Latest news with #HealthCareFinancingCommittee
Yahoo
5 days ago
- Business
- Yahoo
Industry pushes back on Senate-backed Rx price cap idea
BOSTON (SHNS) – Less than two weeks after the Senate moved to create a new prescription drug price cap system in Massachusetts, an industry official warned against legislative 'leapfrog' that could complicate the most recent round of reforms. A top pharmaceutical industry lobbyist urged lawmakers to hit the brakes on an attempt to impose upper price limits on certain medications, arguing that the new regulations would come while another cost control law is still being implemented. Both a 23-page amendment added to the Senate's fiscal year 2026 budget and a much broader, 118-page standalone bill (S 868) would allow the Health Policy Commission to impose upper price limits on some prescription drugs to cap what patients, providers and pharmacies pay. Kelly Ryan, deputy vice president for state policy at the influential industry group PhRMA, told legislators Monday the proposal would 'leapfrog substantial legislation enacted here in Massachusetts just this past December,' referring to a new prescription drug price control law. That law limited patient costs to no more than $25 for certain name-brand medications to treat chronic illnesses and eliminated those costs for similar generic options. It also created a new licensure process for pharmacy benefit managers, and stood up an Office for Pharmaceutical Policy and Analysis within the HPC. 'Where the bill before you focuses primarily on manufacturers when we're looking at pricing, the office is tasked with looking at the broader supply chain, providing detailed analysis, reports and policy recommendations,' Ryan told the Health Care Financing Committee at a hearing about the new bill. 'We urge the committee to let that work proceed before taking any next steps.' The Senate has not embraced the industry call to slow down. In late May, before lawmakers heard testimony on the larger bill at a public hearing, the Senate adopted a budget rider that would empower the HPC with the ability to cap certain drug costs and set limits on what Bay Staters pay. Sen. Cindy Friedman, who co-chairs the Health Care Financing Committee and authored both the bill and the amendment, said during budget debate the upper price limit measure builds on the new law with 'one more step in that direction.' 'Pharmaceutical companies should be thrilled to have their drugs go through this because they should have enormous value, right?' she told Ryan during Monday's hearing. 'We're looking for drugs that are very high cost with lots and lots of value. We want to know about that, and we're willing — we believe people should be willing to pay for that. It would seem to me this would work in your favor because, I would hope, your drugs have enormous value.' A handful of other states have pursued similar price caps, prompting legal battles. Ryan said 'not one [state's system] has been implemented to date.' 'States have spent years and millions of dollars, and not a single patient has been impacted,' she said. 'In fact, patients are likely going to be negatively impacted by [upper price limits].' Health care spending in Massachusetts continues to surge well beyond state targets for cost containment, burdening many household budgets and putting care out of reach for some low-income residents. While the Senate budget amendment focuses on prescription drug price caps, Friedman's underlying bill reaches into many other areas of reform, including by giving regulators more flexibility to examine an individual hospital, health system or insurer's spending. The legislation would also boost penalties for failure to comply with cost control plans and give the Division of Insurance new tools to modify premium rate increases, according to a summary produced by advocacy group Health Care for All. 'It is individuals, families and businesses who will ultimately bear the burden of these costs, both through increased premiums and growing out-of-pocket costs. An unacceptable 40% of residents continue to report challenges affording care,' Alex Sheff, senior director of policy and government relations at Health Care for All, said. 'These costs come on top of the growing cost of living, challenges that leave residents with impossible choices between paying rent and getting the health care that they need.' The Health Care Financing Committee is weighing a suite of other bills supporters say would rein in health care costs and promote affordability. Committee co-chair Rep. John Lawn said at the start of Monday's hearing that the panel 'must put more focus on all areas of the drug supply chain' to understand what causes high drug prices. Another proposal before the panel (H 1398 / S 899) would require hospitals receiving state funding to compensate their CEOs at a rate no more than 50 times the amount that the hospital's lowest-paid worker earns. Dr. Taylor Walker, a physician at Cambridge Health Alliance and president of the physician union CIR SEIU, said 44 of 57 health care CEOs in Massachusetts earn more than 50 times the salary of their institution's lowest-paid worker. Rep. John Moran asked Walker if the CEO compensation limit could push health care executives to leave for higher-paying roles elsewhere, such as in the pharmaceutical sector. 'I'd say the problem is actually not losing talent because we don't want to pay CEOs $6 million a year. The problem is that we're losing talent because we don't want to pay our doctors who are actually taking care of our patients, and we don't really give a shit about the people who are taking care of our communities,' Walker said. 'This is something that is absolutely maddening.' WWLP-22News, an NBC affiliate, began broadcasting in March 1953 to provide local news, network, syndicated, and local programming to western Massachusetts. Watch the 22News Digital Edition weekdays at 4 p.m. on Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
