October 28, 2019 - Issue: Vol. 165, No. 170 — Daily Edition116th Congress (2019 - 2020) - 1st Session

[Pages H8526-H8527]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  PAYMENT COMMISSION DATA ACT OF 2019

  Ms. SCHAKOWSKY. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1781) to amend titles XVIII and XIX of the Social Security 
Act to provide the Medicare Payment Advisory Commission and the 
Medicaid and CHIP Payment and Access Commission with access to certain 
drug payment information, including certain rebate information, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1781

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Payment Commission Data Act 
     of 2019''.

     SEC. 2. PROVIDING THE MEDICARE PAYMENT ADVISORY COMMISSION 
                   AND MEDICAID AND CHIP PAYMENT AND ACCESS 
                   COMMISSION WITH ACCESS TO CERTAIN DRUG PAYMENT 
                   INFORMATION, INCLUDING CERTAIN REBATE 
                   INFORMATION.

       (a) Access to Certain Part D Payment Data.--Section 1860D-
     15(f) of the Social Security Act (42 U.S.C. 1395w-115(f)) is 
     amended--
       (1) in paragraph (2)--
       (A) in subparagraph (A)(ii), by striking ``and'' at the 
     end;
       (B) in subparagraph (B), by striking the period at the end 
     and inserting ``; and''; and
       (C) by inserting at the end the following new subparagraph:
       ``(C) by the Executive Director of the Medicare Payment 
     Advisory Commission for purposes of monitoring, making 
     recommendations, and analysis of the program under this title 
     and by the Executive Director of the Medicaid and CHIP 
     Payment and Access Commission for purposes of monitoring, 
     making recommendations, and analysis of the Medicaid program 
     established under title XIX and the Children's Health 
     Insurance Program under title XXI.''; and
       (2) by adding at the end the following new paragraph:
       ``(3) Additional restrictions on disclosure of 
     information.--The Executive Directors described in paragraph 
     (2)(C) shall not disclose any of the following information 
     disclosed to such Executive Directors or obtained by such 
     Executive Directors pursuant to such paragraph, with respect 
     to a prescription drug plan offered by a PDP sponsor or an 
     MA-PD plan offered by an MA organization:
       ``(A) The specific amounts or the identity of the source of 
     any rebates, discounts, price concessions, or other forms of 
     direct or indirect remuneration under such prescription drug 
     plan or such MA-PD plan.
       ``(B) Information submitted with the bid submitted under 
     section 1860D-11(b) by such PDP sponsor or under section 
     1854(a) by such MA organization.
       ``(C) In the case of such information from prescription 
     drug event records, in a form that would not be permitted 
     under section 423.505(m) of title 42, Code of Federal 
     Regulations, or any successor regulation, if made by the 
     Centers for Medicare & Medicaid Services.''.
       (b) Access to Certain Rebate and Payment Data Under 
     Medicare and Medicaid.--Section 1927(b)(3)(D) of the Social 
     Security Act (42 U.S.C. 1396r-8(b)(3)(D)) is amended--
       (1) in the matter before clause (i), by striking 
     ``subsection (a)(6)(A)(ii)'' and inserting ``subsection 
     (a)(6)(A)'';
       (2) in clause (iv), by striking ``and'' at the end;
       (3) in clause (v), by striking the period at the end and 
     inserting ``, and'';
       (4) by inserting after clause (v) the following new clause:
       ``(vi) to permit the Executive Director of the Medicare 
     Payment Advisory Commission and the Executive Director of the 
     Medicaid and CHIP Payment and Access Commission to review the 
     information provided.'';
       (5) in the matter at the end, by striking ``1860D-
     4(c)(2)(E)'' and inserting ``1860D-4(c)(2)(G)''; and
       (6) by adding at the end the following new sentence: ``Any 
     information disclosed to the Executive Director of the 
     Medicare Payment Advisory Commission or the Executive 
     Director of the Medicaid and CHIP Payment and Access 
     Commission pursuant to this subparagraph shall not be 
     disclosed by either such Executive Director in a form which 
     discloses the identity of a specific manufacturer or 
     wholesaler or prices charged for drugs by such manufacturer 
     or wholesaler.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Illinois (Ms. Schakowsky) and the gentleman from Texas (Mr. Burgess) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from Illinois.


