Senate Bill Would Add PACE Program to 340B

by admin | October 14, 2011 7:41 pm

October 14, 2011—U.S. Sen. Herb Kohl (D-Wisc.) is urging the congressional “super committee” on deficit reduction to save tax dollars by expanding 340B drug discounts to more than 160 programs in 29 states that help seniors needing nursing home care remain in their own homes for as long as possible. In a letter to the deficit panel, Kohl, the chairman of the Special Committee on Aging, explained that under his plan the programs would keep only 10 percent of their 340B savings, with the rest going to shore up Medicare.

Meanwhile, Sen. Tom Harkin (D-Iowa), who heads the Health, Education, Labor and Pensions Committee as well as the Appropriations Subcommittee on Labor, Health and Human Services, and Education, also wrote to the super committee urging it to achieve budget saving by extending the 340B program to the hospital inpatient setting. Bipartisan legislation to do sohas already been introduced in the House[1] and is expected to be filed in the Senate before the end of this year.

Kohl’s proposed Prescription Drug Cost Control Act (S. 1699) would add the 75 organizations that offer services under the federal Program of All-Inclusive Care (PACE) to the list of 340B covered entities. According to the National PACE Association, about 23,000 seniors are enrolled nationwide, most of them dually eligible for Medicare and Medicaid. Their average age is 80, many have multiple chronic conditions and about half have been diagnosed with dementia. PACE enrollees now get their prescription drugs through Medicare Part D.

Under Kohl’s bill, PACE providers that serve Part D eligible individuals would have to participate in 340B. The Department of Health and Human Services (HHS) also would have to develop a way to ensure that 340B discounts and Part D rebates are not provided on the same PACE drugs.

Groups bidding to operate a PACE program would have to include an estimate of their annual 340B savings in their submissions. Ninety percent of their 340B savings would stay with the federal government to help finance Medicare. The PACE programs would be able to get the remaining 10 percent by submitting plans to HHS showing how they would use the funds to improve patient services and health information technology.

Kohl’s bill would also attempt to rein in federal drug costs by requiring drug manufacturers to pay rebates on Medicare Part B drugs, letting the federal government negotiate a drug’s Part B price if it is the drug’s biggest buyer, and giving the government the lowest price among functionally equivalent Part B drugs.

In his letter to the super committee, Kohl also recommended letting the government negotiate Medicare Part D drug prices, requiring manufacturers to pay rebates on Part D drugs for beneficiaries dually eligible for Medicare and Medicaid, and ending so called “pay-for-delay” settlements that keep generic drugs off the market.

Rep. Henry Waxman (D-Calif.), the senior Democrat on the House Energy and Commerce Committee, also wrote to the super committee endorsing Part D rebates and excoriating “pay-for-delay” deals, as did Rep. Elijah Cummings (D-Md.), the ranking member of the Oversight and Government Reform Committee. Cummings also asked the committee to consider letting the government negotiate Part D drug prices and letting the Office of Personnel Management contract directly with pharmacy benefits managers to obtain lower drug prices for federal workers, retirees and dependents.

Pharmaceutical manufacturers oppose most of these proposals and have been especially critical of calls for rebates on Part D drugs.

Source URL: https://340bemployed.org/senate-bill-would-add-pace-program-to-340b/

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