This Week in Washington: House stalls on defense spending bill, but begins negotiations among Republicans on appropriations; Senate was expected to move forward on three appropriations bills, but has now stalled; House to vote on large healthcare package on transparency
House Delays Vote on Defense Spending Bill
On Sept. 13, House Republicans delayed a procedural vote on the defense appropriations bill after House Freedom Caucus members stated they would not vote for the bill due to a lack of spending cuts outlined in other appropriations bills. In the meantime, the Main Street Republican Caucus and the House Freedom Caucus negotiated to develop a plan to have a Continuing Resolution through Oct. 31, with an eight percent across-the-board reduction in spending except for the Department of Defense and the Department of Veterans Affairs. It is unclear that there are enough votes in the House to pass such a measure.
House to Vote on Lower Costs, More Transparency Act
The House is expected to vote on the Lower Costs, More Transparency Act, a large healthcare package seeking to increase healthcare pricing transparency. The legislation contains provisions that would implement site-neutral payments for off-campus hospital outpatient departments, ban pharmacy benefit manager (PBM) spread pricing, extend funding for health programs and require hospitals and other providers to publish the prices they charge for services.
The package includes:
H.R. 3561, PATIENT Act of 2023
This legislation would expand hospital price transparency requirements, extend funding for the Community Health Center Fund and other programs, and implement site-neutral payments for drugs administered by physicians in off-campus hospital outpatient departments.
H.R. 4839, Hospital and ASC Price Transparency Act of 2023
This legislation would require hospitals to publicly disclose the standard charges for all items and services for at least 300 shoppable services.
H.R. 3248, Diagnostic Lab Testing Transparency Act
This legislation would strengthen price transparency of clinical diagnostic laboratory tests under the Medicare program and require providers to disclose the discounted cash price and insurer- negotiated minimum and maximum rates of tests.
H.R. 4882, Clinical Laboratory Price Transparency Act of 2023
This legislation would require providers to publicly disclose the cash and insurer-negotiated rates for clinical diagnostic laboratory tests offered by a lab included on the list of shoppable services by the Centers for Medicare and Medicaid Services (CMS).
H.R. 4828, Imaging Services Price Transparency Act of 2023
This legislation would require providers to disclose the cash price and insurer-negotiated rates for certain imaging services.
H.R. 4905, Health Insurance Price Transparency Act of 2023
This legislation would require health insurers to share cost-sharing and pricing information with patients.
H.R. 4507, Transparency in Coverage Act of 2023
This legislation would require insurers to share pricing information for healthcare services and require PBMs to share cost information with plan sponsors.
H.R. 2697, Pharmacy Benefit Manager Accountability Act
This legislation would require PBMs to disclose information regarding the rebates, fees and alternative discounts they receive from prescription drugs. It would also require PBMs to disclose drug wholesale acquisition costs and enrollee total out-of-pocket spending.
H.R. 4822, Health Care Price Transparency Act
This legislation would require PBMs to share net price data, aggregate rebate information, out-of-pocket spending and acquisition costs for all drug classes upon request by an employer.
H.R. 3282, Promoting Transparency and Health Competition in Medicare Act
This legislation would require public reporting of data from healthcare entities who share common ownership interests within the Medicare program, specifically insurers who own pharmacies, PBMs and healthcare providers.
H.R. 4883, Medicare Common Ownership Transparency Act of 2023
This legislation would require Medicare Advantage (MA) organizations to disclose common ownership of pharmacies, PBMs and providers to the Department of Health and Human Services (HHS).
H.R. 3284, Providers and Payers COMPETE Act
This legislation would require the HHS Secretary to submit an annual report to Congress detailing the impact Medicare regulations have on healthcare payer and provider consolidation.
H.R. 3839, Increasing Transparency in Generic Drug Applications Act
This legislation would improve the Food and Drug Administration’s (FDA) review process of generic drugs and allow the FDA to inform drug sponsors about differences between their application and the reference product.
H.R. 1613, Drug Price Transparency in Medicaid Act
This legislation would prohibit PBMs from using spread pricing within the Medicaid program.
H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department to submit to the Centers for Medicare and Medicaid services an attestation with respect to each such department.
This legislation would require off-campus outpatient departments to use a unique health identifier when billing for services.
H.R. 3417, FAIR Act
This legislation would require off-campus outpatient departments to bill for services provided using a unique health identifier.
H.R. 4509, Transparency in Billing Act
This legislation would require group health plans to only pay claims submitted by hospitals that have implemented accurate billing practices, policies and procedures.
H.R. 2559, Strengthening Community Care Act of 2023
This legislation would extend funding for the Community Health Center Fund, the National Health Service Corps and the Teaching Health Center Graduate Medical Education Program.
