MTM, pharmacy measures in final HCR bill
Cost analysis, text of bill released as clock ticks
toward House vote on Sunday.
With a nonpartisan cost estimate showing that the final health care
reform (HCR) bill will reduce the federal deficit in each of the next
two decades, the House of Representatives is set for a vote on the
legislation this weekend.
The House can vote on the bill 72 hours after the language was made
public, making a vote possible after noon Eastern time on Sunday.
The cost
analysis, conducted by the Congressional Budget Office (CBO), shows
a deficit reduction of $138 billion in 2010–19. The CBO generally
estimates costs for only 10 years. But Congress had asked for
projections of the bill’s long-term impact. Looking at the
subsequent 2020 decade, CBO predicted the bill would lower the deficit
by around 0.5% of the Gross Domestic Product. Democrats pegged that at
$1.2 trillion, according to reports in lay media.
The CBO analysis is considered conservative since it only includes
numbers for which reliable estimates are available. Thus, innovations
such as medication therapy management (MTM) are generally scored as
neutral or negative, since the only sure thing is that providers would
have to be paid for the services. An article in today’s Washington
Post questions the accuracy of the forecast, noting that this
estimate contains more uncertainty than most because of the bill’s
comprehensive nature.
Included in the legislation are numerous pharmacy-related provisions,
including a grants program for medication therapy management sought by
APhA and other members of the pharmacy coalition. An adjustment for
pharmaceutical pricing based on average manufacturer price, or AMP, is
also in the bill.
In the reconciliation
package that will go to the Senate for certain “fixes”
to the big bill, the AMP formula is tweaked further. Language
closing the Medicare Part D prescription drug doughnut hole in
increments over the next decade is also in the reconciliation bill. This
year, Part D beneficiaries would receive a $250 rebate after they reach
the gap in coverage.
If the HCR package is passed by the House, the bill would go to
President Obama for his signature. Once that happens, the reconciliation
would go to the Senate for its consideration. Some observers think that
the public signing for HCR would be of the reconciliation package rather
than the main document now before the House.
In addition to the Democrats’ full-court press on the HCR bill
that is evident on cable news channels, President Obama held a
campaign-style rally in support of HCR this morning at George Mason
University, just outside Washington. The House Rules Committee posted a
section-by-section analysis of the bill, now titled H.R. 4872,
The Health Care & Education Affordability Reconciliation Act of
2010, and the reconciliation language. The House Committee on Energy
and Commerce posted an analysis
showing the benefits of the bill for each county in the United
States.
Related resources on www.pharmacist.com:
L. Michael Posey, BPharm (mposey)
Posted March 18, 2010, 4:00 pm EDT
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