Posted by on September 18, 2023 7:40 pm
Categories: News The Hill

Lawmakers prepare to probe PBMs in second hearing

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The Big Story 

Lawmakers set sights on PBMs in second hearing

A House Oversight subcommittee on Tuesday will examine the pricing tactics of pharmacy benefit managers, the second time it has held a hearing focused on the PBM industry.

© The Hill, Tierney L. Cross

Oversight Committee Chairman James Comer (R-Ky.) indicated in a statement that the focus would be on issues like rebates and so-called “spread pricing,” which he said “benefit PBMs and have helped the three largest PBMs monopolize the pharmaceutical market.”


During the first hearing on PBMs held this year by the committee, Comer said, “We are sincere about identifying waste, fraud, and abuse in the federal government. And when you look at problems that every American has, prescription drug costs are at the top of the list.”


Comer is not a fan of PBMs. He launched an investigation into PBM business practices in March, and at an unrelated hearing with the Health and Human Services (HHS) secretary in June he expressed support for dismantling PBMs.


Speaking to HHS Secretary Xavier Becerra, Comer accused PBMs of weaponizing their access to patient information and questioned if and how they engaged in “self-serving practices at the expense of patients and taxpayers.”


Bipartisan legislation in both chambers seeks to reform the PBM industry.

In the Senate, the “Pharmacy Benefit Manager Transparency Act” was introduced in January and would prohibit PBMs from engaging in certain practices including charging health plans and payers difference prices.


An estimate from the Congressional Budget Office found this bill could save taxpayers $740 million over 10 years.


The “Protecting Patients Against PBM Abuses Act” was introduced earlier this year in the House and would require the companies to disclose how much in rebates and administrative fees they receive.

Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel and Joseph Choi — every week we follow the latest moves on how Washington impacts your health.

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Essential Reads 

How policy will be impacting the health care sector this week and beyond:

The Indiana Supreme Court Disciplinary Commission filed a complaint against Indiana Attorney General Todd Rokita (R) on Monday, alleging his public statements following news of an OB-GYN providing abortion services to a 10-year-old Ohio girl amounted to misconduct. Indiana doctor Caitlin Bernard made national news last year in sharing her story of providing abortion services to a 10-year-old girl who was raped and then denied …

Indiana Attorney General Todd Rokita (R) has filed a lawsuit against the health system where a 10-year-old Ohio girl received abortion services last year after being denied in her home state, alleging the institution failed to enforce HIPAA. In July 2022, Indiana OB-GYN Caitlin Bernard, employed by IU Health, garnered national attention after sharing with the Indianapolis Star her account of providing abortion services to a …

Former Vice President Mike Pence said Sunday that he’s not sure if he will get the newly approved COVID-19 vaccine booster, but he encouraged other Americans to at least consider it. “We haven’t made a decision on that yet as a family,” Pence replied when asked if he would get the shot in a CNN interview Sunday. “I think every family ought to make those decisions.” The FDA approved an additional COVID-19 booster shot last week …

The Hill event

Making the Grade: Solving the U.S. Math Problem, Sept. 26, 3:30-5:30 p.m. ET | National Press Club Holeman Lounge & streaming


A recent study by NWEA found that middle and elementary school students’ math progress stagnated last year. Join The Hill as we convene lawmakers, math advocates and educators to discuss the state of U.S. math education and why it’s no longer acceptable to laugh off being “bad at math.” Speakers include:

Rep. Jim Baird (R-Ind.), co-sponsor of Mathematical and Statistical Modeling Education ActRep. Bill Foster (D-Ill.), member of the House Financial Services CommitteeRebecka Peterson, 2023 National Teacher of the Year
Tim Hudson, Chief Learning Officer at DreamboxJosh Recio, Course Program Specialist, Secondary Mathematics at the University of Texas at Austin; and more.

On Our Radar 

Upcoming news themes and events we’re watching:

The House Energy & Commerce health subcommittee will hold a Tuesday hearing on “Examining Policies to Improve Seniors’ Access to Innovative Drugs, Medical Devices, and Technology.”

A House Oversight Subcommittee will hold a hearing Tuesday examining the role of pharmacy benefit managers’ pricing tactics

The House Ways & Means Committee will hold a Tuesday hearing examining the No Surprises Act and the Biden administration’s implementation of surprise medical billing protections

In Other News 

Branch out with a different read from The Hill:

Biotech entrepreneur Vivek Ramaswmay and his wife, Apoorva Ramaswamy, an assistant professor and surgeon, disagree about taking the COVID-19 vaccine — a topic that has become a focal point in the 2024 GOP primary race.

Around the Nation 

Local and state headlines on health care:

Sober homes promised help and shelter. Some delivered fraud, officials say. (The Washington Post)

Just two doctors serve this small Alabama town. What’s next when they want to retire? (KFF Health News)

Federal officials order Oregon State Hospital to make ‘immediate’ changes following escape (KEZI)

What We’re Reading 

Health news we’ve flagged from other outlets:

‘The rule has sticks as well’: Biden’s getting tough with health insurers (Politico)

Climate change impeding fight against AIDS, TB and malaria (Reuters)

Sore throat, then congestion: Common Covid symptoms follow a pattern now, doctors say (NBC News)

What Others are Reading 

Most read stories on The Hill right now:

House Republicans’ proposed short-term spending bill is facing internal opposition that could sink the measure and complicate the conference’s … Read more

President Biden is trailing former President Trump, former U.N. Ambassador Nikki Haley and Sen. Tim Scott (R-S.C.) in several hypothetical 2024 match-ups … Read more

What People Think 

Opinions related to health submitted to The Hill:

You’re all caught up. See you tomorrow! 

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