Congressional Recess

from National FV:

Congress is in recess until October 15. When they return, they must address FY 2020 appropriations, because the "continuing resolution" enacted last month expires on November 21. See Short-Term Funding Bill Keeps Government Open, Also Includes Sound Provision Reducing Federal and State Medicaid Drug Costs (Georgetown Center for Children and Families blog post, 10/3/19). There is still continued interest in addressing prescription drug prices and surprise medical billing. Those are both controversial issues, however, so it may be difficult to craft legislation that can get through Congress. More information about these issues can be found in the October 3 Update.

 

With respect to surprise medical bills, the chairman of the House Ways and Means Committee, Richard Neal (D-MA), has suggested that Congress enact a law requiring the administration to undertake a "negotiated rulemaking process." Under such a plan, the administration would convene a committee consisting of key stakeholders (doctors, hospitals, insurers) and the Departments of Health and Human Services, Treasury, and Labor. That committee would recommend parameters for setting payment rates for surprise bills, while ensuring that consumers would be held harmless. The federal departments would then develop a proposed rule with a public comment period. The key stakeholders have different positions on how to pay these out-of-network payments. Physicians, physician practice groups, and hospitals prefer negotiated rates, while insurers prefer a "benchmark" approach. A good explanation of the issue can be found in The Health 202: Doctors Are Gaining the Edge in Fight over Surprise Medical Billing (Washington Post, 9/23/19). See also We Need Benchmarking, Not Arbitration, to Quell

Surprise Medical Billing (STAT's 'First Opinion" blog post, 10/7/19).

With respect to prescription drug prices, it has been reported that staffers from the administration and House Speaker Nancy Pelosi have been discussing her bill on the topic. See Trump and Pelosi Aides Talk Drug Costs Despite Impeachment (Associated Press, 10/1/19).

 

Meanwhile, many states are addressing these issues. See:

• State Legislative Action to Lower Pharmaceutical Costs (National Academy on State Health Policy, 9/26/19)
• States Lead on Surprise Medical Billing Protections, Congress Poised to Follow (National Academy on State Health Policy, updated 10/4/19)