The Trump administration could release a proposed rule that aims to force hospitals to disclose payer-negotiated rates before the end of the year, White House Domestic Policy Council chief Joe Grogan said Friday.
"Hopefully we will have another announcement this month, maybe in December, but I am hopeful this month, that is going to gore a lot of oxen," Grogan told reporters at a briefing hosted by the Alliance for Health Policy.
The price transparency proposal was supposed to be included in the CMS' Outpatient Prospective Payment System final rule that came out Nov. 1, but was left out after significant backlash from hospitals and questions about CMS' legal authority to implement the measure. The agency said it received more than 1,400 comments on the idea. The CMS sent a separate price transparency rule to the U.S. Office of Management and Budget for review on Oct. 29.
The agency had hoped the transparency rule would drive down healthcare costs. When asked, Grogan said potential cost savings are unclear, but "could be huge."
Providers think that price transparency for negotiated rates could enable price-fixing conspiracies among commercial insurers. Grogan brushed off concerns that the end result will be higher rates.
"It will go out as proposed and we will solicit comment, and we may make changes by the time it hits final," Grogan said.
He also said he remains optimistic that Congress could pass major legislation addressing prescription drug prices and surprise medical bills this year.
"Everything is set up to do it. This is the right president to do it. This is a once-in-a-generation opportunity to confront these issues in a non-ideological fashion," Grogan said.
Grogan specifically named three bills as central to the administration's healthcare agenda: a plan by Senate Finance Chair Chuck Grassley (R-Iowa) and Sen. Ron Wyden (D-Ore.) to streamline Medicare's pharmacy drug benefit and create an out-of-pocket cap for beneficiary costs; legislation addressing surprise medical bills; and a bill by Grassley and Senate Minority Whip Dick Durbin (D-Ill.) to require drugmakers to disclose list prices in television advertisements, which mirrors a CMS rule that has so far been stymied in court.
While the White House has backed the Grassley-Wyden drug pricing package in its current form, Grogan made it abundantly clear that he opposed adding any kind of rebate reform to the package. He would rather focus on simplifying the Medicare Part D benefit and addressing retroactive fees pharmacy benefit managers charge pharmacies.
"If somebody has an easy legislative solution to the rebate problem I'm all ears, but I think they're not going to get there," Grogan said.
Grogan's statements contradict Grassley's office, which has said the Finance Committee chairman plans to include rebate reform in a new tweaked version of the legislation.
"Chairman Grassley continues to work in a bipartisan manner with ranking member Wyden on the issue of prescription drug prices, but we're not going to negotiate specifics through the news media," a Grassley spokesman said in response to Grogan's comments.
Insurers and hospitals detested the White House's failed version of rebate reform, which the administration withdrew after the Congressional Budget Office estimated it would cause premiums to rise in Medicare Part D.
