Mariam Eatedali Analyzes Legislation Aimed at Lowering Health Care Costs

June 10, 2019

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On May 23, the Senate Health, Education, Labor and Pensions (HELP) Committee released a discussion draft of the Lower Health Care Costs Act of 2019, which addresses pervasive, longtime issues within the U.S. health care system.

In a June 10 article for Fierce Healthcare, McGuireWoods Consulting research associate, Mariam Eatedali, analyzed the major components of the legislation, including health care pricing, technology and transparency.

Beginning with pharmaceutical companies and the prices they set, the bill addresses the entire supply chain of prescription drugs.

“The goal is to lower the price of prescription drugs themselves while also paving the way for biosimilars and generics to get to the market faster,” Eatedali said. “The legislation provides patent protections, not the regulation of drug prices, as a means of lowering drug costs.”

In addition, the legislation also covers surprise medical billing, and requires out-of-network providers practicing in in-network facilities to accept in-network rates.

“The legislation does not propose a way for out-of-network healthcare providers to be paid by insurers,” she said. “Instead, the bill contains three options for doing so. Sponsors will make a decision on which to include in the final bill after they have received comments on the draft.”

To further assist with lowering health care costs, the bill creates a third party, non-government entity to sift through patient data and create a price transparency database that patients, providers and payers can use. It also provides more use of and access to telehealth and allow patients access to their own claims data.

The Lower Health Care Costs Act of 2019 also responds to the recent rise of measles outbreaks and anti-vaccination messaging.

Eatedali noted, “the bill proposes that the Centers for Disease Control and Prevention award competitive grants to fund national campaigns aimed at increasing awareness of vaccines for the prevention and control of contagious diseases.”

The HELP Committee invited public comments on the discussion draft and the comment period concluded June 5 for further consideration.