                             General Leave

  Ms. SCHAKOWSKY. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 1781.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Illinois?
  There was no objection.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise in support of H.R. 1781, the Payment Commission 
Data Act of 2019.
  This bill will provide the Medicare Payment Advisory Commission, 
otherwise known as MedPAC, and the Medicaid and CHIP Payment and Access 
Commission, MACPAC, with access to drug pricing and rebate data under 
Medicare parts B and D, as well as under Medicaid.
  MedPAC and MACPAC are independent, nonpartisan commissions that 
advise Congress on issues affecting the Medicare and Medicaid programs. 
Currently, MedPAC and MACPAC lack access to this drug pricing data and 
are limited in their ability to provide information to Congress on the 
skyrocketing costs of prescription drugs.
  H.R. 1781 is a simple but critical fix to ensure that the commissions 
have access to this data in order to analyze and report to Congress on 
these urgent issues.
  Mr. Speaker, I urge my colleagues to support this bill, and I reserve 
the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 1781, the Payment Commission 
Data Act of 2019, which was introduced by my colleague, Representative 
Carter of Georgia. This bill provides the Medicare Payment Advisory 
Commission, colloquially known as MedPAC, and the Medicaid and CHIP 
Payment and Access Commission, affectionately known as MACPAC, with 
access to certain drug payment information.
  MedPAC is an independent congressional agency that serves to advise 
Congress on issues affecting the Medicare program. And MACPAC is a 
nonpartisan legislative branch agency that provides policy and data 
analysis and makes recommendations to Congress on issues affecting 
Medicaid and the State Children's Health Insurance Program.
  The issue was brought to our attention that despite getting similar 
data, such as plan bid data, we were surprised to learn that while this 
data could be shared by the Center for Medicare and Medicaid Services 
with the Government Accountability Office and the Congressional Budget 
Office, it could not be shared with MedPAC or MACPAC, leading us to 
this effort to correct this in a bipartisan way through H.R. 1781.
  By providing these entities with drug payment and drug rebate 
information, MedPAC and MACPAC will be better able to analyze the drug 
cost data in the Medicare and Medicaid programs. Therefore, these 
commissions will be able to make better recommendations to Congress on 
how to address drug pricing based on accurate and factual data.
  In a letter from MedPAC to Chairman Pallone, Chairwoman Eshoo, 
Republican Leader Walden, and myself in March, MedPAC said that ``a 
statutory change giving us access to these data would enhance our 
capabilities for assisting the Congress on issues relating to 
prescription drug costs.'' The letter further outlines a number of ways 
that this data would help MedPAC support Congress and serve the 
commission's intended purpose.
  Mr. Speaker, I include in the Record their letter.
                                         Medicare Payment Advisory


                                                   Commission,

                                   Washington, DC, March 26, 2019.
     Re: Drug pricing and rebate data
     Hon. Frank Pallone, Jr.,
     Chairman, Committee on Energy and Commerce,
     House of Representatives, Washington, DC.
     Hon. Anna G. Eshoo,
     Chairman, Subcommittee on Health, Committee on Energy and 
         Commerce,
     House of Representatives, Washington, DC.
     Hon. Greg Walden,
     Ranking Member, Committee on Energy and Commerce,
     House of Representatives, Washington, DC.
     Hon. Michael C. Burgess, M.D.,
     Ranking Member, Subcommittee on Health, Committee on Energy 
         and Commerce,
     House of Representatives, Washington, DC.
       Dear Chairmen and Ranking Members: The Medicare Payment 
     Advisory Commission (MedPAC) is an independent, legislative 
     branch agency established by the Balanced Budget Act of 1997 
     (P.L. 105-33) to provide expert policy and technical advice 
     to the Congress on issues affecting the Medicare program. 
     Medicare spending has grown substantially over the last 
     decade, particularly for

[[Page H8527]]

     prescription drugs, placing an increasing financial burden on 
     the taxpayers and beneficiaries who finance it. Congress 
     plays a vital role in overseeing Medicare and solving these 
     fiscal challenges so that the program remains secure for 
     current and future beneficiaries. MedPAC serves as an 
     important source of information and advice to the Congress as 
     it exercises that oversight. To enable MedPAC to best advise 
     the Congress on how to address the problems stemming from the 
     high and rising costs of prescription drugs, I am writing to 
     request a narrow change in law that would grant MedPAC staff 
     access to important drug pricing and rebate data that other 
     congressional agencies are already able to use. The change in 
     statute is necessary because MedPAC is unable to access the 
     data under existing statutory authority.
       MedPAC uses a wide variety of data in order to support the 
     Congress' oversight of Medicare, and the Commission has a 
     strong track record of protecting different types of 
     proprietary and confidential information. For example, MedPAC 
     uses and keeps secure the bids that private insurance plans 
     submit under Medicare Parts C and D, data that Medicare 
     Advantage plans submit on encounters between beneficiaries 
     and their health care providers, and data on beneficiaries' 
     use of prescription drugs.
       To ensure that the Congress has comprehensive and up-to-
     date information, MedPAC strives to use all available data 
     pertinent to our analyses. The Commission uses these data to 
     provide information to the Congress on spending by Medicare 
     and its beneficiaries and to help the Congress develop 
     policies to improve the value of taxpayer dollars used to 
     finance the program. MedPAC delivers this information in 
     mandated reports, congressional testimony, and frequent 
     briefings to congressional staff.
       The large growth in drug spending has been a key 
     contributor to the financial strain on Medicare and its 
     beneficiaries. Today, Medicare spends more than $100 billion 
     annually on prescription drugs under Parts B and D, and 
     beneficiaries are exposed to more than $20 billion in cost 
     sharing liability. Of particular concern is the growing 
     number of beneficiaries who are exposed to very large cost 
     sharing amounts when they take extremely high-priced drugs.
       Despite broad data access under its authorizing statute, 
     MedPAC is unable to access important drug pricing and rebate 
     information under Medicare Parts B and D, and under Medicaid, 
     because of how specific places of the Social Security Act are 
     constructed (for example, MedPAC is not specifically named in 
     Section 1927(b)(3)(D) of the Social Security Act as one of 
     the entities with access to certain data detailing how much 
     the Medicare program and its beneficiaries pay for 
     prescription drugs). Because we lack these important data, we 
     have been limited in the analysis and information we can 
     provide to the Congress as it grapples with how to bring down 
     the prices of drugs for beneficiaries and taxpayers. A 
     statutory change giving us access to these data would enhance 
     our capabilities for assisting the Congress on issues related 
     to prescription drug costs.
       With these data, MedPAC staff could:
       Assist Congress in understanding the true costs (net of 
     rebates) of prescription drugs to beneficiaries and taxpayers 
     under the Medicare program.
       Evaluate different policy options that aim to bring down 
     the prices of drugs and the cost sharing that beneficiaries 
     face for their medicines at the point of sale.
       Provide insight into how Part D plans manage the growth in 
     drug prices.
       Analyze the effects of market entry and competition on drug 
     prices.
       MedPAC looks forward to continuing to support the Congress 
     in developing approaches to payment that ensure beneficiary 
     access to important therapies, while reducing costs for the 
     Medicare program and its beneficiaries. I very much 
     appreciate your consideration of this request for this 
     statutory change, and I also appreciate the support that the 
     Congress has long given to the Commission.
           Sincerely,
                                         Francis J. Crosson, M.D.,
                                                         Chairman.

