Health

Key bill—the PATIENT Act—clears committee unanimously In a Full Committee markup today, the Energy and Commerce Committee passed bipartisan solutions to lower the cost of health care and increase price transparency, as well as improve farmers and pet owners' access to safe and effective animal drugs.  House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) on the PATIENT Act:   “Patients are frustrated. The system must be more simple, transparent, and affordable.     "We spend more on health care as a percentage of our economy than any other developed nation.     “And for their money, Americans are rewarded with a bureaucratic and overly burdensome system.    “They see the corporations responsible for providing and paying for care go to great lengths to hide costs, deny payment for care, and weigh patients down in complexity.     “What we are doing here today won’t solve every problem in our health care system.     “I have said this is just a first step towards addressing the problems we face.     “But we can be proud of the meaningful, bipartisan policies included in this amendment that will lower costs and improve transparency for patients.”   Subcommittee on Health Chair Brett Guthrie (R-KY):  “We’re also promoting access to care for vulnerable Americans who need lifesaving, one-of-a kind treatments.    “My bill, the Medicaid VBPs for Patients Act, or the MVP Act, would provide access to the most innovative cures for Medicaid patients living with otherwise incurable or untreatable life-threatening conditions through value-based agreements. “We are talking about patients dealing with diseases, such as sickle cell and debilitating bleeding disorders.    “I want to personally thank Representative Eshoo for her leadership to take on this bill with me that will ultimately save lives and promote long-term savings for state Medicaid programs.”   Legislative Vote Summary:  H.R. 1418 , the Animal Drug User Fee Amendments of 2023 , sponsored by Reps. Greg Pence and Kim Schrier, was favorably reported, without amendment, to the House by a bipartisan vote of 49-0.  H.R. 2544 , the Securing the U.S. Organ Procurement and Transplantation Network Act , led by Reps. Larry Bucshon and Robin Kelly, was favorably reported, without amendment, to the House by a bipartisan vote of 48-0.  H.R. 2666 , the Medicaid VBPs for Patients (MVP) Act , led by Reps. Brett Guthrie and Anna Eshoo, was reported favorably, as amended, to the House by a bipartisan vote of 31-19.  H.R. 3284 , the Providers and Payers COMPETE Act, led by Reps. Michael Burgess and Debbie Dingell, was reported favorably, as amended, to the House by a bipartisan vote of 49-0.  H.R. 3290 , To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program , led by Rep. Larry Bucshon, was favorably reported, as amended, to the House by a vote of 29-22.  H.R. 3561 , the Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023, led by Reps. Cathy McMorris Rodgers and Frank Pallone Jr., was favorably reported, as amended, to the House by a bipartisan vote of 49-0. 

Washington. D.C. — House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) delivered the following remarks on the House Floor today in support of H.R. 467, the HALT Fentanyl Act , in order to save lives and make communities safer. LIVES ARE ON THE LINE “Madam Speaker, to save lives and make our communities safer, I rise in support of the HALT Fentanyl Act. “Illicit Fentanyl is one of the greatest threats we face as a nation. “Illicit drug manufacturers are diverting precursor chemicals from some of China’s 160,000 chemical plants and shipping them to Mexico, where cartels are producing mass quantities of illicit fentanyl and fentanyl-related substances. “These are being smuggled across our southern border and killing more people than ever. “According to an analysis by the Washington Post, fentanyl poisoning is the number one cause of death for people 18-49. “I think about my friend, Molly Cain, from Spokane. She lost her son Carson. And, Deb and Ray Cullen from Pennsylvania who lost their son Zach. “Both Carson and Zach were killed instantly by substances laced with illicit fentanyl. “Molly asked me how many more letters from grieving parents is it going to take for action. “The fact is it shouldn’t take another letter, another day. “It shouldn’t take another lost loved one. “The HALT Fentanyl Act will save lives. “We must make sure that law enforcement has the permanent tools they need to seize these extremely lethal poisons. “It is the DEA’s number one legislative priority. “Without those tools, drug traffickers—being sourced from China—will be emboldened to push deadlier and deadlier drugs across the border. “We can’t let that happen. “Let’s come together today for a more secure future for every community in America. “I urge support of the HALT Fentanyl Act. ”

Washington, D.C. — House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) delivered the following opening remarks at today’s Health Subcommittee markup to lower health care costs and to expand competition and access to care. Excerpts and highlights below: BIPARTISAN SOLUTIONS FOR THE AMERICAN PEOPLE “I’m proud this committee is building on its rich, bipartisan history to come together on important priorities for the American people. “The legislation we are considering today will help lower costs for Americans and provide more health care price transparency, responsibly fund community health centers and diabetes research, prevent harmful cuts to hospitals that serve the most vulnerable patients, train more doctors in our communities, and improve FDA’s review of animal drugs used by farmers and pet owners. “We are taking action on the American people’s priorities to make the health care system more affordable and patient-friendly. “We all know that health care is too expensive and the system is far too complicated. “And well-intentioned government policies too often provide more benefits to large and well-resourced