Grassley Gains HHS Secretary Nominee Commitments on Transparency, Protecting Taxpayer Dollars

 

 

WASHINGTON – Sen. Chuck Grassley, a senior member and former chairman of the Senate Finance Committee, today gained commitments from President Donald Trump’s Health and Human Services (HHS) Secretary nominee Alex Azar II regarding transparency and protecting taxpayer dollars. Azar committed to continuing the online posting by HHS of payments to physicians by drug companies in accordance with the Physician Payments Sunshine Act and to working to fix the Medicaid Drug Rebate Program to prevent waste and fraud of taxpayer dollars. Video of the exchange can be found here and transcripts below.

 

Signed into law in 2010, Grassley is the co-author of the Physician Payments Sunshine Act disclosure requirements for drug company payments to doctors. Between 2013 and 2016, industry payments totaled $24.94 billion, covering 40.77 million records. Grassley is the lead co-sponsor of pending bipartisan legislation, the Provider Payment Sunshine Act, to apply the disclosure requirements to nurse practitioners and physician assistants.

 

For months, Grassley has pressed for the accurate classification of prescription drugs under the Medicaid Drug Rebate Program. Grassley’s work was prompted by letters from Iowans about increasing EpiPen costs. Grassley previously expressed disappointment regarding the settlement between the Justice Department and EpiPen-maker Mylan over its misclassification, saying the amount shortchanged taxpayers. Grassley also sought accurate overpayment amounts for Dilaudid and Prilosec, two other popular drugs that reportedly were misclassified.

 

 

GRASSLEY: Will you commit to continuing to collect and post all the data currently available on the Open Payments website?

 

AZAR: Yes, Senator Grassley, as you know I am a big supporter of the “Sunshine Act” and your work there and supported it at the time that you had first proposed it. I think that transparency is extremely helpful.

 

 

GRASSLEY: How will you approach fixing the Medicaid Drug Rebate Program so that it is properly overseen and taxpayers’ losses are kept to a minimum?

 

AZAR: Thank you. Senator, I was very concerned to see the media reports and to read that report from the Inspector General on the Rebate Program, and I certainly will work with Administrator Verma as well as with CMS to ensure that the program is improved to get at that. One of the key issues, I think, is to ensure are the regulations and guidance – they’re clear, so that those companies knew what their obligation is, and if necessary moving to enforcement to ensure that they understand that these are obligations that need to be held up.

 

 

The full transcript of Grassley’s and Azar’s exchange can be found below.

 

GRASSLEY: As I promised you in my office, you know about the questions I’m going to ask. I only have 2 questions. The first one involves the Physician Payments Sunshine Act that I worked hard to get passed and is part of Obamacare. Background to my question: in March of 2017, the University of Iowa reported a growing crisis of prescription opioid use and overdoses in Iowa. While lower than some states, Iowa has seen rates of prescription drug deaths quadruple since 1999. In addition to concerns about misuse of these drugs, I also think it’s important to protect patient access to needed medications. One strategy to achieve that balance is to ensure that prescribing decisions are made in the best interest of the patient, and not as a result of inducement to health care providers by drug companies. Recent reports have raised concern about payments from pharmaceutical companies to health professionals and the effect on opioid prescribing practices. The bipartisan Physician Payment Sunshine Act was designed to provide transparency regarding payments to physicians from drug companies. This law created the Open Payments Database at CMS. In November, Senator Blumenthal and I wrote a letter to your department thanking for the support that CMS Center for Program Integrity is given. In that letter, we further encouraged the prioritization of funding and administration of the Open Payments Database. Now you may wonder why I’m asking this question. Before I ask it, Mr. Chairman, I’d like to have the Blumenthal-Grassley letter in the University of Iowa report put in the record.

 

HATCH: Without objection.

 

GRASSLEY: A year ago, I think it was in the Omnibus Appropriations Bill, a group of doctors in the House of Representatives tried to gut this legislation. We prevented that. So, a very simple question to you. Will you commit to continuing to collect and post all the data currently available on the Open Payments website?

 

AZAR: Yes, Senator Grassley, as you know I am a big supporter of the “Sunshine Act” and your work there and supported it at the time that you had first proposed it. I think that transparency is extremely helpful.

 

GRASSLEY: My second and last question. Since the EpiPen misclassification fiasco, I focused a lot of my oversight on the Medicaid Drug Rebate Program. In the course of my oversight, I found that during the Obama Administration, CMS did not properly oversee the program causing billions in taxpayer dollar losses. For just the EpiPen, the taxpayers may have lost out on more than $1 billion…$1.7 billion lost, but DOJ recovered $475 million, so a $1.3 billion loss. Now why they didn’t go after the other $1.3 billion, I never got an answer from DOJ. In December 2017, the HHS Inspector General released a report on the Rebate Program and found that hundreds of drugs were potentially misclassified. For instance, out of a sampling of just 10 drugs from 2012-16, Medicaid may have lost $1.3 billion in rebates. Now that’s just from a sampling…we don’t know how many billions of other dollars may have been lost. So my question to you – by the way, I’d like to also have submitted a letter that I have from former CMS [Acting] Administrator Slavitt for the record.

 

HATCH: Without objection.

 

GRASSLEY: So this question. There’s a lot of taxpayer money at stake here. How will you approach fixing the Medicaid Drug Rebate Program so that it is properly overseen and taxpayers’ losses are kept to a minimum?

 

AZAR: Thank you. Senator, I was very concerned to see the media reports and to read that report from the Inspector General on the Rebate Program, and I certainly will work with Administrator Verma as well as with CMS to ensure that the program is improved to get at that. One of the key issues, I think, is to ensure are the regulations and guidance – they’re clear, so that those companies knew what their obligation is, and if necessary moving to enforcement to ensure that they understand that these are obligations that need to be held up.

 

GRASSLEY: Thank you, because doing that you can save a lot of taxpayers’ money.

 

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