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Executive Order on Lowering Prices for Patients by Eliminating Kickbacks to Middlemen
whitehouse.gov ^ | July 24, 2020 | President Donald J Trump

Posted on 07/24/2020 5:11:32 PM PDT by ransomnote

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1Purpose.  One of the reasons pharmaceutical drug prices in the United States are so high is because of the complex mix of payers and negotiators that often separates the consumer from the manufacturer in the drug-purchasing process.  The result is that the prices patients see at the point-of-sale do not reflect the prices that the patient’s insurance companies, and middlemen hired by the insurance companies, actually pay for drugs.  Instead, these middlemen — health plan sponsors and pharmacy benefit managers (PBMs) — negotiate significant discounts off of the list prices, sometimes up to 50 percent of the cost of the drug.  Medicare patients, whose cost sharing is typically based on list prices, pay more than they should for drugs while the middlemen collect large “rebate” checks.  These rebates are the functional equivalent of kickbacks, and erode savings that could otherwise go to the Medicare patients taking those drugs.  Yet currently, Federal regulations create a safe harbor for such discounts and preclude treating them as kickbacks under the law.

Fixing this problem could save Medicare patients billions of dollars.  The Office of the Inspector General at the Department of Health and Human Services has found that patients in the catastrophic phase of the Medicare Part D program saw their out-of-pocket costs for high-price drugs increase by 47 percent from 2010 to 2015, from $175 per month to $257 per month.  Narrowing the safe harbor for these discounts under the anti-kickback statute will allow tens of billions in dollars of rebates on prescription drugs in the Medicare Part D program to go directly to patients, saving many patients hundreds or thousands of dollars per year at the pharmacy counter.

Sec. 2Policy.  It is the policy of the United States that discounts offered on prescription drugs should be passed on to patients.

Sec. 3Directing Drug Rebates to Patients Instead of Middlemen.  The Secretary of Health and Human Services shall complete the rulemaking process he commenced seeking to:

(a)  exclude from safe harbor protections under the anti-kickback statute, section 1128B(b) of the Social Security Act, 42 U.S.C. 1320a–7b, certain retrospective reductions in price that are not applied at the point-of-sale or other remuneration that drug manufacturers provide to health plan sponsors, pharmacies, or PBMs in operating the Medicare Part D program; and

(b)  establish new safe harbors that would permit health plan sponsors, pharmacies, and PBMs to apply discounts at the patient’s point-of-sale in order to lower the patient’s out-of-pocket costs, and that would permit the use of certain bona fide PBM service fees.

Sec. 4Protecting Low Premiums.  Prior to taking action under section 3 of this order, the Secretary of Health and Human Services shall confirm — and make public such confirmation — that the action is not projected to increase Federal spending, Medicare beneficiary premiums, or patients’ total out-of-pocket costs.

Sec. 5.  General Provisions.  (a)  Nothing in this order shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department or agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

DONALD J. TRUMP

THE WHITE HOUSE,
July 24, 2020.



TOPICS: Miscellaneous
KEYWORDS: drugs; kickbacks; pharma

1 posted on 07/24/2020 5:11:32 PM PDT by ransomnote
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To: ransomnote

Your thumb stuttered...


2 posted on 07/24/2020 5:14:03 PM PDT by gov_bean_ counter (AOC the bartender would have had to work on the second floor at Miss Kitty’s saloon...)
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To: ransomnote

Whack - A - Mole continues.


3 posted on 07/24/2020 5:18:06 PM PDT by ChildOfThe60s (HU)
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To: ransomnote

Eliminating the middlemen, AKA Benefit Managers, and the “rebate scam” is a good start. Now let’s make it illegal for anyone with interest in a “healthcare provider” to serve on the Board of Directors of a pharmaceutical company. Then make sure drugs that are created using Federal $$$$ via grants, public university research, etc are DISCOUNTED in the USA, not jacked up so we pay twice.

Yet another swamp that needs draining.


4 posted on 07/24/2020 5:27:39 PM PDT by ETCM
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To: ransomnote; bitt; little jeremiah; GOPJ; a little elbow grease

Kinda like trump said: “this should have been done a long time ago”

Cutting out the unnecessary unknown middleman is a perfect example of why the DS & MSM hate trump.

It’s not the twitter. It’s not his toxic masculinity.

What it is is trump is exposing the corrupt crooks for what they are & turning off the tap on all the money they have been ripping off from the tax paying citizens.

Party’s over.

That’s why they hate him


5 posted on 07/24/2020 5:30:43 PM PDT by thinden
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To: ransomnote

“Kickbacks to middlemen,” AKA rebates.

Vendors in all industries use them as incentives to marketers to sell their products.

But calling them “kickbacks” sounds so much more sinister.

Killing all the hyper-regulation in the pharmaceutical industry would actually accomplish the intended goal.


6 posted on 07/24/2020 5:31:31 PM PDT by E. Pluribus Unum (You are in far greater danger from authoritarian government than you are from a seasonal virus.)
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To: E. Pluribus Unum

BecUse “rebates” hides the a reason for higher than necessary prices..


7 posted on 07/24/2020 5:37:15 PM PDT by gov_bean_ counter (AOC the bartender would have had to work on the second floor at Miss Kitty’s saloon...)
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To: gov_bean_ counter

Deregulate the industry.

This is just treating too much regulation with more regulation.


8 posted on 07/24/2020 5:40:30 PM PDT by E. Pluribus Unum (You are in far greater danger from authoritarian government than you are from a seasonal virus.)
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To: E. Pluribus Unum

“Kickbacks to middlemen,” AKA rebates.

Vendors in all industries use them as incentives to marketers to sell their products.

But calling them “kickbacks” sounds so much more sinister.

Killing all the hyper-regulation in the pharmaceutical industry would actually accomplish the intended goal.

~~~~~~~~~~~~~~~~~~~
In addition to rebates, the DOJ has prosecuted many large,costly, illicit kick back schemes in the past 2 years.


9 posted on 07/24/2020 6:53:29 PM PDT by ransomnote (IN GOD WE TRUST)
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To: ransomnote

Not sure why we haven’t been looking at the pharma industry like a monopoly and/or a public utility.
That de-regulation thing could be risky.
I know - don’t Lizzy Warren more ideas.


10 posted on 07/24/2020 9:17:53 PM PDT by Honest Nigerian
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