Welcome to the House Committee on Energy and Commerce

WASHINGTON, D.C. – Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, delivered the following opening statement at today’s hearing titled Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain.

Subcommittee Chairman Griffith’s opening statement as prepared for delivery:

“First, I want to recognize the bipartisan bill that we were able to pass last week that included many important health care provisions and lowered health care costs for all Americans.

“Today, we will discuss health care costs and patient access challenges by examining affordability across the entire pharmaceutical supply chain.

“I’m proud of this subcommittee’s work, but there is still more to be done, which is why I am eager to continue building on our affordability series with today’s hearing that comes after we heard from insurance executives last month.

“We now will hear from stakeholders who are part of the complex pharmaceutical drug supply chain.

“To regular people, this system may seem simple: a disease is researched and a treatment is developed, then that treatment is manufactured and distributed to a hospital, pharmacy, or other health entity before it is dispensed to a patient.

“However, there are many more layers that are involved in this process that affect how a drug gets to a patient and how that drug is priced.

“One of the most frustrating aspects of the supply chain is that it operates in a blackbox.

“Luckily, we have witnesses here to provide their perspectives and shine a light on the process.

“Do each of these entities in front of us today play a role in getting the drug to a patient? Yes.

“Are there too many cooks in the kitchen at times? Probably so.

“Today is a great opportunity for Congress to get a glimpse and see what is happening, and look for ways to help make prescription drugs more affordable.

“In 2017, this same subcommittee held a hearing similar to this one.

“A lot has changed since then.

“I am glad we are reexamining what we learned from that hearing to continue working towards what we all want: lowering costs for patients while ensuring that America remains a leader in pharmaceutical innovation.

“We have PhRMA and BIO in front of us who can speak to the intricacies that go into researching, developing, and pricing a drug on the market.

“We will also get the perspective of generic drugs from the Association for Accessible Medicines who can speak on the issues in that area.

“We also have the Pharmaceutical Care Management Association here who is the trade association that represents pharmaceutical benefit managers, or PBMs.

“In theory, PBMs manage prescription drug benefits for insurance companies, employers, and others.

“What we heard in our hearing last month is that insurance companies own many PBMs.

“The largest three insurance owned PBMs control over 80 percent of the market.

“How they manage these benefits is a mystery and can lead to higher drug prices.

“However, just last week, led by Representative Buddy Carter from Georgia, Congress passed and the President signed into law the biggest PBM reform package in history.

“These bills will bring more transparency into this system, lower costs, and allow for more access to medicines.

“The Healthcare Supply Chain Association is here on behalf of Group Purchasing Organizations, or GPOs, which act as intermediaries between manufacturers and providers.

“In front of us is also the Healthcare Distribution Alliance, who is involved in the distribution of prescription drugs along the supply chain.

“I am looking forward to hearing from the National Community Pharmacists Association who is before us today as well, since they represent community pharmacists.

“These community pharmacies serve a critical role in bringing care to patients, especially in rural areas; yet, many have had to sadly close their doors in recent years due to factors we will discuss today.

“The ERISA Industry Committee is also here to discuss their point of view for employers when it comes to high costs, as well as decisions they make based on those costs.

“Each of these different entities play a unique role in how a drug finally gets to a patient.

“In this meeting, we will hear from these witnesses on how to navigate this complex web on behalf of the American people.

“I look forward to the discussion.”

WASHINGTON, D.C. – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman John James (MI-10) celebrated House passage of legislation advanced by the Committee on Energy and Commerce to strengthen America’s energy supply chains, reduce reliance on adversarial nations, and safeguard the resources essential to our economy and national security.

H.R. 3617, the Securing America’s Critical Minerals Supply Act, requires the Department of Energy to assess critical energy resource supply chains, including critical minerals and rare earth elements, and to strengthen supply chains that are vulnerable to disruption or overreliance on adversarial nations. By taking a holistic view of critical energy resources, the Department of Energy can identify vulnerabilities and address supply chain disruptions to help ensure Americans have access to affordable, reliable, and secure energy systems.

