[Congressional Record Volume 165, Number 170 (Monday, October 28, 2019)]
[House]
[Pages H8526-H8527]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PAYMENT COMMISSION DATA ACT OF 2019
Ms. SCHAKOWSKY. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 1781) to amend titles XVIII and XIX of the Social Security
Act to provide the Medicare Payment Advisory Commission and the
Medicaid and CHIP Payment and Access Commission with access to certain
drug payment information, including certain rebate information, as
amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 1781
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Payment Commission Data Act
of 2019''.
SEC. 2. PROVIDING THE MEDICARE PAYMENT ADVISORY COMMISSION
AND MEDICAID AND CHIP PAYMENT AND ACCESS
COMMISSION WITH ACCESS TO CERTAIN DRUG PAYMENT
INFORMATION, INCLUDING CERTAIN REBATE
INFORMATION.
(a) Access to Certain Part D Payment Data.--Section 1860D-
15(f) of the Social Security Act (42 U.S.C. 1395w-115(f)) is
amended--
(1) in paragraph (2)--
(A) in subparagraph (A)(ii), by striking ``and'' at the
end;
(B) in subparagraph (B), by striking the period at the end
and inserting ``; and''; and
(C) by inserting at the end the following new subparagraph:
``(C) by the Executive Director of the Medicare Payment
Advisory Commission for purposes of monitoring, making
recommendations, and analysis of the program under this title
and by the Executive Director of the Medicaid and CHIP
Payment and Access Commission for purposes of monitoring,
making recommendations, and analysis of the Medicaid program
established under title XIX and the Children's Health
Insurance Program under title XXI.''; and
(2) by adding at the end the following new paragraph:
``(3) Additional restrictions on disclosure of
information.--The Executive Directors described in paragraph
(2)(C) shall not disclose any of the following information
disclosed to such Executive Directors or obtained by such
Executive Directors pursuant to such paragraph, with respect
to a prescription drug plan offered by a PDP sponsor or an
MA-PD plan offered by an MA organization:
``(A) The specific amounts or the identity of the source of
any rebates, discounts, price concessions, or other forms of
direct or indirect remuneration under such prescription drug
plan or such MA-PD plan.
``(B) Information submitted with the bid submitted under
section 1860D-11(b) by such PDP sponsor or under section
1854(a) by such MA organization.
``(C) In the case of such information from prescription
drug event records, in a form that would not be permitted
under section 423.505(m) of title 42, Code of Federal
Regulations, or any successor regulation, if made by the
Centers for Medicare & Medicaid Services.''.
(b) Access to Certain Rebate and Payment Data Under
Medicare and Medicaid.--Section 1927(b)(3)(D) of the Social
Security Act (42 U.S.C. 1396r-8(b)(3)(D)) is amended--
(1) in the matter before clause (i), by striking
``subsection (a)(6)(A)(ii)'' and inserting ``subsection
(a)(6)(A)'';
(2) in clause (iv), by striking ``and'' at the end;
(3) in clause (v), by striking the period at the end and
inserting ``, and'';
(4) by inserting after clause (v) the following new clause:
``(vi) to permit the Executive Director of the Medicare
Payment Advisory Commission and the Executive Director of the
Medicaid and CHIP Payment and Access Commission to review the
information provided.'';
(5) in the matter at the end, by striking ``1860D-
4(c)(2)(E)'' and inserting ``1860D-4(c)(2)(G)''; and
(6) by adding at the end the following new sentence: ``Any
information disclosed to the Executive Director of the
Medicare Payment Advisory Commission or the Executive
Director of the Medicaid and CHIP Payment and Access
Commission pursuant to this subparagraph shall not be
disclosed by either such Executive Director in a form which
discloses the identity of a specific manufacturer or
wholesaler or prices charged for drugs by such manufacturer
or wholesaler.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from
Illinois (Ms. Schakowsky) and the gentleman from Texas (Mr. Burgess)
each will control 20 minutes.
The Chair recognizes the gentlewoman from Illinois.
General Leave
Ms. SCHAKOWSKY. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days in which to revise and extend their remarks
and include extraneous material on H.R. 1781.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Illinois?
There was no objection.
Ms. SCHAKOWSKY. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise in support of H.R. 1781, the Payment Commission
Data Act of 2019.
This bill will provide the Medicare Payment Advisory Commission,
otherwise known as MedPAC, and the Medicaid and CHIP Payment and Access
Commission, MACPAC, with access to drug pricing and rebate data under
Medicare parts B and D, as well as under Medicaid.
MedPAC and MACPAC are independent, nonpartisan commissions that
advise Congress on issues affecting the Medicare and Medicaid programs.
Currently, MedPAC and MACPAC lack access to this drug pricing data and
are limited in their ability to provide information to Congress on the
skyrocketing costs of prescription drugs.
