The Senate reached an agreement on the outstanding funding bills for this fiscal year, which include several NCPA priority PBM reform provisions. Under the agreement between Senate Democrats and the White House, the Senate voted to "break up" the existing funding package, taking the controversial Department of Homeland Security (DHS) bill out and passing a short-term continuing resolution (CR). The CR will give Congress two weeks to further negotiate on DHS funding. Due to congressional rules, everything must now go back to the House of Representatives. The vote was taken Friday night, after we finished producing the qAM edition for Monday.
While NCPA does not expect controversy in the House's re-vote on the remaining five funding bills packaged together (which initially passed 341 to 88 on Jan. 22), this situation is still very fluid. As the funding deadline was Friday at midnight, a large portion of the federal government is now under a government shutdown, and it's up to the House to vote on a combined package consisting of the larger funding package and the short-term CR for DHS. The House is expected to vote today, Feb. 3.
The Senate passed the remaining funding package, with the bills broken apart, by a vote of 71 to 29. The part of the bill funding the Department of Health and Human Services includes provisions requiring the Centers for Medicare & Medicaid Services (CMS) to define and enforce "reasonable and relevant" Medicare Part D contract terms, and gives the agency enforcement authority; promote transparency by allowing CMS to track payment trends to pharmacies and pharmacy inclusion in PBM networks, including a designation of essential retail pharmacies; and prohibit PBM compensation in Medicare Part D from being tied to the manufacturer's list price of a drug in an effort to reduce drug prices and save money for taxpayers.
