Senate Finance Committee leaders Friday released changes to the Prescription Drug Pricing Reduction Act that would eliminate impending Medicaid cuts to disproportionate share hospitals for two years, as advocated for by the AHA, and make permanent the Medicare payment adjustment for certain low-volume hospitals and the Medicare-Dependent Hospital Program.

The revised bill also would require states to report on non-DSH Medicaid supplemental payments; redefine Medicaid shortfall and third-party payments; require the Government Accountability Office to study and report on uncompensated care costs for disproportionate share hospitals; and increase Medicaid funding to U.S. territories for four years. In addition, the bill would extend the AHA-supported Community Mental Health Services Demonstration Program for two years and add 11 new states to the demonstration.

Among other changes, the bill would reduce beneficiary cost-sharing during the initial phase of the Part D benefit from 25% to 20% and require brand-name drugs to provide a 7% discount; reset the catastrophic discount to 14%; direct insurers to offer a cap on monthly out-of-pocket costs; and require Part D plans and pharmacy benefit managers to include concessions and fees negotiated with a pharmacy in the price beneficiaries pay at the pharmacy.    

The original bill cleared the committee in July.

Related News Articles

Headline
The AHA has released several resources that can be used to educate members of Congress and community stakeholders about the potential effects of harmful cuts…
Perspective
Public
The House Energy & Commerce Committee in just over a week is expected to mark up its portion of the budget reconciliation bill to enact key pieces of…
Headline
A study published April 28 by Health Affairs Scholar found low-income adults living in states with Medicaid expansion experienced an average 9.5% relative…
Headline
The AHA April 30 released a report highlighting how hospitals and health systems continue to experience significant financial headwinds that can challenge…
News
The AHA April 29 urged majority and minority leaders in both the Senate and House to not make disruptive policy changes to Medicaid and other coverage options…
Perspective
Public
One year ago, a nurse at Children’s Hospital Colorado went above and beyond in a way that a very young patient and her family will never forget. Kayla…