Preventing price fixing and keeping patients’ options open The AMAC Action team worked to ensure that harmful language that would price-fix fees for direct primary care physicians, limit how funds in health savings accounts (HSA) could be used, and restrict patient options was removed from the CARES Act. We also worked to protect patients by having language that would have established federal benchmarking for surprise medical billing arbitration stricken from the bill. Prescription Drug Middlemen Rebate Rule One of AMAC Action’s signature issues focuses on the “pay to play” relationships pharmacy benefit managers (PBM) have with drug manufacturers and we have been working to remove the middleman money from the outpatient prescription drug supply chain for over two years. AMAC Action has lobbied Members of Congress and the Trump Administration on our own and in alliance with a coalition of physician and patient advocates to detail how these relationships negatively impact the list cost of prescription drugs. In July 2020, President Trump signed an Executive Order that directs PBMs to share the rebates they receive from drug companies at the point of purchase with Medicare beneficiaries. This action is estimated to save Medicare beneficiaries 30 percent on their out-of-pocket expenses for prescription drugs. It is worth noting that AMAC is the only national member benefits organization representing millions of seniors whose advocacy affiliate has been steadily highlighting the negative influence of middleman money in the outpatient prescription drug supply chain. AMAC Action continues to lobby Congress on a similar relationship group purchasing organizations have with manufacturers and suppliers that drives up costs in the hospital supply chain. Hospital Price Transparency In response to the Trump Administration’s executive order to improve price and quality transparency in health care, the U.S. Department of Health and Human Services (HHS) issued a final rule requiring hospitals to publish their prices, both discounted cash prices and secret negotiated rates. The American Hospital Association (AHA) and other hospital groups immediately sued HHS to stop the rules from taking effect, alleging the requirements were unconstitutional and burdensome. Along with PatientRightsAdvocate.org and other advocacy groups, AMAC filed an amicus brief in support of health care price transparency and a functional, competitive market in health care. In June of 2020, the D.C. Federal District Court upheld the rule, and the hospital groups immediately appealed. AMAC and the advocacy groups filed a second amicus brief in the Appeals Court. Finally, within days of the rule taking effect, on December 29, 2020, the U.S. Court of Appeals for the D.C. Circuit upheld the hospital rule, negating the hospitals’ lawsuit and paving the way for patients to see real prices starting January 1, 2021. This victory for American health care consumers, which was assisted by thousands of recommendations made by AMAC members directly to HHS to craft the final rule (see: Grassroots Advocacy; Calls-to-Action), recognizes that price transparency will empower patients to make informed decisions, put downward pressure on prices, and greatly reduce the burden of health care to our citizens, businesses, and economy.
AMAC Action | www.amacaction.org | 855.809.6976 | info@amacaction.org
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