By Maddie Mason, Associate, Policy
The Senate Committee on Health, Education, Labor and Pensions released draft legislation on May 23, 2019 to reduce health care costs. The patient community has faced significant challenges due to the increasing out-of-pocket costs for health care products and services. The NHC submitted comments last week, applauding the Committee’s efforts to reduce health care costs and offering suggestions to strengthen the draft legislation.
The NHC urges the Committee to consider the implications this bill could have on patients, thus in our comments we offered the following recommendations on a variety of areas that have the potential to greatly impact patients.
Title I: Ending Surprise Medical Bills
Surprise medical bills from unknown, out-of-network services often place a heavy financial burden on patients. The NHC fully supports the Committee’s efforts to protect patients from paying higher costs for out-of-network services rendered while receiving care from an in-network facility. The NHC offered two considerations to further strengthen this title:
- The Committee should define (or provide reference for) what deems a patient as being “stable” to set a standard.
- The Committee should ensure that results from the proposed annual report on surprise medical bills are shared with states.
Title II: Reducing the Prices of Prescription Drugs
Prescription drug costs can place a significant financial burden on patients, especially those with complex conditions. The NHC supports the Committee’s commitment to avoiding delays in product availability by preventing gaming by bad actors, and the Committee’s efforts to implement safeguards for citizen petitions misused by stakeholders to delay, rescind, or withdraw a manufacturer’s drug application. The NHC suggested the following:
- The Committee should engage with stakeholders to create an effective literacy toolkit for patient and other audiences.
- The Committee should withdraw or provide justification for the provision to remove requirements that biologic products adhere to US Pharmacopeia (USP) public quality standards.
Title III: Improving Transparency in Health Care
Having access to clear and concise health care information is an important step toward giving patients the power to make informed health care decisions. The NHC supports the Committee’s provision that would ensure robust networks and prohibit anticompetitive practices that lead to the exclusion of providers. We also appreciate the Committee’s additional protections that would require health plans to have up-to-date directories of in-network providers or require health plans to make the information available to patients within 24 hours of a request. In addition, the NHC is supportive of the Committee’s inclusion of parameters that would require bills to be sent to patients in a timely matter and ensure enrollee access to cost-sharing information. The NHC suggested:
- The Committee should ensure that the entity selected to create and maintain the health care claims database makes the protection of patient privacy a top priority.
Title IV: Improving Public Health
It is important that public health initiatives aim to offer equitable opportunities for vulnerable populations and make investments toward long-term impacts on patient health. The NHC supports the Committee’s goals to improve awareness of vaccines and obesity and address the barriers regarding maternal health. The NHC offered the following comment:
- The Committee should require HHS to broadly disseminate research findings on maternal discrimination prevention in order to inform other health care specialties.
Title V: Improving the Exchange of Health Information
Ensuring that patient health information protections are included in legislation is a top priority of the NHC. The NHC applauds the Committee on their endeavor to improve security with increased access to online information. The NHC suggested the following:
- The Committee should work with stakeholders to establish parameters on how health plans provide patients with new information about their own services, provider networks and expected out-of-pocket costs.
- The Committee should require the GAO work with stakeholders to develop recommendations to address existing coverage gaps.