DCMedical News: Friday, October 26, 2018
DCMedical News-DCMN
Washington, D.C.
Friday, October 26, 2018
DCMedical News is published every day either the House or the Senate is in session. See scheduled sessions at the bottom of this newsletter. Congress is in recess until November 13th, when publication of DCMN will resume.
The Big Story in Health Care: Mid-Term Elections November 6, related stories below.
A poll of registered voters by the Kaiser Family Foundation found (report here, Altman commentary here) that “Leading up to the 2018 midterm elections, seven in ten voters (71 percent) say health care is “very important” in making their voting decision for Congress this year, slightly larger than the shares that say the same about the economy and jobs (64 percent). Majorities also say the same about gun policy (60 percent), immigration (55 percent), tax cuts and tax reform (53 percent) and foreign policy (51 percent). While at least half of voters say all of the issues provided are “very important” to their vote, when asked to choose the one issue that is the “most important” in their voting decision for Congress this year, the largest share of voters chooses health care (30 percent). This is followed by the economy and jobs (21 percent), gun policy (15 percent), and immigration (15 percent). (Politico Pro infographic based on the report, here.)
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Eleven physician members of Congress up for re-election: Ten Representatives (list here, with medical specialty) all running. Senator Barrasso of Wyoming, an orthopedic surgeon, is also up for re-election this year.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Medicaid an Election Issue: Medicaid expansion an issue (ballot questions and positions of candidates) in many states, for example in the Georgia Gubernatorial race, here. Lobbying on Medicaid expansion has interest groups who may pay, or benefit, for example in Idaho, Nebraska, Montana and Utah, report here and here. Ballot questions profiled here.
Obamacare vs. Repeal and Replace: A significant issue in many states, for example the Missouri Senate race, here, and West Virginia, here.
Protection for patients with pre-existent conditions: An issue in many races, for example in Midwestern state Gubernatorial races, report here.
And Medicare-for-All: Kaiser Health News reports (here) that “Politicians Hop Aboard ‘Medicare-for-all’ Train, Destination Unknown.”
DRUGS AND DEVICES
President Announces Plan to Cap Drug Prices, a Top Campaign Issue: Thursday the President announced a plan to institute “reference pricing” for Medicare Part B drug payments. The website of the Assistant Secretary for Planning and Evaluation (ASPE) at HHS had this summary: “The prices charged by drug manufacturers to wholesalers and distributors in the United States are 1.8 times higher than in other countries for the top drugs by total expenditures separately paid under Medicare Part B. U.S. prices were higher for most of the drugs included in the analysis, and U.S. prices were more likely to be the highest prices paid among the countries in our study.” The ASPE report is here.
Politico reports this mid-term election campaign angle: “Health care has emerged as a hot issue in the midterms,” with Democrats making gains by pledging to preserve Obamacare coverage for people with pre-existing conditions. “Those protections would have been undermined in GOP repeal bills and are now threatened by a White House-backed lawsuit brought by conservative states. Trump’s pivot to drug prices could help Republican candidates needing a winning message on health.”
CMS lost no time following through. Thursday afternoon a proposed rule (here) appeared in the Federal Register, an “International Pricing Index [IPI] Model for Medicare part B Drugs.” “The IPI Model test would include the following components: ● Set the Medicare payment amount for selected Part B drugs to be phased down to more closely align with international prices; ● Allow private-sector vendors to negotiate prices for drugs, take title to drugs, and compete for physician and hospital business; and ● Increase the drug add-on payment in the model to reflect 6 percent of historical drug costs. ● Pay physicians and hospitals the add-on based on a set payment amount structure; CMS would calculate what CMS would have paid in the absence of the model, before sequestration, and redistribute this amount to model participants based on a set payment amount.”
READING AND REFERENCE
Congressional Research Service Updates FAQs on PPACA: Report here.
Health Care Cost Institute Reports on Prices: Prices grew at three times the rate of inflation 2012-2016, wide local variation, no single factor responsible (report here, web site https://the-dataface.github.io/hcci-price-index.)
CBO on Modeling Health Insurance: Address to American Academy of Actuaries, slides here.
American Journal of Managed Care: “The Characteristics of Physician Practices Joining the Early ACOs,” here, see DCMN 10-25-2018.
Journal of Managed Care & Specialty Pharmacy, abstracts of the “Academy of Managed Care Pharmacy” meeting October 22-25, 112 pgs. here.
“Medicaid Enrollment & Spending Growth: FY 2018 & 2019”: Kaiser Family Foundation report, here.
EVENTS & MEETINGS
Oct. 26
8:45 to 9:45 a.m., Health and Human Services Secretary Alex Azar at The Brookings Institution. Webcast at https://www.brookings.edu/eventsremarks-by-health-and-human-services-secretary-alex-azar
12:00 to 1:00 p.m., Healthcare Leadership Council Briefing “State of the Healthcare Workforce,”
2322 Rayburn Bldg., Washington, DC, contact: Kelly Fernandez, (202) 449-3452, kfernandez@hlc.org
Oct. 30
2:00 p.m. to 3:30 p.m., HFMA webinar, “Developing a Pricing Strategy for the 2019 CMS Transparency Requirement,” information at www.hfma.org.
Nov. 1
Open enrollment in exchange plans begins, through 12-15, see healthcare.gov.
Nov. 6
Mid-term elections
Nov. 8
Through Nov. 13, 2018 AMA Interim Meeting, Gaylord Convention Center, National Harbor, Maryland
Nov. 12
Through November 14, National Association of Medicaid Directors, Washington Hilton, Agenda (10 pgs.), here.
Nov. 14
9:00 a.m. to Noon, Wall Street Comes to Washington, Health Care Roundtable, investment professionals on a panel moderated by Paul Ginsburg, information at www.jktgfoundation.org.
Nov. 27
9:00 a.m., Duke Margolis Center on “Root Causes of Drug Shortages and Finding Enduring Solutions,” Washington Marriott Metro Center, (McClellan, Gottlieb, FDA panel), agenda here.
Nov. 28
10:00 a.m., Senate HELP Committee Hearing: Reducing Health Care Costs: “Improving Affordability Through Innovation,” 430 Dirksen Senate Office Building, announcement here.
Nov. 29
The “Office of the National Coordinator” annual meeting, continuing November 30, two day tentative agenda (Jared Kushner!) here.
Dec. 4
9:00 a.m., CMS sponsors a “Town Hall” meeting “to discuss fiscal year (FY) 2020 applications for add-on payments for new medical services and technologies under the hospital inpatient prospective payment system (IPPS). Registration required by 11-19-2018, Federal Register notice here.
FOR REFERENCE
Members of the Senate (here) and Members of Senate Committees (here), Senate Calendar (here).
Members of the House with their House Committees (here), House Calendar (here).
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
Publication will resume Tuesday, November 13th.
November publication dates: 13, 14, 15, 16, 26, 27, 28, 29, 30
December publication dates: 3, 4, 5, 6, 7, 10, 11, 12, 13, 14
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com