PBM BILL ADVANCES — The Senate Finance Committee approved a legislative package Wednesday that aims to require more transparency from pharmacy benefit managers, POLITICO’s David Lim reports. The bill, which advanced 26-1, would place new requirements on contracts between Medicare Part D plan sponsors and pharmacy benefit managers, the so-called pharmacy middlemen who negotiate drug prices between manufacturers, insurers and government health providers like Medicare and Medicaid. The lone holdout was Sen. Ron Johnson (R-Wis.). If passed, the new requirements would mandate that payments to PBMs must be for a “bona fide service fee” not linked to a drug list price. Rebates, discounts and price concessions that result in a lower net cost for covered Part D drugs would still be allowed. ANOTHER TRANSPARENCY PACKAGE ADVANCES — The House Ways and Means Committee approved a health care package Wednesday on a party-line vote, POLITICO’s Megan Wilson reports. The partisan vote came after talks between Republicans and Democrats broke down last week. The 150-page bill includes proposals that would promote price transparency among hospitals, health plans and PBMs; require prior authorizations from Medicare Advantage plans to be handled electronically; and usher in site-neutral payment policies that ensure patients pay the same for a service regardless of where it’s performed. But Democrats were upset at the last-minute removal of a provision that aimed to reveal private equity ownership of hospitals and nursing homes after months of talks with Republicans on the issue. SENATE TO VA: DO MORE ON PACT ACT — Nearly a year after the PACT Act massively expanded health care for veterans exposed to burn pits and other toxic chemicals, key Senators say the VA needs to go further, POLITICO’s Ben Leonard reports. At a Wednesday hearing, Senate Veterans’ Affairs Committee Chair Jon Tester (D-Mont.) raised concerns about the complexity of the VA’s website. He and ranking member Jerry Moran (R-Kan.) said they hope to expand care for veterans who have had other types of chemical exposures not covered by the legislation. Moran raised concerns about claim backlogs. As of mid-July, the agency had received nearly 745,000 PACT Act–related claims. At the hearing, the VA touted “aggressive” hiring to help process the incoming claims but said there was a backlog of 243,000 as of June 30. The agency expects the backlog to grow into fiscal 2024 and then stabilize around 100,000 or less by 2025. “It’s a constant tension … to deliver timely benefits … while delivering them in a quality and accurate manner,” said Joshua Jacobs, VA under secretary for benefits. VA officials said they’re examining whether the department can establish new conditions covered under the act.
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