corporations than they do patients.” INCREASING PRICE TRANSPARENCY AND COMPETITION “Take the story of Mike Lauze, from Maine. “Last year he spent one hour in an O.R. undergoing eye surgery. “His bill included 3 separate facility fees totaling $7,800 and professional fees totaling $6,200. “Why are three facility fees necessary for one hour of surgery in one O.R.? I do not know. “But I do know that the system must be simpler, more affordable and work better for patients. “That is why we are moving bills today to increase price transparency and competition throughout the health care system. “I thank Ranking Member Pallone for his partnership on our bill, the Transparent PRICE Act, which builds on work done by the Trump and Biden administrations to bring prices to patients. “We have had two hearings on price transparency and lowering health costs. “I know they have spurred additional ideas on how to help patients and look forward to taking a first step on that work today and continuing this work moving forward.” REAUTHORIZING CRITICAL PROGRAMS “There is another critical reason this markup is so important: The American people want accountability in our government. “Congress cannot meaningfully fulfill its critical oversight and spending roles without examining the reauthorizations of expiring programs through regular order. “We have heard from HRSA on the importance of these programs and worked hard to make sure that additional mandatory spending is fully offset. “I am proud that we are extending mandatory funding for the Teaching Health Center GME program for 6 years. “This will help as they plan and recruit for future residency classes. “Extending mandatory funding for the Community Health Center Fund will help ensure that Health Centers in my district have adequate resources to provide much-needed primary care services in the community. “Finally, regarding ADUFA, whether or not you know it, almost everyone in this room relies on the animal drugs approved by the FDA. “Whether you have a pet, drink milk, or eat meat, the FDA plays a very important role in making sure the drugs we give animals work and are safe. “It is important we get this done on time and work in a bipartisan way, without divisive and controversial amendments. “So, I’m glad we’re on track to reauthorize this on time by moving Representative Pence’s legislation through subcommittee today. “I look forward to today’s discussion, as we prepare for a full committee markup. “The Energy and Commerce Committee will continue to plow the hard ground on the most important issues before us as a nation and that certainly includes making sure people can find the care they need at a price they can afford.”

Report alleges patients frequently forced to pay out-of-pocket for services that should be covered Washington, D.C. — House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA), Subcommittee on Health Chair Brett Guthrie (R-KY), and Subcommittee on Oversight and Investigations Chair Morgan Griffith (VA), on behalf of the Health and Oversight Subcommittee Republicans, wrote to the President and CEO of The Cigna Group regarding an investigative report by ProPublica.   In the letter, the members note that Cigna disputes the report as “biased” and “incomplete,” and they ask the insurance company to respond to the allegations that it uses automation and AI technology to deny claims.   According to the report titled “How Cigna Saves Millions by Having its Doctors Reject Claims Without Reading Them,” which focuses on Cigna’s procedure-to-diagnosis (PXDX) review process:   The PXDX review process denies payments for claims indiscriminately, potentially leading to improper denials of coverage for medically necessary tests and procedures.   The process automatically categorizes certain claims as “unnecessary” using an algorithm in place of a clinician’s judgement.   Patients are then reportedly told that a clinician has decided such claims were not necessary and therefore not covered, despite the clinician having never reviewed individual claims.   Only an estimated five percent of policy-holders appeal denials of coverage.   By contrast, nearly one-in-five prior authorization denials in Cigna’s Medicare Advantage plans were appealed.   Why It Matters:    80 percent of Medicare Advantage coverage denials were overturned, suggesting that Cigna’s PXDX review process is leading to patients paying out-of-pocket for medical care that should be covered under their insurance policy contract.   The Chairs requested Cigna turn over documents related to the PXDX process and answer the following questions by May 30, 2023:   Describe in detail the PXDX review process, including its development, implementation, and ongoing usage.   Identify all insurance plans offered or administered by Cigna whose claims are subject to PXDX review, including, if applicable, Medicare Advantage plans.   Identify all medical directors employed by Cigna who review, submit, or approve coverage denials generated by the PXDX review process, include in your response the medical directors’ work email address, the nature of claims reviewed, and tenure at the company.   Provide the following statistics for plan year 2022 for both commercial and government contracts (broken down by government program):   The number of claims reviewed by the PXDX process;   The number of claims denied under the PXDX process;   The number of claims reviewed and denied by each clinician employed by Cigna who participates in the claim review process;   The number of claims denied by each clinician employed by Cigna and the number of claims that were actually reviewed by such clinicians;   The number of claims denied under the PXDX process that were appealed; and   The number of claims denied under the PXDX process that were appealed and overturned.   In addition, the letter serves as a request to preserve all existing and future documents related to the PXDX process.   CLICK HERE to read the full letter. 

