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Plunging ahead despite paralyzing partisanship in the nation's capital, senior lawmakers of both parties Thursday proposed legislation to tackle surprise medical bills and other concerns, from prescription drug costs to uneven vaccination rates. The draft bill from Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., echoes a time when health care issues often led to dialogue and cooperation between political parties. Alexander chairs the Health, Education, Labor and Pensions committee, while Murray is the ranking Democrat. (Alonso-Zaldivar, 5/23)

Washington finds itself having a genuine policy debate that isn’t driven by party line. The president gave a speech this month about the need for action, standing in front of patients who’d received huge surprise bills. Various lawmakers from the House and the Senate have introduced bills with solutions — all bipartisan. Some of them include elements that might seem unusual for Republican proposals: setting prices, if only in limited circumstances. Surprise bills — which occur when a hospitalized patient is treated by a doctor who is not in the same insurance network as the hospital, and is billed for the difference — aren’t tied to any of the political controversies about Obamacare. (Sanger-Katz, 5/24)

Kaiser Health News: Sen. Alexander Releases Bipartisan Plan To Lower Health Costs, End Surprise Bills

“These are common sense steps we can take, and every single one of them has the objective of reducing the health care costs that you pay for out of your own pocket,” Alexander said in a statement. “We hope to move it through the health committee in June, put it on the Senate floor in July and make it law.” It would be a mammoth piece of legislation, targeting nearly every area of the health care industry for reform, including surprise medical bills, prescription drugs, transparency, public health and health information. Alexander said at a White House event earlier this month that he hopes to get the package to the Senate floor by the end of July. (Bluth, 5/23)

The package contains nearly three dozen specific bipartisan provisions that will reduce the cost of what Americans pay for health care, Alexander said. It sidesteps controversial issues like ObamaCare repeal, Medicare for All and abortion funding. Aside from surprise billing, the package also aims to provide transparency to rebates between drug companies and the pharmacy benefits manager “middlemen.” The goal is to bring the package to the Senate floor this summer, and Alexander and Murray requested members submit comments on the bill by June 5. (Weixel, 5/23)

There would be no more "all-or-nothing" clauses where hospitals force insurers to contract with all their facilities by saying if they don't contract with all of them they can't contract with any. Hospitals could also no longer hide certain anti-competitive contract features from the employer plans they contract with. Plan sponsors would have to sign off on all contract terms before entering into an agreement with a hospital network or third-party administrator. The Government Accountability Office would be mandated to investigate profit-sharing between hospitals, contract management groups, specialty physicians and specialty physician contractors. (Luthi, 5/23)

But the draft legislation includes several aggressive proposals that have the potential to upend the controversial business model of drug industry middlemen known as pharmacy benefit managers. Most notably: The package would ban “spread pricing,” an industry practice that allows PBMs to pocket the difference between a pharmacy price and wholesale price from a drug maker. The surprisingly weighty drug-pricing policies in the Alexander-Murray package offer one of the best barometers yet of Congress’s willingness to pursue aggressive pharmaceutical industry reforms. And they stand a real chance of becoming law: The duo is known for advancing policies that eventually become law, and the White House in recent months has emphasized both high drug costs and surprise medical bills as priorities. (Florko and Facher, 5/23)

Landmark Texas legislation to protect unsuspecting patients from surprise medical bills and shield them from disputes between insurers and health care providers will soon head to the governor's office to become law. Gov. Greg Abbott has signaled support of the bill and is expected to sign it. The law would go into effect Jan. 1, 2020. ...The sweep of the law's scope has caught national attention as health economists have long tagged the state as having one of the worst records for surprise medical bills in the United States. But suddenly, with the passage of the law and others this session, Texas has been catapulted into having some of the strongest patient protections in the nation. (Deam, 5/23)

President Trump is expected to release an executive order as early as next week to mandate the disclosure of prices in the health-care industry, according to people familiar with the discussion. The order could direct federal agencies to pursue actions to force a host of players in the industry to divulge cost data, the people said. The administration is also looking at using agencies such as the Justice Department to tackle regional monopolies of hospitals and health-insurance plans over concerns they are driving up the cost of care, according to two people familiar with the discussions. (Armour, 5/24)