The U.S. House of Representatives Passes ACG Priority: Thank You ACG Members for Your Advocacy Efforts!
From ACG Legislative and Public Policy Council Chair, Whitfield L. Knapple, MD, FACG
On Thursday, the U.S. House of Representatives voted 230-192 to pass H.R. 3, the “Elijah E. Cummings Lower Drug Costs Now Act.” The bill included language from the “Removing Barriers to Colorectal Cancer Screening Act” (H.R. 1570)—a top ACG legislative priority. Medicare beneficiaries are currently subject to cost-sharing when a polyp is removed during a screening colonoscopy. ACG members have long championed legislation to resolve this issue. Thank you ACG members for all of your advocacy efforts, and thank you to the ACG Governors for requesting that H.R. 1570 be included in any larger, year-end health care package.
Two Republican House members voted for H.R. 3: Brian Fitzpatrick (R-PA) and Jamie Herrera Butler (R-WA). The House also defeated a Republican alternative drug pricing amendment 223-201, but this alternative also included language from H.R. 1570. Why is this important? While H.R. 3 is not expected to go anywhere in the U.S. Senate, our efforts are not for naught. Since H.R. 1570’s language was included in both the Democratic and Republican U.S. House proposals, ACG continues to push both Republican and Democratic U.S. Senators to include the bipartisan “Removing Barriers to Colorectal Cancer Screening Act” in any of its year-end health care packages.
What does HR 3 do? The bill requires the U.S. government to negotiate the prices of drugs for federal health care programs based on an “Average International Market” price. This includes at least 25 Medicare Part D drugs annually, ultimately increasing this number to 50 (this was added to get more House Democrats to approve the bill). The bill also allows commercial insurers to request the same pricing. The bill caps out-of-pocket drug spending at $2,000 for Medicare Part D beneficiaries. HR 3 also restricts annual drug manufacturer price increases, forcing companies to rebate the portion of the increase that is above the rate of inflation. Of note to ACG members, the bill also encourages use of physician-administered biosimilars in Medicare Part B by increasing reimbursement.
The Congressional Budget Office (CBO) predicts that the legislation overall would save the federal government $456 billion over 10 years. Of note, CBO estimates that the cost of implementing H.R. 1570 is $3 billion over 10 years. The CBO projects that H.R. 3 would result in 30 fewer drugs being approved over the next decade due to the impact on research and development. As context, according to Politico, roughly 300 new drugs are approved every decade. Read the full CBO cost estimate here.
ACG will continue to update you as talks progress on the U.S. Senate side of the Capitol Building.
Thank you again ACG members!
New Practice Management Toolbox Article on How to Get What You Want From Negotiation
A Message from Practice Management Committee Chair Dr. Louis J. Wilson, MD, FACG
No matter what practice setting they are in, doctors cannot avoid taking responsibility for improving their practice.
Watch as Dr. Wilson invites you to explore the Practice Management Toolbox, a series of highly relevant articles that will improve your practice written by your ACG colleagues on the Practice Management Committee.