HHS says in the blueprint that it wants to...
1. Let Medicare Part D plans change covered drug lists if manufacturers jack up prices in the middle of the year. | POSSIBLE IMPACT ON YOU: Mid-year complaints.
2. Ease the quality rating rules for Medicare plans that refuse to let enrollees use expensive drugs. | POSSIBLE IMPACT ON YOU: Client complaints about denials.
3. Create a better drug pricing dashboard, so everyone knows what's happening to drug prices. | POSSIBLE IMPACT ON YOU: Client questions about the dashboard.
4. Look into the idea of covering packages, or 'bundles,' of goods and services that include drugs. | POSSIBLE IMPACT ON YOU: Clients may expect you to understand the bundles.
5. Look into the idea of making pharmacy benefits managers act as fiduciaries on behalf of the consumers, and put the consumers' interests first. | POSSIBLE IMPACT ON YOU: You'd get to watch PBMs deal with THEIR fiduciary rule.
6. Investigate whether manufacturer drug rebates and co-pay discount cards for consumers actually drive up prices. | POSSIBLE IMPACT ON YOU: Consumers might complain when their rebates and discount cards disappear.
7. Move toward increasing the amount of price information patients get when they're buying drugs. | POSSIBLE IMPACT ON YOU: Maybe you could somehow build the tools into your website.
President Donald Trump’s U.S. Department of Health and Human Services (HHS) has posted a 45-page document that could, eventually, affect trillions of dollars in spending, affect what drugs drug companies sell, and determine whether sick patients live or die.
The document is a blueprint for developing a strategy for lowering drug prices and reducing patients’ out-of-pocket spending on drugs.
The document is simply a policy statement and a list of questions. It will not officially start a rulemaking process. New regulations and policy changes may never show up. But, in theory, the blueprint could lead the way to major changes in how the U.S. health care system works.
A copy of the document is available here.
The blueprint is set to show up in the Federal Register, a government regulation publication, Wednesday.
Comments on the proposals and responses to HHS questions will be due 60 days after the official publication date.
Many of the proposed changes would have a direct effect only on drug manufacturers and large pharmacy benefits managers (PBMs).
Others, such as some of the proposed rule changes for Medicare Part D prescription drug plans, could affect insurance agents who sell Medicare drug plans and try to provide post-sale support for their customers.
We have listed seven changes that seem the most likely to affect agents in the idea “gallery” above. Just click on the arrows to see the idea cards.
— Read Rare Loss for U.S. Pharma Lobby Will Cost the Industry Billions, on ThinkAdvisor.