A U.S. House Energy & Commerce subcommittee plans next week to markup bills on transparency and competition in health care and send them to the full committee for votes before Memorial Day. Although its Republican vice chair’s draft 340B bill was on the agenda for a late April hearing, the subcommittee will not move any 340B legislation in May, sources said.
A spokesperson for the E&C Republican majority did not respond to a request for comment yesterday about reports that the E&C health subcommittee will hold a markup hearing on May 17, followed by a full committee hearing on May 24 to vote on the bills. Neither session had been officially announced as of early this morning.
Sources say E&C Health Chair Brett Guthrie (R-Ky.) is firm that his subcommittee will not act on 340B legislation if it lacks bipartisan support.
The subcommittee held hearings on March 28 and April 26 and 340B was discussed at length during both. The panel released 17 actual and draft bills in conjunction with the second hearing, including Vice Chair Larry Bucshon’s (R-Ind.) draft bill to impose new reporting requirements on disproportionate share hospitals and potentially other covered entities as well.
News surfaced last week that E&C full committee member Doris Matsui (D-Calif.) is working on legislation to prohibit drug manufacturer restrictions on 340B covered entities’ use of contract pharmacies. The American Hospital Association and hospital group 340B Health both said they back Matsui’s bill. Both previously said the time was not ripe yet for Congress to get involved.
340B Truth Webinar on Thursday
Ad hoc groups of 340B covered entities and consultants, meanwhile, are seeking consensus on how best to end the nearly three-year-old fight over the use of 340B discounts in the contract pharmacy setting. Their talks include how to answer calls for more accountability from hospitals about how they use 340B program earnings. One of the groups, 340B Truth, is holding a webinar Thursday to release and get feedback on its executive leadership team’s proposal.
Pharmaceutical Research and Manufacturers of America and the National Association of Community Health Centers announced in March that they co-wrote and formed an alliance to promote 10 core principles to guide federal 340B legislation. Their agenda partly overlaps with Bucshon’s bill but is more punishing for DSH hospitals. Legislation to enact the PhRMA/NACHC plan hasn’t been introduced yet. The groups seem to be focused now on gaining converts to their cause.
Reps. Abigail Spanberger (D-Va.) and Dusty Johnson (R-S.D.) last month reintroduced the PROTECT 340B Act—a bipartisan bill to shield 340B covered entities and contract pharmacies from discrimination by insurers and pharmacy benefit managers. AHA, America’s Essential Hospitals, 340B Health, and NACHC support its passage. The bill had 115 sponsors during the last session of Congress. It has six so far in this session.
In the Senate, Sen. Mike Braun (R-Ind.) reportedly planned on May 2 to offer a 340B amendment to a pharmacy benefit management reform bill. The Health, Education, Labor, and Pensions Committee hearing was recessed amid Republican procedural complaints. According to news organization STAT, Braun’s amendment “would make hospitals that serve uninsured and underinsured patients disclose how they use discounts that drug companies are required to provide.” The hearing is scheduled to resume on Thursday at 10 a.m. Eastern.
Health Resources and Services Administration Administrator Carole Johnson told the E&C health subcommittee on April 19 that HRSA would welcome congressional help ensuring there is “accountability and transparency” in the 340B program. Health and Human Services Secretary Xavier Becerra told the Senate Finance Committee on March 29 that the 340B program “doesn’t have the transparency we need” and “we are going to do what we can to make it more transparent.” The next day, Braun reintroduced his bill from the last session of Congress to require all 340B covered entities to let HHS audit, at HHS’s expense, “the records of the entity to determine how net income from purchases under this section are used by the covered entity.” Braun’s bill also would require entities to “retain such records and provide such records and reports” as HHS determines necessary.