influence
Operation Tweak the IRA commences
Two proposals to weaken Medicare's drug price negotiation program are getting a hearing before a House Energy & Commerce subcommittee today.
One bill, dubbed the ORPHAN Cures Act, would allow an orphan drug to avoid negotiation as long as it is approved exclusively for rare diseases. Currently, the law only exempts drugs that have a single orphan designation from the negotiation process.
The bill has bipartisan backing, though Democratic lawmakers are a who's who of pharmaceutical industry allies from states with a big biotech presence: Rep. Scott Peters (Calif.), Don Davis (N.C.), Josh Gottheimer (N.J.), and Wiley Nickel (N.C.).
The other, called the Maintaining Investments in New Innovation Act, would delay the negotiation process for genetically targeted technologies by four years, to put them on par with the exemptions that biologic drugs receive.
white house
Mr. Cuban goes to Washington
Tim Heitman/Getty Images
The White House is hosting a listening session on PBM reform on Monday, with invitees including the namesake of the Mark Cuban Cost Plus Drug Company Mark Cuban and FTC Chair Lina Khan, my colleague Ed Silverman scooped yesterday.
The listening session comes as efforts to reform PBM practices have stalled amid disagreements on Capitol Hill over their scope. Read more, including what Cuban told Ed his agenda would be going into the meeting.
capitol hill
To fight another day
Now that talks on major health issues like PBM reform and site-neutral payments have stalled, many of my sources are expecting a major health care showdown in December. Take this comment by Taylor Hittle, a GOP staffer on the House Education and the Workforce Committee, at the National Association of Benefits and Insurance Professionals event in Washington this week:
"Going into the lame duck, we are really hopeful to be able to get [PBM reform] past the finish line," she said.
There's a slew of new deadlines for health policy on Dec. 31. Here are a few to watch:
- Medicare's telehealth flexibilities will be expiring. These are potentially expensive, popular policies that lawmakers will be eager to extend.
- Allowances for employers to provide first-dollar telehealth coverage to employees in high-deductible health plans will also expire.
- Physicians will be facing yet another 1.25% in cuts to their Medicare payments.
Another important dynamic: Rep. Cathy McMorris Rodgers (R-Wash.) and several other top GOP health care lawmakers in the House are retiring (and note that Sen. Bernie Sanders (I-Vt.) hasn't said he's running for re-election yet). So there may be an additional incentive to pass legacy items. Don't underestimate the power of this dynamic — see former Sen. Lamar Alexander's last-minute push to pass surprise billing protections in his final days as a senator in 2020 as one example.
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