Congress

The final version of opioid legislation excludes brand-drug industry-backed Part D changes, and now brand lobbyists have set their sights on the lame-duck session for getting Congress to lower the industry’s share of seniors’ drug costs.

Bicameral negotiators left out of the final opioid legislation a pay-for that would have extended the time kidney-failure patients could stay on private insurance.

Pharmacists will be allowed to tell customers when it is cheaper to fill prescriptions without insurance after the president signs legislation the House has sent to him banning so-called gag orders.

Senate Minority Leader Chuck Schumer (D-NY) is the key lawmaker in brand drug makers’ play to get Congress to lower their share of seniors’ drug costs, sources on both sides of the lobbying effort say.

Rep. Suzan DelBene (D-WA) is drumming up support for a letter that will ask CMS to adjust the low-volume threshold in order to include more providers in the Merit-based Incentive Payment System as part of the final 2019 physician fee schedule – an agency move that would be supported by some stakeholders like Premier and the American Medical Group Association even though the American Medical Association and others want CMS to finalize the exemption as proposed.

Brand drug makers have inched closer to getting Congress to lower their share of seniors’ drug costs by adding to opioid legislation an unrelated package that combines the brand-backed Part D measure with watered-down pro-generic legislation and a provision that averts steep drug cost increases for seniors in 2020.

Brand drug makers have inched closer to getting Congress to lower their share of seniors’ drug costs by adding to opioid legislation an unrelated package that combines the brand-backed Part D measure with watered-down pro-generic legislation and a provision that averts steep drug cost increases for seniors in 2020.

CMS faces growing pressure to scrap its controversial plan to allow step therapy for Medicare Part B drugs: Dozens of specialty physician groups and state medical societies are seeking congressional leaders' help in getting the Trump administration to reverse course.

Despite being omitted from the Senate’s recently approved opioid bill, some rollback of a federal prohibition on using Medicaid funds to pay for substance-abuse treatment in large inpatient facilities may still be included in the final version of opioid legislation slated to be released in coming days, Senate aides say.