Those
hoping
for
meaningful
drug
pricing
and
prior
authorization
reform
this
holiday
season
received
a
lump
of
coal
instead.
On
Saturday,
President
Joe
Biden
signed
a
narrower
spending
bill
that
avoided
a
government
shutdown
but
left
out
several
healthcare
provisions
that
were
included
in
the
original
bill.
The
original
was
opposed
by
Tesla
CEO
Elon
Musk
and
President-elect
Donald
Trump,
who
argued
that
it
included
government
waste,
according
to
the
Washington
Post.
Because
of
this,
drug
pricing
reform
became
“collateral
damage”
and
was
part
of
the
healthcare
provisions
that
were
excluded
in
the
new
bill,
advocacy
organization
Patients
for
Affordable
Drugs
Now
said
in
an
announcement.
The
reforms
cut
out
from
the
package
included:
-
The
Affordable
Prescriptions
for
Patients
Act,
which
limits
the
number
of
patents
pharmaceutical
companies
can
apply
to
biologics -
A
provision
of
the
Lower
Costs,
More
Transparency
Act,
which
addresses
a
hurdle
in
generic
drug
approvals
by
requiring
the
FDA
to
provide
clearer
guidance
on
ingredient
differences -
The
Modernizing
and
Ensuring
PBM
Accountability
Act,
which
seeks
to
disconnect
pharmacy
benefit
managers’
(PBM)
revenue
from
drug
prices
in
Medicare
Part
D,
reducing
the
incentives
for
PBMs
to
push
higher-cost
medications.
It
would
also
require
them
to
disclose
drug
pricing
and
related
information
to
Part
D
plan
sponsors.
“These
critical
reforms
had
strong
bipartisan
support,
saved
taxpayers
billions
of
dollars,
and
would
have
delivered
real
relief
for
patients,”
said
Merith
Basey,
executive
director
of
Patients
For
Affordable
Drugs
Now,
in
a
statement.
“Leaving
these
bills
out
of
the
end-of-year
package
means
that
Americans
will
continue
to
pay
the
highest
drug
prices
in
the
world.
Regrettably,
politics
and
powerful
outside
interests
took
precedence
over
the
needs
of
patients.”
The
organization
added
that
excluding
these
measures
means
the
next
chance
to
pass
them
won’t
be
until
the
next
Congress,
delaying
relief
for
millions
of
Americans.
Drug
pricing
reform
wasn’t
the
only
healthcare
provision
left
out
of
the
updated
spending
bill.
Prior
authorization
reform
also
didn’t
make
it
in
the
final
package,
as
well
as
a
provision
to
address
declining
reimbursement
rates
for
Medicare.
This
was
blasted
by
the
American
Medical
Association.
“Congress
heads
home
today
leaving
in
place
a
2.83%
cut
for
doctors,”
said
Bruce
A.
Scott,
MD,
president
of
the
American
Medical
Association,
in
a
statement.
“It
did
not
provide
a
rational
permanent,
inflation-based
update
as
the
Medicare
Payment
Advisory
Commission
recommended.
It
didn’t
even
offer
doctors
a
Band-Aid
in
the
form
of
a
cut
reduction,
as
the
cost
of
delivering
care
rises
3.5%
next
year.”
The
new
spending
bill
also
provided
shorter
extensions
for
Medicare
telehealth
flexibilities
and
the
Acute
Hospital
Care
at
Home
program.
Both
of
these
provisions
are
extended
through
March
31,
2025.
The
original
bill
included
a
two-year
extension
of
the
Medicare
telehealth
flexibilities
and
a
5-year
extension
of
the
Acute
Hospital
Care
at
Home
program.
Kyle
Zebley,
senior
vice
president
of
public
policy
at
the
American
Telemedicine
Association,
said
the
outcome
wasn’t
what
the
organization
had
“fully
hoped
for,”
but
that
the
legislation
is
still
“an
important
step
to
avoid
disruptions
in
critical
areas
of
telehealth
access.”
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