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The ins and outs of the new House health package
House Republicans on three panels circulated a draft health price transparency package with some reforms to payment practices of PBMs and hospitals, I reported yesterday. A big caveat: Democrats aren’t necessarily on board, and changes could still come before the bill’s expected introduction on Friday.
Some major provisions stayed in, including a small site-neutral pay policy to equalize payment for administering medications regardless of location, and another that would ban PBMs from charging Medicaid more than they pay pharmacies for drugs. It also featured a provision that will require health insurance companies and PBMs to issue reports to the employers that hire them, which comes after a STAT investigation showed consulting firms routinely take large sums from PBMs and then direct employers to those PBMs, creating clear conflicts of interest.
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