H.R. 1781 is a simple but critical fix to ensure that the commissions
have access to this data in order to analyze and report to Congress on
these urgent issues.
Mr. Speaker, I urge my colleagues to support this bill, and I reserve
the balance of my time.
Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 1781, the Payment Commission
Data Act of 2019, which was introduced by my colleague, Representative
Carter of Georgia. This bill provides the Medicare Payment Advisory
Commission, colloquially known as MedPAC, and the Medicaid and CHIP
Payment and Access Commission, affectionately known as MACPAC, with
access to certain drug payment information.
MedPAC is an independent congressional agency that serves to advise
Congress on issues affecting the Medicare program. And MACPAC is a
nonpartisan legislative branch agency that provides policy and data
analysis and makes recommendations to Congress on issues affecting
Medicaid and the State Children's Health Insurance Program.
The issue was brought to our attention that despite getting similar
data, such as plan bid data, we were surprised to learn that while this
data could be shared by the Center for Medicare and Medicaid Services
with the Government Accountability Office and the Congressional Budget
Office, it could not be shared with MedPAC or MACPAC, leading us to
this effort to correct this in a bipartisan way through H.R. 1781.
By providing these entities with drug payment and drug rebate
information, MedPAC and MACPAC will be better able to analyze the drug
cost data in the Medicare and Medicaid programs. Therefore, these
commissions will be able to make better recommendations to Congress on
how to address drug pricing based on accurate and factual data.
In a letter from MedPAC to Chairman Pallone, Chairwoman Eshoo,
Republican Leader Walden, and myself in March, MedPAC said that ``a
statutory change giving us access to these data would enhance our
capabilities for assisting the Congress on issues relating to
prescription drug costs.'' The letter further outlines a number of ways
that this data would help MedPAC support Congress and serve the
commission's intended purpose.
Mr. Speaker, I include in the Record their letter.
Medicare Payment Advisory
Commission,
Washington, DC, March 26, 2019.
Re: Drug pricing and rebate data
Hon. Frank Pallone, Jr.,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Hon. Anna G. Eshoo,
Chairman, Subcommittee on Health, Committee on Energy and
Commerce,
House of Representatives, Washington, DC.
Hon. Greg Walden,
Ranking Member, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Hon. Michael C. Burgess, M.D.,
Ranking Member, Subcommittee on Health, Committee on Energy
and Commerce,
House of Representatives, Washington, DC.
Dear Chairmen and Ranking Members: The Medicare Payment
Advisory Commission (MedPAC) is an independent, legislative
branch agency established by the Balanced Budget Act of 1997
(P.L. 105-33) to provide expert policy and technical advice
to the Congress on issues affecting the Medicare program.
Medicare spending has grown substantially over the last
decade, particularly for
[[Page H8527]]
prescription drugs, placing an increasing financial burden on
the taxpayers and beneficiaries who finance it. Congress
plays a vital role in overseeing Medicare and solving these
fiscal challenges so that the program remains secure for
current and future beneficiaries. MedPAC serves as an
important source of information and advice to the Congress as
it exercises that oversight. To enable MedPAC to best advise
the Congress on how to address the problems stemming from the
high and rising costs of prescription drugs, I am writing to
request a narrow change in law that would grant MedPAC staff
access to important drug pricing and rebate data that other
congressional agencies are already able to use. The change in
statute is necessary because MedPAC is unable to access the
data under existing statutory authority.
MedPAC uses a wide variety of data in order to support the
Congress' oversight of Medicare, and the Commission has a
strong track record of protecting different types of
proprietary and confidential information. For example, MedPAC
uses and keeps secure the bids that private insurance plans
submit under Medicare Parts C and D, data that Medicare
Advantage plans submit on encounters between beneficiaries
and their health care providers, and data on beneficiaries'
use of prescription drugs.
To ensure that the Congress has comprehensive and up-to-
date information, MedPAC strives to use all available data
pertinent to our analyses. The Commission uses these data to
provide information to the Congress on spending by Medicare
and its beneficiaries and to help the Congress develop
policies to improve the value of taxpayer dollars used to
finance the program. MedPAC delivers this information in
mandated reports, congressional testimony, and frequent
briefings to congressional staff.
The large growth in drug spending has been a key
contributor to the financial strain on Medicare and its
beneficiaries. Today, Medicare spends more than $100 billion
annually on prescription drugs under Parts B and D, and
beneficiaries are exposed to more than $20 billion in cost
sharing liability. Of particular concern is the growing
number of beneficiaries who are exposed to very large cost
sharing amounts when they take extremely high-priced drugs.
