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The House passed its health bill. How's the Senate doing?

The House's passage of its big health care transparency bill this week shifts the focus to the Senate, which will have to work out a health package with the House on issues like hospital payments, PBMs and other provider issues.

We caught up with Senate Finance Chair Ron Wyden in the Capitol on Tuesday to get his take on what's next.

Driving the news: Wyden said he wants the PBM provisions to be "much" broader than what is in the House measure (which focuses on transparency and banning spread pricing in Medicaid).

  • Wyden said it is important to make PBM reforms in Medicare, in the belief that "the private sector will replicate it."

  • A bipartisan Senate Finance package includes initiatives like lowering patient out-of-pocket costs for certain drugs and "delinking" PBM compensation from a drug's price. House Energy and Commerce recently approved some similar measures, but they were not wrapped in the transparency bill that passed the full chamber.

Between the lines: The outlook for site-neutral hospital payments in the Senate is cloudier. The House bill includes a modest measure to apply the idea to physician-administered drugs.

  • Asked about that provision, Wyden said he is "going to have to look at it," noting he has been juggling a lot of issues and has not "spent a tremendous amount" of time on the site-neutral push.

  • He and Ranking Member Mike Crapo did make some comments in favor of the notion last month but noted that more study could be needed.

  • As we wrote on Tuesday, hospital opposition still looms over the issue.

The bottom line: Much still needs to be hammered out between the chambers.

  • But Wyden is making the case to leadership, especially on the PBM front.

  • Asked about including his measures in the Jan. 19 government funding package, Wyden said: "I have been in constant contact with Leader Schumer stressing how important this is."

  • Though he added, "He obviously has got a lot of balls to juggle."



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