  Mr. BURGESS. Mr. Speaker, this bill continues the work of the Energy 
and Commerce Committee last Congress where we marked up a discussion 
draft of this very bill at the Health Subcommittee, which I chaired. 
Drug pricing remains an issue for patients in the United States and 
this bill will allow the House to act on factual analysis and 
recommendations to help lower drug prices for Americans.
  Mr. Speaker, I urge fellow Members to support H.R. 1781, and I 
reserve the balance of my time.
  Ms. SCHAKOWSKY. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I am pleased to yield 5 minutes to the 
gentleman from Georgia (Mr. Carter), the principal author of this bill 
and a valuable member of the Health Subcommittee of the Committee on 
Energy and Commerce.
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker, I rise to speak in support of my bill, H.R. 1781, the 
Payment Commission Data Act.
  Last year, the Medicare Payment Advisory Commission, MedPAC, and the 
Medicaid and CHIP Payment Advisory Commission, MACPAC, who serve as 
nonpartisan advisory panels to Congress, came to us with a problem: 
They did not have the data needed to fully study prescription drug 
rebates.
  This bill ensures MedPAC and MACPAC have access to the data they need 
to make informed recommendations to Congress. This increase in 
transparency is extremely helpful in allowing MedPAC and MACPAC to 
analyze how competition in our drug market is currently working and how 
part D plans are managing the growth in drug prices. They will be able 
to turn that new knowledge into improved policy recommendations on how 
we, as Congress, can bring down the price of drugs for patients.
  Simply put, this bill is just good governance.
  Importantly, I think this bill, as well as the bill we just spoke 
about, H.R. 2115, are shining examples of what is possible when 
Republicans and Democrats are working together to lower the cost of 
drugs for patients.
  In the Energy and Commerce Committee, we have worked all year to 
advance a number of good, bipartisan drug policies that could make a 
difference for patients.

                              {time}  1945

  Looking across the Capitol, there are dozens more bipartisan reforms 
that I think could get robust support here in the House.
  The issue of prescription drug costs is simply too important to be 
sacrificed in the name of electoral politics. Today is proof that we 
can, in fact, pass bipartisan drug pricing reforms.
  So I call on my colleagues on the other sides of the aisle: Let's 
build on today and continue advancing the bipartisan policies we know 
can become law and actually make a difference for patients in the 
country.
  I want to thank my friend and colead, Representative Tom O'Halleran, 
as well as Representatives Rice, Panetta, Gianforte, and Welch for 
their leadership on this bill.
  I urge my fellow Members to support transparency in our drug supply 
chain and to support H.R. 1781.
  Mr. BURGESS. Mr. Speaker, I urge support of the underlying bill, and 
I yield back the balance of my time.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, I would like to point out that this evening, early 
evening and now, we have passed a total of five pieces of legislation, 
a couple of which were also out of the Ways and Means Committee. I 
think it is a tremendous success and a bipartisan success.
  So I want to thank Chairman Frank Pallone and the chair of the Health 
Subcommittee, Anna Eshoo; Ranking Member Walden and ranking member of 
the Health Subcommittee, Mr. Burgess, for their hard work.
  But I also do want to just take a moment to thank the staff on both 
sides of the aisle. On the Democratic staff we have: Stephen Holland, 
Jacquelyn Bolen, Kimberlee Trzeciak, Una Lee, Tiffany Guarascio, and 
Waverly Gordon.
  These bills will strengthen our healthcare workforce and increase 
transparency in prescription drug prices. They are all critical. I am 
very proud that we were able to work in a bipartisan way to, hopefully, 
right now, have them pass.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from Illinois (Ms. Schakowsky) that the House suspend the 
rules and pass the bill, H.R. 1781, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________