“Keeping our nation strong and secure means having access to reliable and affordable energy. Right now, the technologies that power our grid rely on critical minerals produced and controlled by adversarial nations,” said Chairman Guthrie. “To address this crucial issue, the House passed the Securing America’s Critical Minerals Supply Act, which strengthens the Department of Energy’s support for critical energy resource supply chains, which are vital to keeping the lights on for American families and powering U.S. industrial facilities. Thank you to Congressman James for his leadership on this important legislation.”

“This bill is a bold step toward ensuring the United States leads in energy innovation, security, and independence, and I’m thrilled to see it pass the House. We cannot be the ‘land of the free’ if we choose to rely on critical mineral supply chains that are dependent on child and slave labor,” said Rep. James. “This is about unleashing American energy, powering our factories, fueling innovation, and securing our future. It’s a massive step towards building an energy-independent America and putting an end to overreliance on adversaries, dictators, and despots around the world.”

BACKGROUND:

Energy supplies are the linchpin to U.S. global leadership in next generation technologies and industries, job growth in communities across the country, and a robust defense industrial base.

Despite vast domestic natural resources, the United States remains heavily reliant on foreign adversaries for critical energy resources that are essential to our economic and national security:

• The U.S. is 100 percent reliant on imports for 16 critical minerals and 50 percent import reliant on an additional 50 vital mineral commodities;
• China maintains 60 percent of the world’s production of rare earth elements and 90 percent of their global processing capacity.

In recent years, adversarial nations like China have sought to exploit U.S. vulnerabilities, issuing export bans on key minerals, materials, and resources that are essential to both our manufacturing and defense industry.

WASHINGTON, D.C. – Today, Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, led a hearing titled Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain, featuring witness testimony from representatives across the entire prescription drug supply chain.

“I’m proud of this subcommittee’s work, but there is still more to be done—which is why I was proud to continue building on our affordability series through today’s hearing with representatives across the entire prescription drug supply chain,” said Chairman Griffith. “Hearing from these witnesses on how to best navigate this complex web helps Congress make better-informed policy decisions so that we are able to meaningfully lower the cost of care for all American patients.”

Watch the full hearing here:

Below are key excerpts from today’s hearing:

Congressman Troy Balderson (OH-12): “I represent a very rural district, and not only is access to health care a problem, but access to pharmacy services is growing more challenging as well. A 2025 FTC report examined PBM pharmacy contracting practices and found that internal PBM documents suggested rural pharmacies are often forced to accept ‘take it or leave it’ reimbursement rates. Could you elaborate on the specific challenges rural pharmacies face when negotiating contracts with PBMs, and how these practices may affect access to care in rural communities?” Mr. Hoey: “‘Take it or leave it’ contracts are part and parcel of the so-called negotiations between pharmacies and PBMs. PBMs hold all the leverage. They hold the patient lives. So, if a pharmacy does not sign whatever is put in front of them—with very little negotiation—I’m sure our friends at PMA will say there’s robust negotiation, but in reality, it’s a take-it-or-leave-it contract. These pharmacies are often forced to sign contracts that pay them below their cost to acquire the drug. And yes, rural pharmacies, as well as pharmacies in underserved areas, urban areas, and suburban communities, are all taking contracts in which they are paid below cost. As a result, 5,000 pharmacies have gone out of business in the last four years alone. That’s 5,000 fewer pharmacy choices in just four years. It’s a systemic problem. In fact, pharmacy deserts—especially in your district in Ohio and across the country—are growing because of these ‘take it or leave it’ contracts.”

