Daily on Healthcare: Providers would face pay cut under Senate surprise billing legislation

By | July 17, 2019

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PROVIDERS WOULD FACE PAY CUT UNDER SENATE SURPRISE BILLING LEGISLATION: Average payment rates to doctors and hospitals could fall by as much as 20% nationally under legislation to lower healthcare costs that is making its way through the Senate, according to a projection by the Congressional Budget Office.

The legislation, the Lower Health Care Costs Act, would go after the issue of surprise medical bills and help cheaper generics move to market faster. The legislation also would raise the legal age to buy tobacco from 18 to 21, among other public health measures.

Medical providers are still hoping that Congress will make changes to the legislation, which has cleared committee and hasn’t been scheduled for a vote before the full Senate. Providers mainly object to language in the bill that would let the government place limits on what they are allowed to charge.

The plan could backfire: If the bill causes significant downward pressure on prices, it could cause providers to consolidate, which could in turn eventually lead to price increases, CBO warns.

The bill would also:

*Increase direct spending by about $ 18.7 billion and increase revenues by $ 26.2 billion from 2019 to 2029, for a net decrease in the deficit of $ 7.6 billion.

*Reduce premiums for private health insurance plans by roughly 1%.

*Reduce direct government spending on prescription drugs by $ 3.8 billion and increase revenues by $ 0.7 billion, for a total reduction in the deficit of about $ 4.6 billion.

*Tobacco use would see a decline of roughly 1% over a decade, an estimate that the CBO expects will grow in the long-run. Changing the minimum age to buy tobacco would cost the government more, increasing the deficit of about $ 628 million over 10 years.

Read the full report.

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at dailyonhealthcare@washingtonexaminer.com. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

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UP FOR A VOTE: OBAMACARE’S ‘CADILLAC TAX:’ The House is set to vote Wednesday on a bill that would fully repeal Obamacare’s tax “Cadillac Tax” on health insurance plans deemed overly generous. The legislation, introduced by Joe Courtney, a Connecticut Democrat, is expected to pass easily because it has 361 co-sponsors.

26 BILLS SET FOR MARKUP IN E+C: The Energy and Commerce Committee on Wednesday will mark up legislation to address robocalls, prescription drug price transparency, and surprise medical bills. Tune in.

The committee will also vote on an arbitration amendment: The vote on legislation to end surprise medical bills will include a vote on an amendment to turn to arbitration as a backstop if insurers or providers want to contest the price of medical services. Modern Healthcare has the details.

SANDERS CHALLENGES DEMOCRATS TO TURN DOWN PHARMA OR INSURER CONTRIBUTIONS: Democratic presidential candidate Bernie Sanders will pledge Wednesday that he will not accept any campaign donations from health insurance companies or pharmaceutical companies, and will call on other Democrats running for the White House to do the same. Sanders will make the announcement around 4 p.m. in a “Medicare For All” speech.

“You can’t change a corrupt system by taking its money,” Sanders said in a statement. “If we are going to break the stranglehold of corporate interests over the healthcare needs of the American people, we have got to confront a Washington culture that has let this go on for far too long.“

Sanders predicts “Medicare for all” will cost about $ 40 trillion: The Medicare for All Act, Sanders said Tuesday, would cost between $ 30 trillion and $ 40 trillion over a decade. He then said his plan would be much less expensive than the healthcare system in place in the long-term. “What the most serious economists tell us, that if we do nothing to fundamentally change the healthcare system, we would be spending something like $ 50 trillion over a 10 year period,” Sanders said.

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Sanders’ off-the-cuff estimate is roughly in line with the 2018 projection from the libertarian Mercatus Center at George Mason University, which said the cost of Medicare for All would be $ 32.6 trillion.

PLANNED PARENTHOOD OUSTS PRESIDENT AFTER LESS THAN A YEAR ON THE JOB: Planned Parenthood removed Dr. Leana Wen Tuesday after she had served only eight months as president of the organization and its political arm, Planned Parenthood Action Fund. In response to the closed board meeting deciding her departure, Wen wrote the she had tried to protect abortion rights by advancing the argument that abortion “is not a political issue but a health care one, and that we can expand support for reproductive rights by finding common ground with the majority of Americans who understand reproductive health care as the fundamental health care that it is.” She added that she and the board held “philosophical differences” over the direction Planned Parenthood should take to protect abortion rights.

CMS TO ALLOW NURSING HOMES TO USE BINDING ARBITRATION AGREEMENTS: CMS released a final rule Tuesday that will allow nursing homes to use binding arbitration agreements, which would keep residents from suing providers over issues including neglect or abuse. But the rule — which replaces an Obama-era ban on binding arbitration agreements that was stalled by the courts — won’t allow nursing homes to require residents to sign arbitration as a condition for care, and says that nursing homes must explain clearly to residents exactly what the agreement means before asking if they want to sign it. However, Public Citizen, a progressive think tank that advocates for nursing home quality, took issue with the rule, calling it “a shameful move” that will give nursing homes “a Get Out of Jail Free card” for abuse.

DEMOCRATS URGE THE USDA TO STOP RELOCATION TO KANSAS CITY: House and Senate Democrats urged the U.S. Department of Agriculture to scrap plans to relocate some workers to Kansas City, Missouri, Tuesday, saying that the move would “gut” the ability of the agency’s Economic Research Service and National Institute of Food and Agriculture to do their jobs. The Democrats warned that most of the employees wouldn’t move, leaving the agency understaffed.

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BIPARTISAN LAWMAKERS LAUNCH TASK FORCE TO IMPROVE ACCESS TO HEALTHCARE IN RURAL AREAS: Bipartisan representatives of the Ways and Means Committee launched the “Rural and Underserved Communities Health Task Force,” an effort to improve access to healthcare in rural areas in which hospitals are closing quickly, leaving many Americans without ways to obtain healthcare. Alabama Democrat Terri Sewell said the issue is a “plague” that won’t solve itself overnight. Since 2010, 107 rural hospitals have shut their doors.

The Rundown

STAT How pharma, under attack from all sides, keeps winning in Washington

Washingtonian DC types have been flocking to shrinks ever since Trump won. And a lot of the therapists are miserable.

The Denver Post Colorado’s health exchange premiums expected to drop 18% – if feds approve reinsurance

Morning Consult On controlling health costs, most voters trust … no one

Kaiser Health News Pain meds as public nuisance? Oklahoma tests a legal strategy against opioid maker



Congress in session.

July 16-17. Hilton DC National Mall Hotel. World Congress Medicare Summit. Agenda.

July 16-17. Hilton DC National Mall Hotel. World Congress Medicaid Summit. Agenda.

THURSDAY | July 18

8 a.m. AJAX. Axios event on “The Future of Pain Management.” Details.

2 p.m. 2253 Rayburn. AIDS Institute congressional briefing on “Viral Hepatitis Elimination in the U.S.” RSVP.

3:30 p.m. 1225 I St NW. Bipartisan Policy Center event on “The Sandwich Generation’s Financial Strain: How Caregivers Balance Family and Finances.” Details.

4 p.m. CVC 209-08. Chamber of Commerce event on “Tomorrow’s Cures: Impacts of the International Pricing Index.”

FRIDAY | July 19

8 a.m. 2101 Constitution Ave. NW. National Academies of Sciences, Engineering, and Medicine will host a workshop on “Preparedness for 21st Century Health Threats.” Details.

MONDAY | July 22

July 22-23. Better Medicare Alliance Medicare Advantage Summit. Details.