Despite broad data access under its authorizing statute,
MedPAC is unable to access important drug pricing and rebate
information under Medicare Parts B and D, and under Medicaid,
because of how specific places of the Social Security Act are
constructed (for example, MedPAC is not specifically named in
Section 1927(b)(3)(D) of the Social Security Act as one of
the entities with access to certain data detailing how much
the Medicare program and its beneficiaries pay for
prescription drugs). Because we lack these important data, we
have been limited in the analysis and information we can
provide to the Congress as it grapples with how to bring down
the prices of drugs for beneficiaries and taxpayers. A
statutory change giving us access to these data would enhance
our capabilities for assisting the Congress on issues related
to prescription drug costs.
With these data, MedPAC staff could:
Assist Congress in understanding the true costs (net of
rebates) of prescription drugs to beneficiaries and taxpayers
under the Medicare program.
Evaluate different policy options that aim to bring down
the prices of drugs and the cost sharing that beneficiaries
face for their medicines at the point of sale.
Provide insight into how Part D plans manage the growth in
drug prices.
Analyze the effects of market entry and competition on drug
prices.
MedPAC looks forward to continuing to support the Congress
in developing approaches to payment that ensure beneficiary
access to important therapies, while reducing costs for the
Medicare program and its beneficiaries. I very much
appreciate your consideration of this request for this
statutory change, and I also appreciate the support that the
Congress has long given to the Commission.
Sincerely,
Francis J. Crosson, M.D.,
Chairman.
Mr. BURGESS. Mr. Speaker, this bill continues the work of the Energy
and Commerce Committee last Congress where we marked up a discussion
draft of this very bill at the Health Subcommittee, which I chaired.
Drug pricing remains an issue for patients in the United States and
this bill will allow the House to act on factual analysis and
recommendations to help lower drug prices for Americans.
Mr. Speaker, I urge fellow Members to support H.R. 1781, and I
reserve the balance of my time.
Ms. SCHAKOWSKY. Mr. Speaker, I reserve the balance of my time.
Mr. BURGESS. Mr. Speaker, I am pleased to yield 5 minutes to the
gentleman from Georgia (Mr. Carter), the principal author of this bill
and a valuable member of the Health Subcommittee of the Committee on
Energy and Commerce.
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for
yielding.
Mr. Speaker, I rise to speak in support of my bill, H.R. 1781, the
Payment Commission Data Act.
Last year, the Medicare Payment Advisory Commission, MedPAC, and the
Medicaid and CHIP Payment Advisory Commission, MACPAC, who serve as
nonpartisan advisory panels to Congress, came to us with a problem:
They did not have the data needed to fully study prescription drug
rebates.
This bill ensures MedPAC and MACPAC have access to the data they need
to make informed recommendations to Congress. This increase in
transparency is extremely helpful in allowing MedPAC and MACPAC to
analyze how competition in our drug market is currently working and how
part D plans are managing the growth in drug prices. They will be able
to turn that new knowledge into improved policy recommendations on how
we, as Congress, can bring down the price of drugs for patients.
Simply put, this bill is just good governance.
Importantly, I think this bill, as well as the bill we just spoke
about, H.R. 2115, are shining examples of what is possible when
Republicans and Democrats are working together to lower the cost of
drugs for patients.
In the Energy and Commerce Committee, we have worked all year to
advance a number of good, bipartisan drug policies that could make a
difference for patients.
{time} 1945
Looking across the Capitol, there are dozens more bipartisan reforms
that I think could get robust support here in the House.
The issue of prescription drug costs is simply too important to be
sacrificed in the name of electoral politics. Today is proof that we
can, in fact, pass bipartisan drug pricing reforms.
So I call on my colleagues on the other sides of the aisle: Let's
build on today and continue advancing the bipartisan policies we know
can become law and actually make a difference for patients in the
country.
I want to thank my friend and colead, Representative Tom O'Halleran,
as well as Representatives Rice, Panetta, Gianforte, and Welch for
their leadership on this bill.
I urge my fellow Members to support transparency in our drug supply
chain and to support H.R. 1781.
Mr. BURGESS. Mr. Speaker, I urge support of the underlying bill, and
I yield back the balance of my time.
Ms. SCHAKOWSKY. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I would like to point out that this evening, early
evening and now, we have passed a total of five pieces of legislation,
a couple of which were also out of the Ways and Means Committee. I
think it is a tremendous success and a bipartisan success.
So I want to thank Chairman Frank Pallone and the chair of the Health
Subcommittee, Anna Eshoo; Ranking Member Walden and ranking member of
the Health Subcommittee, Mr. Burgess, for their hard work.
But I also do want to just take a moment to thank the staff on both
sides of the aisle. On the Democratic staff we have: Stephen Holland,
Jacquelyn Bolen, Kimberlee Trzeciak, Una Lee, Tiffany Guarascio, and
Waverly Gordon.
These bills will strengthen our healthcare workforce and increase
transparency in prescription drug prices. They are all critical. I am
very proud that we were able to work in a bipartisan way to, hopefully,
right now, have them pass.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentlewoman from Illinois (Ms. Schakowsky) that the House suspend the
rules and pass the bill, H.R. 1781, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
____________________