The air was already pretty thin in Washington but the Senate impeachment trial has taken what little oxygen there was out of the Capitol. While the most media outlets are transfixed by the proceedings, the government grinds on.
- In an interview with CNBC at Davos, President Trump indicated that entitlement reform was something he would be "looking" at after the 2020 election. While he provided no specifics, we think the president is smart enough to know where his base is and any entitlement reform to Medicare is going to target providers. On our hit list will be: Post-acute payment reform, continued expansion of site-neutral payment policies and reform and expand DME competitive bidding.
- The bipartisan, bicameral agreement on controlling the so called "surprise" or out of network billing took another broadside this week when the National Taxpayers Union and Heritage Action, the lobbying wing of the Heritage Foundation, started a mobilization effort to squash the bill. Questions about "surprise" bills are the single most frequently discussed issue with clients and we have argued that the legislation is not likely to become law given the impasse on how to resolve payment. See our recent Black Book on MD at the 35:27 mark. https://app.hedgeye.com/feed_items/80133. If conservative groups "score" a vote on the legislation, expect a rapid retreat on this issue and a fallback to more reporting and disclosure similar to the laws of New York, New Jersey and Tennessee.
- President Trump is unhappy with his polling on health care issues and that has given new life to a proposed rule that would set Medicare reimbursement of certain drugs based on prices paid in OECD countries. As with drug importing we are dubious such a program is even possible or effective. Many drugs available in the US are not sold abroad. There is right now no uniform mechansims for determining how prices would be determined across so many international governments. But, hey, its the silly season. Look for an announcement of some sort in the next week or so.
- MedPAC is looking at reforming the Transitional Drug Add-on Payment for ESRD. Recall that the payments for calcimemetics has been a feature of DVA's earnings calls for several quarters. The administration has already taken steps to reform the add-on payment by suspending it when drug companies fail to report their ASP. MedPAC is leaning toward recommending a complete elimination of the payment.
Have a great weekend and call with questions. We turned CNN off so we have plenty of time to talk about other things beside impeachment.
Emily Evans
Managing Director – Health Policy
Twitter
LinkedIn