13-05-2025
- Health
- Yahoo
Financial carrot eyed to revitalize primary care
BOSTON (SHNS) – A parade of primary care physicians pleaded with lawmakers Monday to devote new funding toward the sector, warning that staff shortages and long waits for appointments will worsen without action. Building on years of alarming reports about gaps in care, doctors and reform supporters urged lawmakers to craft a baseline spending target and to overhaul payment processes. State watchdogs have already cautioned that Boston has some of the longest wait times for new patient physicals in the country and that Massachusetts has a comparably low share of physicians working in primary care. Several veteran doctors on Monday offered anecdotes of their own. Dr. Katherine Atkinson, a family doctor based in western Massachusetts, said she struggles to recruit new physicians to her practice even when medical students voice an enthusiasm for primary care. 'They always come and are really excited by what we do, and they say, 'This is what I want to do.' And then a year later, I get a heartbreaking email that says, 'Dr. Kate, I ran the numbers, and I cannot afford to do primary care. I can make five times as much as a cardiologist,'' Atkinson told the Health Care Financing Committee. 'I'm begging you: please pass this or something like this. Do not study it again. I have been testifying for over a decade as things have gotten worse and worse and worse, and we're really at a cliff,' she added. A pair of bills before the committee Monday (H 1370 and S 867) would move toward new payment models for primary care while quantifying the specific share of health care spending that must go toward primary care (12% of total health care expenditures in the Senate bill, at least 15% in the House bill). Reaching those investment targets while controlling overall health care spending could spell painful changes for others in the health care system. Rep. Richard Haggerty, a Woburn Democrat who filed the House proposal, warned of a 'crisis [that] is making it almost impossible to find a primary care physician in our commonwealth in a reasonable amount of time.' 'The idea is straightforward: if we invest more in keeping people healthy, we can avoid the much higher cost of treating them when they get sick,' he said of his legislation. Some physicians have argued that primary care offers too little pay and too much frustration to attract staff compared to other specialized medical fields. A state report published in January found the primary care workforce here is aging and that the share of physicians in direct patient care is dropping. Primary care doctors at Mass General Brigham are moving to join a union. While that unfolds, hospital leaders at MGB announced Monday they would invest nearly $400 million in primary care enhancements, the Boston Globe reported. Tackling problems in primary care has been a topic of debate on Beacon Hill for years, but elected officials have not been able to agree on a path forward. Former Gov. Charlie Baker twice proposed legislation (2019 and 2022) that would have required providers and insurers to increase what they spend on primary and behavioral health care, but lawmakers did not embrace either measure. A lobbyist representing health insurers told lawmakers Monday her group is 'directionally supportive of the provisions in the bill to increase investments and expenditures for primary care.' Sarah Chiaramida, senior vice president and general counsel at the Massachusetts Association of Health Plans, described the Senate version of the bill authored by committee co-chair Sen. Cindy Friedman as the 'right framework.' 'Primary care is the backbone of our health care delivery system, and MAHP supports provisions aimed at increasing expenditures as an important first step to reforming the way we pay for and deliver health care,' Chiaramida said. 'However, it's critical that increased investments in primary care be within the cost growth benchmark and not add to overall health care costs, which is a critical point that is reflected in [the Senate version of the bill] as health care affordability remains a significant research concern. As such, any requirement to increase funding for primary care must be coupled with offsets to other areas of spending to ensure that the overall cost of care does not increase unsustainably in place.' Chiaramida called on lawmakers to give the Health Policy Commission authority to 'strictly enforce these requirements.' Gov. Maura Healey said in January that she would order more resources to be directed to 'the front lines' of primary care, adding that she wants 'to build a whole army of primary care providers to be out there across our state.' During Monday's hearing, co-chair Rep. John Lawn asked longtime physician and former Massachusetts Medical Society President Dr. Alan Goroll what he views as the 'number-one reason' many medical students are not choosing to go into primary care. 'Let me use a military analogy,' Goroll answered. 'You're very patriotic person. You'd like to serve your country. You want to be sure that you have the tools, the technology, the teamwork, the resources and the respect, and that we have your back. Primary care doctors do not feel they have any of that.' 'They are not dummies,' he added about medical students. 'They look at this and they say it's underresourced, the payment system is counterproductive to having time to spend with patients, the prestige is low and the future is dim as they build skyscrapers for cancer and heart disease, stuff for people to come from overseas. They see the resources being put in other places.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
