Page 13 - 2017 V1 InsideOut

★ ★ ★ WashingtonUpdate Legislative acts and actions
HHS Secretary Price Confirmed:
Implications for Healthcare Industry, Stakeholders
by Brad Tallamy
In February, the Senate confirmed Tom Price, MD, as the new Secretary of Health and Human Services (HHS) after a lengthy, contentious and partisan debate. Serving in the House of Representatives for more than 12 years, Secretary Price most recently chaired the House Budget Committee and, as a retired orthopedic surgeon, is the first physician to lead the Agency in nearly 25 years.
Price’s confirmation was a microcosm of the ongoing and oftentimes rancorous debate surrounding the Affordable Care Act and the GOP’s plan to repeal and replace the contro- versial law. Senate Democrats repeatedly expressed concerns that a Price-led HHS would weaken the Affordable Care Act and make significant changes to Medicare, Medicaid, NIH, FDA, CDC, and other federal health programs under the sprawling agency’s purview.
Price is a fiscal conservative; his own Affordable Care Act repeal bill in Congress included replacing income-based subsidies with tax credits to purchase insurance, and he has supported the Medicare "premium support" concept, which Democrats consider anathema. Price also supports increased use of Health Savings Accounts.
Healthcare stakeholders are busy assessing how Price’s confirmation will affect the mar- ketplace. Price’s recent Budget Committee chairmanship and career in medicine offers some insight about what the specialty medicine community can expect in 2017 and for the foreseeable future.
the delivery of care.” While Price affirmed his commitment to preserve CMMI during his nomination process, we can expect future models to be limited in scope, voluntary and with congressional input.
Drug Importation
Increased congressional and stakeholder outrage over drug pricing typically cor- relates with a variety of drug importation proposals and this time is no different. Drug importation legislation in one form or another has been introduced
in almost every Congress since 1999. Congress passed legislation in 2000 and 2003 permitting personal importation from a limited number of countries — but only if the HHS Secretary certifies that the importation program will: (1) pose no additional risk to public health and safety; and (2) significantly reduce the cost of drugs to American consumers. To date, no HHS Secretary — Democrat or Republican — has agreed to provide this certification.
Value-Based Payment Reform
Price’s confirmation largely pleased the physician community, which is increasingly concerned about excessive reporting requirements. The American Medical Association (AMA) released a statement of support following Price’s nomination:
“The American Medical Association strongly supports the nomination of Dr. Tom Price to become the next Secretary of Health and Human Services (HHS). His service as a physician, state legislator and member of the U.S. Congress provides a depth of experience to lead HHS.”
— AMA
Price has been heavily involved with CMS’ implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the transition from fee-for- service to value-based reimbursement. Price joined a chorus of concerned providers in 2016 after the MACRA
final rule was released, stating that new,
burdensome reporting requirements threaten the doctor-patient relationship. We can safely assume that Price will help streamline and moderate implementation to ensure physicians — especially specialists — are equipped to adapt to the changing reality of payment reform.
Price has also been a vocal critic of recent, mandatory Centers for Medicare and Medicaid Innovation (CMMI) payment models. Referencing the Medicare Part B Payment Model, the Comprehensive Care Joint Replacement (CJR) Model and the Cardiac Bundled Payment Model, Price stated in a letter to CMS and CMMI that these models “were developed absent input from impacted stakeholders and fail to include safeguards to protect the delicate balance of quality, cost, and access to care for beneficiaries. These mandatory models overhaul major payment systems, commandeer clinical decision-making, and dramatically alter
Tom Price, MD, the new Secretary of HHS, is the first physician to lead HHS in almost 25 years.
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