Payment Commission Data Act of 2019

Floor Speech

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 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.

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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.

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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.

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Mr. BURGESS. Mr. Speaker, I urge support of the underlying bill, and I yield back the balance of my time.

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