Members press companies to answer what information is collected and where it is sold Washington, D.C. — House Energy and Commerce Committee Republicans, led by Chair Cathy McMorris Rodgers (R-WA) and Committee Democrats, led by Ranking Member Frank Pallone, Jr. (D-NJ), today wrote to the heads of data broker companies, requesting information to help the Committee protect Americans’ data from misuse. They were joined by Subcommittee on Oversight and Investigations Chair Morgan Griffith (R-VA) and Ranking Member Kathy Castor (D-FL), Subcommittee on Innovation, Data and Commerce Chair Gus Bilirakis (R-FL) and Ranking Member Jan Schakowsky (D-IL), Subcommittee on Health Chair Brett Guthrie (R-KY) and Ranking Member Anna G. Eshoo (D-CA), and Subcommittee on Communications and Technology Chair Bob Latta (R-OH) and Ranking Member Doris Matsui (D-CA).  BACKGROUND:   The Subcommittee on Oversight and Investigations launched a bipartisan investigation at a hearing on April 19, 2023, titled “Who is Selling Your Data: A Critical Examination of the Role of Data Brokers in the Digital Economy.”  Data brokers purchase, collect, aggregate, license, sell, or otherwise share a wide range of information from Americans, including but not limited to demographic, location, and health data.  These companies profit from trading in Americans’ personal information, including sensitive information, often with little government oversight and in some cases, without any concern for how buyers use the consumer data that they purchase from brokers.  A recent study from Duke University found, for example, that “some data brokers are marketing highly sensitive data on individuals’ mental health conditions on the open market, with seemingly minimal vetting of customers and seemingly few controls on the use of purchased data.”  KEY EXCERPT:   “American privacy concerns in the data broker industry are not new, and existing laws do not sufficiently protect Americans’ data from misuse. In 2014, the FTC issued a report recommending that Congress require data brokers to increase transparency and give Americans more control of their data. However, data brokers can easily circumvent existing rules and laws regarding the collection and sharing of certain types of data, such as HIPAA.   “Enacting a comprehensive federal privacy law is a top priority for the Committee on Energy and Commerce. Currently, Americans do not have control over whether and where their personal data is sold and shared; they have no guaranteed way to access, delete, or correct their data; and, they have no ability to stop the unchecked collection of their sensitive personal information. According to the Electronic Privacy Information Center, the overcollection and secondary uses of personal data, including the sale to and use by data brokers, are inconsistent with the reasonable expectations of online consumers and may lead to discriminatory targeting that violates the privacy and autonomy of consumers.”  The leaders asked the companies for information pertinent to helping the Committee understand how data brokers purchase, collect, use, license, and sell Americans’ data, including:  What data elements do you possess on Americans and market to your clients?   In particular, do you possess any of the following:  Americans’ health data? If yes, what kind of health data?  Americans’ location data? If yes, what data elements?  Americans’ phone data, such as data on any apps downloaded on their mobile devices? If yes, what data elements?  Information revealing Americans’ purchase history? If yes, what data elements?  Information about children under the age of 13?  Information about children between the ages of 13 and 18?  Are there any categories of Americans’ personal information that you will not purchase, collect, aggregate, license, or sell and, if so, what categories are those?  When you license, sell, or otherwise share Americans’ personal information with your clients, do you require your clients to disclose the purpose(s) for which they will use the data?   If so, what do you do, if anything, to confirm they are using the data for the stated purpose(s)?  How much money did you spend in each of the past five years on purchasing or licensing Americans’ personal information?  What percentage of your annual revenue for each of the past five years was derived from selling or licensing Americans’ personal information?  How many clients did you sell or license Americans’ personal information to?  Does your company use the personal information of Americans that you purchase, collect, or aggregate to categorize people based on income, sex, age, race, or other categories?  What steps, if any, does your company take to protect data of users under eighteen?  When you become aware that you or your clients have transferred Americans’ personal information to a foreign adversary or a company beholden to a foreign adversary—currently defined by the Secretary of Commerce to include China, Russia, North Korea, Cuba, the Maduro regime in Venezuela, and Iran—do you notify the individual(s) whose personal information has been transferred or any U.S. government entity? If not, why not?  You can view the letters below:  Acxiom LLC AtData Babel Street   CoreLogic Solutions, LLC   Epsilon Data Management, LLC Equifax   Experian   Gravy Analytics, Inc. Intelius, LLC Kochava Inc. LiveRamp, Inc. Mylife   Oracle America, Inc.   PeopleConnect, Inc. Placer.ai   RELX Safegraph Inc. Spokeo, Inc.   Thomson Reuters   TransUnion   Verisk Analytics   Whitepages, Inc.