H.R. 2550, Special Diabetes Program Reauthorization Act of 2023
This legislation would reauthorize funding for the Special Diabetes Program through calendar year (CY) 2025.
H.R. 2547, Special Diabetes Program for Indians Reauthorization Act of 2023
This legislation would reauthorize funding for the Special Diabetes Program for Indians through CY2025.
H.R. 2665, Supporting Safety Net Hospitals Act
This legislation would delay cuts to the Medicaid Disproportionate Share Hospital (DSH) payment for fiscal years (FYs) 2024-2025.
H.R. 4527, Health Data Access, Transparency, and Affordability (DATA) Act
This legislation would improve transparency of the health insurance market and ensure that plan fiduciaries can access cost and quality of care information of their plan.
H.R. 4508, Hidden Fee Disclosure Act
This legislation would clarify and strengthen employer-sponsored health plan disclosure requirements.
For more information, click here.
House Committee Chairmen Send Letter to HHS Reiterating Request for COVID-19 Origin Information
On Sept. 14, House Energy and Commerce Committee Chairman Cathy McMorris Rodgers (R-WA), Subcommittee on Oversight and Investigations Chairman Morgan Griffith (R-VA) and Subcommittee on Health Chairman Brett Guthrie (R-KY) sent a letter to the Secretary of the Department of Health and Human Services (HHS) Xavier Becerra, requesting that officials comply with the committee’s requests for COVID-19 origins information.
The chairmen are urging HHS to send requested COVID-19 origin documents and communications by Sept. 21 and stated that they will consider the use of subpoenas if they do not receive them in time. House Committee on Oversight and Accountability Chairman James Comer (R-KY) and Select Subcommittee on the Coronavirus Pandemic Chairman Brad Wenstrup (R-OH) also signed the letter.
For more information, click here.
Rep. Stewart Resigns from Congress
On Sept. 15, Rep. Stewart (R-UT) resigned from Congress. He represented Utah’s 2nd congressional district and was a member of the House Appropriations Committee and the House Permanent Select Committee on Intelligence. There will be a two-month gap before a special election is held to elect his successor on Nov. 21. His resignation comes at a critical time in Congress, with the GOP holding a slim nine vote majority in the House of Representatives.
Senate Vote on “Mini Omnibus” of Three Appropriations Bills May Be Delayed
On Sept. 12, the Senate voted 85-12 to begin debate on the Agriculture-FDA, Military Construction-VA, and Transportation-HUD appropriations bills. The Senate was expected to vote on the mini omnibus this week, however, one senator is objecting because he wants a freestanding Military Construction bill. This is providing time for the House Republicans to continue their negotiations.
Majority Leader Leads Senate Forum on AI
On Sept. 13, Senate Majority Leader Chuck Schumer (D-NY) led the Senate AI Insight Forum. The forum was attended by tech industry leaders and more than 60 senators and staff, and aimed to spur discussion on artificial intelligence (AI) and on the manner in which Congress should draft legislation to regulate the development and use of AI technologies. It was the first of a series of AI-focused forums that the Majority Leader had called for in his AI framework released in June.
For more information, click here.
Senate HELP Committee Chairman Unveils Bipartisan Primary Care and Health Workforce Act
On Sept. 14, Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Bernie Sanders (I-VT) released a draft of the Bipartisan Primary Care and Health Workforce Act and announced that he and Sen. Marshall (R-KS) had reached an agreement on the bill. The legislation would address primary care challenges and health workforce shortages and would reauthorize community health and medical education programs. It would:
- Reauthorize $5.8 billion per year in funding for the Community Health Center Fund through fiscal year (FY) 2026;
- Reauthorize $1.5 billion in funding for the Teaching Health Center Graduate Medical Education Program through FY 2028;
- Reauthorize $950 million per year in funding for the National Health Service Corps through FY 2026;
- Provide $1.2 billion in grants to community colleges and universities to increase nursing program enrollment;
- Provide $300 million to primary care doctor residency programs and invest in dental training and workforce programs; and
- Implement provisions aimed at prohibiting anticompetitive practices by hospitals and insurance companies, including banning certain facility fees.
The Senate HELP Committee will mark up the legislation on Sept. 21. Ranking Member Bill Cassidy (R-LA) announced that he opposes the bill, arguing that it lacks full Hyde amendment protections related to abortion and fails to specify how funding increases will be paid.
For more information on the bill, click here.
Sen. Romney Announces Plan to Retire
On Sept. 13, Sen. Romney (R-UT) announced that he will not run for reelection and will retire after his current term ends on Jan. 3, 2025.
Read more on healthcare policy in McGuireWoods Consulting’s Washington Healthcare Update.