Congresswoman Kat Cammack (FL-03): “Three companies control the majority of drug distribution in the United States, and many are vertically integrated to control each phase of the prescription drug supply chain—from manufacturer to pharmacy. Does consolidating the prescription drug industry lower prices for patients? Yes or no?” Mr. Davis: “It has the potential to, yes.” Congresswoman Kat Cammack: “Respectfully, your own industry report projects that the ‘big three’ will generate $871 billion in revenue this year—after four straight years of double-digit growth. So, if this is potentially saving patients money, why are revenues growing so fast, and where are patients seeing the savings?”

Congressman Michael Rulli (OH-06): “President Trump recently launched TrumpRx, a revolutionary platform aimed at bringing price transparency and competition back to the drug market. My constituents tell me every day about how much they dread going to the pharmacy because they never know what price they’re going to pay at the counter; it always changes. Then, you have brand-name versus [generic]... How have your members reacted to the transparent pricing of brand-name [drugs] on TrumpRx?” Mr. Marin: “The PBM industry is all about transparency. We are enhancing it for our customers every day, particularly for employers. The bill Congress passed a couple of weeks ago takes [transparency] to another level—we’re happy with that. We support and applaud the mission of the administration’s goal with TrumpRx.”

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means, Congressman David Schweikert (AZ-01), Chairman of the Ways and Means Subcommittee on Oversight, and Congressman Vern Buchanan (FL-16), Chairman of the Ways and Means Subcommittee on Health, authored ** a letter ** to the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) requesting a meeting on the concerning evidence detailed in the letter that points to large-scale, ongoing Medicare fraud in Los Angeles County, along with what action is being taken to address the situation.

“The House Committee on Energy and Commerce has an extensive history of digging deeper into matters where program integrity has been compromised. This letter is crucial in our commitment to eliminating waste, fraud, and abuse in federal health care programs,” said Chairmen Guthrie, Joyce, and Griffith. “Republicans have spent much of this Congress furthering legislation to protect our most vulnerable Americans—especially seniors, but our work is not done. Continued oversight is crucial to uphold the integrity of programs that serve our most vulnerable populations. We applaud the ongoing work being conducted by HHS-OIG in cracking down on the fraud that has occurred, and we look forward to addressing the larger-scale scheme that is draining public resources from Americans who need these services the most.”

“Medicare home health and hospice fraud directly undermines the safety and reliability of care for America’s most vulnerable seniors. Auditors have reported an unprecedented jump in home health and hospice fraud in Los Angeles County, California – including one report showing 112 different hospices located at the same physical address. With $1.2 billion in improper payments in home health claims and the Inspector General reporting $198 million in suspected hospice fraud, Gavin Newsom’s California could just as well be another Minnesota,” said Chairman Smith. “The Ways and Means Committee will not hesitate to use our broad oversight authority to get to the bottom of this and protect taxpayers and vulnerable patients against these bad actors.”

BACKGROUND:

Evidence has strongly suggested large-scale Medicare fraud involving home health agencies (HHA) and hospice agencies in Los Angeles County, California, noting that such practices not only drain public resources but also compromise the quality of care provided to patients, especially those most vulnerable populations.

• The Centers for Medicare and Medicaid Services (CMS) found that the 2023 improper payment error rate for home health claims was 7.7 percent, or about $1.2 billion, in 2023.
• In terms of hospice care, HHS OIG reported suspected hospice fraud to be an estimated $198.1 million in fiscal year (FY) 2023.
• CMS has placed HHAs as an area of high risk for Medicare fraud.

Emerging concerns over Medicare fraud in the HHAs and hospice sector highlights heightened activity, specifically in Los Angeles County.

• From 2019 through June 2023, HHAs in the U.S. decreased from 8,838 to 8,280 (6 percent), while, at the same time, HHAs in Los Angeles County increased from 896 to 1,309 (46 percent).
• More than 1,400 new Los Angeles County HHAs enrolled in Medicare in the last five years, representing over 50 percent of all HHAs in the state of California and nearly 14 percent of all HHAs in the country.

