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The U. S. House of Representatives passed H. R. 5378, the Lower Costs, More Transparency Act, a bill to require greater transparency of hospital values, which would value differences between pharmacy benefit managers.
The bill passed the House by a vote of 320 to 71 and now stands before the Senate for consideration. Congress is expected to recess for the year at the end of this week.
It also provides transparency into the value of clinical laboratory tests, so patients can more clearly know the value they will pay for those tests.
The bill spares hospitals $16 billion in cuts to disproportionate share hospital payments for two years.
WHY THIS MATTERS
Site neutral payments are included in the bill.
Rick Pollack, president and CEO of the American Hospital Association, said, “While the AHA appreciates inclusion of a two-year delay on DSH cuts, we have been very clear regarding the harm that would be done to our nation’s hospitals if so-called site-neutral cuts to Medicare were adopted. We have strongly urged that those cuts be eliminated from this legislation. If Medicare site-neutral cuts remain part of this package, we ask that Congress oppose H.R. 5378 (The Lower Costs, More Transparency Act) until such changes are made.”
The Catholic Health Association is also calling on lawmakers to reject site-neutral provisions in the Reduced Costs, More Transparency bill.
Merith Basey, executive director of Patients for Affordable Drugs Now, said, “The House’s decisive bipartisan action tonight in passing the Cost Reduction and More Transparency Act, adding measures to increase transparency and address higher drug costs through the approval procedure for generic drugs. It’s very encouraging and it takes Congress in the right direction. “
But the Pharmaceutical Care Management Association said the bill would not serve the purpose of lowering drug costs.
“America’s pharmacy benefit companies are extremely disappointed by the passage of H.R. 5378 by the U.S. House of Representatives,” the organization said. “The legislation undermines the work of PBMs to reduce prescription drug costs for patients and employers. The bill’s intrusion into private market contracting for pharmacy benefits undermines and weakens the ability of PBMs to offer health plans, employers, and unions the choice of the most cost-effective pharmacy benefits to meet their needs.”
THE BIGGEST TREND
Another bill introduced in the House would avert an imminent 3. 37% cut in doctors’ salaries in Medicare payments to the American Medical Association.
The cuts threaten health care for the elderly as well as the viability of doctors’ offices, especially in rural and underserved areas, the AMA said.