Grassley: Senate drug pricing bill nearing completion | CMS proposes to streamline monitoring of Medicaid beneficiary access | House effort to address unexpected medical bills advances
July 12, 2019
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Grassley: Senate drug pricing bill nearing completion
Chairman Chuck Grassley, R-Iowa, said the Senate Finance Committee is still negotiating final details of drug pricing legislation, but members are "on track to report a bill out of committee very soon." Grassley and the panel's top Democrat, Sen. Ron Wyden, D-Ore., have been working on the measure for months, but some GOP senators have expressed concern that certain provisions too closely resemble price controls.
The Hill (7/11) 
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Legislative & Regulatory News
CMS proposes to streamline monitoring of Medicaid beneficiary access
The CMS wants to overturn a 2015 Obama administration rule that required states to regularly submit access monitoring review plans for certain Medicaid services, saying the rule's focus on fee-for-service care is outdated and that it is burdensome without generating a clear benefit for enrollees. Instead, the CMS is considering a more comprehensive and outcomes-driven approach for tracking access.
Healthcare Finance (7/11),  Modern Healthcare (tiered subscription model) (7/11) 
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House effort to address unexpected medical bills advances
The House Energy and Commerce Subcommittee on Health has advanced a package of 10 measures related to health care, including legislation meant to address unexpected medical bills. The No Surprises Act would require health care facilities to inform patients at least one day before elective care if an out-of-network health care provider would be involved, prohibit balance billing for that care and establish payment rates based on the local market.
HealthLeaders Media (7/11),  Becker's Hospital CFO Report (7/11) 
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Drug Industry Spotlight
Mylan's generic anticlotting drug gets tentative FDA approval
Mylan's biosimilar to Bristol-Myers Squibb's anticlotting drug Eliquis, or apixaban, has received tentative approval from the FDA but will require resolution of patent issues in order to receive full approval.
Seeking Alpha (7/10) 
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Reckitt agrees to $1.4B settlement to stop Suboxone investigation
British firm Reckitt Benckiser reached an agreement with the US Department of Justice and Federal Trade Commission to pay $1.4 billion to stop an investigation into how one of its former businesses marketed the opioid addiction drug Suboxone. Reckitt's former holding Indivior was accused of duping doctors and health benefit programs in the US into believing the film version of Suboxone was safer and not as prone to abuse as other treatments.
Reuters (7/11) 
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Opinion, Commentary & Analysis
Editorial: Rebate rule was bad policy
Savings from drug rebates negotiated by pharmacy benefit managers are applied to insurance plan premiums, and restricting how rebates are used would have resulted in higher premiums, prompting the Trump administration to abandon proposed rules. PBMs are exploring alternative models on their own, and the government should not interfere in the process.
The Wall Street Journal (tiered subscription model) (7/11) 
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PCMA is the national association representing America's pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 266 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D. PCMA is dedicated to enhancing the proven tools and techniques pioneered by PBMs that generate savings and access for consumers and payors.

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