By Johanna Gray

It’s been a very busy month in DC, even separate from our Hill Day!  Here’s what we’ve been tracking: 

Public Health Emergency:  On July 25th, HHS Secretary Alex Azar extended the COVID public health emergency for up to an additional 90 days.  This means that the Medicare waivers related to telehealth and other reimbursement policies will continue at least into the fall.  Depending on where the country is related to COVID at the end of October, the public health emergency may be extended again.  We will keep you posted.     

Trump Administration Drug Pricing Executive Orders: Last week, President Trump released 3 executive orders (EO) and mentioned a 4th that he may sign later this summer.  All of these EOs call for policies that would have to be implemented via regulation or guidance, so there should be opportunities to comment on them before they are implemented.  Here are links to each EO with a brief summary of each from our initial review: 

1. Executive Order on Access to Affordable Life-saving Medications: This EO requires community health centers (CHCs) to price insulin and Epipens at 340B pricing (or actual acquisition, which may be only a penny) for low-income, or underinsured and uninsured people.  Enforcement would come from making it a component of their grant program.  The CHCs are very concerned about this proposal, since it would significantly reduce their program income, and they have existing sliding scale fee programs to reduce costs for low-income patients.
    
2. Executive Order on Increasing Drug Importation to Lower Prices for American Patients: This EO is trying to promote importation of some drugs from Canada, including insulin.
    
3. Executive Order on Lowering Prices for Patients by Eliminating Kickbacks to Middlemen: This directs HHS to finalize rulemaking that would require rebates in Medicare Part D to be passed onto patients, or else they would be found to be kickbacks.  
    
4. Implementing the International Pricing Index: The final EO was mentioned by President Trump but has not yet been released. This would promulgate the International Pricing Index policy first proposed in 2018 that would tie drug prices for Medicare Part B drugs to the prices paid in other countries.  President Trump has indicated that he will release this EO if he is not able to successfully negotiate with the pharmaceutical industry to lower prices directly.  More to come on this!

Congress Working on 5th COVID Package:  Finally, Congress has been negotiating its next large COVID package.  This week, Senate Republicans released 8 different bills that they would combine to make up the Health, Economic Assistance, Liability Protection and Schools (HEALS) Act.  Of note to Alliance members, the HEALS Act would extend current policies related to telehealth through the end of the 2020, or the end of the public health emergency, whichever comes later.  As of this writing, Senate Republicans, House Democrats and the White House have yet to reach agreement on what should be included in this next package, though there is pressure on them to act due to expiring unemployment insurance provisions from prior bills and the continued effects of COVID throughout the country.  Congress is hoping to pass a bill in the next few weeks before its August recess, but the different sides are far apart for now.  We will update you as the debate progresses.