This week’s “Capitol Hill Healthcare Update” includes the latest on a series of healthcare bills scheduled for House votes, including one to repeal the medical device tax; Food and Drug Administration (FDA) Commissioner Scott Gottlieb and National Institutes of Health (NIH) Director Francis Collins’ scheduled testimony on before a House committee; reaction from congressional leaders to the Trump administration’s plan to import drugs from other countries; and more.
HEALTHCARE VOTES DOMINATE HOUSE AGENDA.
Before heading for the exits to begin a month-long recess, the House this week is scheduled to vote on a series of healthcare bills, including expanding health savings accounts and renewing the Children’s Hospital Graduate Medical Education Program.
Although some bills are controversial – like expanding tax-favored health savings accounts (HSAs) – other measures are expected to win bipartisan support, like repealing the medical device tax (see story below). The bills were approved in recent weeks by the Energy and Commerce Committee and the Ways and Means Committee.
One bill combines several stand-alone measures that would make changes to HSAs and flexible savings accounts (FSAs), including allowing FSA balances to carry over into new plan years; allowing working seniors covered by certain high-deductible plans and eligible for Medicare Part A to contribute to an HSA; increasing and adjusting annually for inflation the maximum contribution limits to HSAs; and allowing both spouses to make catch-up contributions to the same HSA.
Another HSA bill would increase first-dollar coverage flexibility in high-deductible plans for insurers to incentivize the use of services that can reduce healthcare costs, such as primary care visits and telehealth services; permit employers to offer free or discounted services at on-site or retail medical clinics without disqualifying an enrollee from contributing to an HSA; overturn an Affordable Care Act restriction that prohibited using HSAs on over-the-counter medicines; and treat certain physical fitness activities, like a gym membership, as a qualified HSA expense.
Separately, the House is scheduled to vote to reauthorize nursing workforce development programs that focus on recruitment, retention and advanced education of skilled nurses, and a bill that would direct the Department of Health and Human Services (HHS) to award grants to improve the training of health professionals in palliative and hospice care. Lawmakers also will vote to reauthorize for five years the Children’s Hospital Graduate Medical Education Program.
HOUSE TO VOTE ON PERMANENT REPEAL OF MEDICAL DEVICE TAX.
The long-running fight over repealing the Affordable Care Act has led to years of partisan battles on Capitol Hill, but the House on Tuesday is expected to vote to permanently repeal the law’s medical device tax by a sweeping margin.
Repealing the 2.3 percent excise tax enjoys broad, bipartisan support in the House. More than 275 lawmakers – including more than three dozen Democrats – are co-sponsoring the bill by Rep. Erik Paulsen, R-Minn., that the House will vote on this week.
There is similar bipartisan support for Senate legislation to end the tax. Sen. Todd Young, R-Ind., last week sent a letter to President Donald Trump to urge him to call on Congress to repeal the device tax. Young’s home state includes 20,000 employees and 150 companies in the medical technology industry.
Still, it’s unlikely Paulsen’s bill will get a vote in the Senate before the November midterm congressional elections. The Senate is focused on approving judicial nominations and scrambling to pass appropriations bills to keep the government funded into the next fiscal year, which begins Oct. 1. But advocates of repealing the tax believe a strong, bipartisan House vote now would help elevate the issue for consideration in year-end budget legislation after the election.
Congress earlier this year suspended the device tax until 2020. But medical device industry advocates want to permanently kill the tax, saying it siphons funds from growing medical technology companies, and burdens innovation and job creation.
SENATE PANEL TO VOTE ON PHARMACIST ‘GAG CLAUSES’ BILL.
The Senate Health, Education, Labor and Pensions Committee on Wednesday is scheduled to vote on bipartisan legislation that would overturn “pharmacy gag clauses.”
Introduced by Sen. Susan Collins, R-Maine, the legislation would allow pharmacists to tell consumers if a prescription drug would cost less if the consumer paid out of pocket rather than used insurance. Currently, pharmacists who disobey these clauses in contracts with pharmacy benefit managers can face penalties.
Collins calls gag clauses “an egregious tool” some insurers use to conceal prescription drug prices from patients at the pharmacy. During testimony before the committee last month, HHS Secretary Alex Azar said the contract provisions were “unconscionable.”
GOTTLIEB, COLLINS TO TESTIFY BEFORE HOUSE PANEL ON ‘CURES’ IMPLEMENTATION.
FDA Commissioner Scott Gottlieb and NIH Director Francis Collins are scheduled to testify. The hearing is the second this month on Cures implementation. The subcommittee, which is chaired by Rep. Michael Burgess, R-Texas, held a hearing last week on implementation of mental health reforms included in Cures.
Gottlieb may be testifying on the Hill again next month. The Senate HELP Committee in August may hold a hearing on the first-year implementation of the FDA Reauthorization Act, which established the most-recent industry user-fee regimes for brand-name drugs, medical devices, generic drugs and biosimilars.
REACTION MIXED FROM GOP LAWMAKERS ON DRUG IMPORTATION PLAN.
Key congressional Republicans offered qualified support for a Trump administration plan to examine whether drug importation could be effective to counter price spikes.
HHS Secretary Alex Azar said he was directing FDA Commissioner Scott Gottlieb to create a working group to examine how to safely import prescription drugs from other countries. Importation would be limited to generic drugs that see “dramatic price increases” and where there is only one U.S. approved manufacturer, Azar said in a statement.
House Energy and Commerce Committee Chairman Greg Walden, R-Ore., and Health Subcommittee Chairman Michael Burgess, R-Texas, issued a joint statement that was more circumspect. They said drug importation is a “complex issue, and there are very important safety concerns which must be adequately addressed.”
Democrats generally praised the move but said drug importation shouldn’t be limited.
HOUSE HEARING TO EXAMINE PHYSICIANS’ MERIT PAYMENTS.
The House Energy and Commerce Health Subcommittee will hold a hearing on implementation of the 2015 overhaul of physician payments.
The hearing will focus on implementation of the Merit-based Incentive Payment System (MIPS), which measures doctors’ performance across several metrics, including quality. The hearing will be the subcommittee’s fourth this Congress on implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.
Although witnesses haven’t been announced, the subcommittee is expected to hear from fee-for-service advocates. Subcommittee members also will examine how MIPS has effectively streamlined legacy quality programs, and provided new financial opportunities for providers to embrace participation and transition to new models of care.
NOTE TO READERS:
The House later this week is scheduled to recess until after Labor Day. The Senate is scheduled to be in session for part of August but mostly to consider Trump administration judicial and other nominations.