[Congressional Record Volume 165, Number 185 (Tuesday, November 19, 2019)]
[House]
[Pages H8961-H8962]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 RECOGNIZING NATIONAL RURAL HEALTH DAY

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Pennsylvania (Mr. Thompson) for 5 minutes.
  Mr. THOMPSON of Pennsylvania. Mr. Speaker, I rise today to recognize 
November 21 as National Rural Health Day.
  Nearly 60 million Americans call rural America home. It is a great 
place to live, to work, and to raise a family.
  To ensure the vitality and vibrancy of rural America, investments in 
infrastructure, technology, and healthcare are critical. Americans in 
every corner of the Nation deserve access to reliable, quality 
healthcare, but rural America faces its own unique health challenges 
that need to be addressed.
  Sadly, rural Americans are more likely than those in urban areas to 
die prematurely from heart disease, cancer, unintentional injury, 
chronic lower respiratory disease, and stroke, the Nation's five 
leading causes of death.
  Rural America is no stranger to healthcare struggles, including long

[[Page H8962]]

distances to the closest hospital, many uninsured or underinsured 
residents, and a larger number of aging residents with chronic 
conditions.
  Another issue is simply the lack of doctors and providers. There are 
only 40 physicians for every 100,000 people in rural America. This 
leads to unserved patients and overworked medical professionals.
  One way to address these issues is through telemedicine. Telemedicine 
can reduce healthcare barriers, increase access, and bolster 
convenience for millions of Americans.
  Telemedicine is critical in ensuring increased access to care for 
Americans who live many miles away from a hospital or a doctor's 
office. It can also make a difference in the lives of limited-mobility 
Americans, like those who may be elderly or living with different types 
of disabilities.
  Another way to improve the health of rural Americans who may be 
considered low-income is to address out-of-pocket costs for Medicaid 
expenses.
  Something that needs to be addressed for seniors in not only rural 
America but also across the country is the misuse of direct and 
indirect remuneration, or DIR, and how it has impacted the part D drug 
plans. Over the years, DIR has become a catchall for pharmacy fees, 
which has unfairly shifted additional costs onto Medicaid patients.
  While progress has been made with the 2018 Medicare part D pricing 
rule, there is still much more to be done. That is why I cosponsored 
H.R. 1034, the Phair Pricing Act. This bill directly addresses 
necessary reforms to DIR fees by doing four key things.
  First, the Phair Pricing Act will require all price concessions 
between a pharmacy and a pharmacy benefits manager be included at the 
point of sale to decrease patient costs.
  Second, the bill will realign market incentives to ensure patients 
have access to and receive the best possible care.
  Third, the Phair Pricing Act will direct the Secretary of Health and 
Human Services to establish a working group of stakeholders to create 
quality measures based on a pharmacy's practice.
  Lastly, the bill would ensure pharmacy benefits managers disclose all 
fees, price concessions, and programs to the Centers for Medicare and 
Medicaid Services.
  Mr. Speaker, rural Americans deserve the best medical care available, 
and we can improve options for them and for all Americans through 
commonsense, bipartisan solutions like investments in telemedicine and 
legislation like the Phair Pricing Act.

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