Washington, D.C. — House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA), Subcommittee on Health Chair Brett Guthrie (R-VA), and Subcommittee on Oversight and Investigations Chair Morgan Griffith (R-VA) issued the following statements after the National Institutes of Health (NIH) restored its grant to EcoHealth Alliance (EHA) that was previously suspended.  Chair Rodgers : “It’s beyond outrageous that NIH would restore funding to this taxpayer funded grant despite well-documented, egregious failures by EcoHealth to comply with grant requirements and NIH’s failure to conduct proper oversight of the grant. The Department of Health and Human Services and the NIH must explain to the American people why it would take this controversial and irresponsible action.”  Health Subcommittee Chair Guthrie : “EcoHealth Alliance not only has documented negligence, ignorance, and failures in following the rules of a taxpayer-funded grant, but also is the subject of a congressional investigation on its research with the Wuhan Institute of Virology. It is shocking and disappointing that the NIH is restoring a taxpayer-funded grant to EcoHealth Alliance. We’re going to get answers on behalf of the American people why their money is being awarded to EcoHealth Alliance.”  Oversight Subcommittee Chair Griffith : “It’s absolutely reckless that the NIH has renewed a grant for EcoHealth Alliance given their negligence and the breach of their contract with the NIH on the coronavirus research done at the Wuhan Institute of Virology. It is now believed likely that COVID-19 was the result of a lab incident at the Wuhan Institute.  “From my observations, EcoHealth Alliance has not been contrite about their failures. And even worse, they have refused to cooperate with Congress in our attempts to get information about the research they were doing at the Wuhan Institute.  “Until they can demonstrate a willingness to work with Congress to resolve outstanding questions and fulfill all of the terms of their federal contracts, paid for with American taxpayer dollars, all funding should remain suspended, and no new contracts should be awarded.”  In response to the announcement and previous testimony before Congress, Chair Rodgers, Guthrie, and Griffith, on behalf of the Health and Oversight Subcommittee Republicans, sent a letter to Department of Health and Human Services Inspector General Christi Grimm (HHS IG), asking for her office’s audit file which supported the decision not to recommend baring EHA from receiving NIH grants. The decision not to refer EHA for debarment, despite an HHS IG report detailing NIH’s failures to oversee the grant to EHA, is under investigation by the Committee.  You can read that letter here .  Additional Background:  January 2023 HHS OIG Report: The National Institutes of Health and EcoHealth Alliance Did Not Effectively Monitor Awards and Subawards, Resulting in Missed Opportunities to Oversee Research and Other Deficiencies  The HHS IG’S Key Findings:  “Despite identifying potential risks associated with research being performed under the EcoHealth awards, we found that NIH did not effectively monitor or take timely action to address EcoHealth's compliance with some requirements.”  “Although NIH and EcoHealth had established monitoring procedures, we found deficiencies in complying with those procedures limited NIH and EcoHealth's ability to effectively monitor Federal grant awards and subawards to understand the nature of the research conducted, identify potential problem areas, and take corrective action.”  Read the full report here .  Chair Rodgers: HHS’s OIG Report Confirms our Concerns with NIH’s Funding of EcoHealth Alliance  Key Quote: “The American people have a right to know what types of potentially risky research their tax dollars are funding. This OIG Report reaffirms many issues Energy and Commerce Republicans have continued to raise with NIH’s negligence in holding EcoHealth Alliance accountable to the terms of grant agreements. Furthermore, the report raises even more questions from the Committee about the apparent special treatment given to EcoHealth Alliance.”  Read more here .  October 2022 E&C Republicans to NIH: Why Resume Taxpayer-Supported Grant Funding to EcoHealth?  Key Quote: “The NIH has a responsibility to the American people to ensure research supported by taxpayer dollars is conducted with the highest standard of integrity, transparency, and safety. To that end, agency officials must answer why they are considering restoring funding to EcoHealth Alliance,” said Chairs Rodgers, Guthrie, and Griffith.  Read the full letter here .