TELEHEALTH BILL GETS STEEP PRICE TAG — Legislation that’s a top priority of the telehealth industry took a blow Monday, when the Congressional Budget Office estimated it would cost $5.05 billion. The Telehealth Expansion Act of 2023 would permanently allow high-deductible health plans to offer telehealth before patients hit their deductible. Congress extended a pandemic-era provision allowing the plans to do so through the end of 2024. According to the CBO, the steep costs would come from lost revenue from Social Security payroll tax collections. It’s another blow for the legislation, which already faced significant Democratic opposition despite having six Democratic co-sponsors and widespread industry support. Democrats have been less enthusiastic about boosting high-deductible health plans than Republicans, arguing they amount to workarounds to the Affordable Care Act that primarily benefits wealthier people. The House Ways and Means Committee advanced the legislation with five Democrats joining Republicans earlier this month, but Democratic leadership — committee ranking member Richard Neal of Massachusetts and Health Subcommittee ranking member Lloyd Doggett of Texas — voted against it, raising concerns about cost. This score likely won’t help. More than 30 million Americans are on high-deductible plans and face uncertainty about their telehealth access after 2024. BIGGER PAHPA, PLEASE — Energy and Commerce Committee ranking member Frank Pallone (D-N.J.) renewed on Monday his push to tackle drug shortages as a part of reauthorizing the Pandemic and All-Hazards Prevention Act. In a statement, Pallone called on the committee’s Republicans to give the FDA new authority to deal with the shortages. “Republican Committee leaders’ assertions that PAHPA shouldn’t include FDA-related policy do not make sense and defy reality considering all previous PAHPAs have included FDA policy,” Pallone said. “The initial PAHPA included a provision requiring FDA to prepare for shortage issues that might arise, and all previous reauthorizations have included FDA-related policy.” Committee Chair Cathy McMorris Rodgers (R-Wash.) has opposed Democrats’ efforts to use PAPHA to expand the FDA’s authority. "E&C Republicans are committed to reauthorizing these key all-hazards and public health security programs on time,” an Energy and Commerce GOP aide told Pulse. “Staying focused on the policies that are under the existing framework is the best way forward to see a bill signed into law before September 30th.” What’s next: Partisan tensions brewed in a subcommittee hearing last month. Lawmakers have a Sept. 30 deadline to act. Rodgers has requested information on how to address drug shortages. CMS FLOATS PEDIATRIC PAY BOOST FOR DIALYSIS — CMS proposes slightly increasing Medicare payments to dialysis centers for treating children amid other payment reforms, POLITICO’s Robert King reports. The agency released its proposed 2024 End-Stage Renal Disease Prospective Payment System rule that lays out dialysis-care payments for Medicare beneficiaries. Overall, the agency proposes a 1.6 percent increase for dialysis facilities next year, with a 2.6 percent bump for hospital-based clinics and 1.6 percent for freestanding facilities. Medicare pays for dialysis services under Part B and for eligible children. However, the agency acknowledged that treatment for such a patient population “tends to be especially complex and costly,” according to a fact sheet in the rule. The agency proposed an additional payment from 2024 through 2026 for all pediatric dialysis cases. CMS proposed to add 30 percent of the total per treatment amount to help cover the extra costs. CMS also wants to increase payments for new renal disease drugs and biologics. Currently, Medicare offers an add-on payment for new renal disease pharmaceuticals for two years after they hit the market. However, the agency wants to extend such payments for another three years.
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