rule proposes establishing six “standardized options” for qualified health plans in the individual market. This proposal is intended to simplify the consumer shopping experience, as research shows that consumers presented with an excessive number of health plan options are more likely to either not choose a health plan or to choose a plan that does not meet their needs. Insurers would not be required to offer standardized plans and could continue to offer non-standardized plans.

The agency released this proposed rule for public inspection on November 20. The deadline for comments is December 21.