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Proposed Medicare Commission Has Targets For Cutting Excess Cost Growth

Executive Summary

The Medicare cost control commission described in Sen. Max Baucus' health reform bill could save the government $22.6 billion by 2019, according to a score by the Congressional Budget Office and Joint Committee on Taxation, partly because it has specific targets for reducing excess cost growth in the program

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Health Care Reform Markups In Brief

PBM transpanancy amendment adopted: An amendment requiring certain data from pharmacy benefit managers working with plans operating in the health insurance exchange that would be created under reform legislation was adopted during markup in the Senate Finance Committee. The amendment, introduced by Sen. Maria Cantwell, D-Wash., would require PBMs to disclose to the exchange plans that they contract with the percent of all prescriptions that are provided through retail and mail-order pharmacies and the generic dispensing and substitution rates at each location; the aggregate amount and types of rebates, discounts and price concessions PBMs negotiate on behalf of plan sponsors and how much of that amount is passed through to the plan sponsors; and the average aggregate difference between the amount the plan pays the PBM and the amount the PBM pays the retail and mail-order pharmacy. Cantwell said the amendment is not expected to require an offset, but the Pharmaceutical Care Management Association, which represents PBMs, said previous Congressional Budget Office scores of similar language could increase drug costs as much as $10 billion

Health Care Reform Markups In Brief

PBM transpanancy amendment adopted: An amendment requiring certain data from pharmacy benefit managers working with plans operating in the health insurance exchange that would be created under reform legislation was adopted during markup in the Senate Finance Committee. The amendment, introduced by Sen. Maria Cantwell, D-Wash., would require PBMs to disclose to the exchange plans that they contract with the percent of all prescriptions that are provided through retail and mail-order pharmacies and the generic dispensing and substitution rates at each location; the aggregate amount and types of rebates, discounts and price concessions PBMs negotiate on behalf of plan sponsors and how much of that amount is passed through to the plan sponsors; and the average aggregate difference between the amount the plan pays the PBM and the amount the PBM pays the retail and mail-order pharmacy. Cantwell said the amendment is not expected to require an offset, but the Pharmaceutical Care Management Association, which represents PBMs, said previous Congressional Budget Office scores of similar language could increase drug costs as much as $10 billion

IMAC Absent From Energy & Commerce Reform Bill; White House Still Pushing

Health reform legislation emerging from the House Energy and Commerce Committee does not include a provision establishing a new executive branch agency to guide Medicare payment policy and reform - despite earlier statements from committee Chairman Henry Waxman, D-Calif., indicating it would

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