On Wednesday, September 5th, the House Energy & Commerce Subcommittee on Health held a hearing, “Opportunities to Improve Health Care,” wherein members were overwhelmingly in support of five pieces of legislation discussed. During that hearing, Committee Members affirmed the need for legislation to ban “gag clauses” to ensure employer and health insurance plans, including Medicare plans, do not restrict pharmacists from advising customers about lower-cost prescription options. This follows a decision by the Senate to also clear a “gag clause” prohibition bill.
On Friday, September 7th, 2018, the Subcommittee held a markup of six bipartisan bills aimed at improving the quality of healthcare, mitigating fraud in the Medicare and Medicaid programs, and supplying Congressional advisory commissions with additional data to complete comprehensive drug pricing analysis. The subcommittee advanced all six bills to the full committee for consideration.
One of the bills advanced, the Advancing Care for Exceptional (ACE) Kids Act (H.R. 3325), seeks to improve the delivery of care for children with complex medical conditions under Medicaid. Representative Joe Barton offered an amendment in the form of a substitute, which was passed by voice vote. The amendment slightly changed the original bill, but members were assured that the changes would not result in a larger federal deficit or an expansion of the existing Medicaid program.
Another bill advanced, H.R. 3891, To amend title XIX of the Social Security Act to clarify the authority of State Medicaid fraud and abuse control units, would broaden the authority of State Medicaid Fraud Control Units (MFCUs) to address abuse and neglect of Medicaid beneficiaries in non-institutional or other settings.
The Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources and (EMPOWER) Care Act (H.R. 5306) would extend funding for Medicaid’s Money Follows the Person Demonstration Program (MFP demonstration) for an additional five years. An amendment in the nature of a substitute was offered by Representative Brett Guthrie and was adopted by the committee under voice vote. The amendment slightly revised the original bill to reauthorize the Money Follows the Person Demonstration through 2019. Ranking Member Green noted that while he wished the demonstration had been reauthorized for longer, one year of funding was better than none.
Another unnumbered bill was passed through, Strengthening the Health Care Fraud Prevention Task Force Act of 2018, codifies authority for the Healthcare Fraud Prevention Partnership (HFPP) and its activities and expands the scope of allowable activities. An amendment in the nature of a substitute was offered by Full Committee Ranking Member Pallone and was adopted by the committee under voice vote. The amendment featured technical improvements to the original bill offered by the Department of Health and Human Services.
A discussion draft of a bill, To amend title XXVII of the Public Health Service Act and title XVII of the Social Security Act to prohibit…, is designed to ban group health plans offered by employers and individual health insurance plans, as well as Medicare Advantage and Part D plans, from restricting a pharmacy’s ability to inform a customer about the lower cost, out-of-pocket price for their prescription.
An unnumbered bill, To amend title XIX of the Social Security Act to provide the Medicare Payment Advisory Commission, would allow the Centers for Medicare and Medicaid Services (CMS) to provide drug rebate data to the Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment Advisory Commission (MACPAC).
The Health Subcommittee has been busy advancing health-related legislation, and we look forward to these bipartisan bills being heard in the full Committee.