Based on data from the March 2022 California State Auditor’s Report and from HHS on hospice ownership, Los Angeles County had more than 31 percent of the hospice agencies in the U.S. in 2022.

• There were approximately 58 million seniors in the U.S. in 2022, with Los Angeles County having approximately 1.49 million seniors (2.5 percent).
• The report highlighted indicators that included a “rapid, disproportionate growth in the number of hospice agencies” and “excessive geographic clustering of hospice agencies,” noting that 112 different licensed hospice agencies were located at the same physical address.
• State auditors in California estimated that hospice agencies in Los Angeles County likely overbilled Medicare by $105 million in 2019.

These accounts of widespread fraud occurring in Los Angeles County’s HHAs and hospice agencies have raised concerns about whether home health and hospice Accrediting Organizations (AO) are effectively examining such organizations at the time of their enrollment in Medicare.

• In November 2024, CMS issued a Quality, Safety, and Oversight memo to surveyors, reminding them to closely inspect hospices’ Medicare enrollment documents to understand changes in ownership and location, but neglecting to encourage AOs to pursue other commonsense antifraud measures.

In April 2025, HHS OIG announced that the Office of Audit Services would compile a report for FY 2026 to identify trends, patterns, and comparisons that could indicate potential vulnerabilities related to new Medicare hospice provider enrollments.

In May 2025, the Health Care Fraud Strike Force—a joint task force of federal, state, and local law enforcement agencies, including HHS OIG—** announced multiple arrests ** following a multi-year investigation into Armenian Organized Crime, which dismantled five hospices in the greater Los Angeles area.

On November 28, 2025, CMS ** announced ** the Calendar Year 2026 Home Health Prospective Payment System Final Rule, providing comments that suggest an interest in addressing the aforementioned accounts of fraud.

WASHINGTON, D.C.  – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting a briefing to better understand the Department of Health and Human Services’ (HHS) recent actions and ongoing work to enhance safety within the organ procurement and transplantation system. On Thursday, September 18, 2025, the Department of Health and Human Services (HHS) announced major efforts to improve safety, transparency, and efficiency within the organ procurement and transplantation system, including the decertification of an organ procurement organization (OPO) for the first time in U.S. history. According to the announcement , the decision was made “after an investigation uncovered years of unsafe practices, poor training, chronic underperformance, understaffing, and paperwork errors.” The Committee has a history of ensuring patient safety remains the highest priority in our organ procurement and transplantation system, as evident from the Committee’s work last Congress on organ transplantation and donation issues as well as its oversight this Congress. As a part of its ongoing investigation, the Committee requests that CMS respond to questions, including those related to the decertification of the OPO in South Florida and the prevalence of incidents similar to those outlined in the Health Resources and Services Administration’s (HRSA) investigative report, to ensure patient safety remains a top priority. Read the full letter HERE . “While the Committee applauds efforts taken by CMS to uphold the highest standards of care to which all OPOs are expected to adhere, HHS’s announcement decertifying the Life Alliance Organ Recovery Agency illustrates the urgency of this moment and why the subcommittee is not finished with our oversight of the organ transplant system,” said Chairmen Guthrie and Joyce. “It is our moral obligation as members of Congress to establish safeguards and prevent these harmful practices from persisting further, and we look forward to obtaining answers from the agency about the prevalence of these incidents, as well as how CMS plans to proceed with prioritizing patient safety first and foremost.” Background: During the 118th Congress, the Committee on Energy and Commerce led the passage of the Securing the U.S. Organ Procurement and Transplantation Network Act to both modernize the Organ Procurement and Transplantation Network (OPTN) and allow HRSA to institute a competitive contracting process to find the best contractors for various OPTN functions. This legislation was signed into law on September 22, 2023.  On March 20, 2024, the Committee launched an investigation into the organ procurement and transplantation system by sending a letter to United Network for Organ Sharing (UNOS) requesting information related to concerns surrounding data security and operability, patient safety and equity, and conflicts of interest.   On March 20, 2024, the Committee also sent a letter to HRSA requesting information related to implementation of the Securing the U.S. Organ Procurement and Transplantation Network Act as well as other concerns related to effective oversight and management.  On September 11, 2024, the Subcommittee on Oversight and Investigations held a hearing that focused on the implementation of reforms at the OPTN, including the need for stronger oversight and accountability as well as ongoing patient safety concerns.  During the hearing, questions were raised related to allegations of mismanagement and patient safety concerns after patients began exhibiting signs of increased neurologic function after being previously deemed suitable as an organ donation candidate. Several of these allegations, particularly those related to patient safety, were later substantiated through the findings contained in HRSA’s March 2025 report.  On March 24, 2025, HRSA’s Division of Transplantation issued a report that summarized the findings of its investigation into KYDA, the OPO now known as Network for Hope, which serves Kentucky and parts of Ohio, West Virginia, and Indiana.   HRSA’s investigation examined an “index case” and an additional 351 unique cases of authorized, not recovered (ANR) patients. This means that the patients were considered for donation after circulatory death recovery, but no organs were transplanted. The report showed that nearly 30 percent of the cases “had concerning features.” The concerning features included problems with patient-family interactions, medical assessments and team interactions, recognition of high neurologic function, and recognition and documentation of drugs in records.  On May 28, 2025, HRSA issued a corrective action plan to the OPTN, which directed the OTPN to take specific actions within a specified period of time, including developing a 12-month OPTN monitoring plan for KYDA to address concerns identified. The corrective action plan also requires the OPTN to propose policies for public comment to improve safeguards for potential donation after circulatory death (DCD) patients in the organ procurement process and increase information shared with patient families regarding DCD organ procurement.  On July 22, 2025, the House Committee on Energy and Commerce’s Subcommittee on Oversight and Investigations held a hearing examining concerning practices within our nation’s organ procurement and transplant system that were identified by HRSA’s investigation.  On September 12, 2025, the Committee sent a bipartisan letter to HRSA requesting a briefing on its ongoing oversight of patient safety in our nation’s organ procurement and transplant system. ###

