Update on Prescription Drug Legislation

For more information about this blog post, please contact Khaled J. KleleLatoya Caprice Dawkins, or Ryan M. Magee.

Last week, the House approved two bills intended to improve prescription drug pricing transparency for patients.  H.R. 2115, the Public Disclosure of Drug Discounts Act, requires CMS to publish certain payment information regarding pharmacy benefit managers (PBMs) and prescription drugs.  The House also approved H.R. 1781,  Payment Commission Data Act of 2019, which together with H.R. 2115, proposes amending Titles XVIII and XIX of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers.  Both bills should now progress to the Senate for consideration. 

Primary Care First Model:   CMS recently opened the application period for the Primary Care First advanced alternative payment model.  The start date was delayed to January 1, 2021. To meet that start date, you must apply by January 22, 2020. 

CMS Delays Pricing Requirement:  We previously reported in July 2019 that the Trump Administration would require hospitals to publish their negotiated rates with insurers.   CMS recently announced that it was delaying the rule to address the more than 1400 comments it received in connection with the Proposal, but the Trump Administration continues to push the rule and will likely expand it to include insurers, which will more than likely lead to legal action.