VIEW FROM THE UPPER CHAMBER — The ball is in the Senate’s court on health legislation after the House passed a sweeping health care package Monday adding new transparency requirements for pharmacy benefit managers, insurers and hospitals. The Senate Finance and Health, Education, Labor and Pensions Committees have each advanced their own bills on PBMs out of committee, setting up the two chambers to reconcile their legislation. What they said: Senate Finance Chair Ron Wyden (D-Ore.) told Pulse on Tuesday that he’s still reviewing the House proposal and took a victory lap over the 26-0 margin by which his package advanced out of committee. HELP Chair Bernie Sanders (I-Vt.) told Pulse the House package was a “start” but that lawmakers “need to do a lot better.” Site-neutral payments are expected to be a key focus area. The House package would change Medicare payment policy so drugs administered in a hospital outpatient department are reimbursed at the same rate as in a doctor's office. Wyden and ranking member Mike Crapo (R-Idaho) have expressed openness to site-neutral reforms, but it’s unclear what that might look like. The HELP Committee advanced primary care and workforce legislation from Sanders and Sen. Roger Marshall (R-Kan.) with its own site-neutral provisions, though different than the House’s, banning hospitals from charging “facility fees” for outpatient clinics. Hospitals have come out in force against such proposals, arguing they would force cuts and impact access to care. They constitute the bulk of the deficit reduction from the House package, which would cut $715 million from the deficit over a decade, according to the Congressional Budget Office. DIABETES UNDER DISCUSSION — A Senate HELP Committee hearing on Thursday will take a sweeping look at diabetes and obesity. Our Megan R. Wilson obtained the written testimony of the five witnesses, which include type 1 diabetes advocates and professors of psychology, nutrition and medicine. Here are some takeaways: — There’s a push to move bipartisan insulin legislation to lower costs: The issue has been top of mind for Senate Majority Leader Chuck Schumer, but the measure hasn’t seen floor time. — Ozempic gets name-checked: Yale School of Medicine professor Kasia Lipska discusses the high cost of diabetes treatments and drug negotiation. — Academics talk labeling: The FDA is looking into rules for labels on unhealthy food, including front packaging that calls out high levels of saturated fats or sugar. However, some topics — like food marketing, an update to dietary guidelines and sugar content in processed snacks — and solutions, such as higher taxes for junk-food makers, remain outside the committee’s scope. Sanders’ office didn’t respond to questions about what legislation could be on the horizon. STRONG SUPPORT FOR SUPPORT ACT — The House and the Senate HELP Committee advanced landmark legislation Tuesday to expand treatment for opioid use disorder as the nation’s rate of fatal overdoses remains near record highs, POLITICO’s Carmen Paun reports. The House voted overwhelmingly to reauthorize a 2018 law that expired at the end of September. The Support for Patients and Communities Reauthorization Act from Rep. Brett Guthrie (R-Ky.) would bring back a requirement for states to cover drug-assisted treatment for opioid use disorder through Medicaid, among other provisions. The HELP Committee also approved its version of the SUPPORT Act reauthorization bill 19-1, setting up consideration by the full Senate and likely enactment of a new law soon.
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