WASHINGTON, D.C. – Yesterday, Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, and Congressman Gary Palmer (AL-06), Chairman of the Subcommittee on Environment, sent a letter to Gene Dodaro, the Comptroller General of the Government Accountability Office (GAO), requesting an assessment of available or emerging technologies and materials that could be used to supplement critical minerals in semiconductors. “Critical minerals such as lithium, cobalt, and rare earth elements are essential for technologies used in many sectors of the economy, including energy, transportation, national defense, health care, and consumer electronics,” said Chairmen Joyce and Palmer . “These minerals are vulnerable to supply-chain disruptions for several reasons, including U.S. reliance on foreign sources, as well as the rapid growth in demand for critical minerals in the U.S. and abroad.” CLICK HERE to read the full letter. The letter asks the GAO to examine: The status of domestic technologies and supplemental materials, such as critical minerals found in mine waste, tailings, or reclaimed from end-of-life batteries and electronic waste, that can serve as substitutes for foreign-sourced critical minerals from non-allied nations needed for semiconductors and energy grid or power electronics, including impacts on material and product performance. Key technological challenges to the development or adoption of these domestic supplemental and materials to advance the diversification of U.S. critical mineral sources. BACKGROUND: In May, the Subcommittee on Oversight and Investigations held a hearing on ways to enhance our critical mineral supply chains. Energy and Commerce Committee Republicans are committed to strengthening our critical mineral supply chains and finding solutions to reduce our reliance on foreign sources, particularly when it comes to foreign adversaries like China. The Trump Administration has also worked hard to bolster these supply chains. Critical minerals are essential to American technologies and industries, and finding innovative domestic solutions that can contribute to our independence from non-allied nations is essential as we work to onshore American innovation and strengthen our national security. ###